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HomeMy WebLinkAbout01-0697 PETITION FOR PROBATE and GRANT OF LETTERS ~-OI' "97 Estate of D:>nald E. Zimnennan also known as No. To: Register of Wills for the Deceased. County of Cumberland in the Social Security No. 196-14-1323 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut rix in the last will of the above decedent, dated August 14 " and codicil(s) dated named ,19~ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h is last family or principal residence at 105 Cockleys Drive l~per AllAn ~own~h;p (list street, number and muncipality) Decendent, then 75 years of age, died April 19. 2001 , ~ at HarrLc;bt.n::g, PA Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ ,1 0 , ()1)'0 r IJ() $ $ $ WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentm:.y (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. l~ /J4/ )~~ ~(I) - -g .g Bettv R. Zimnennan C'3',= 105 CockleysDrive 3~ (I) '- MAr.h;:m; r.!=:h1 lrg I PA 1 701:)1:) :5 0 ~ c:: 00 en OATH OF" PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I ss COUNTY OF CUMBERIAND J The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well an ruly administer the estate according to law. , affirmed and 25th en ~. ~ l::l - ;: ~ ~ /tP - ~,,~~J3 ~o. 21-2001-697 Estate of Ibnald E. Zimnennan , Deceased DECREE OF PROBATE A~D GRA~T OF LETTERS AND NOW July 26th P9 2001, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated Auqust 14, 1997 described therein be admitted to probate and filed of record as the last will of Ibnald E. Zimnennan and Letters Testamentary are hereby granted to Betty R. Zimnerman FEES Probate, Letters, Etc. ......... $ 50 00 Short Certificates(\O) . . . . . . . . .. $ 30.00 Renunciation ................ $ x-Pages (11) $ 33.00 JCP 5.00 Cert. Copy Will TOTAL - $ L . uu Filed J.l.llY. 26 II 2001 . . . . . . . . . S. . . . . . . . . . $120.00 9rl7 C. BJ:j~~IdL~ . Registe of Wills Me. Lewis '7 Bridget M. Whitley, St. Ct. #33580 ATTORNEY (Sup. Ct. I.D. No.) Keefer Wood Allen & Rahal, LLP P.O. Box 11963, Harrisburq, PA 17108-1963 ADDRESS (717) 255-8027 PHONE MAILED IErI'ERS 'TO ATTORNEY WARNING: IT IS ILLEGAL TO ALTER THIS COPY OR TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH. UJII1MONWEALTH OF PENNSYLVANiA DE PAF1TMENT OF HEALTH VITAL RECORDS :.or: .'~;. rEGISTR.AR'S CERTIFICATION OF DEATH CERT. NO. T 4 8 6 7 7 5 5 .~".(~\~~7Q[ef~~~, /.\I~. .<1'.' r>""'\ i,' _~, ,,(I ~_\ /,'~.';;:j.'/ .......~\<L--:...~ /$,~' ~~ ,\v~ I~ ~" ~~' "i~~ I~ (....) "'. i.i:~ \~, ,,'i ~ .~, . .! $1 ".~. ,"' *1. Ii ~,..::~l! \~". ~'..... . .""~. \\\1 :=- . "f Il . "\:I,\' 'r \ ,;; '<-z-,.-_ IMp~1 ~\ '';,1,1.'" ~<z~:":!~~.'.:..~!f!.!..f.i!.-U. April 19, 2001 Date of Issue of This Certification 21-2001-697 Name of Decedent Donald E. -------.-------....----...------ ---'-~---- ~ ~/!(LJii Zimmerman Ld\.t Sex ___M.al.a_________ Social Security No. _~-=-.l.!L=_J1V_______ Date of Death Apr! 1 19, 2001 Date of Birth_ Janua!y_~1926 _,____ Birthplace __~Q.wer__~l~n_,Township, Cumberlan~, County, Pennsylvania Place of Death ___Har..}'j.sburg_ Hospi ta 1 ~-(1;'II,t\' N:-m:t' Dauphin County )I,':t.., Harris?urg City 80(OI.Jgll Ti]WrlS~II.( Pennsylvania Race_______!!h!_1:e______ Occupation Insurance Agent Decedent's Marital Status Married __ Mailing Address __ 105___ -. _____ Armed Forces? (Yes or No) Yes ~JL'~:t)(, Cockley's Drive ~.)tl-'~d _~echanicsburg PA ~~Ity or T (wm State !nformant___Mrs '~!_1:y~Zimmerman Funeral Director Scott D. Brermeman, FD Name and Address of Funeral Establishment Cocklin Puneral Home, IDe. ,30 N. Chestnut Street, Dillsburg, PA 17019 Interval Between Onset and Death Part I Immediate Cause (a)__~!mon~fl Failure 20 days (b)__ Adl!!.~~espirat?ry D_~stress Syndrome 20 days (c) _______.__.________________________~__.________ Part II: (d) _______m____________.~__~__ Other Significant Conditions ___ J~..Q.!.Q.!lil]:"...Y__ArJ:~~...Y Disease, Redo Coronary Arte_ry Bypass I ___----L- Manner of Death Describe how injury occurred: Natural Accident ~x Homicide Pending Investigation Could not be Determined o Suicide I-l Name and Title of Certfier William B. lams. MQ (M.D., D.O., Coroner, M.E.) Address__________ 423 N.._ ,21st StI~. Camp Hill,__PL.l:.ZQ.!.1_____ This is to certify that the information here given is correctly copied from an original certificate of d(~ath duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent fil~~ 'r' ~~~ 67608 LI! :il PL'~i~~rrClr ;)r V;tal RAcords District No ~PE;! 19~c;:.~~QL__,_ 153 L~n Road, Dillsburg, PA 17019 :;t'(':'I!l..,Jljn,s ;-'i'y Bor:)U~1n. Ly:,nsh:p '. \ LAST WILL AND TESTAMENT OF DONALD E. ZIMMERMAN I, DONALD E. ZIMMERMAN, of 105 Cockleys Drive, Upper Allen Township, Mechanicsburg, Cumberland County, Pennsylvania, do hereby make this my Last Will and Testament, reVOking any former wills and Codicils made by me. FIRST: I am married to Betty R. Zimmerman, and all refer- ences to my wife in this will are to her. I have two children: Kathy J. Myers (born June 11, 1953) and Connie M. Rehman (born June 10, 1955). These and any other children born to or adopted by my wife and me are described in this will as "my children," or as "a child of mine." Any person born to or adopted by a child of mine is described in this will as "my issue." Provided, however, that no adopted person shall benefit hereunder unless the order or decree of adoption is entered before such adopted person attains the age of twenty-one (21) years. SECOND: I give my tangible personal property and all casualty insurance that I am carrying on said tangible personal property, to my wife, Betty R. Zimmerman, or, if she does not survive me, I give said property to my children living at my death to be divided equitably between them as they may determine, or, if they are unable to agree, as my Executor shall determine, after considering the wishes of such children. I have complete confidence that my wife, my children or my Executor will honor ~ -1- : \ ; I any written instructions that I may leave with regard to said tangible personal property. Any such property not so distributed shall be sold, and the proceeds added to my residuary estate to pass as hereafter described. THIRD: I give, devise and bequeath the rest, residue and remainder of my estate, real and personal, to my wife. Should she not survive me, or to the extent that she, or her executor, trustee, attorney-in-fact, or other successor in interest, disclaims any interest, I give, devise and bequeath such rest, residue and remainder, or interest therein or portion thereof, to my Trustee, hereinafter named, IN TRUST NEVERTHELESS, to be held, administered and distributed for all purposes as part of the Bypass Trust. FOURTH: The Bypass Trust shall be held, administered and distributed as follows: (1) My Trustee shall pay to or apply for the benefit of anyone or more of my said wife, my children and my issue, until division into shares pursuant to Paragraph (4), all of the net income from the Bypass Trust in convenient installments in such shares and proportions as my Trustee in its sole discretion shall determine primarily for the health care, education, support and maintenance in reasonable comfort of my said wife, children and issue, taking into consideration to the extent my Trustee deems advisable, any other income or resources of my said wife, ~ -2- , , . " . children and issue known to my Trustee, considering that my wife is the primary object of my bounty. (2) Prior to division into shares pursuant to Para- graph (4), my Trustee may pay to or apply for the benefit of any one or more of my said wife, children and issue such sums from the principal of the Bypass Trust in such shares and proportions as in its sole discretion shall be necessary or advisable from time to time for the health care, education, support and mainte- nance in reasonable comfort of my said wife, children and issue, taking into consideration to the extent my Trustee deems advis- able, any other income or resources of my said wife, children and issue known to my Trustee, considering that my wife is the primary object of my bounty. Any payment or application of benefits for a beneficiary pursuant to this Paragraph shall be charged against this Trust as a whole rather than against the ultimate distributive share of such beneficiary to whom or for whose benefit the payment is made. (3) Upon the death of my said wife, the entire remain- ing principal of the Bypass Trust shall be divided into equal separate shares so as to provide one (1) share for each then- living child of mine, one (1) share for each deceased child of mine who shall leave issue then living and one (1) share to be divided between or among my grandchildren, per capita, with the issue of a deceased grandchild to take the deceased grandchild's share. The share provided for a living child of mine shall be ~ -3- ... I ." distributed to such child. The share provided for a deceased child of mine who shall leave issue then living shall be distrib- uted per stirpes to such issue. (4) If at the time of my death, or at any later time prior to final distribution hereunder, my said wife and all my issue are deceased and no other disposition of the property is directed by this Trust, then and in that event only, the then- remaining property of this Trust, together with any undistributed income, shall be divided and paid over and distributed to Mona- ghan Presbyterian Church, Dillsburg, Pennsylvania, without restriction as to use. FIFTH: If any share hereunder becomes distributable to a beneficiary who has not attained the age of thirty-five (35) years, then such share shall immediately vest in such benefici- ary, but notwithstanding the provisions herein, my Trustee shall retain possession of such share in trust for such beneficiary until such beneficiary attains the age of thirty-five (35) years, using so much of the net income and principal of such share as my Trustee deems necessary to provide for the proper health care, education, support and maintenance in reasonable comfort of such beneficiary, taking into consideration to the extent my Trustee deems advisable any other income or resources of such beneficiary or his or her parents known to my Trustee. Any income not so paid or applied shall be accumulated and added to principal. Such beneficiary's share shall be paid over and distributed to ~ -4- I I <' I such beneficiary upon attaining the age of thirty-five (35) years, or if he or she shall sooner die, to his or her executors or administrators. I recommend that my Trustee consider dis- tributing approximately one-third (1/3) of that portion of the principal of such beneficiary's share which my Trustee antici- pates will ultimately be paid to such beneficiary when the beneficiary reaches twenty-five (25) years of age, approximately one-half (1/2) of the remaining portion when the beneficiary reaches thirty (30) years of age, and the remainder when the beneficiary reaches thirty-five (35) years of age. My Trustee shall have with respect to each share so retained all the powers and discretions had with respect to the trusts created herein generally. SIXTH: Anything in this Will to the contrary notwithstand- ing, no trust created herein shall continue beyond twenty-one (21) years after the deaths of one, the last to die of my issue living at the time of my death; and two, all issue, living at the time of my death, of the individual serving as President of the united States at my death and all issue, living at the time of my death, of said individual's five (5) immediate predecessors in said office; upon the expiration of such period, all trusts shall terminate and all the assets thereof shall be distributed to those beneficiaries (and in the same proportions) as are then entitled to receive the income therefrom. ~ -5- SEVENTH: If any beneficiary and I should die under such circumstances as would render it doubtful whether the beneficiary or I died first, then it shall be conclusively presumed for the purposes of this my will that said beneficiary predeceased me: provided, however, that if my wife shall die with me as afore- said, I direct that my wife shall be conclusively presumed to have survived me. EIGHTH: (1) I name as my Executrix my wife, Betty R. Zimmerman. If she is unable or unwilling to serve, I name as my Co-Executors my daughters, Kathy J. Myers and Connie M. Rehman. If either of my daughters is unable or unwilling to serve, the other shall serve alone. If both of my daughters are unable or unwilling to serve, I name as my Executor Mellon Bank, N.A., Commonwealth Region, 10 South Market Square, Harrisburg, Dauphin County, Pennsylvania. I direct that my Executor, herein referred to as my Executor regardless of number or gender, serve without bond in any jurisdiction in which called upon to act. (2) I name as my Trustee Mellon Bank, N.A., Common- wealth Region. I direct that my Trustee, herein referred to as my Trustee regardless of number or gender, serve without bond in any jurisdiction in which called upon to act. (3) Except as otherwise provided herein, if Mellon Bank, N.A., or any successor as herein defined should fail to qualify as Trustee hereunder, or for any reason should cease to act in such capacity, the successor or substitute Trustee shall ~ -6- be some bank or trust company with trust powers, which successor or substitute Trustee shall be designated in a written instrument filed with the court having jurisdiction over the probate of my estate and signed by my wife. Following the death or incapacity of my wife, this power may be exercised by a majority of my children who have attained the age of eighteen {18} years, or if they fail to act, by the court having jurisdiction over the probate of my estate. The situs of the Trust may be transferred to the situs of any such successor or substitute Trustee by designation in the written instrument aforesaid. I direct that at least two individuals or a qualified bank or trust company with trust powers shall serve as my Trustee at all times. {4} For services as Executor and Trustee, my Executor and Trustee shall receive reasonable compensation. NINTH: (l) I give to any Executor and to any Trustee named in this will or any Codicil hereto or to any successor or substitute Executor or Trustee all of the powers enumerated in this will and all of the powers applicable by law to fiduciaries in the Commonwealth of Pennsylvania and in particular through the Pennsylvania Probate, Estates and Fiduciaries Code, as effective and as in effect on the date hereof, during the administration and until the completion of the distribution of my estate, and until the termination of all trusts created in this will or any Codicil hereto and until the completion of the distribution of the assets of such trusts. I direct that all such powers shall ~ -7- (' .' be construed in the broadest possible manner and shall be exer- cisable without court authorization. (2) In determining the federal estate and income tax liabilities of my estate, my Executor shall have discretion to select the valuation date and to determine whether any or all of the allowable administration expenses in my estate shall be used as federal estate tax deductions or as federal income tax deduc- tions and shall have the discretion to file a joint income tax return with my wife. (3) If at any time any trust created hereunder (or any share thereof if the trust shall have been divided into shares) shall be of such value that, in the opinion of my Trustee, the administration expense of holding the assets contained therein in trust is not justified, my Trustee, in its absolute discretion, may terminate such trust and distribute the trust property to the person or persons then entitled to receive or have the benefit of the income therefrom or the legal representative of such person. If there is more than one income beneficiary, my Trustee shall make such distribution to such income beneficiaries in the proportion in which they are beneficiaries or if no proportion is designated in equal shares to such beneficiaries. (4) My Executor and Trustee are authorized and empowered to acquire and to retain, either permanently or for such period of time as my Executor or Trustee may determine, any assets, including the capital stock of any closely held ~ -8- r . .1 J. corporation, whether such assets are or are not of the character approved or authorized by law for investment by fiduciaries and whether such assets do or do not represent an overconcentration in one investment. (5) My Executor and my Trustee are authorized and empowered to disclaim any interest, in whole or in part, of which I, my Executor, or my Trustee, may be the beneficiary, devisee, or legatee, by executing an appropriate instrument (in accordance with section 2518 of the Internal Revenue Code of 1986, as amended, or such similar section as may then be in effect). (6) My Executor and Trustee are authorized and empowered to sell at public or private sale, or exchange, and to encumber or lease, for any period of time, any real or personal property and to give options to buy or lease any such property. Additionally, my Executor and Trustee are authorized and empowered to compromise claims, to borrow from anyone (including a fiduciary hereunder) and to pledge property as security there- for, to make loans to and to buy property from anyone (including a fiduciary or beneficiary hereunder); provided that any such loans shall be adequately secured and at a fair interest rate. (7) My Executor and Trustee are authorized and empowered to allocate property, charges on property, receipts and income among and between principal or income, or partly to each, without regard to any law defining principal and income. ~ -9- ( . TENTH: No person who at any time is acting as a co-trustee (if any) hereunder shall have any power or obligation to partici- pate in or to exercise any discretionary authority that I have given to my Trustee to pay principal or income to such person, or for his or her benefit or in relief of his or her legal obliga- tions. Such discretionary authority shall be exercised solely by the disinterested co-trustee(s). ELEVENTH: No interest of any beneficiary under this will, any Codicil hereto, or any trust created herein, shall be subject to anticipation or to voluntary or involuntary alienation. TWELFTH: All estate, inheritance, succession and other death taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property comprising my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid out of the residue of my estate, as if such taxes were expenses of administration, without apportionment or right of reimbursement. I authorize my Executor ~ -10- ~ . 1 . . .' .. . and Trustee to pay all such taxes at such time or times as deemed advisable. IN WITNESS WHEREOF, I have set my hand and seal on this my Last will and Testament this /l/1;!,day of ~ , 1997. ~E~.(SEAL) DONALD E. Z ERMAN SIGNED, SEALED, PUBLISHED, and DECLARED by DONALD E. ZIMMERMAN, as and for his Last will and Testament, on the day and year last above written, in the presence of us, who, at his request, in his presence, and in the presence of each other, all being present at the same time, have hereunto subscribed our names as witnesses: /LuL L. ~ ~ vJ. ~:- -11- . . I . .iII; SELF-PROVING AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF W-fY\.Q.QAQ~ SSe WE, DONALD E. ZIMMERMAN, and HEATH L. ALLEN , and SHAWN W. WEIS , the Testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last will and that he had signed willingly (willingly directed another to sign for him), and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the will as witness and to the best of his or her knowledge the Testator was at that time eighteen (18) years of age or older, of sound mind, and under no constraint or undue influence. r DONALD E. ZI Testator /[~ L. ~.-::- witness ~ vJ. W~ Witness witness Subscribed, sworn to, and acknowledged before me by DONALD E. ZIMMERMAN, the Testator, and subscribed and sworn to before me by HEATH L. ALLEN , and SHAWN W. WEIS , witnesses, this I '-{ ~ day of ~~~y , 1997. ~~,i ju~ otary Public '- NOTARIAL SEAL MARJORIE L. JOHNSON, Notary Public City of Harnsburg, Dauphin County L.,.~_ Commission Expires March 8, 1999 -12- t' IN THE MATTER OF THE ESTATE OF DONALD E. ZIMMERMAN, DECEASED : IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 2001-00697 RECEIPT, RELEASE, REFUNDING AND INDEMNITY AGREEMENT CONCERNING FINAL DISTRIBUTION OF ESTATE THIS AGREEMENT, made as ofthe~to. 'fI.- day of November, 2002, WITNESSETH: THE CIRCUMSTANCES leading up to the execution of this Agreement are as follows: 1. Donald E. Zimmerman (the "Decedent"), a married man, died testate on April 19, 2001, and his wife, Betty R. Zimmerman, duly qualified as executor (the "Executor") of the Decedent's probate estate (the "Estate"). 2. Article SECOND of the Decedent's Last Will and Testament, dated August 14, 1997 (the "Will") provides for the distribution of the Decedent's tangible personal property to the Executor. 3. Shortly after the Decedent's death, the Executor distributed the Decedent's tangible personal property to herself, in satisfaction of her rights under Article SECOND of the Will. 4. Article THIRD of the Will provides as follows: THIRD: I give, devise and bequeath the rest, residue and remainder of my estate, real and personal, to my wife. Should she not survive me, or to the extent that she, or her executor, trustee, attorney-in-fact, or other successor in interest, disclaims any interest, I give, devise and bequeath such rest, residue and remain- der, or interest therein or portion thereof, to my Trustee, hereinafter named, IN TRUST NEVERTHELESS, to be held, administered and distributed for all purposes as part of the Bypass Trust. 5. By instrument dated September 6, 2001, the Executor disclaimed the bequest of the residue of the Estate of the Decedent, which Disclaimer is duly recorded in the Office of the Register of Wills of Cumberland County, Pennsylvania. 6. By virtue of the disclaimer, the residue of the Estate passes to the trustee named in the Will, to be held as the Bypass Trust, and administered and distributed as provided in Article FOURTH of the Will. 7. Article EIGHTH, Paragraph (2) of the Will names Mellon Bank, N.A. (the "Trustee") as trustee of any trusts created by the Will, including the Bypass Trust. 8. The value of the principal and income of the Estate which is distributable to the Trustee is indicated on the informal account of the Executor which is attached hereto as Exhibit A and incorporated herein by reference. 9. The Trustee desires that the final distribution of the Estate be made without the formality of an accounting in the Orphans' Court Division of the Cumberland County Court of Common Pleas (the "Court"), and the Executor is willing to make such distribution upon the execution of this Agreement. 10. Betty R. Zimmerman is the Decedent's surviving spouse, and Kathy 1. Myers and Connie M. Rehman are the Decedent's adult children (collectively, the "Beneficiaries"). The Beneficiaries also desire the Executor to settle the Estate informally in order to avoid the expense and delay involved with the formal adjudication of an accounting by the Court. NOW THEREFORE, in consideration of the foregoing and intending to be legally bound hereby, the Trustee does, for itself, its successors and assigns, hereby agrees as follows: -2- 1. The Trustee waives any right which it may have under law to require that an accounting of the Estate be filed with, and approved by, the Court. 2. The Trustee hereby fully releases and discharges the Executor, and each of the Executor's employers, employees, agents, attorneys, advisors, and counselors, and their respective heirs, legal representatives, successors and assigns, from any and all rights, claims, and actions which the Trustee, on its own behalf and on behalf of its successors and assigns now has or may hereafter have against the Executor arising out of the administration of the Estate and the failure of the Executor to file an accounting of such administration with, and obtain the approval of, the Court. 3. The Trustee acknowledges receipt from the Executor of the amounts shown on Exhibit A, Schedule of Combined Balance on Hand, attached hereto and incorpo- rated by reference, in full and complete satisfaction of any and all of its respective right, title and interest in and to the Estate. 4. The Trustee hereby agrees, to the extent of the funds received by it and remaining in its possession, to indemnify, save and hold harmless the Executor from and against any and all claims, loss, liability, or damage which the Executor may suffer or to which she may be subjected by reason of the distribution described in this Agreement. 5. The Trustee covenants and agrees, to the extent of the funds received by it and remaining in its possession, to refund to the Executor any amount which may hereafter be determined to have been an erroneous or excess distribution. 6. The Trustee consents to the Court exercising personal jurisdiction over it in any suit or action arising out of the enforcement of this Agreement. AND FURTHERMORE, the Beneficiaries, in consideration of the foregoing and intending to be legally bound hereby, jointly and severally, for themselves, their heirs, personal representatives, successors and assigns, do hereby agree as follows: 1. The Beneficiaries waive any rights which they may have under law to require that an accounting of the Estate be filed with, and approved by, the Court. 2. The Beneficiaries hereby release, remise, quitclaim and forever discharge the Trustee, its successors and assigns, from and against any and all claims they may have against the Trustee in connection with the Trustee's waiver of its right to a -3- formal accounting by the Court. 3. The Beneficiaries hereby fully release and discharge the Executor, and each of the Executor's employers, employees, agents, attorneys, advisors, and counselors, and their respective heirs, legal representatives, successors and assigns, from any and all rights, claims, and actions which the Beneficiaries now have or may hereafter have against the Executor arising out of the administration of the Estate and the failure of the Executor to file an accounting of such administration with, and obtain the approval of, the Court. 4. The Beneficiaries consent to the Court exercising personal jurisdiction over them in any suit or action arising out of the enforcement of this Agreement. IN WITNESS WHEREOF, the Trustee, by its duly authorized representative, and the Beneficiaries, have executed the attached consents to this Agreement. -4- CONSENT TO RECEIPT.. RELEASE.. REFUNDING AND INDEMNITY AGREEMENT CONCERNING FINAL DISTRIBUTION OF ESTATE I, Angela R. Thompson, in my capacity as Assistant Vice President of Mellon Bank, N. A., the Trustee of the Bypass Trust under the Last Will and Testament of Donald E. Zimmerman, deceased, hereby consent to and join in the Receipt, Release, Refunding and Indemnity Agree- ment Concerning Final Distribution of the Estate of Donald E. Zimmerman, deceased, a copy of which Agreement, including all exhibits, has been provided to me. ATTEST: MELLON BANK, N.A. Trustee of the Trust Under Will of Donald E. Zimmerman E(;/(~ j By: COMMONWEALTH OF PENNSYLVANIA COUNTY OF ---;:> C<.Mf k I certify that on Jfl..4 Cl/l'n ~ / 7 , 2002, Angela R. Thompson personally appeared before me, a Notary Public of the Commonwealth of Pennsylvania, and acknowledged, to my satisfaction, that she is an Assistant Vice President of Mellon Bank, N.A., a corporation, and the person who executed the above instrument, and that she, being authorized to do so, executed the foregoing instrument on behalf of the corporation for the uses and purposes ss. expressed in the instrument. In witness whereof, I set my hand and official seal. '/11aJ;ftfIL Notary Public i/ , /J~ N(::;'nai'::::;I~ Martha H ; : ' "",. n tr Ci~~ (',I I'""'\~, 'i.' ,i~ '~,>l.!i": " " . .' \. !~ .nh, L~~\..o,r':>-:.' ", .' )..."'J,, 1 M..)nJb;:-- -".. ..,~.~- ;:~~~:;r::~:;i~~r~~_i -5- CONSENT TO RECEIPT.. RELEASE.. REFUNDING AND INDEMNITY AGREEMENT CONCERNING FINAL DISTRIBUTION OF ESTATE AND RECEIPT FOR DISTRIBUTION I, Betty R. Zimmerman, hereby acknowledge receipt of the tangible personal property of the Decedent, and I hereby consent to and join in the Receipt, Release, Refunding and Indemnity Agreement Concerning Final Distribution of the Estate of Donald E. Zimmerman, deceased, a copy of which Agreement, including exhibits, has been provided to me. &~L7~ (SEAL) COMMONWEAL TH OF PENNSYL VANIA COUNTY OF ~ SS. On this, the ~ 1 ~ day of N 0"1 ~ , 2002, before me, the undersigned officer, personally appeared Betty R. Zimmerman, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same in the capacities and for the purposes therein contained. IN WITNESS WHEREOF, I hereunder set my hand and official seal. ~(j- ~. -6- J'; C ! ~50~1ty, I ._~~-- CONSENT TO RECEIPT.. RELEASE.. REFUNDING AND INDEMNITY AGREEMENT CONCERNING FINAL DISTRIBUTION OF ESTATE I, Kathy J. Myers, hereby consent to andjoin in the Receipt, Release, Refunding and Indemnity Agreement Concerning Final Distribution of the Estate of Donald E. Zimmerman, deceased, a copy of which Agreement, including exhibits, has been provided to me. COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF On this, the ~ day of ~ev' , 2002, before me, the undersigned officer, personally appeared Kathy J. Myers, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed th~ SaIne fur the pur pu~es therdn cOlJ.tail1ed. IN WITNESS WHEREOF, I hereunder set my hand and official seal. ~~ No~Public NOT ARIAL SEAL SCOTT M. DINNER, Notary Public Camp Hill Bora., Cumberland County M Commission Expires October 23, 2006 -7- CONSENT TO RECEIPT.. RELEASE.. REFUNDING AND INDEMNITY AGREEMENT CONCERNING FINAL DISTRIBUTION OF ESTATE I, Connie M. Rehman, hereby consent to and join in the Receipt, Release, Refunding and Indemnity Agreement Concerning Final Distribution of the Estate of Donald E. Zimmerman, deceased, a copy of which Agreement, including exhibits, has been provided to me. ~~~~ Connie M. Rehman (SEAL) STATE OF MARYLAND COUNTYOF ;9~ry- SS. n,. . J _ / On this, the l~t:l day of ~ , 2002, before me, the undersigned officer, personally appeared Connie M. Rehman, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged ttat she executed the same fer the pUl."poses theff~in contained. IN WITNESS WHEREOF, I hereunder set my hand and official seal. ~J.I~~ Notary Pub ic , /J / ~ ~J/f' 5~--V-' -8- SUMMARY OF ACCOUNT Estate of Donald E Zimmerman For Period 04/19/2001 Through 09/30/2002 Proposed Distribution to Beneficiaries Principal Receipts Net Gain (or Loss) on Sales or Other Dispositions Other Receipts Less Disbursements: Administration Expenses (prin) Fees and Commissions (prin) Funeral Expenses (prin) Balance before Distributions Distributions to Beneficiaries Principal Balance on Hand For Information: Changes in Investment Holdings Income Receipts Less Disbursements: Income Taxes Balance before Distributions Distributions to Beneficiaries Income Balance on Hand Combined Balance on Hand Page 11 1 2 3 4 4 $28,052.77 15,233.10 10,952.38 5 6 7-9 10 flb1 A Fiduciary Acquisition Value $532,881.74 ----------- ----------- $568,188.76 4,017.72 0.00 $572,206.48 54,238.25 $517,968.23 0.00 $517,968.23 $ 15,558.51 645.00 $ 14,913.51 0.00 $ 14,913.51 $532,881.74 ----------- ----------- RECEIPTS OF PRINCIPAL Estate of Donald E Zimmerman As of 09/30/2002 Assets Listed in Inventory (Valued as of date of death) Money Market Accounts DF Tax Exempt Money Market Fund $26.40 Accrued Interest Common Stocks John Hancock Financial 95 Units Mutual Funds MPAM Large Cap Stock Fund 4,867.385 Units MPAM Penna Int Mun Bd Fund 16,631.131 Units $489.45 Accrued Dividend State Farm Growth Fund 5,876.072 Units Certificates of Deposit Mellon Bank CD $203.65 Accrued Interest TOTAL INVENTORY $ 51,642.95 213,035.30 281,522.61 · Page -1 Fiduciary Acquisition Value $ 13,452.60 3,331.65 546,200.86 5,203.65 $568,188.76 GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS Estate of Donald E Zimmerman For Period 04/19/2001 Through 09/30/2002 08/06/2001 Sale of asset MPAM PA Inter Muni Bd 16,631.131 Units Net Proceeds Fiduciary Acquisition Value Net Gain 08/06/2001 Sale of asset MPAM Large Cap Stock Fd 4,867.385 Units Net Proceeds Fiduciary Acquisition Value Net Loss Gain $216,537.33 212,545.85 $ 3,991.48 $ 49,111.91 51,642.95 12/18/2001 Long term capital gains dividend reinvestment 57.818 units Net Proceeds Fiduciary Acquisition Value Net Gain Total Gains and Losses Less Loss Net Gain $ 2,557.28 0.00 2,557.28 $6,548.76 (2,531.04) $ 4,017.72 , Page '2 Loss $ 2,531.04 $2,531.04 DISBURSEMENTS OF PRINCIPAL · Page 9 Estate of Donald E Zimmerman For Period 04/19/2001 Through 09/30/2002 Administration Expenses (prin) 05/17/2001 Mellon Bank - custodial fee $ 289.57 06/15/2001 Mellon Bank - custodial fee 292.27 07/17/2001 Mellon Bank - custodial fee 291.60 08/17/2001 Mellon Bank - custodial fee 293.52 09/17/2001 Mellon Bank - custodial fee 291.50 10/16/2001 Mellon Bank - custodial fee 297.06 11/16/2001 Mellon Bank - custodial fee 297.04 12/17/2001 Mellon Bank - custodial fee 297.09 01/17/2002 Pennsylvania Inheritance Tax 19,469.20 01/17/2002 Mellon Bank - custodial fee 297.06 01/18/2002 Pennsylvania Inheritance Tax 41.66 02/05/2002 Register of Wills Additional probate fee 220.00 02/15/2002 Mellon Bank - custodial fee 271.66 03/15/2002 Mellon Bank - custodial fee 271.67 04/17/2002 Mellon Bank - custodial fee 271.89 05/17/2002 Mellon Bank - custodial fee 272.04 06/17/2002 Mellon Bank - custodial fee 272.25 07/17/2002 Mellon Bank - custodial fee 272.19 08/16/2002 Mellon Bank - custodial fee 271.66 09/17/2002 Mellon Bank - custodial fee 271.84 09/27/2002 Family Exemption amount paid to Betty R. Zimmerman 3,500.00 ----------- $ 28,052.77 DISBURSEMENTS OF PRINCIPAL Estate of Donald E Zimmerman For Period 04/19/2001 Through 09/30/2002 Fees and Commissions (prin) 01/23/2002 George Clauser Fees for real estate appraisals 01/23/2002 Keefer Wood Allen & Rahal, LLP Attorney fees and disbursements 06/25/2002 Mellon Private Asset Management Tax return preparation fee 09/27/2002 Keefer Wood Allen & Rahal, LLP Attorney fees and disbursements Funeral Expenses (prin) 09/27/2002 Funeral expenses (burial, luncheon, headstone) reimbursed to Betty R. Zimmerman TOTAL DISBURSEMENTS OF PRINCIPAL $ 2,030.00 6,476.06 250.00 6,477.04 .Page 4 $ 15,233.10 10,952.38 $ 54,238.25 Checking Accounts Estate Cash Account Common Stocks John Hancock Financial 95 Units Mutual Funds State Farm Growth Fund 6,056.13 Units Less: Income balance on hand PRINCIPAL BALANCE ON HAND PRINCIPAL BALANCE ON HAND Estate of Donald E Zimmerman As of 09/30/2002 · Page 5 Current Value Carrying Value $240,219.44 $240,219.44 2,641.00 3,331.65 205,787.30 289,330.65 $448,647.74 14,913.51 $532,881.74 14,913.51 $433,734.23 $517,968.23 ----------- ----------- ----------- ----------- INFORMATION SCHEDULES Estate of Donald E Zimmerman For Period 04/19/2001 Through 09/30/2002 Changes in Investment Holdings MPAM Large Cap Stock Fund $ 51,642.95 08/06/2001 Sale of asset MPAM Large Cap Stock Fd 4,867.385 Units -51,642.95 MPAM Penna Int Mun Bd Fund $213,035.30 05/01/2001 Dividend -489.45 08/06/2001 Sale of asset MPAM PA Inter Muni Bd 16,631.131 Units -212,545.85 State Farm Growth Fund $ 281,522.61 06/19/2001 periodic dividend {reinvested} 36.71 Units 1,704.06 12/18/2001 Dividend reinvestment 40.773 Units 1,803.40 12/18/2001 Long term capital gains dividend reinvestment 57.818 Units 2,557.28 06/26/2002 Dividend reinvestment 44.757 Units 1,743.30 Mellon Bank CD $ 5,203.65 09/22/2001 Interest -203.65 09/22/2001 Mellon Bank Certificate of Deposit - matured and redeemed -5,000.00 .Page 6 $ 0.00 0.00 289,330.65 0.00 RECEIPTS OF INCOME Estate of Donald E Zimmerman For Period 04/19/2001 Through 09/30/2002 Dividends MPAM Large Cap Stock Fund 06/04/2001 Dividend 07/02/2001 Dividend 08/01/2001 Dividend MPAM Penna Int Mun Bd Fund 05/01/2001 Dividend 06/05/2001 Dividend 07/02/2001 Dividend 08/01/2001 Dividend 09/04/2001 Dividend State Farm Growth Fund 06/19/2001 periodic dividend (reinvested) 12/18/2001 Dividend reinvestment 06/26/2002 Dividend reinvestment Total Dividends Interest DF Tax Exempt Money Market Fund 05/01/2001 Interest 06/01/2001 Interest 07/02/2001 Interest 08/01/2001 Interest $ 38.94 4.87 4.87 48.68 $ 283.37 764.54 727.59 793.91 149.21 2,718.62 $ 1,704.06 1,803.40 1,743.30 5,250.76 $ 15.28 40.38 35.56 36.82 .Page 'it $ 8,018.06 RECEIPTS OF INCOME Estate of Donald E Zimmerman For Period 04/19/2001 Through 09/30/2002 f.Page e 09/04/2001 Interest $ 497.63 10/01/2001 Interest 222.89 848.56 Estate Cash Account 10/01/2001 Monthly Interest $ 464.94 11/01/2001 Monthly interest 716.59 12/03/2001 Monthly interest 622.50 01/02/2002 Monthly interest 589.39 02/01/2002 Monthly interest 537.22 03/01/2002 Monthly interest 430.41 04/01/2002 Monthly interest 459.23 05/01/2002 Monthly interest 443.18 06/03/2002 Monthly interest 453.96 07/01/2002 Monthly interest 445.99 08/01/2002 Monthly interest 446.67 09/03/2002 Monthly interest 440.29 ----------- 6,050.37 Mellon Bank CD 09/22/2001 Interest $ 153.83 Total Interest $ 7,052.76 Other Income MPAM Large Cap Stock Fund 05/07/2001 Fee reimbursement income 26.31 06/08/2001 Fee reimbursement income 29.08 07/10/2001 Fee reimbursement income 27.42 RECEIPTS OF INCOME Estate of Donald E Zimmerman For Period 04/19/2001 Through 09/30/2002 08/10/2001 Fee reimbursement income 09/10/2001 Fee reimbursement income MPAM Penna Int Mun Bd Fund 05/07/2001 Fee reimbursement income 06/08/2001 Fee reimbursement income 07/10/2001 Fee reimbursement income 08/10/2001 Fee reimbursement income 09/10/2001 Fee reimbursement income Total Other Income TOTAL RECEIPTS OF INCOME $ 27.36 4.43 114.60 $ 87.78 90.80 88.31 91.37 14.83 373.09 .Page 9 $ 487.69 $ 15,558.51 DISBURSEMENTS OF INCOME Estate of Donald E Zimmerman For Period 04/19/2001 Through 09/30/2002 Income Taxes 07/01/2002 United States Treasury Fiduciary Income Tax for FY 2001 07/01/2002 PA Dept. of Revenue Fiduciary Income Tax for FY 2001 TOTAL DISBURSEMENTS OF INCOME $ 337.00 308.00 page- H) $ 645.00 $ 645.00 ., , . . PROPOSED DISTRIBUTIONS TO BENEFICIARIES Estate of Donald E Zimmerman For Period 04/19/2001 Through 09/30/2002 l'age- 1-! To: Trust U/ W of Donald E. Zimmerman Distribution of Residue 09/30/2002 The beneficiary will receive a 100% interest in the estate's residue, representing a portion of the following assets: Cash $240,219.44 John Hancock Financial 95 Units Current balance 3,331.65 $3,331.65 State Farm Growth Fund 6,056.13 Units Current balance 289,330.65 $289,330.65 Total $532,881.74 TOTAL PROPOSED DISTRIBUTIONS TO BENEFICIARIES $532,881.74 ----------- ----------- --. Register 0f Wills of Cumberland County, Pennsylvania .. INVENTORY Estate of Donald E. Zimmerman No. 2001-0697 also known as Date of Death 04/19/2001 , Deceased Social Security No. 196-14-1323 I. Bettv R. Zimmerman Personal Representative{s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. 1.0. No.: 33580 Attorney: Bridaet M. Whitlev Address: P.O. Box 11963 Harrisbura. PA 17108-1963 Telephone: 717-255-8027 Description Value 5,876.972 shares State Farm Growth Fund $281,522.71 Mellon Bank Certif'lcate of Deposit #01107335 with accrued interest 5,203.65 or; tf*t- _.... .. =(1) 0 :j :;:t N cr" (F " '- ~ Z N W ::0 m n !;:~ (:/ "'f:! r"! " -0 W cx::; Total: $286,726.36 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. Form RW-7 (Dauphin County) - Rev. 9/92 /6-o?~6 -$ \ BUREAU OF INDIVIDUAL TAXES \I INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 BRIDGET M WHITLEY KEEFER ETAL PO BOX 11963 HBG PA \j~171108 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN * REY-75' EX AFP CUl-02) ,....-,' Ul. "t" ) ~ ...:. : 1':5 08-05-2002 ZIMMERMAN 04-19-2001 21 01-0697 CUMBERLAND 202 AlIOUnt Rellitted DONALD E MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR FILES ~ RE;;:;iir-EX-1rFP--(oi~-02)-----.il-NOificE--OF-iDETifRMiN1rfiCtN-AN-D-A!fSES!fMENY----------------------------- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER .. ESTATE OF ZIMMERMAN DONALD E FILE NO.21 01-0697 ACN 202 DATE 08-05-2002 ESTATE TAX DETERMINATION 1. Credit For State Death Taxes as Verified 16,392.48 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) 19,610.46 3. Inheritance Tax Assessed by Other States or Territories of the United States (Excluding Discount and/or Interest) .00 4. Total Inheritance Tax Assessed 19,610.46 5. Pennsylvania Estate Tax Due .00 6. Amount of Pennsylvania Estate Tax Previously Assessed Based on Federal Estate Tax Return .00 7. Additional Pennsylvania Estate Tax Due .00 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 -IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) '" .... COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT BRIDGET M SHITLEY ESQUIRE 210 WALNUT STREET HARRISBURG, PA 17101 -------- fold ESTATE INFORMATION: SSN: 196-14-1323 FILE NUMBER: 21-2001- 0697 DECEDENT NAME: ZIMMERMAN DONALD E DATE OF PAYMENT: 01/23/2002 POSTMARK DATE: 01/22/2002 COUNTY: CUMBERLAND DATE OF DEATH: 04/19/2001 NO. CD 000783 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $19,469.20 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: BRIDGET M WHITLEY ESQUIRE CHECK# 10346759 SEAL INITIALS: CW RECEIVED BY: $19,469.20 MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS oJ . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT BRIDGET M WHITLEY ESQUIRE 210 WALNUT STREET HARRISBURG, PA 17101 -------- fold ESTATE INFORMATION: SSN: 196-14-1323 FILE NUMBER: 21-2001- 0697 DECEDENT NAME: ZIMMERMAN DONALD E DATE OF PAYMENT: 01/23/2002 POSTMARK DATE: 01/22/2002 COUNTY: CUMBERLAND DATE OF DEATH: 04/19/2001 NO. CD 000782 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $ 99.60 I I I I I I I I TOTAL AMOUNT PAID: $99.60 REMARKS: BRIDGET M WHITLEY ESQUIRE CHECK# 65322 SEAL INITIALS: CW RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS "'COMMON~EALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX( 11-96l RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT BRIDGET M WHITLEY ESQUIRE 210 WALNUT STREET HARRISBURG, PA 17101 -------- fold ESTATE INFORMATION: SSN: 196-14-1323 FILE NUMBER: 21-2001- 0697 DECEDENT NAME: ZIMMERMAN DONALD E DA TE OF PAYMENT: 01/23/2002 POSTMARK DATE: 01/22/2002 COUNTY: CUMBERLAND DATE OF DEATH: 04/19/2001 NO. CD 000781 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $41 .66 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: BRIDGET M WHITLEY ESQUIRE CHECK# 10346982 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS $41 .66 MARY C. LEWIS REGISTER OF WILLS /0- c:27'b ~ ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG I PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE * NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (01-02> BRIDGET M WHITLEY KEEFER ETAL PO BOX 11963 HBG PA lil08 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11-11-2002 ZIMMERMAN 04-19-2001 21 01-0697 CUMBERLAND 101 DONALD E Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REv=isi;-j-E3f-AFP--fol-:02i--No;--icE--oF-'rNHEififANci-TAx-jrpPRAisEMENT~--AL1-owAN-ci-oR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF ZIMMERMAN DONALD E FILE NO. 21 01-0697 ACN 101 DATE 11-11-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Mortgages/Notes Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule f) (6) 7. Transfers (Schedule G) (7) 8. Total Assets NO. 01 .00 3,331.65 .00 .00 .00 .00 .00 (8) NOTE: To insure proper credit to your account, subllit the upper portion of this form with your tax payment. 3,331.65 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax .00 .00 (11) (12) (13) (14) on 3,331.65 .00 1,196,096.07 NOTE: I~ an assessment was issued previously, lines 14, IS and/or 16, 17, 18 and 19 will re~lect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (IS) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due 477,345.51 X 00 = 167,031.58 X 045 = .00 X 12 = .00 X 15 = (19)= .00 7,516.42 .00 .00 7,516.42 TAX CREDITS: r-ft.n~n. 1C1:1,,;1:~t"1 II l+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-19-2002 CDOO0783 .00 7,301.77 01-22-2002 CDOO0781 .00 41.66 01-22-2002 CDOO0782 .00 99.60 10-17-2002 CDOO1744 2.92- 76.31 TOTAL TAX CREDIT 7,516.42 BALANCE OF TAX DUE .00 INTEREST AND PEN. .42 TOTAL DUE .42 · If PAID AFTER DATE INDICATED, SEE REVERSE fOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS.) \, /6 -c2~ --3 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG. PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV-1'07 EX AFP (01-02) BRIDGET M WHITLEy.02 KEEFER ETAL PO BOX 11963 HBG _r) L. , :2 1 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-29-2002 ZIMMERMAN 04-19-2001 21 01-0697 CUMBERLAND 101 DONALD E AlIOunt Reid tted , . CRA.-.17108 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE1 PA 17013 NOTE: To insure proper credit to your accountl submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-V':ii,',-j-i3fAFP--foi-:oz'Y------...--INirERi,.-ANc'E-fAx--STA-YEME-tif-oF-Accouiif--.-..--------------------- ESTATE OF ZIMMERMAN DONALD E FILE NO.21 01-0697 ACN 101 DATE 07-29-2002 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUEl APPLICATION OF ALL PAYHENTSI THE CURRENT BALANCEI ANDI IF APPLICABLE I A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 01-01-2002 PR I NCI PAL TAX DUE: ........................................................................................................................................................................................................................... 71442.96 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-19-2002 CDOO0783 .00 71301.77 01-22-2002 CDOO0781 .00 41.66 01-22-2002 CDOO0782 .07- 99.60 TOTAL TAX CREDIT 71442.96 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATEI SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $11 NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRll YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. l / 6 -c:2~ 6' '-.3 ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT * REV-li07 EX AFP COl-02) BRIDGET M WHITLEY KEEFER ETAL PO BOX 11963 HBG .02 --2 'I :?-j DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-29-2002 ZIMMERMAN 04-19-2001 21 01-0697 CUMBERLAND 102 DONALD E Allount Rellitted '... ftAt17108 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLEI PA 17013 NOTE: To insure proper credit to your accountl subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-Y=i6oj-ix--AFP--foi-.:ozi-------...--iNifERITANci--flX--STA-YEMENY-OF-lC-COUiiy--.-..--------------------- ESTATE OF ZIMMERMAN DONALD E FILE NO. 21 01-0697 ACN 102 DATE 07-29-2002 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUEl APPLICATION OF ALL PAYHENTSI THE CURRENT BALANCEI ANDI IF APPLICABLE I A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 01-01-2002 P R I NC I PAL TAX DUE: ........................................................................................................................................................................................................................... 121167.50 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-19-2002 CDOO0783 .00 121167.43 TOTAL TAX CREDIT 121167.43 BALANCE OF TAX DUE .07 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATEI SEE REVERSE TOTAL DUE .07 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $11 NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRll YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. l /6w~1/6 -0 " BUREAU OF INDIVIDUAL TAXES ~INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN '* REV-485 EX AFP e01-02> 'OZ JUL 26 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-29-2002 ZIMMERMAN 04-19-2001 21 01-0697 CUMBERLAND 201 DONALD E BRIDGET M WHITLEY KEEFER ETAL PO BOX 11963 HBG ; .')-; .,_L AlIOUnt Rellitted ~.~.; ,"" PA 17i\&8; MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE1 PA 17013, NOTE: To insure proper credit to your account1 subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ~ RE-V:483--EX-j{FP--{oi~-02i-----.-.-NO-ficE--OF-1iETifiMiNlrfio-N-AN-j-AifsESS-MENif---------------------------- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN .. ESTATE OF ZIMMERMAN DONALD E FILE NO.21 01-0697 ACN 201 DATE 07-29-2002 ESTATE TAX DETERMINATION 1. Credit For State Death Taxes as Verified 16,392.48 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) 19.610.46 3. Inheritance Tax Assessed by Other States or Territories of the United States (Excluding Discount and/or Interest) .00 4. Total Inheritance Tax Assessed 19,610.46 5. Pennsylvania Estate Tax Due .00 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 -IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $11 NO PAYMENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) /6 -~1/b -t3 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT * REY-1U1 EX AFP (01-02) '01,-./.) , . . .JUL 26 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-22-2002 ZIMMERMAN 04-19-2001 21 01-0697 CUMBERLAND 101 DONALD E BRIDGET M WHITLEY KEEFER ETAL PO BOX 11963 Ct i.: HBG PA 17108 \.... Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REy:i6oj-iifAFi.--foi-.:oz.r------...--INH-iRITANCE"-TAif-STA-YEME-tiy-OF'-Accouiif--...--------------------- ESTATE OF ZIMMERMAN DONALD E FILE NO. 21 01-0697 ACN 101 DATE 07-22-2002 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 01-01-2002 PR I NC I PAL TAX DU E : ........................................................._................................................................................................................................................................ 7,442.96 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-22-2002 CDOO0781 .00 41.66 01-22-2002 CDOO0782 .00 99.60 01-22-2002 CDOO0783 3.66- 7,305.36 TOTAL TAX CREDIT 7,442.96 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) /b-~~b-~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG~ PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT * REV-16D7 Ell AFP t01-0Z) '02 JUt --:' r.: LO :20 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-22-2002 ZIMMERMAN 04-19-2001 21 01-0697 CUMBERLAND 102 DONALD E BRIDGET M WHITLEY KEEFER ETAL PO BOX 11963 HBG Allount Rellitted ~, .' f"11 '_ "~;A'17108 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-y-:i6'ifj-ix--AFP--foi-::ozi-------...--xNiiiRITANc'E-ylX--si'i,fiME-tif-oF'-lccouiif--.-..---------------- ----- ESTATE OF ZIMMERMAN DONALD E FILE NO. 21 01-0697 ACN 102 DATE 07-22-2002 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 01-01-2002 PR I NC I PAL TAX DU E : ........................................................................................_................................................................................................................................. 12,167.50 PAYMENTS (TAX CREDITS): INT AT REV PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-22-2002 CDOO0783 .00 12,163.84 EREST IS CHARGED THROUGH 08-06-2002 TOTAL TAX CREDIT 12,163.84 THE RATES APPLICABLE AS OUTLINED ON THE ERSE SIDE OF THIS FORM.* BALANCE OF TAX DUE 3.66 INTEREST AND PEN. 6.11 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 9.77 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAY"ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) ~ / b--.~~ ~~ --~3 7/0 \ "'v COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPARTMENT 280601 HARRISBURG, PA 17128-0601 7 -16-2002 Telephone 717 783-5826 Bridget M. Whitley Esq. Keefer Wood Allen & Rahal, LLP P.O. Box 11963 Harrisburg, PA 17108 Re: Estate of Donald E. Zimmerman File Number 2101-0697 Date of Death: 4-19-2001 Dear Ms. Whitley: Enclosed is a "Notice of Inheritance Tax Appraisement, Allowance or Disallowance of Deductions and Assessment of Tax," (REV-1547 EX), ACN 101 establishing the tax applicable to all present interests in the above estate. Also enclosed is a "Notice of Inheritance Tax Appraisement, Allowance or Disallowance of Deductions and Assessment of Tax," (REV-1547 EX), ACN 102 establishing the tax applicable to future interests where the rate of tax is uncertain. Based on the provisions of the above decedent's Will, Deed of Trust and the information reported on Schedule M by the estate representative, the Department concurs with the estate representative's compromise proposal, and the tax on the future interests have been assessed as shown on the ACN 102 assessment notice. All existing inheritanceand/or estate tax payments have been appropriately applied. Any changes which become necessary as a result of a protest decision or an order of court will be reflected in adjustments to both ACN 101 and ACN 102. Please contact me at the telephone number above if you have any questions. Sincerely, " ""-) 0 0 r _ ./'" t j t-/'-\ ~ Bill Lyons Trust Valuation Specialist Inheritance Tax Division Enclosure BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* REV-1547 EX (12-97) PC Bridget M. Whitley Esq. Keefer Wood Allen & Rahal, llP P.O. Box 11963 Harrisburg PA 17108 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NO. COUNTY ACN 7-16-2002 Donald E. Zimmerman 4-19-2001 2101-0697 Cumberland 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: Register of Wills Cumberland County Courthouse Carlisle, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ - -rfeV:1547 EX -(06--97fpc - - - - - - - - - - - - - Noi'it-e - CfF -INt:fERI"i A-Nce-tj\)( A P-PRAis-E ME-Nt: - AlI.oWANCi:- OR- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF Donald E. Zimmerman FILE NO. 2101-0697 ACN 101 DATE 7-16-2002 TAX RETURN WAS: ( 0 ) ACCEPTED AS FILED ( ~ ) CHANGED see attached RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. MortQaQes/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/ Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 29,557.38 10. Debts/MortQaQe Liabilities/Liens (Schedule I) (10) 0.00 11. Total Deductions (11) 29,557.38 12. Net Value of Tax Return (12) 1,192,764.42 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) 0.00 14. NetValueofEstateSubiecttoTax (14) 1,192,764.42 NOTE: If an assessment was issued previously, lines 14,15 and/or 16,17 and 18 will reflect figures that include the total of ALL returns assessed to date. (1 ) (2) (3) (4) (5) (6) (7) 0.00 281,522.61 0.00 0.00 382,608.32 0.00 558,190.87 (S) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 1,222,321.80 ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 taxable at SiblinQ rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: (15) 475,646.37 X .00 0.00 (16) 165,399.07 X .045 7.442.96 (17) X .12 (18) X .15 (19) 7.442.96 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 1-22-2002 CDOO0781 -3.66 41.66 1-22-2002 CDOO0782 99.60 1-22-2002 CDOO0783 7,305.36 TOTAL TAX CREDIT 7,442.96 BALANCE OF TAX DUE 0.000 INTEREST 0.00 TOTAL DUE 0.00 * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. (IF TOTAL DUE IS LESS THAN $I, NO PAYM&:NT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) REV-1470 EX (6-88) . INHERITANCE TAX EXPLANATION OF CHANGES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENrS NAME Donald E. Zimmerman FILE NUMBER REVIEWED BY Bill Lyons ACN 2101-0697 101 SCHEDULE ITEM NO. EXPLANATION OF CHANGES The tax due on all current interests is reflected on the attached Inheritance Tax Assessment. The tax due on all future interest uncertainties is covered on the attached compromise tax assessment,(ACN 102). ROW Page 1 .. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* REV-1547 EX (12-97) PC Bridget M. Whitley Esq. Keefer Wood Allen & Rahal, LLP P.O. Box 11963 Harrisburg PA 17108 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NO. COUNTY ACN 7 -16-2002 Donald E. Zimmerman 4-19-2001 2101-0697 Cumberland 102 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: Register of Wills Cumberland County Courthouse Carlisle, PA 17013 CUT ALONG THIS LINE c::> RETAIN LOWER PORTION FOR YOUR RECORDS ~ . -R-EV:1547 EX -(06-97YPC - - - - - - - - - - - - - -Noi'ic-e .O-F -IN~fERii A-NClrTAj( AP-PR-Ais-EMENi'~ - ALL.OWANCE- OR- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF Donald E. Zimmerman FILE NO. 2101-0697 ACN 102 DATE 7-16-2002 TAX RETURN WAS: ( IZI ) ACCEPTED AS FILED ( D ) CHANGED RESERVATION CONCERNING FUTURE INTEREST. SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortaaaes/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/ Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 0.00 10. Debts/Mortaaae Liabilities/Liens (Schedule I) (10) 0.00 11. Total Deductions (11) 0.00 12. Net Value of Tax Return (12) 551.718.98 13. Charitable/Governmental Beauests; Non-elected 9113 Trusts (Schedule J) (13) 0.00 14. Net Value of Estate Subiect to Tax (14) 551.718.98 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17 and 18 will reflect figures that include the total of A.b.b. returns assessed to date. (1 ) (2) (3) (4) (5) (6) (7) 0.00 0.00 0.00 0.00 0.00 0.00 551,718.98 (8) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 551.718.98 ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 taxable at SiblinQ rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: (15) 281.330.07 X .00 0.00 (16) 270,388.91 X .045 12.167.50 (17) X .12 (18) X .15 (19) 12,167.50 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 1-22-2002 CDOO0783 -5.99 12,163.81 I TOTAL TAX CREDIT 12,163.81 BALANCE OF TAX DUE 3.66 INTEREST 6.10 TOTAL DUE 9.76 * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. (IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUllU:D. IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT WHITLEY BRIDGET M KEEFER,WOOD,ALLEN & RAHAL P.O. BOX 11963 HARRISBURG, PA 17108-1963 -------- fold ESTATE INFORMATION: SSN: 196-14-1323 FILE NUMBER: 2101-0697 DECEDENT NAME: ZIMMERMAN DONALD E DA TE OF PAYMENT: 10/18/2002 POSTMARK DATE: 10/17/2002 COUNTY: CUMBERLAND DA TE OF DEATH: 04/19/2001 NO. CD 001744 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $76.31 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: BRIDGET M WHITLEY ESQUIRE CHECK# 10437635 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS $76.31 MARY C. LEWIS REGISTER OF WILLS , . I ~~ STATUS REPORT UNDER RULE 6.12 Name of Decedent: Donald E. zimmerman Date of Death: APril 19. 2001 will No. 2001-00697 Admin. NO. Pursuant to Rule 6.12 of the supreme Court orphans' Court Rules, I report the following with respect to completion of the administra- tion of the above-captioned estate: 1. State whether administration of the estate is complete: Yes xx No 2. If the answer is NO, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the court? Yes No xx b. The separate orphans' Court No. (if any) for the person- al representative's account is: c. Did the personal representative state an account infor- mally to the parties in interest? Yes xx No d. copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the clerk of the orphans' Court and may be attached to this report. Date: APr~l 21. 2003 ~~~.frU7 Bridget M. whitley Name (please type or print) Keefer, wood, Allen & Rahal LLP 210 walnut St., P.O. Box 11963 Harrisburg. PA 17108-1963 Address 717-255-8027 Tel. No. capacity: personal Representative counsel for personal representative xx Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 . Phone: (717) 240-6345 Date: 3/10/2003 ZIMMERMAN BETTY R 105 COCKLEYS DRIVE MECHANICSBURG, PA 17055 RE: Estate of ZIMMERMAN DONALD E File Number: 2001-00697 Dear Sir/Madam: It has corne to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 4/19/2003 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, DONNA M. OTTO DEPUTY REGISTER OF WILLS cc: /File Counsel Judge : ~. .:.-..:. <f 'J ~ ... ~~-.-~ il~I'II....... --,.1: !/_ It...::i ~ ; !'lllll~ f~ ! ! II ~ t,'"J ,;, . i C'::\,. . i ~~'l~ ~'~ J! t.\'~I.~~r,~.. :;~. -...~ ' ~. ..'.... :0\ f'J ~ ,'...: '. 2" !,.,~~'I~~ ; \~:/::::S)\ ""J ~..o l/Q) ;:.; \ i :2 ~ . .ri.' i " c:. :; Ll. ! : ',<fy -; J" ti:L.-' / . :~ ,\-~~-Od M (..0 0") ~ .....-I ~Moo $0.0(..00 ~O"'J.....-I cn.....-lt- ~.....-I.....-I ::1~<C .sop... ro t:O .., 3: .~ 0::1 oo,.:,.c .....-I If) ~ .- $0.0 ~ ~ C :3 o U "0 C co "'t: Q) .0 E :3 UQ) ~ o co ( \to- :3' (/j 0" ( =(/)1 .~ ~ ~. Q) \to- :3. -J 0 0 t . Q).c ()~~ (/j :3 .. ~.- 0 o ~-~U ~ ~a::~ ..~ es ~ ""'-<J ..;l ~-==-j ~Q~..cl ~ e.--~ ~~<~ E --- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Donald E. Zimmerman Date of Death: April 19, 2001 Will No.: 2001-00697 To the Register: I certify that notice of estate administration required by Rule 5.6 of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on July 31.2001: Betty R. Zimmerman, 105 Cockleys Drive, Mechanicsburg, PA 17055 Kathy J. Myers, 1701 Creek Vista Drive, New Cumberland, PA 17070 Connie M. Rehman, 10300 Parkman Road, Silver Spring, MD 20903 Mellon Bank, Attention: Sharon Garcia, Trust Department, P.O. Box 1010, Harrisburg, PA 17108-1010 Notice has now been given to all persons entitled thereto under Rule 5.6 (a). Date: July 3~J 2001 ~fA~ ');t. JfQ-~ r idget M. Whitley, Esq. Keefer Wood Allen & Rahal, LLP P.O. Box 11963 Harrisburg, PA 17108-1963 Capacity: Counsel for Personal Representative ~ IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE Whether you will receive any money or property will be determined wholly or partly by the decedent's will. lfthe decedent died without a will, whether you will receive any money or property will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND PENNSYLVANIA In re Estate of Donald E. Zimmerman, deceased, TO: Betty R. Zimmerman 105 Cockleys Drive Mechanicsburg, PA 17055 Please take notice of the death of decedent and the grant of letters to the personal representative named below. The Decedent, Donald E. Zimmerman, died, on the 19th day of April, 2001, at Harrisburg Hospital, City of Harrisburg, Dauphin County, Pennsylvania. The Decedent died testate (with a Will). The personal representative of the Decedent is Betty R. Zimmerman, 105 Cockleys Drive, Mechanicsburg, P A 17055 (717) 766-3574. The Will has been filed with the Office of the Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, P A 17013-3387; Phone number (717) 240-6345. A copy of the Will may be obtained by contacting the Register of Wills and paying the charges for duplication. Date: July 31, 2001 ~~.~ Bridget M. Whitley, Esq. Keefer Wood Allen & Rahal, LLP P.O. Box 11963, Harrisburg, PA 17108 Telephone (717) 255-8027 Capacity: Counsel and Personal Representative IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE Whether you will receive any money or property will be determined wholly or partly by the decedent's will. If the decedent died without a will, whether you will receive any money or property will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND PENNSYL VANIA In re Estate of Donald E. Zimmerman, deceased, TO: Kathy J. Myers 1701 Creek Vista Drive New Cumberland, P A 17070 Please take notice of the death of decedent and the grant of letters to the personal representative named below. The Decedent, Donald E. Zimmerman, died, on the 19th day of April, 2001, at Harrisburg Hospital, City of Harrisburg, Dauphin County, Pennsylvania. The Decedent died testate (with a Will). The personal representative of the Decedent is Betty R. Zimmerman, 105 Cockleys Drive, Mechanicsburg, P A 17055 (717) 766-3574. The Will has been filed with the Office of the Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, P A 17013-3387; Phone number (717) 240-6345. A copy of the Will may be obtained by contacting the Register of Wills and paying the charges for duplication. Date: July 31, 2001 ~,.o/?f. ~ Bridget M. Whitley, Esq. Keefer Wood Allen & Rahal, LLP P.O. Box 11963, Harrisburg, PA 17108 Telephone (717) 255-8027 Capacity: Counsel and Personal Representative IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE Whether you will receive any money or property will be determined wholly or partly by the decedent's will. If the decedent died without a will, whether you will receive any money or property will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND PENNSYLVANIA In re Estate of Donald E. Zimmerman, deceased, TO: Connie M. Rehman 10300 Parkman Road Silver Spring, MD 20903 Please take notice of the death of decedent and the grant of letters to the personal representative named below. The Decedent, Donald E. Zimmerman, died, on the 19th day of April, 2001, at Harrisburg Hospital, City of Harrisburg, Dauphin County, Pennsylvania. The Decedent died testate (with a Will). The personal representative of the Decedent is Betty R. Zimmerman, 105 Cockleys Drive, Mechanicsburg, P A 17055 (717) 766-3574. The Will.has been filed with the Office of the Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, PA 17013-3387; Phone number (717) 240-6345. A copy of the Will may be obtained by contacting the Register of Wills and paying the charges for duplication. Date: July 31, 2001 ~~)fl. ~ Bridget M. Whitley, Esq. Keefer Wood Allen & Rahal, LLP P.O. Box 11963, Harrisburg, PA 17108 Telephone (717) 255-8027 Capacity: Counsel and Personal Representative IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE Whether you will receive any money or property will be determined wholly or partly by the decedent's will. If the decedent died without a will, whether you will receive any money or property will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND PENNSYLVANIA In re Estate of Donald E. Zimmerman, deceased, TO: Mellon Bank Attention: Sharon Garcia Trust Department P.O. Box 1010 Harrisburg, P A 17108-1010 Please take notice of the death of decedent and the grant of letters to the personal representative named below. The Decedent, Donald E. Zimmerman, died, on the 19th day of April, 2001, at Harrisburg Hospital, City of Harrisburg, Dauphin County, Pennsylvania. The Decedent died testate (with a Will). The personal representative of the Decedent is Betty R. Zimmerman, 105 Cockleys Drive, Mechanicsburg, P A 17055 (717) 766-3574. The Will has been filed with the Office of the Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, P A 17013-3387; Phone number (717) 240-6345. A copy of the Will may be obtained by contacting the Register of Wills and paying the charges for duplication. Date: July 31,2001 ~>>t. ~ Bridget M. Whitley, Esq. Keefer Wood Allen & Rahal, LLP P.O. Box 11963, Harrisburg, PA 17108 Telephone (717) 255-8027 Capacity: Counsel and Personal Representative IN THE MATTER OF THE ESTATE OF DONALD E. ZIMMERMAN, DECEASED : IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 2001-00697 INSTRUMENT OF DISCLAIMER THIS INSTRUMENT, made this t day of J~ R. ZIMMERMAN (the "Disclaimant"), , 2001, by BETTY WITNESSETH: THE CIRCUMSTANCES leading up to the execution of this Instrument are as follows: 1. Donald E. Zimmerman (the "Decedent"), a married man, died testate on April 19, 2001, and his wife, Betty R. Zimmerman, duly qualified as executor (the "Executor") of the Decedent's probate estate (the "Estate"). 2. The Decedent and the Disclaimant were co-owners, as tenants by the entireties, of a Mellon Bank certificate of deposit, account number 01107335 (the "Certificate of Deposit"). 3. The Decedent's Estate consists of 5,876.072 shares of the State Farm Growth Fund; 4,867.385 shares of the MPAM Large Cap Stock Fund; 16,631.131 shares of the MPAM Pennsylvania Intermediate Municipal Bond Fund, with accrued income of $489.45; and 13,426.40 shares of the DF Tax Exempt Money Market Fund, with accrued income of $26.40 (collectively, the "Probate Assets"). 4. Article THIRD of the Last Will and Testament of the Decedent, dated August 14, 1997 (the "Will") provides as follows: THIRD: I give, devise and bequeath the rest, residue and remainder of my estate, real and personal, to my wife. Should she not survive me, or to the extent that she, or her executor, trustee, attorney-in-fact, or other successor in interest, disclaims any interest, I give, devise and bequeath such rest, residue and - 1 - remainder, or interest therein or portion thereof, to my Trustee, hereinafter named, IN TRUST NEVERTHELESS, to be held, administered and distributed for all purposes as part of the Bypass Trust. 5. The Disclaimant desires to renounce, absolutely and forever, her survivorship rights with respect to the Certificate of Deposit. The Disclaimant understands that as a result of her renunciation, the Decedent's undivided one-half (1/2) interest in the Certificate of Deposit will pass into the residue of the Estate. 6. The Disclaimant desires to renounce, absolutely and forever, her bequest of the residue of the Estate of the Decedent. 7. The Disclaimant desires to retain her beneficial interest in the Decedent's Bypass Trust, which will receive the Decedent's undivided one-half (1/2) interest in the Certificate of Deposit, and all of the Probate Assets (after deductions for inheritance taxes and expenses of estate administration). 8. The Disclaimant desires to exercise the rights granted to her in Chapter 62 of the Pennsylvania Probate, Estates and Fiduciaries Code, 20 Pa.C.S. Sections 6201-6207, to disclaim, release, and renounce, absolutely and forever, any and all of her right, title and interest in and to her survivorship interest with respect to the Decedent's undivided one-half (1/2) interest in the Certificate of Deposit, and any and all of her right, title and interest in and to the residue of the Decedent's Estate. 9. It is the Disclaimant's intention that this Instrument shall constitute a "qualified disclaimer" under Section 2518 of the Internal Revenue Code of 1986, as amended, and applicable Treasury Regulations issued thereunder., NOW THEREFORE, the Disclaimant, intending to be legally bound hereby, for herself, - 2 - her heirs, personal representatives, successors and assigns, does, by these presents, hereby disclaim, release and renounce, absolutely and forever, any and all right title and interest in and to the Decedent's undivided one-half (112) interest in the Certificate of Deposit and the Probate Assets as identified above in Paragraphs 2 and 3 (which Paragraphs are incorporated herein by reference as if they were fully set forth); provided, however, that nothing in this Instrument shall modify, diminish or affect the beneficial interest of the Disclaimant in and to such disclaimed property which thereby passes to the Bypass Trust under the Will. AND, the Executor hereby accepts this Instrument for the purposes expressed herein, so that the Decedent's undivided one-half (1/2) interest in the Certificate of Deposit shall pass to the residue of the Estate, and the residue of the Estate shall pass to the Bypass Trust, for the benefit of the Disclaimant and the Decedent's issue. IN WITNESS WHEREOF, and intending that this Instrument shall be delivered to the Executor and filed of record in the Office of the Register of Wills of Cumberland County, Pennsylvania, the Disclaimant has hereunder set her hand and seal to this Instrument on the date first above written. LYNdf/1.~rdp WITNESS q~~ Z~~~ BETTY R. MERMAN "Disclaimant" and "Executor" - 3 - COMMONWEALTH OF PENNSYLVANIA : ss. COUNTY OF CUMBERLAND On this, the G~ day of ~ ,2001, before me, the undersigned officer, personally appeared BETTY R. ZIMMERMAN, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. In witness whereof, I hereunto set my hand and official seal. ~c~CJ=LL NOT AAfAl SEAL C CYNTHIA J. RULE, Notary Public aa'P Hi~ ~.rt).. CU,mberland County. """,,".4;; !res Jan. 24,2004 - 4- ::: REV-1500 EX + (6-00) OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA REV-1500 /& - ,1.V~ ~ -7- DEPARTMENT OF REVENUE V DEPT. 280601 . INHERITANCE TAX RETURN FiLE NUMBER. HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 2001 0697 CQUNTYCQDE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Zimrernen, Donald E. 196-14-1323 DECE- DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE DENT 04/19/01 . 01/03/1926 WITH THE REGISTER OF WILLS ". (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER zimrernen, Betty R. ~ 3. Remainder Return CHECK ~' Original Return r Supplemental'Return (date of death prior to 12-13-82) APPRO- 4. Limited Estate 4a. Future Intllrest Compromisll 5. Federal Estate Tax Return Required ~ateofdeathafter12-12-82) PRIATE 6. Decedent Died Testate 7. ecederlt Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach copy of Will) tttach acopy of Trust) BLOCKS 9. Litigation Proceeds Received 10. pousal Poverty Credit (date of death between 0 11. Election to tax under Sec. 9113(A) U-31-S1 and 1-1-95) (Attach Sch 0) jfll$.~ijMiJ~f(ijI!Q_~p;~g~lll!~m1jn.G9l!ijjlPilftji4i!tA%.l~ijQijMA'tj\$l$!!9liIit!Mtioo;IMjlIlTOi" NAME COMPLETE MAILING ADDRESS COR- Bridqet M. Whitlev P.O. Box 11963 RE- FIRM NAME (If Applicable) Harrisbillg , PA 17108 SPON DENT Keefer Wood Allen & Rabal, LLP TELEPHONE NUMBER 00 f3 ::0 717-255/-8027 ;; ('!} ;:rJ (1) ~."; ,.i' q cr &FFICIAL{l:ISE ONLY 1. Real Estate (Schedule A) (1) NObe ~ ":'I,} 2. Stocks and Bonds (Schedule B) (2) 281,522.t;1 N 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) None W 4. Mortgages & Notes Receivable (Schedule D) (4) None -V 5. Cash, Bank Deposits & Miscellaneous Personal ~J.J Property (Schedule E) (5) 382,608.)4 ~ 6. Join~y Owned Property (Schedule F) CO 0 Separate Billing Requested (6) None RECA- PITULA- 7. Inter-Vivos Transfers & Miscellaneous TtON Non-Probate Property (Schedule G or L) (7) 558,190.87 8. Total Gross Assets (total Lines 1-7) (6) 1,222,321.80 9. Funeral Expenses & Administrative Costs (Schedule HI(9) 29,557.38 10. Debts of Decedent, Mortgage Liabilities, & Liens(Schedule I) (10) None 11. Total Deductions (total Lines 9 & 10) (11) 29,557.38 12. Net Value of Estate (Line 8 minus Line 11) (12) 1,192,764.42 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax (13) None has not been made (Schedule J) 14. Net Value Subject to Tax (Une 12 minus Une 13) (14) 1,192,764.42 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amountof line 14 taxable at the spousal t(1J( rate, or transfers under Sec. 9116 {al\1.2} 756,976.44 X .0 0 (15) 0.00 TAX 16. Amountof Line 14taxableat lineal rate 435,787.98 X .0 ~ (16) 19,610.46 0.00 - COMPU- 17. Amount 01 line 14 taxable at s'lbl'lng rate X .12 (17) 0.00 TATION 18. Amount of Line 14 taxable at collateral rate 0.00 X .15 (18) 0.00 19. Tax Due (19) 19,610.46 20. 0 ~~~~ij~!ifYQ!lAllilijilijjlli$i!ijQjjrR~NQi!:iIl'Nj~jijjfj!ii_1ft1 """""""""",,,,,,,,,,,,,',i"""",'~ii!alinlQiR!IttQ',AN$~M;@J:~(I.e$TIQl'I$!qi!!,,*,liIi;!\\'.i\N:P\l!;!;g.jIlGJR,MA'!'B$!>?g)'"" o PA15001 NTF 29755 Copyright 2000 Greatland/Nelco LP - Forms Software Only ....."..- ....... ...--..... ...-....... --.. "'--"-,'"'.'-''' .. ......-.-,,<".... Estate of: Donald E. zimmerman SUMMARY OF ALlJJCIIITICNS 10 BENEFICIARIES Taxable at lineal rate Trust Under will Kathy J. Myers 270,388.91 165,399.07 435,787.98 21-2001-0697 Estate of Donald E. Zimmerman REV-1500 File Number 21-2001-0697 Calculation of share of Estate taxable at 0% as a spousal transfer: Net value of estate per LINE 12: Less: (1) Non-probate items passing to surviving spouse: Schedule E, Item 3 - State Farm Ins. Supp. Contract Schedule E, Item 4 - State Farm Ins. Ext. Term. Pay Schedule E, Item 5 - State Farm Ins. (Carolyn Rehman, Ins.) Schedule E, Item 5 - State Farm Ins. (Ryan Rehman, Ins.) Schedule E, Item 6 - State Farm Ins. (Brooke Rehman, Ins.) Schedule G, Item 8 - State Farm Ins. Deferred Annuity Schedule G, Item 9 - State Farm Ins. Deferred Annuity Schedule G, Item 10 - Transatlantic Life Annuity (2) Non-probate items passing to other beneficiaries Schedule G, Item 1 - Individual Retirement Account Value of Bypass Trust $246,715.35 126,559.00 1,609.25 1,716.81 804.26 46,124.80 10,878.13 41.238.77 $475,646.37 $165,399.07 Marital Share of Bypass Trust, per Schedule M Future Interest Compromise Lineal Share of Bypass Trust, per Schedule M Future Interest Compromise Marital Share of Bypass Trust, per Schedule M Future Interest Compromise Non-probate assets (as described above) Portion of estate taxable at 0% as spousal transfer Portion of estate taxable at 0% as spousal transfer Portion of estate taxable at 4.5% as lineal transfer Individual Retirement Account Bypass Trust Share $165,399.07 270.388.91 $1,192,764.42 (641.045.44) $551,718.98 281,330.07 270.388.91 551,718.98 281,330.07 475.646.37 $756,976.44 $756,976.44 435.787.98 $1,192,764.42 PA REV-1500 EX (6-00) Page 2 Decedent's Complete Address: STREET ADDRESS 105 Cocklevs Drive CITY I STATE I ZIP Mechanic PA 17055 Tax Payments and Credits: 1. Tax Due (page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discou nt (1) 19,610.46 Total Credits (A + 8 + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty TotallnterestfPenalty (D + E) 4. If line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 LIne 20 to request a refund 5. If Line 1 + Line 3 is greater than Una 2, enter the difference. This is the TAX. DUE. A. Enter the interest on the tax due. 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. " ,~~keCheckPayableto REGISTER,OF"ViILLS, AGENT /~[~!~~X~~!~~+~~f8[[8!i~a~u~~+i~~~~~~tx6i~ax~I;!~';[~fAgX~~~6~~iXY~~tdgk~} (3) 0.00 (4) (5) 19, 610 .4~ (5A) 0.00 (58) 19,610.46 1. Did decedent make a transfer and: a. retain the use or income of the property transferred; ..,......,.......,.. b. retain the right to designate who shall use the property transferred or its income; c. retain a reversionary interest; or. . . , . . . . . . . . . . . . . . . , . . . . . , . . . . . . . . . . . . . d. receive the promise for life of either payments, benefits or care? , . . . . . 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . , . , . . . . . . , . . . . . . . . , . . . . . . , . . 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . , , . . . . , . . . . . . , . , . . . . . , . , . . . . . . , . . . . . , . . . IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties 01 perjury, I declare that I have examined this return including accompanying schedules and statements, and to the best of my knowledge and beilef, it is true, correct and complete. Declaration at preparer other ttlan the personal representative is based on information 01 which re arer has an knowled e. SIGNAT OF PERS E ONSI8LE FOR FILl~G RETURN DAT ~ ~ ~ Yes No ~ ~ 8 ~ .0 D ADD ESS See S e attached SIGN~OF PREPARER O~HER J ADDRESS 210 Walnut Street, Harrisburg, PA DAT ~Z-- 17108-1963 ..'...................:.'::,',:::,:"",:,,::;:::::,:,::::},::,;;;::"",:,:-, :"'::':'::""':':"':':":"::::::::::::':":::"::'::,::,:::::,::::::::::,::":,,:,:,:-:.:-,,..,.,. . ....'.,.'.,..,:,:",:,::,,:,: ,:::,;:',:,:,:,::,:,....... For dates'o('leat'ti on or'afi'e;~July"i'''1'994 arid i:iefoj-e'jarl~iary 1,1'S9S;'tri'e taiC'ra."te imposed"I':"th'El'riiii'value'of't"r'ansfers'to'or for t'tie'use'of the'surviving's'po'use (s'3Oj~ [72P.S.1i 9116(a)(1,1)(i)j. For dates of death on or a1ter January 1, 1995, the ta)(rate is impcsed on the net value 01 trans1ers to or tor the use of the surviving spouse is 0% [72 P.S. Ii 9116 (a}(1.1)(ii)). Thestatute MnpQ nnt ",,,,,,mnt a transfer to a surviving spouse from tax. and the statutory requirements for disclosure of assets and filingataxreturn are stillapplicabie even if the surviving spouse is the only beneficiary. For dates of death on or after JL.lly 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, orastepparentofthechildisO% [72 P.S.li9116(a)(1.2)l. The tax rate impond on the net value of transfers to or for the use of the decedel'lt's lineal beneficiaries is 4.5%, except as noted in 72.P.S.1i 9116(1.2) [72 P.S.1i 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% [72 P.S. Ii 9116(a)(1.3)l. A sibling is defined, under Section 91Q2, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. o PA15002 NTF 29756 Copyright 2000 Greatland/Nelco LP - Forms Software Only Estate of: D:lnald E. zinmerTIl3Il 21-2001-0697 The following person(s) are signing the ret= as representative(s) of the estate: Betty R. ZimreITl\3l1 105 Cockleys Drive Mechanicsburg, PA 17055 . REV-1;03 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ibnald E. Zi!llrennan SCHEDULE B STOCKS & BONDS FILE NUMBER 21-2001-0697 All property Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 State Farm Growth Fund 5,876.072 shares 281,522.61 TOTAUA!sa enter an line 2, Recaoitulation) $ (If more space is needed, insert additional sheets of the same size) 281,522.61 7 CPA31 NTF 10905 Copyright Forms Software Only, 1997 Nelco, Inc. . REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Donald E. Zimre:rman SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-2001-0697 Include proceeds of litigation & date proceeds were received by the estate. All prop. Jolntlv-owned with rlaht 01 survlvorshln must be disclosed on Sch. F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 Mellon Bank CD #01107335 5,000.00 2 Interest on above i tern accrued as of decedent's death 203.65 3 State Farm Insurance SUpplementary contract No. 1505-2016 (Keogh Plan) Betty R. zimre:rman is the beneficiary 246,715.35 4 State Farm Insurance Extended Tennination payrrents, payable at the rate of $1, 196 . 69 per m::m.th to Betty R. Zimre:rman, f= as long as she lives. The asset is valued at the present value of the payrrents over Mrs. Zimre:rman's life expectancy . 126,559.00 5 State Farm Life Insurance Policy #LF-0945-9371, Carolyn M. Rehm3n, Insured By terms of the contract, Betty R. Zimre:rman became the owner upon decedent's death. 1,609.25 6 State Farm Life Insurance Policy #LF-1071-6400, Ryan B. Rehman, Insured By terms of the =tract, Betty R. zimre:rman became the owner upon decedent's death. 1,716.81 7 State Farm Life Insurance Policy #LF-1379-9169, Brooke M. Rehman, Insured By terms of the contract, Betty R. Zimre:rman became the owner upon decedent's death. 804.26 TOTAL (Also enter on line 5, Recapitulation' $ (If more space is needed, insert additional sheets of the same size) 382,608.32 7 CPA81 NTF 10908 Copyright Forms Software Only, 1997 Nelco, Inc. REV-1510 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Donald E. Zirrrrermm SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21-2001-0697 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM INCLUDE NAME OF THE TRANSFEREE, THEIR DATE OF DEATH RELATIONSHIP TO DECD & DATE OF TRANSFER. NO. ATTACH COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET 1 Individual Retirerrent Account holding 3,452.287 shares of State Farm Growth Fund (dad value $47. 91 per share) . Paid to Kathy J. Myers as beneficiary The decedent created a revocable trust on October 13, 1989 with Mellon Bank (fonnerly Carrronwealth National Bank) as Trustee. As of the date of death, the Trust had the assets listed below as items 2 through 6: 2 MPAM Large Cap Stock Fund 4,867.385 shares 3 MPAM Penna Int Mun Ed Fund 16,631.131 shares 4 Accrued incare to Date of Death 5 DF Tax Exerrpt Money Market Fund 6 Interest on above i tern accrued as of decedent's death % OF EXCLUSION DECD'S (IF INTEREST APPLICABLE) TAXABLE VALUE 165,399.07 51,642.95 212,545.85 489.45 13,426.40 26.40 7 Metropolitan Life Investors Variable Annuity Betty R. ZimrenTl3.Il, beneficiary 16,419.05 8 State Farm Insurance Calpany Deferred Life Annuity Policy LF-1087-8950 Betty R. ZimrenTl3.Il is the survivor annuitant 46,124.80 Total fran continuation naae (s) 52,116.90 1 CPA01 NTF 10910 TOTAL {Also enter on line 7, Recapitulation} $ (If more space is needed, insert additional sheets of the same size) 558,190.87 Copyright Forms ScHware Only, 1997 Nelco, Inc. Estate of: IXmald E. Zimre!JlBI1 Page 2 21-2001-0697 SCHEDULE G -- Inter-Vivos Transfers and Non-Probate Property Item No. Description 9 State Farm Insurance Carpany Deferred Life Armuity Policy LF-1393-9452 Betty R. Zimre!JlBI1 is the survivor annuitant 10 Transatlantic Life Insurance Armuity Policy #26140734 Betty R. Zimre!JlBI1 is the beneficiary Date of Death Value of Asset 'TOI1\L. (Cany forward to rrain schedule) . . . . . . % Of Decd's Interest Exclusion Taxable Value 10,878.13 41,238.77 52,116.90 REV-1511EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Donald E. zinmerrran SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-2001-0697 Debts of decedent must be reported on Schedule I. ITEM NO. DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 Cocklin Funeral Hare 8,463.38 2 Funeral lnnchean 300.00 3 Headstone purchase and engraving 2,189.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 0.00 Name of Personal Representative(s) Social Security Number(s)/EIN No. of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees Name: Keefer Wood Allen & Rahal, LLP 12,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00 Claimant Betty R. Zinmerrran Street Address 105 Cockleys Drive City Mechanicsburq State PA Zip 17055 Relationship of Claimant to Decedent Survi vinq Spouse 4. Probate Fees 75.00 5. Accountant's Fees 0.00 $. Tax Return Preparer's Fees 0.00 7 Clauser Real Estate Appraisals 2,030.00 8 Attorneys accrued and anticipated disburserrents in cormection 500.00 with estate administration TOTAL IAlso enwr on line 9, Recapitulation) $ 29,557.38 (If more space is needed, insert additional sheets of the same size) 7 CPA11 NTF 10911 Copyright Forms Software Only, 1997 Nelco, Inc. REV-1513 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES Donald E. Zimrernan No. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 Betty R. Zimrernan 105 Cockleys Drive Mechanicsburg, PA 17055 2 Trust Under Will c/o Mellon Private Asset Managerent P.O. Box 1010 Harrisburg, PA 17108-1010 3 Kathy J. Myers 1701 Creek Vista Drive New Cumberland, PA 17070 FILE NUMBER RELATIONSHIP TO DECEDENT Do Not Ust Trustee(s) surviving spouse Daughter 21-2001-0697 AMOUNT OR SHARE OF ESTATE 756,976.44 270,388.91 165,399.07 ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 17 AS APPROPRIATE ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE None B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS None 7 CPA13 NTF 10913 TOTAL OF PART II n ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00 Copyright Forms Software Only, 10197 Neice, Inc. (If more space is needed, insert additional sheets of the same size) REV-'647 EX. 19-0* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT sa -.~M FUTURE INTEREST COMPROMISE Check Box 4a on Rev-1500 Cover Sheet ESTATE OF Donald E. Zirrmennan FILE NUMBER 21-01-0697 This Schedule is appropriate only for estates of decedents dying after Oecember 12,1982. This schedule is to be used for all future interests where the rate of tax which will be applicable when the future interest vests in possession and enjoyment cannot be established with certainty. Indicate below the type of instrument which created the future interest and attach a copy to the tax return. !9 Will 0 Trust 0 Other I. Beneficiaries NAME OF BENEFICIARY RELATIONSHIP DATE OF BIRTH AGE TO NEAREST BIRTHDAY 1. Betty R. Zirrmennan sw:viving spouse 8/24/1931 70 2. 3. 4. 5. II. For decedents dying on or after July 1, 1994, if a surviving spouse exercised or intends to exercise a right of withdrawal within 9 months of the decedent's death, check the appropriate block and attach a copy of the document in which the surviving spouse exercises such withdrawal right. 0 Unlimited right of withdrawal 0 Limited right of withdrawal ll!. Explanation of Compromise Offer: The Bypass Trust created under the Last Will and Testament of the Decedent p ~or the payment of all inccxne to the surviving spouse, children and issue, and liiscretionary distribution of principal to the sw:viving spouse, children and is p'he Trustee is familiar with the income and assets of the sw:viving spouse, and ~ticipates distributing all of the inccxne to the surviving spouse and none to hildren and issue. The Trustee does not anticipate distributing any principal o either the surviving spouse, children or issue during the surviving spouse's ifetime. Therefore, it is proposed to value the Bypass Trust as a life estate he surviving spouse, remainder to children and issue. Based on the IRe Section ate for April 2001 (6%), and the age of the surviving spouse (70l the value of urviving spouse's life estate is 51% of the Trust and the remainder is 49% of t rust. The attached affidavit of Mellon PRivate Asset Management is attached in urther support of the proposed canpomise. IV. Summary of Compromise Offer: 1. Amount of Future Interest. . ....... ....... ....... ...... ..... ......$ 55L718.98 2. Value of Line 1 exempt from tax as amount passing to charities, etc. - 0 (also include as part of total shown on Line 13 of Cover Sheet) .$ - 3. Value of Line 1 passing to spouse at appropriate tax rate Check One 0 6%, 0 3%, ~ 0% . . . . . . . . . . . . . . . . ..... $ 281,330.07 (also include as part of total shown on Line 15 of Cover Sheet) 4. Value of Line 1 taxable at lineal rate .....$ 270,388.91 Check One D 6%, iM 4.5% ... . . . . . . . . . . . . . (also include as part of total shown on Line 16 of Cover Sheet) 5. Value of Line 1 taxable at sibling rate (12010) (also include as part of total shown on Line 17 of Cover Sheet) ... ..$ - 0 - 6. Value of Une 1 taxable at collateral rate (15%) (also include as part of total shown on L.ine 18 of Cover Sheet) ... . .$ - 0 - 7. Total value of Future Interest (sum of Lines 2 thru 6 must equal Line 1) .... ........ ...... . .$ 551,718.98 rovides sue. for 7520 the he (If more space is needed, insert additional sheets of the same size) Life Estate and Remainder Factors Calculation of Life Estate portion of Donald E, Zimmerman Trust UIW Transfer Date: 97520 Rate: Calculation Type: Principal: Age: Factor: Value: Life Estate 0,50993 $281,338,07 4/2001 6,00% One Life $551,719 70 Remainder 0,49007 $270,380,93 ESTATE OF DONALD E. ZIMMERMAN, DECEASED AFFIDAVIT OF SHARON M. GARCIA ASSIST ANT VICE PRESIDENT MELLON PRIVATE ASSET MANAGEMENT TRUSTEE UNDER WILL OF DONALD E. ZIMMERMAN Commonwealth of Pennsylvania County of Dauphin SHARON M. GARCIA, Assistant Vice President, Mellon Private Asset Management, Trustee under Will of Donald E. Zimmerman, deceased, being duly sworn according to law, deposes and says: 1. The Last Will and Testament of Donald E. Zimmerman provides as follows regarding the distribution of trust income: (1) My Trustee shall pay to or apply for the benefit of anyone or more of my said wife, my children and my issue, until division into shares pursuant to Paragraph (4), all of the net income from the Bypass Trust in convenient install- ments in such shares and proportions as my Trustee in its sole discretion shall determine primarily for the medical care, education, support and maintenance in reasonable comfort of my said wife, children and issue, taking into consideration to the extent my Trustee deems advisable, any other income or resources of my said wife, children and issue known to my Trustee, considering that my wife is the primary object of my bounty. 2. The Last Will and Testament of Donald E. Zimmerman provides as follows regarding the distribution of trust principal: (2) Prior to division into shares pursuant to Paragraph (4), my Trustee may pay to or apply for the benefit of anyone or more of my said wife, children and issue such sums from the principal of the Bypass Trust in such shares and proportions as in its sole discretion shall be necessary or advisable from time to time for the medical care, education, support and maintenance in reasonable comfort of my said wife, children and issue, taking into consideration to the extent my Trustee deems advisable, any other income or resources of my said wife, children and issue known to my Trustee, considering that my wife is the primary object of my bounty. Any payment or application of benefits for a beneficiary pursuant to this Paragraph shall be charged against this Trust as a whole rather than against the ultimate distributive share of such beneficiary to whom or for whose benefit the payment is made. 3. The Last Will and Testament of Donald E. Zimmerman provides for the following appointment as Trustee: (2) I name as my Trustee Mellon Bank, N.A., Commonwealth Region. I direct that my Trustee, herein referred to as my Trustee regardless of number or gender, serve without bond in any jurisdiction in which called upon to act. Mellon Private Asset Management is a division of Mellon Private Banking, which assumed all fiduciary appointments of Mellon Bank, N.A. 4. We have met with Betty R. Zimmerman to discuss our proposed administration of the Bypass Trust, and have discussed her financial circumstances and those of her immediate family, which constitute the members of the class of eligible beneficiaries of the Bypass Trust. 5. Based on what we have learned of the financial circumstances and the current needs of Betty R. Zimmerman, and of her children and issue, and pursuant to the decedent's declaration that A...my wife is the primary object of my bounty...B, I would expect that periodic discretionary disbursements of whatever income is generated by the Trust would be made to Mrs. Zimmerman. 6. Similarly, in view of the assets, income and expenses of Betty R. Zimmerman, and of her children and issue currently known to us, I do not anticipate that it will be necessary to invade the principal of the Trust in order to make distributions to any of the class of beneficiaries during Mrs. Zimmerman's lifetime. ~Yvv~' 1SHARON M. GARCIA ASSISTANT VICE PRESIDENT MELLON PRIVATE ASSET MANAGEMENT Sworn and subscribed to before me, on this , 8 day of 9 (/,'1> u..OA."-F 2002. \--1J70vctlw\ d"'~ Notary Public My Commission expires: Notarial Seal Martha H. Heil, Notary Public Hamsbutg, Dauphin County My Commission Expires Feb. 4, 2002 MemT1er, Pennsylva"'<, A.sSOC\atlon of Nolanss -2- LAST WILL AND TESTAMENT OF DONALD E. ZIMMERMAN I, DONALD E. ZIMMERMAN, of 105 cockleys Drive, upper Allen Township, Mechanicsburg, Cumberland County, Pennsylvania, do hereby make this my Last Will and Testament, revoking any former wills and Codicils made by me. FIRST: I am married to Betty R. Zimmerman, and all refer- ences to my wife in this will are to her. I have two children: Kathy J. Myers (born June 11, 1953) and Connie M. Rehman (born June 10, 1955). These and any other children born to or adopted by my wife and me are described in this Will as "my children," or as "a child of mine." Any person born to or adopted by a child of mine is described in this will as "my issue." Provided, however, that no adopted person shall benefit hereunder unless the order or decree of adoption is entered before such adopted person attains the age of twenty-one (21) years. SECOND: I give my tangible personal property and all casualty insurance that I am carrying on said tangible personal property, to my wife, Betty R. zimmerman, or, if she does not survive me, I give said property to my children living at my death to be divided equitably between them as they may determine, or, if they are unable to agree, as my Executor shall determine, after considering the wishes of such children. I have complete confidence that my wife, my children or my Executor will honor UJ -1- any written instructions that I may leave with regard to said tangible personal property. Any such property not so distributed shall be sold, and the proceeds added to my residuary estate to pass as hereafter described. THIRD: I give, devise and bequeath the rest, residue and remainder of my estate, real and personal, to my wife. Should she not survive me, or to the extent that she, or her executor, trustee, attorney-in-fact, or other successor in interest, disclaims any interest, I give, devise and bequeath such rest, residue and remainder, or interest therein or portion thereof, to my Trustee, hereinafter named, IN TRUST NEVERTHELESS, to be held, administered and distributed for all purposes as part of the Bypass Trust. FOURTH: The Bypass Trust shall be held, administered and distributed as follows: (1) My Trustee shall pay to or apply for the benefit of anyone or more of my said wife, my children and my issue, until division into shares pursuant to Paragraph (4), all of the net income from the Bypass Trust in convenient installments in such shares and proportions as my Trustee in its sole discretion shall determine primarily for the health care, education, support and maintenance in reasonable comfort of my said wife, children and issue, taking into consideration to the extent my Trustee deems advisable, any other income or resources of my said wife, ~~~ <-~,/}- C -2- children and issue known to my Trustee, considering that my wife is the primary object of my bounty. (2) Prior to division into shares pursuant to Para- graph (4), my Trustee may pay to or apply for the benefit of any one or more of my said wife, children and issue such sums from the principal of the Bypass Trust in such shares and proportions as in its sole discretion shall be necessary or advisable from time to time for the health care, education, support and mainte- nance in reasonable comfort of my said wife, children and issue, taking into consideration to the extent my Trustee deems advis- able, any other income or resources of my said wife, children and issue known to my Trustee, considering that my wife is the primary object of my bounty. Any payment or application of benefits for a beneficiary pursuant to this Paragraph shall be charged against this Trust as a whole rather than against the ultimate distributive share of such beneficiary to whom or for whose benefit the payment is made. (3) upon the death of my said wife, the entire remain- ing principal of the Bypass Trust shall be divided into equal separate shares so as to provide one (1) share for each then- living child of mine, one (1) share for each deceased child of mine who shall leave issue then living and one (1) share to be divided between or among my grandchildren, per capita, with the issue of a deceased grandchild to take the deceased grandchild's share. The share provided for a living child of mine shall be ,!?lj -3- distributed to such child. The share provided for a deceased child of mine who shall leave issue then living shall be distrib- uted per stirpes to such issue. (4) If at the time of my death, or at any later time prior to final distribution hereunder, my said wife and all my issue are deceased and no other disposition of the property is directed by this Trust, then and in that event only, the then- remaining property of this Trust, together with any undistributed income, shall be divided and paid over and distributed to Mona- ghan Presbyterian Church, Dillsburg, Pennsylvania, without restriction as to use. FIFTH: If any share hereunder becomes distributable to a beneficiary who has not attained the age of thirty-five (35) years, then such share shall immediately vest in such benefici- ary, but notwithstanding the provisions herein, my Trustee shall retain possession of such share in trust for such beneficiary until such beneficiary attains the age of thirty-five (35) years, using so much of the net income and principal of such share as my Trustee deems necessary to provide for the proper health care, education, support and maintenance in reasonable comfort of such beneficiary, taking into consideration to the extent my Trustee deems advisable any other income or resources of such beneficiary or his or her parents known to my Trustee. Any income not so paid or applied shall be accumulated and added to principal. Such beneficiary's share shall be paid over and distributed to -4- ~ , such beneficiary upon attaining the age of thirty-five (35) years, or if he or she shall sooner die, to his or her executors or administrators. I recommend that my Trustee consider dis- tributing approximately one-third (1/3) of that portion of the principal of such beneficiary's share which my Trustee antici- pates will ultimately be paid to such beneficiary when the beneficiary reaches twenty-five (25) years of age, approximately one-half (1/2) of the remaining portion when the beneficiary reaches thirty (30) years of age, and the remainder when the beneficiary reaches thirty-five (35) years of age. My Trustee shall have with respect to each share so retained all the powers and discretions had with respect to the trusts created herein generally. SIXTH: Anything in this will to the contrary notwithstand- ing, no trust created herein shall continue beyond twenty-one (21) years after the deaths of one, the last to die of my issue living at the time of my death; and two, all issue, living at the time of my death, of the individual serving as President of the united states at my death and all issue, living at the time of my death, of said individual's five (5) immediate predecessors in said office; upon the expiration of such period, all trusts shall terminate and all the assets thereof shall be distributed to those beneficiaries (and in the same proportions) as are then entitled to receive the income therefrom. -5- A4:' ...;;- (/ SEVENTH: If any beneficiary and I should die under such circumstances as would render it doubtful whether the beneficiary or I died first, then it shall be conclusively presumed for the purposes of this my will that said beneficiary predeceased me; provided, however, that if my wife shall die with me as afore- said, I direct that my wife shall be conclusively presumed to have survived me. EIGHTH: (1) I name as my Executrix my wife, Betty R. zimmerman. If she is unable or unwilling to serve, I name as my Co-Executors my daughters, Kathy J. Myers and Connie M. Rehman. If either of my daughters is unable or unwilling to serve, the other shall serve alone. If both of my daughters are unable or unwilling to serve, I name as my Executor Mellon Bank, N.A., Commonwealth Region, 10 South Market Square, HarriSburg, Dauphin County, Pennsylvania. I direct that my Executor, herein referred to as my Executor regardless of number or gender, serve without bond in any jurisdiction in which called upon to act. (2) I name as my Trustee Mellon Bank, N.A., Common- wealth Region. I direct that my Trustee, herein referred to as my Trustee regardless of number or gender, serve without bond in any juriSdiction in which called upon to act. (3) Except as otherwise provided herein, if Mellon Bank, N.A., or any successor as herein defined should fail to qualify as Trustee hereunder, or for any reason should cease to act in such capacity, the successor or substitute Trustee shall -6- ~ o be some bank or trust company with trust powers, which successor or substitute Trustee shall be designated in a written instrument filed with the court having jurisdiction over the probate of my estate and signed by my wife. Following the death or incapacity of my wife, this power may be exercised by a majority of my children who have attained the age of eighteen (18) years, or if they fail to act, by the court having jurisdiction over the probate of my estate. The situs of the Trust may be transferred to the situs of any such successor or substitute Trustee by designation in the written instrument aforesaid. I direct that at least two individuals or a qualified bank or trust company with trust powers shall serve as my Trustee at all times. (4) For services as Executor and Trustee, my Executor and Trustee shall receive reasonable compensation. NINTH: (1) I give to any Executor and to any Trustee named in this will or any Codicil hereto or to any successor or substitute Executor or Trustee all of the powers enumerated in this will and all of the powers applicable by law to fiduciaries in the Commonwealth of Pennsylvania and in particular through the pennsylvania Probate, Estates and Fiduciaries Code, as effective and as in effect on the date hereof, during the administration and until the completion of the distribution of my estate, and until the termination of all trusts created in this will or any Codicil hereto and until the completion of the distribution of the assets of such trusts. I direct that all such powers shall -7- H..-- '/7 / .? be construed in the broadest possible manner and shall be exer- cisable without court authorization. (2) In determining the federal estate and income tax liabilities of my estate, my Executor shall have discretion to select the valuation date and to determine whether any or all of the allowable administration expenses in my estate shall be used as federal estate tax deductions or as federal income tax deduc- tions and shall have the discretion to file a joint income tax return with my wife. (3) If at any time any trust created hereunder (or any share thereof if the trust shall have been divided into shares) shall be of such value that, in the opinion of my Trustee, the administration expense of holding the assets contained therein in trust is not justified, my Trustee, in its absolute discretion, may terminate such trust and distribute the trust property to the person or persons then entitled to receive or have the benefit of the income therefrom or the legal representative of such person. If there is more than one income beneficiary, my Trustee shall make such distribution to such income beneficiaries in the proportion in which they are beneficiaries or if no proportion is designated in equal shares to such beneficiaries. (4) My Executor and Trustee are authorized and empowered to acquire and to retain, either permanently or for such period of time as my Executor or Trustee may determine, any assets, including the capital stock of any closely held -8- Mz y corporation, whether such assets are or are not of the character approved or authorized by law for investment by fiduciaries and whether such assets do or do not represent an overconcentration in one investment. (5) My Executor and my Trustee are authorized and empowered to disclaim any interest, in whole or in part, of which I, my Executor, or my Trustee, may be the beneficiary, devisee, or legatee, by executing an appropriate instrument (in accordance with section 2518 of the Internal Revenue Code of 1986, as amended, or such similar section as may then be in effect). (6) My Executor and Trustee are authorized and empowered to sell at public or private sale, or exchange, and to encumber or lease, for any period of time, any real or personal property and to give options to buy or lease any such property. Additionally, my Executor and Trustee are authorized and empowered to compromise claims, to borrow from anyone (including a fiduciary hereunder) and to pledge property as security there- for, to make loans to and to buy property from anyone (including a fiduciary or beneficiary hereunder); provided that any such loans shall be adequately secured and at a fair interest rate. (7) My Executor and Trustee are authorized and empowered to allocate property, charges on property, receipts and income among and between principal or income, or partly to each, without regard to any law defining principal and income. ~~ } -9- TENTH: No person who at any time is acting as a co-trustee (if any) hereunder shall have any power or obligation to partici- pate in or to exercise any discretionary authority that I have given to my Trustee to pay principal or income to such person, or for his or her benefit or in relief of his or her legal obliga- tions. Such discretionary authority shall be exercised solely by the disinterested co-trustee(s). ELEVENTH: No interest of any beneficiary under this Will, any Codicil hereto, or any trust created herein, shall be subject to anticipation or to voluntary or involuntary alienation. TWELFTH: All estate, inheritance, succession and other death taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property comprising my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid out of the residue of my estate, as if such taxes were expenses of administration, without apportionment or right of reimbursement. I authorize my Executor ~ -10- and Trustee to pay all such taxes at such time or times as deemed advisable. IN WITNESS WHEREOF, I have set my hand and seal on this my Last will and Testament this Ilf~day of ~ , 1.997. .auJj B FVn~ (SEAL) DONALD E. Z ERMAN SIGNED, SEALED, PUBLISHED, and DECLARED by DONALD E. ZIMMERMAN, as and for his Last Will and Testament, on the day and year last above written, in the presence of us, who, at his request, in his presence, and in the presence of each other, all being present at the same time, have hereunto subscribed our names as witnesses: /LcdL L. ~ ~ CJ. lA-/'-~- -ll- SELF-PROVING AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF GJJY\.~0A.C.l : : SS. : WE, DONALD E. ZIMMERMAN, and HEATH L. ALLEN , and SHAWN W. WEIS the Testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and that he had signed willingly (willingly directed another to sign for him), and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the will as witness and to the best of his or her knowledge the Testator was at that time eighteen (18) years of age or older, of sound mind, and under no constraint or undue influence. DO~ ~~~:;:;;ator /l~ L. ~___ Witness ( i VV /,~'_", ' ," L.\"/ c::::. ~- _m '/,---~ Witness witness Subscribed, sworn to, and ZIMMERMAN, the Testator, HEATH L. ALLEN SHAWN W. WEIS of ~l <c-t "",y , 1997. acknowledged before me by DONALD E. and subscribed and sworn to before me by , and I'-I-~ day , witnesses, this ~OJ\ ~\UJ { joktvJ-ifYV Notary Publ ic '- NOTARIAL SEAL MARJORIE L. JOHNSON, Notary Public City of Harrisburg, Dauphin county ~.Q~~_~~pires March 8, 1999 -12- IN THE MATTER OF THE EST A TE OF DONALD E. ZIMMERMAN, DECEASED : IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 2001-00697 INSTRUMENT OF DISCLAIMER THIS INSTRUMENT, made this t day of JF R. ZIMMERMAN (the "Disclaimant"), ,2001, by BETTY WIT N E SSE T H: THE CIRCUMSTANCES leading up to the execution of this Instrument are as follows: 1. Donald E. Zimmerman (the "Decedent"), a married man, died testate on April 19, 2001, and his wife, Betty R. Zimmerman, duly qualified as executor (the "Executor") of the Decedent's probate estate (the "Estate"). 2. The Decedent and the Disclaimant were co-owners, as tenants by the entireties, of a Mellon Bank certificate of deposit, account number 01107335 (the "Certificate of Deposit"). 3. The Decedent's Estate consists of 5,876.072 shares of the State Farm Growth Fund; 4,867.385 shares of the MPAM Large Cap Stock Fund; 16,631.131 shares of the MPAM Pennsylvania Intermediate Municipal Bond Fund, with accrued income of $489.45; and 13,426.40 shares of the DF Tax Exempt Money Market Fund, with accrued income of $26.40 (collectively, the "Probate Assets"). 4. Article THIRD of the Last Will and Testament of the Decedent, dated August 14, 1997 (the "Will") provides as follows; THIRD: I give, devise and bequeath the rest, residue and remainder of my estate, real and personal, to my wife. Should she not survive me, or to the extent that she, or her executor, trustee, attorney-in-fact, or other successor in interest, disclaims any interest, I give, devise and bequeath such rest, residue and -1- remainder, or interest therein or portion thereof, to my Trustee, hereinafter named, IN TRUST NEVERTHELESS, to be held, administered and distributed for all purposes as part of the Bypass Trust. 5. The Disclaimant desires to renounce, absolutely and forever, her survivorship rights with respect to the Certificate of Deposit. The Disclaimant understands that as a result of her renunciation, the Decedent's undivided one-half (112) interest in the Certificate of Deposit will pass into the residue ofthe Estate. 6. The Disclaimant desires to renounce, absolutely and forever, her bequest of the residue of the Estate of the Decedent. 7. The Disclaimant desires to retain her beneficial interest in the Decedent's Bypass Trust, which will receive the Decedent's undivided one-half(1I2) interest in the Certificate of Deposit, and all of the Probate Assets (after deductions for inheritance taxes and expenses of estate administration). 8. The Disclaimant desires to exercise the rights granted to her in Chapter 62 of the Pennsylvania Probate, Estates and Fiduciaries Code, 20 Pa.C.S. Sections 6201-6207, to disclaim, release, and renounce, absolutely and forever, any and all of her right, title and interest in and to her survivorship interest with respect to the Decedent's undivided one-half (112) interest in the Certificate of Deposit, and any and all of her right, title and interest in and to the residue of the Decedent's Estate. 9. It is the Disclaimant's intention that this Instrument shall constitute a "qualified disclaimer" under Section 2518 of the Internal Revenue Code of 1986, as amended, and applicable Treasury Regulations issued thereunder., NOW THEREFORE, the Disclaimant, intending to be legally bound hereby, for herself, - 2 - her heirs, personal representatives, successors and assigns, does, by these presents, hereby disclaim, release and renounce, absolutely and forever, any and all right title and interest in and to the Decedent's undivided one-half (112) interest in the Certificate of Deposit and the Probate Assets as identified above in Paragraphs 2 and 3 (which Paragraphs are incorporated herein by reference as if they were fully set forth); provided, however, that nothing in this Instrument shall modifY, diminish or affect the beneficial interest of the Disclaimant in and to such disclaimed property which thereby passes to the Bypass Trust under the Will. AND, the Executor hereby accepts this Instrument for the purposes expressed herein, so that the Decedent's undivided one-half (112) interest in the Certificate of Deposit shall pass to the residue of the Estate, and the residue of the Estate shall pass to the Bypass Trust, for the benefit of the Disclaimant and the Decedent's issue. IN WITNESS WHEREOF, and intending that this Instrument shall be delivered to the Executor and filed of record in the Office of the Register of Wills of Cumberland County, Pennsylvania, the Disclaimant has hereunder set her hand and seal to this Instrument on the date first above written. uiA/4/l1.~d/ WITNESS ' ,(~ Z~~..J BETTY R. MERMAN "Disclaimant" and "Executor" - 3 - COMMONWEALTH OF PENNSYLVANIA : ss. COUNTY OF CUMBERLAND On this, the G~ day of ~ ,2001, before me, the undersigned officer, personally appeared BETTY R. ZIMMERMAN, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. In witness whereof, I hereunto set my hand and official seal. ~;~LL NOTARIAL SEAL CYNTHIA J. RULE, Notary Public c. amp HI". Boro.. Cumberland Cou~ty 'JlJ~g.EfTlm~!!lQ~9~ Jan. 24. 2004 - 4- .' SIN:;I.E-T:n:'R = OF 'mUST I, Dft.....A\....~ Co? ~"""'~'ltM"~ of .~___c-w.A..~3:.e...L~u12G....l ~, hereby transfer to ~ NATIONAL BANK as trustee the property described in the annexed schedule to be held IN 'mlST as follows: I. Lifet:ilt'te Trust: OJring 1lTi lifet:ilt'te 1lTi trustee shall invest ani manage the property as a separate trust, ani make distributions as follows: A. Pavments: As much, even if all, of the net income ani priroipal as I may from t:ilt'te to tilna direct in writing shall be paid either to me or as I may specify; B. Balance: My remaining net i.nc:orre shall frem time to tilna be accumuJ.ated ani added to principal; however, C. Di=hilitv: If I am, in 1lTi trustee's opinion, disabled by advanced age, illness or other cause, as much of the net income ard principal as my tr.lStee may from time to t:ilt'te think desirable. for 1lTi or 1lTi depen:ient's welfare. comfort, support or !!l!Iergency needs shall be paid to either of us or applied directly for those purposes. II. Di"'""""ition at rw.th: Upon 1lTi death my trustee shall pay the then-remainin:] principal ani any undistributed net i.nc:cme to certain beneficiaries I nalre a supplemental benefici,a..-y schedule. If that schedule is net accepted by my trustee. or if the schedule is not in existence at 'lIrf death the principal ard income shall be paid to or in trust for such one or more persons or organizations on such terms as I may appoint by a will specifically referring to this power of appointment or, in default of appointment or insofar as it is not effective, to 1lTi personal representative for distribution as part of my estate. III. Riahts F-~-"""': I reserle the following rights, each of which may be exerciSed \</henever ani as often as I may wish: A. To Add: '!he right to add to this trust with assets acceptable to my trustee; ani B. To Revoke: '!he right by an inst.rurnent in writing - other than a will - to revoke or amen:i this deed ani the trust hereun::l.er in part or in \</hole. However, amendments must be approvEd by my trustee . 'N. Mana. '-'IL Previsions: I authorize my trustee: A. Retain/Invest: To retain ani to invest in all foms of real and personal property, including corm.:ll1 trust ~~,. ll\l.1tU;l1 eun:m ard money market deposit a=unts c...,erated or offered by my corporate trustee. or any affiliate of it, regardless of any limitations iJtp:lsed by law on investments by rrustees, or any principle of law concernin;r investment diversification; B. Comcromise: To compromise claims and to abardon property which, in my trustee's opinion, has little or no value; C. Borrow: To borrow from anyone, even if the lender is a trustee hereunder, and to pledge prcpert"/ as security for repayment of the fun::ls borrowed; D. Sell/T""5E!: To sell at public or private sale, to exchange or to lease for any period of time, arrJ real or personal property, an:! to give options for sales or leases; E. caoital O1anaes: To join in any merger, reorganization, voting- trust plan or other concerted action of security holders, an:! to delegate discretionary duties with respect thereto; F. Allocate: To allocate arrj property received or charge incurred to principal or income or partly to each, witheM; regard to any law defining principal and inccme; and G. Distribute: To distribute in cash or in Jdnd. These powers shall exterxi to all property at arrj time held by my trustee an:! shall continue in full force until the actual distribution of all such property. All p:owers, authorities, and discretion granted by this deed shall be in addition to those granted by law and shall be exercisalJle without court authori-zation. v. (', ... -'lSation: My corporate trustee sl".all receive c:c:mpmsation in a=rdance with its standard schedule of fees in effect while its services are perfotmed. VI. Sit.",. and Governin:r law: The situs of this deed shall be in Pennsylvania, and all questions as to the validity or effect of this deed or the aclll\ini.stration of the tnlst hereunder si'.all be governed by the law of Pennsylvania. Executed \?-, 0<:.. ~o'l!!.~"tl. , lS}i3.. .tl-JJ E r.....~ Witnesses: Q A 0 - 77-7. ~/~uJ 2 S'lM'E OF ss. a:mm OF On , 19_, before me, the Ul'ldersigned notazy public, personally appeared (a) ani in due form of law acknculedqed the foreqoirq iJ1strument to be his act arxi dee:i ani desired the saIl'e to be recorded as such. Witness Irrf hard ani notarial seal the day arxi year aforesaid. Notary Public My Colmlission Expires: !he foregoirq deed of trJst was delivered, and is hereby aooepted, in Pennsylvania, on \"3. OC""t"o ~'-1t.. , 19"-<\. By 3 SCHEIXJI..E RUJ:;Ht<W 'I'O IN THE 1INNEXED DEED OF 'mJST Dated ,19_ From , T1:uStor To cx::M1ONWEALTH NATIONAL BlINK, Trustee 4 "''' .... Mutual '~" Funds" State Farm VP Management Corp. May 21, 2001 Kathy J. Myers 1701 Creek Vista Dr. New Cumberland, PA 17070-2212 P.O. Box 219548 Kansas City, Missouri 64121 -9548 1-800-447-4930 RE: IRA Account #60067147 New #70290014 Donald Zimmerman IRA Dear Ms. Myers: I have been notified of the death of your father, Donald Zimmerman. Please accept my condolences. Our records show you as the primary beneficiary ofMr. Zimmerman's IRA. On the date of death, April 19, 2001, the Growth Fund of the above referenced account held 3,452.287 shares. The price per share was S~7.91 for a value of$165,399.07. Please note that the price per share can vary from day to day. Mr. Zimmerman was over 70 Yz and therefore required to take distributions from his IRA. The distribution for year 200 I has already been redeemed. If you wish to continue distributions for future years, based on your single non-recalculated life expectancy, please complete and return the enclosed IRA Systematic Withdrawal Plan form. These distributioD5 must begin no later than December 31, 2002. You may also elect to redeem all the shares in the above account. The shares need to be redeemed no later than December 3 I, 2002. I will need the enclosed Distribution Request form completed and returned by you. Before the shares in the account can be redeemed, we need a copy of the death cenificate certified by the appropriate local official. You may want to seek tax advice regarding your particular circumstances. If you have any questions, please write to the above address or phone 1-800-447-0740. Our hours are Monday through Friday between the hours of7:30 a.m. to 4:15 p.m. CST. Sincerely, '1<Cvv.-''''- '--L,,,G.U Karen Kroll Retirement Services Representative Enclosure State Farm Mutual Funds are not insurance oroducts and are offered by State Farm VP Management Corp" One State Farm Plaza. 8loomington, Illinois 617\0.0001, 1-800.447-4930. State Farm Insurance Companies STAT! FAIlM A INSUll....Nc;l , PO Box 8000 BALLS TON SPA NY 12020-8000 August 13, 2001 Donald Zimmerman 105 Cockleys Drive MECHANICSBURG, PA 17055-5808 Policy: SC-1505-2016 Annuitant: Donald Zimmerman POLICY STATUS The value of this policy on 4/19/01 was $246,715.35 n~&~ Jill Bennett L!H Admin Clerk III HPJE State Farm Life Insurance Company (Not licensed in New YOfk or Wisconsin) State Farm Life and Accident Assurance Company (Licensed in New York and Wisconsin) State Farm Insurance Companies STAn ,1.'_ A INSU.A.MU. May 15,2001 Betty Zimmerman Spacious Acres 105 Cockleys Drive Mechanicsburg, PA 17055-5808 ""nnsylvania Regional OffIce One Slate Farm Drive Concordville. Pennsylvania 19339-0001 Termination Payments Estate of Donald Zimmerman #38-2303 Dear Mrs. Zimmerman: The enclosed check #113 402S00A in the amount'ofSl;661.01 ~presents the April 30,2001 termination payment. In addition, we have received approval based upon the documents you provided to continue making monthly lifetime payments to you as follows: Survivor's Company662/3 Amount State Farm Mutual Auto Ins Company $ 925.27 State Farm Fire and Casualty Ins Company $ 227.19 State Farm General Insurance Company $ 11.33 State Farm Life Insurance Company $ 32.90 Total Monthly Payment $ 1,196.69 Sincerely, ~~~ c>-h~t(cer-- Robert Obergefell Accounting Manager RO/jm Fred Dannels egina Hines Corporate Accounting Benefits \,\~'i 11.) 2'U~' ~.~.'r\. HOME OFFICES: BLOOMINGTON. ILLINOIS 81710.0001 Annuity Factors Present Value Calculation of State Farm Insurance Extended Termination Payments to be paid to Betty R Zimmerman $1,196.69 per month, for life, commencing 5/1/2001. 8/3/2001 Transfer Date: 97520 Rate: Calculation Type: Aggregate Annual Payments: Payment Timing: Age: 4/2001 6.00% One Life $14,360 Begin 70 Annuity Factor: 8.4988 First Factor Subtotal Payment Value Annual: 1.0000 $122,043 $14,360 $136,403 Semiannual: 1.0148 $123,849 $7,180 $131,029 Quarterly: 1.0222 $124,752 $3,590 $128,342 Monthly: 1.0272 $125,362 $1,197 $126,559 Weekly: 1.0291 $125,594 $276 $125,870 Form 712 (Rev. 8-9-4) Ii!!IIII Uvlng Insured. (FOe Wdh United States Gift Tax Return, Form 709. May Be Filed Wdh United States Estate Tax Return, Form 706 or Form 706-NA, Where Decedent Owned Insurance on Life of Another) SECTION A. - Generallnlormallon Page 2 33 First name and middle initlal of donor (or decedent) 34 Last Name Oonald E Zimmerman Date of gift for which valuation data submitted ...............................................................,......... Date 01 decedent's death for which valuation data submitted................................................... SECTION B. - Policy lnlonmatlon 35 Social Security Number 196-14-1323 36 37 19-Apr-2001 38 Name of Insured Carotyn M Rehman Name and address of insurance company State Farm Life Insurance Company One State Farm Plaza Bloomington, lIIinois 61710 39 Sex Female 40 Date of Birth Q6-0ct-1987 41 42 Type of Policy 143 Policy Number 44 Face Amount 46 Issue Date Whole Life L431.Q945-9371 $50.000.00 07-Apr- 1988 46 Gross premium 47 Frequency of payment $149.50 Annual 48 Assignee's name 49 Date assigned Betty Zimmerman 60 If irrevocable designation of beneficiary made, name of 61 Sex 62 Date of birth. 63 Date designated beneficiary if known 54 If other than simple designation, quote in full. (Attach additional sheet if necessary.) 65 If policy is not paid up: a Interpolated terminal reserve on date of death, assignment or irrevocable designation of beneficiary.......... ........... .... . ............................... ................... ................................. $1 ,027.00 b Add proportion of gross premium paid beyond date of death, assignment or irrevocable designation of beneficiary ................... ....................................................................................... $144.58 c Add adjustment on account of dividends to credit of policy......................................................... $518.67 d Total (add lines a, b, and c)... ............................... ......................................................................... e Outstanding indebtedness against policy........................................ ..,.......................................................... ........... f Net total value of the polley (for gift or estate tax purposes) (subtract line e from line d)....................................... 56 If policy is either paid up or a single premium: a Total cost, on date of death, assignment or irrevocable designation 0; benefICiary. of a single-premium policy on life of insured at attained age, for original face amount plus any additional paid~up insurance (additional face amount $ 0.00) (If a single premium policy for the total face amount would not have been issued on the life of the insured as of the date specified, nevertheless, assume that such a policy could then have been purchased by the insured and state the cost thereof, using for such purpose the same formula and basis employed, on the date specified, by the company in calculating single premiums.) b Adjustment on account or dividends to credit of policy .............................................................. c Total (add lines 560 and 56b)....................................................................................................................... d Outstanding indebtedness against policy .............................. ................................................................................ e Net value of policy (for gift or estate tax purposes) (subtract line S6d from line S6c).......................................... The undersigned officer of thQ abO"e.named insurance company nereby certifies thattl'lis statement $4l!ts forth true and correct information Signature: ~ CV . "\.,l- ~ ~0-~'"V Title: AssociateActuary Date ol Certification: ~) Ilclc I Form 112 (RIIY. 8-94) ... Uving Insured (File With United States Gift Tax Return. Form 709. May Be Filed With United States Estate Tax Return, Form 706 or Form 706-NA, Where Decedent Owned Insurance on ute ot Another) SeCTION A. - General Information Page 2 33 35 Social Security Number 196-14-1323 First name and middle initial of donor (or decedent) 34 Last Name Donald E Zimmerman Date of gift for which valuation data submitted ......,.......................h......................,.................. Date of decedenrs death for which valuation data submitted................................................... SECTION B. - Policy Information 36 37 19-Apr-2oo1 38 Name of Insured Ryan B Rehman Name and address of insurance company State Farm Life Insurance Company One State Farm Plaza Bloomington, Illinois 61710 38 Sex Male 40 Date of Birth 29-Nov-1989 41 42 Type of Policy 143 PoUcy Number 44 Face Amount 45 Issue Date Whole Ufe L431-1071-6400 $50.000.00 02-Jan-1990 46 Gross premium 47 Frequency of payment $169.50 Annual 48 Assignee's name 49 Date assigned Betty Zimmerman 50 If irre'iocable designation of beneficiary made, name of 51 Sex 52 Date of birth, 53 Date designated beneficiary if known 54 If other than simple designation, quote in full. (Attach additional sheet if necessary.) 55 If policy is nol paid up: a Interpolated terminal reselVe on date of death, assignment or irrevocable designation of beneficiary.... ............... ..................................................................................... $1,123.00 b Add proportion of gross premium paid beyond date of death, assignment or irrevocable designation of beneficiary......................................... ......................... ............................. $119.35 c Add adjustment on account of dividends to credit of policy......................................................... $474.46 d Total (add lines a, b, and c)................................. ................................ ........................................................ e Outstanding indebtedness against policy..................... .......................................................................................... f Net total value of the policy (for gift or estate tax purposes) (subtract Une e from line d)....................................... 56 If policy is either paid up or a stngle premium: a Total cost, on date of death, assignment or irrevocable designation of beneficiary, of a single-premium policy on life of insured at attained age, for original face amount plus any additional paid-up insurance (additional face amount $ 0.00) (If a single premium policy for the total face amount would not have been issued on the life of the insured as of the date specified, nevertheless, assume that such a policy could then have been purchased by the insured and state the cost thereof, using for such purpose the same formula and basis employed, on the date specified, by the company in calculating single premiums.) b Adjustment on account of dividends to credit of policy... .......................................................... c Total (add lines 56a and 56b)................................................................................................................... d Outstanding indebtedness against policy.................... ......................,... ............... ,........................ ....... ................. e Net value of licy (for gift or estate tax purposes) (subtract line 5ed from line 56c).......................................... TtuJ undersigned officer of th9 abo..,.named insuranc?I company hereby certifies that this statement sets forth true and correct information. / Signature: 'J) ~-V ^<l-<l. k: S,-k~L,^,-, c.... Tille: AssociateActuary DateofCertmeat;on: 211D/0 ( Form 712 (Rev. S.94) mill Uving Insured (File With United States Gift Tax Return, Form 709. May Be Filed With United States Estate Tax Return, Form 706 or Form 706-NA, Where Decedent Owned Insurance on Life of Another) SECTION A. - GenerallnfonnaliQn Page 2 33 35 Social Security Number 196-14-1323 First name and middle initial of donor (or decedent) 34 last Name Donald E Zimmerman Date of gift for which valuation data submitted .....,.................................................................., Date of decedenfs death for which valuation data submitted................................................... SECTION B. - PQllcy InlQnnatiQn 36 37 19-Apr-2001 38 Name of Insured Brooke M Rehman Name and address of insurance company State Farm Life Insurance Company One state Farm Plaza Bloomington, Illinois 61710 38 Sex Female 40 Date of Birth 04-Aug-1994 41 42 Type of Policy 143 Policy Number 44 face Amount 46 Issue Date Whole life N431-1379-9169 $50,000.00 Q6.0cl-1994 46 Gross premium 47 f~uency 01 payment $170.00 Annual 48 Assignee's name 48 Dale asslgned Betty Zimmerman 50 If irrevocabte designation of beneficiary made, name of 51 Sex 52 Date of birth, 53 Date designated beneficiary il known 54 If other than simple designation, quote in full. (Attach additional sheet if necessary.) 55 II policy is not paid up: a Interpolated terminal reserve on date of death, assignment or irrevocable designation 01 beneficiary. .......... . ............... ...... ............. ........... ........ ........... ............... ................................ $576.00 b Add proportion of gross premium paid beyond date of death, assignment or irrevocable designation of beneficiary..... ...................................................................................................... $79.18 c Add adjustment on account of dividends to credit of policy............................................... $149.08 d Total (add lines a, b, and c)........................................................................................................................... e Outstanding indebtedness against policy ......................................................................,.......... ....... ........................ f Net total value of the policy (for gift or estate tax purposes) (subtract line e from line d)....................................... 56 If policy is either paid up Of a single premium: a Total cost, on date of death, assignment or irrevocable designation of beneficiary, of a single-premium policy on life of insured at attained age, for original face amount plus any additional pald~up insurance (additional face amount $ 0.00) (If a single premium policy for the total face amount would not have been Issued on the life of the insured as of the date specified, nevertheless, assume that such a polley could then have been purchased by the Insured and state the cost thereof, using for such purpose the same formula and basis employed, on the date specified, by the company in calculating single premiums.) b Adjustment on account of dividends to credit of policy.............................................................. c TQtal (add linea 560 and 56b)....................................................................................................................... d Outstanding indebtedness against policy........ .......... .......................................u........................ ........................... e Net value of policy (for gift or estate tax purposes) (subtract line S6d from line S6c).......................................... The undersigned officer of the abOve-named insunmce compan'i hereby certifies that thls statement sets forth true and correct information. Signature: j) c-t' G ,; C~ )( 5fu"~"r'--' Title: Aaaociate Actuary Date QI CertificatlQn: 5'//0 It, I @ Mellon Mellon Private Asset Management" 6 August, 2001 Bridget M. Whitley, Esq. Keefer Wood Allen & Rahal PO Box 11963 Harrisburg, PAl 71 08-1963 Re: Donald E. Zimmerman TR #10172398BN8 Dear Bridget; Thanks for the notice regarding this estate. I will need the following items for termination: . Death Certificate . Short Certificate . Instructions for transfer offunds to the Estate Account. . Estate Tax Identification Number In the meantime I have sold the assets in the trust and will have the "Estate" sign release documents to close the trust. I will send these to you for review if you like. A copy of the June 30, 2001, statement is enclosed. The trust was valued as of date of death as follows DF Tax Exempt Money Market $ 13,426.40 MPAM Large Cap Stock Fund $ 51,64295 MPAM PA Intermediate Muni Bond Fund $212,545.85 Accrued Income to D.O.D. $ 51585 Total Value at D.O D. $278,13105 If you need any additional information at this time please do not hesitate to call me at (717) 780-3016. Very truly yours; ~ Assistant Vice President Enclosures COInmoflwclIlth Region 12th fluor. 2 t'. Second Street. PO. Box lOW . Harrisburg, PA 17108-1010 (717l 231-7465 Office A .lll'lloJl Fil!ulIcial Compan\' ,',I 717 231 6509 AUG 10 2001 11'38 FR MELLON,HBG TRU5T DEPT717 231 6509 TO 92558050 P.01/01 Accrued Income to D.O.D. Donald E. Zimmerman Tr. #10172398BN8 Income Balance at 0.0.0. $ Accrued Interest on: OF Tax Ex. M.M. M~AM ~A Inter Muni Fd Total Accrued Interest $ 26.40 $ 469.45 $ 515.65 Total Accrued Income $ 515.85 FAX MemO T.~~:t (~ C(II pt.: FAX Number: :2"1'1>' 'lfJd) COUlJll_ta: No. 01 "'9.' -1 ((ib Mellon Ba~k Fro.." .;) lAo.A.01 !2/1)\.llJ- _ COJDopl., l FAXl'iI_r. Ii PhODe NlUDber: i ** TOTAL PAGE.01 ** State Farm Insurance Companies STATE ,""Rolli A auu....Ncl . PO Box 8000 BALLSTON SPA NY 12020-8000 August 13, 2001 Betty R Zimmerman 105 Cockleys Dr MECHANICSBURG PA 17055-5808 State Farm Regional Office PO Box 8000 BALLSTON SPA NY 12020-8000 policy: LF-1087-8950 Annuitant: Owner: Betty R Zimmerman Betty R Zimmerman POLICY STATUS The value of this policy on 4/19/01 was $46,124.80 ~ Jill Bennett L/H Admin Clerk III Agent: Walter Harg~aves Ph. 717-766-6385 HPJE PS 38-6156 State Farm Ufe Insurance Company (Not licensed in New Yoek. Of Wisconsin} State Farm Ufe and Accident Assurance Company (Licensed in New York and Wisconsin) sU.n F"'RM State Farm Insurance Companies A UUU....NCE . PO Box 8000 BALLSTON SPA NY 12020-8000 August 13, 2001 Betty R Zimmerman 105 Cockleys Dr MECHANICSBURG PA 17055-5808 State Farm Regional Office PO Box 8000 BALLS TON SPA NY 12020-8000 Policy: LF-13 93 - 9452 Annuitant: Owner: Betty R Zimmerman Betty R Zimmerman POLICY STATUS The value of this policy on 4/19/01 was $10,878.13 r2u-A...- ~v~ Jill Bennett L/H Admin Clerk III Agent: Walter Hargraves Ph. 717-766-6385 HPJE PS 38-6156 State Farm Life Insurance Company (Not licensed in New York Of Wisconsin) State Farm Ufe and Accident Assurance Company (Licensed in New York and WiSConsin) i. TRANS AMERICA . ANNUITY ADMINISTRATION Administrative Office: 4333 Edgewood Road NE Cedar Rapids~ Iowa 52499-0001 M ailing Address: P.O. Box 3183 Cedar Rapids, Iowa 52406-3183 September 14, 2001 Betty R Zimmerman c/o Keefer Wood Allen & Rahal POBox 11963 Harrisburg PA 17108-1963 RE: Annuity Policy Number(s) 26140734 Dear Betty R Zimmerman: Our office has received your request concerning the above listed non- qualified tax deferred annuity. We have been notified that the annuitant, Donald E Zimmerman, is deceased. Please accept our company's sincere condolences for your recent loss. This annuity currently reflects the following information: Annuitant: Owner (s) : Primary Beneficiary(-ies) Policy Date: Today's Full Value: Taxable Portion: Death Value as of 04-19-2001: Donald E Zimmerman Donald E Zimmerman Betty R Zimmerman 11-06-2000 $122,823.42 $8,469.52 $41,238.77 As primary beneficiary of this annuity, you have a variety of options for death claim processing. Receiving the funds through a death claim in a lump sum payment would be the first option. The interest portion will be reported as a taxable distribution, and the following January you will receive a Form 1099-R reporting this distribution. If you would like to choose this option, we will need the following: · Certified copy of the death certificate . Original policy . Annuity Claimants Statement Your second option would be to delay the lump sum payment for up to five (5) years from the date of death. To complete the claim, you will be responsible for notifying the company prior to the end of the fifth year. It is important to note that you may not redesignate a beneficiary under this option. In the event of your death, any Transamerica Assllrance Compan:, Trans3mcrica Life [murance and Annuity Company Transarncrica Occidental Lift: Insurance Company ~~~ t... REV-1'OO EX +(6-00) OFFICIAL USEONL Y '" REV-1500 :1 COMMONWEALTH OF PENNSYLVANIA / {.., - d'l~ - DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 2001 0697 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Zimmerman, Donald E 196-14-1323 DECE- DATE OF DEATH (MM-DD-YEAR) [ DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE DENT 04/19/2001 01/03/1926 WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Zimmerman Bettv R 190-26-6205 3. Remainder Return CHECK ~ ' "'om "~m ~' '"~__m ~ (date of death prior to 12-13-82) APPRO- 4. Limited Estate 4a. Future Interest Compromise 5. Federal Estate Tax Re1urn Required (date of death atter 12-12-,62} PRIATE 6. DececlentOiedTestate 7. Decedent Mamtalned a living Trust 8. Total Number of Safe Deposit Boxes (Attach copy of Will) (Attach acopyof Trust) BLOCKS 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death between 0" Election to taxunderSeC,9113(A\ 12-31-91 and 1-1-95) (Attach Sch 0) THIS SECTION MUST BE COMPLETEO, ALL CORRESPONDENCE S. CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS COR- Bridaet M. Whitlev P.O. 11963 RE- Box SPON FIRM NAME (If Applicable) Harri.sburg, PA 1710B-1963 DENT Keefer Wood Allen & Rahal LLP TELEPHONE NUMBER 717-255-B027 . .' 0.00 OFFICIAL USE ONLY ,. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3,331.65 . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 0.00 4. Mortgages & Notes Receivable (Schedule D) (4) 0.00 -.." 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 0.00 6. Jointly Owned Property (Schedule F) o Separate Billing Requested (6) 0.00 RECA- PITULA- 7. Inter-Vivos Transfers & Miscellaneous TION Non-Probate Property (Schedule G or L) (7) 0.00 8. Total Gross Assets (total Lines 1-7) (8) 3,331. 65 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 0.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (1 0) 0.00 11. Total Deductions (total Lines 9 & 10) (11) 0.00 12. Net Value of Estate (Une 8 minus Line 11) (12) 3,331.65 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax (13) 0.00 has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Une 13) (14) 3,331.65 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amount o~ Une 14taxable a11he spousal 1a)( rate, or transfers under Sec. 9116{a)(1.2} 1,699.14 x.OO (15) 0.00 - TAX 16. Amountof line 14 taxable at lineal rate 1,632.51 X.045 (16) 73.46 - COMPU- 17. Amountof Line 14taxableatsibling rate 0.00 X .12 (17) 0.00 TATlON 18. Amountof Line 14 taxable at collateral rate 0.00 X .15 (18) 0.00 19. Tax Due (19) 73.46 20. 0 I CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT I >> BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND RECHECK MATH<< o PA15001 NTF 29755 Copyrigh12DCrO Gre<ltlandlNelco LP- Forms Software Only PA R~-1500 EX (6-00) Decedent's Complete Address: I STREET ADDRESS 105 Cockleys Drive I CITY Mechanicsburq Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Page 2 I STATE PA I ZIP 17055 (1) 73.46 0.00 0.00 0.00 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E Penalty 0.00 ~_ __~___ ~__~ 0 . 00 Totallr.~erestJPenalty (D ~ E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 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. A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (3) 0.00 (4) (5) 73.46 (SA) 2.85 (5B) 76.31 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred; b. retain the right to designate who shall use the property transferred or its income; c. retain a reversionary interest; or. d. receive the promise for life of either payments, benefits or care? 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN. -Onder 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 information of ~hich preparer has any knowledge. _,_,____, ________~_ SIGf-,{A iU OF PERSON ESPONSiBlE r-QA ;:'lllNG RETURN "4~ ~______ Cockleys Drive Me hanicsburg, PA 17055 ATURE OF PREPARER OTHER THAN REPRESENTATIVE >>to f:J+Ut. ~DDRESS eefer Wood Allen & Rahal, LLP P.O. Box 11963 Harrisburg, PA 17108-1963 Yes No ~ I 8 ~ o :8J DAI~ III/'. /" ~~----- I Fo.r dates of death all arafterJuly 1, 1994and before January 1, 1995,the tax ratfl imposed on tile nBt "alue of transf"'Tsta artarthe use af the sUf"iving spo.use is 3% 172P.S.I 9116(a)(1.1)(i)]. For dates 01 death o.n oratter January 1, 1995,tl1e tax rate is ilTIpo:;ed Qllthenatvalue af transfers to arffJftheuse of the surviving spouse isO%[72 P.S. g9116(a)(1.1)(iil1. The statute daes no.t exempt a transfer to a slll"wing spollse trom tax, and the statutory requirements for disclosure of assets and filing a tax return are still <,pplicable even if thesllrvivingspauseistl1eo.nlybenefici,uy. FordatesafdeathanorafterJuly1,2000: Ih",taxratelmposedo.nthenetvalueo.ftransfersfromadeceasedcbildtwenty-oneycarsofageoryo.ungeratdeathtoartortheuseofanaturai parant, an adoptive parent, ar astepparent af tbe child is 0% [72 P.S. g9116(aX1.2)]. The tax rala imposed on the net value of tranEf<<lrEto or tOI the '.lEe af the decedent's Ij"eal beneficiaries is 4.5%, except as nated in 72.P.S. g 9116(1.2) [72 P.S. 11 91 16(a){1)j The tax rate imposed all the net value o.t transfers to 01' for the use af the decedent's siblings is 120/0 [72 P.S. !i 9116(a)(1.3)]. A sibling is defined, under Sectio.n 9102, as an individual who has at least one parent in COlTImon with the decedent, whether by blo.od aradoptian. o PA15002 NTF 29756 Copyright 2000 GreatlandlNe\co lP - Forms Saftware Only REV-1,03 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Zimmerman, Donald E SCHEDULE B STOCKS & BONDS FILE NUMBER 21-2001-0697 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NO. 1. 95 Shares John Inc. valued at DESCRIPTION Hancock Financial Services, $35.07 per share VALUE AT DATE OF DEATH 3,331. 65 NTF33300 TOTAL (Also enter on line 2, Recapitulation) $ (If more space IS needed, insert additional sheets of the same size) o PA15031 Copyright 2000 GreatlandlNelco LP - Forms Software Only 3,331.65 Attachment to Supplemental Inheritance Tax Return Estate of Donald E. Zimmerman 196-14-1323 The Executor recently discovered the existence of 95 shares of John Hancock Financial Services, Inc. stock, with a date of death value of$35.07 per share, for a total value of $3,331.65. These shares will form part of the residue of the estate, and will pass to a trust for the benefit of decedent's spouse and children. Pursuant to the previously approved future interest compromise, 51% of the value of the trust is taxed at the spouse's rate of 0%, and 49% of the value of the trust is taxed at the lineal rate of 4.5%. The tax was due on January 22, 2002 (January 19 was a Saturday, January 20 was a Sunday and January 21 was a legal holiday for state and county offices). The interest has been calculated on the daily rate of .000164 times 237 days (through October 18, 2002).