HomeMy WebLinkAbout06-22-05
REV-1500 EX (6-00)
OFFlClAL USE ONLY
.
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
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COUN1Y CODE
-.9L 0433 ___
YEAR NUMBER
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DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Newcomb Kath n
DATE OF DEATH (MM-DD-YEAR) DA1E OF BIRTH (MM-DD-YEAR)
2/19/2005 3/25/1912
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
T
SOCIAL SECURJTY NUMBER
156-38-3117
THISRETURH MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOC~LSECURnYNUMBER
Decedent Died Testate (Attach copy of 'N1U)
litigation Proceeds Received
o 2. Supplemental Return D '3. Remainder Return (elate of eleath priorto '2-13-82)
o 4a. Future Interest Compromise (dale of death efter 12-12-82) D 5. Federal Estate Tax Return Required
[i] 7. Decedent Maintained a Living Trust (Attach copy of Trust) L 8, Total Number of Safe Deposit Boxes
o 10. Spousal Poverty Credlt \1I"t~ n\ lIealh belwun 12.31-91 "'" 1-1-95) D 11. Elect\on to tax under Sec. 9113(A) (Att$ch SchO)
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limited Estate
Original Return
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THIS SECTION MUST BE COMPLETEO, ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPlEiE MA1UNG ADDRESS
oner, CPA 5006 E Trindle Road
& Daub
Mechanicsburg, PA 17050
717-506-1222
1. Real Estate (Schedule A)
(1)
(2)
OFF\C\Il,lUSE ONl"f
2, Stocks and Bonds (Schedule B)
c,
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
.. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E) (5)
Z 6. Jointly OlNlled Property (Schedule F) 16)
0 D Separate Billing Requested
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~ 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
:J (Schedule G or L)
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n: 8. Total Gross Assets (total Lines 1-7)
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LU 9. Funeral Expenses &. Administrative Costs (SchedUle H) (9)
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10. Debts of Decedent, Mortgage Liabilities, & Liens \Sct\~I:l\lle I) (10)
11. Total Deductions (lotal Lines 9 &. 10)
674,530
(13)
16,545
657,985
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(11)
12. Net Value of Estate (Line B minus line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
(12)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(1')
657,985
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a){1.2)
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17. Amount of Line 14 taxable at sibling rate
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647,986
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10,000
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x .0 ~(16)
x .12 117)
x .15 (18)
(19)
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29,159
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16. Amount o'f line 14 taxable allinea! rate
19. Tax Due
1,500
30,659
18. Amount ofllne 14 taxable at collateraJ rate
20
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CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
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Decedent's Complete Address:
S1REET ADDRESS
~~5 Mefsiah Circle
Cumberland
CITY
Mechanicsburcr
ISTA1E
PA
I ZIP
17055-
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. CreditslPayments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
30.659
o
27.000
1.421
Total Credits (A + 6 + C) (2)
28.421
3. Interest/Penalty if applicable
D. Interest
E. Penalty
o
o
TotallnteresVPenalty (D + E) (3)
o
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 (4)
o
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
2.238
A. Enter the interest on the tax due. (SA)
o
6. Enter the total of line 5 + SA. This is the BALANCE DUE. (56)
Make Check Payable to: REGISTEROFWILLS,AGENT
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2.238
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? . . . . . . . . . . . . . . . . . . . . . . . . . . .. (XJ
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? D
4. Did decedent awn an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designatjon? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D []a
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 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, corract and complete
Declaration of preparer other than the personal representative is based on atiO() of which prep has any knowledge
Yes
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No
IGNATURE Of PERSON RESPONSIBLE FOR FILING R
Peter E Newcomb
ADDRESS
8707 182nd Street E
SIGNATURE OF PREPARER 01HER 1HAN REPRESENTA
Ti.moth C Wa oner, CPA
ADDRESS
Paya1lup, WA 98375-6240
DA
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Mechanicsburg PA 17050
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For dates 01 death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S, ~ 9916 (a) (1.1) (i)].
For dates of death 01'1 or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~ 91 16 (a) (1,1) (ii)]
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after Jufy 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 OTfor the use of a natural p~ren\, an adoptive parent,
or a stepparent ofthe chiid is 0% [72 P,S. ~ 9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedellt's lir'oea\ beneficiaries \s 4.5%, except as noted in 72 P,S. S 9116{1.2) 172 P.S. ~9' 16(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. 99116(a)(1.3)] A sibling is defined, under Section 9102, as an
individual who has at least olle parent in common with the decedent, whether by blood or adoption,
3W46461QOO
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LAST WILL . AND TESTAMENT
I, Kathryn T. Newcomb, now of the Borough of
Lemoyne, Cumberland County, Pennsylvania, being of sound
mind, make this will, hereby revoking all my former wills
and codicils.
PAYMENT OF DEBTS AND FTJNF:8AL CLA1JSF.
FIRST: I direct the payment of my just debts and
funeral expenses, the expenses of my last illness and the
expenses of administering my estate be paid out of my
estate. In addition, during my lifetime, I have made
arrangements for my body to be cremated upon my death, and
the remains to be inserted in the Fairview Cemetery, in
Westfield, New Jersey, with the remains of my late beloved
husband, M. Edgerton Newcomb, Jr.; and I confirm my desire
for such arrangements to be followed.
EXECUTOR AND SUCCESSOR
SECOND: I appoint my son Peter E. Newcomb as executor
of this will. If Peter E. Newcomb is unable or unwilling to
act or continue as executor, for any reason whatsoever and
whether before or after my death, I appoint my daughter,
Mary N. Parker as successor executrix.
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DISTRIBUTION OF REAL PROPERTY AND RF,SIDlJAL REAL AND PERSONAT,
PROPERTY AND POUR OVF.R '1'0 REVOCABLE INTF.RVIVOS TRUST
THIRD: Any residual real or personal property deemed
not to have been transferred to my Revocable Intervivos
Trust shall nevertheless pour over from this my Last Will
and Testament into the Trust for disposition under the
Newcomb dated the
Revocable Intervivos Trust of Kathryn T.
t-d
a3 - day of November, 1994, as amended
provisions of the
at any time prior to my death, or, if said Trust is no
longer in effect, to hold In Trust or be distributed on the
terms and conditions specified in said Trust Agreement or
its schedules or attachments on the date of this Will or of
the last Codicil hereto, with like effect as if they were
set forth herein verbatim.
DISTRIBUTION OF' PERSONAL OR REAr, PROPERTY TO MINORS
FOURTH: Any such property to which a minor would
otherwise become entitled but which the executor thinks
unsuitable for such minor shall be held in safekeeping by
the guardian or shall be sold and the proceeds thereof shall
be distributed to the guardian of the estate of such minor
hereinafter named, without bond, and the receipt of such
guardian shall be a complete release of the executor. Any
such property to which a minor thus becomes entitled may be
delivered to the guardian named herein, without bond, and
the receipt of such person shall be a complete release of
the executor.
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)
In case of disagreement among my children, the executor
is authorized to make the division having due regard for the
personal preferences of my heirs, but making such division
in as nearly equal shares as the executor deems practical.
I direct that the expense of packing, shipping,
insuring and delivering any such property to a beneficiary
entitled thereto shall be paid by the executor as an
administrative expense of my estate. In addition, to the
extent practical in the executor's sole discretion, I
bequeath any policy of insurance on such property to the
beneficiary to whom such property is bequeathed.
C:;UARDTANSHIP CLAUS?
FIFTH: If any beneficiary of my estate is under the
age of 18 years at the time at which distribution of any
property devised and bequeathed by this will would otherwise
be made to such beneficiary, the executor shall distribute
all such property to the guardian of the estate of such
beneficiary hereinafter named, or to the natural guardian of
said beneficiary, at the sole discretion of hereinafter my
named guardian of the estates of any minor beneficiaries.
The guardian shall hold, manage, invest and reinvest
the property, shall collect the income thereof, and shall
apply so much of the net income and, if the net income is
insufficient, so much of the principal of the property held
for such beneficiary as the guardian shall deem necessary or
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advisable for such beneficiary's health, maintenance,
support and education.
The guardian shall accumulate any surplus net income
annually and add the same to the principal of the property
held for such beneficiary. No interest in income or
principal shall be assignable by a beneficiary or available
to anyone having a claim against a beneficiary before actual
payment to the beneficiary.
When such beneficiary attains the age of 18 years, the
guardian shall distribute to such beneficiary all property
held by the guardian for such beneficiary.
If such beneficiary dies before attaining the age of 18
years, the guardian shall distribute to the personal
representative of such beneficiary's estate all property
held by the guardian for such beneficiary.
POWERS CI,AlTSE
SIXTH: No fiduciary under this will shall be required
to give bond or other security for the faithful performance
of the fiduciary's duties.
Any such fiduciary shall have the following powers, in
addition to those given by law:
To invest in, accept and retain any
real or personal property, including stock of
a corporate fiduciary or its holding company,
without restriction to legal investments;
To sell, exchange, partition or lease
for any period of time any real or personal
property and to give options therefore for
cash or credit, with or without security;
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To borrow money from any person
including any fiduciary acting hereunder, and
to mortgage or pledge any real or personal
property;
To hold shares of stock or other
securities in nominee registration form,
including that of a clearing corporation or
depository, or in book entry form or
unregistered or in such other form as will
pass by delivery;
To engage in litigation and
compromise, arbitrate or abandon claims;
To make distributions in cash, or in
kind at current values, or partly in each,
allocating specific assets to particular
distributees on a non-pro rata basis, and for
such purposes to make reasonable
determinations of current values;
To make elections, decisions,
concessions and settlements in connection
with all income, estate, inheritance, gift or
other tax returns and the payment of such
taxes, without obligation to adjust the
distributive share of income or principal of
any person affected thereby;
To payoff any loans I may have taken
against any life insurance policies owned by
me that remain unpaid at the time of my
death; and
To retain uninvested cash, in such
amounts and for such period of time as the
fiduciary shall deem advisable for the proper
administration of the property.
PROVISION FOR TAXF.S
SEVENTH: All estate taxes, inheritance taxes, transfer
taxes and other taxes of similar nature payable by reason of
my death to any government or subdivision thereof upon or
with respect to any property subject to any such tax, and
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any penalties thereon, shall be paid by the executor out of
the principal of that portion of my estate disposed of by
any ARTICLE of this will, and all interest with respect to
any such taxes shall be paid by the executor out of the
income or principal or partly out of the income and partly
out of the principal of such portion of my estate, in the
absolute discretion of the executor, without reimbursement
from or apportionment among the beneficiaries, recipients or
owners of such property for any such taxes, penalties or
interest; provided, however, that the executor shall not pay
any such taxes, penalties or interest attributable to any
property included in my estate solely because of a power of
appointment thereover which I possess but have not exercised
or any transfer subject to generation-skipping transfer tax.
INTERCHANGEABILITY OF LANG1JAGF: AND HEADINGS
EIGHTH: Any term used in the singular or plural, or in
the masculine, feminine or neuter form, shall be singular or
plural, or masculine,. feminine or neuter as a proper reading
of this will may require. The words child or children shall
include stepchild or stepchildren. The headings used in the
various paragraphs of this will are included for convenience
only and shall have no legal significance.
GOVERNING LAW
NINTH: Questions pertaining to the validity,
construction and powers created under this will shall be
6
.y:r; JI. ini tials
determined in accordance with the Laws of the Commonwealth
of Pennsylvania.
PRF,F,MPTION
TENTH: The terms of my Revocable Intervivos Trust
shall supersede, take precedent over, preempt and prevail
over the provisions of this my Last will and Testament.
IN WITNESS WHEREOF I have hereunto set my hand and seal
-'
this my will comprised of seven pages this ;} j - day of
~
, 1994.
Ka~~w~4U~EAL)
Signed, sealed, published and declared by the above-
named Kathryn T. Newcomb, as and for her last will, in the
presence of us and each of us, who, at her request and in
her presence and in the presence of each other, have
hereunto subscribed our names as witnesses thereto the day
and year last above written.
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COMBINED ACKNOWLEDGMENT AND AFFIDAVIT
Commonwealth of Pennsylvania
County of Cumberland
ss:
-r We, ~ts; T. Newcomb, the t statrix in,
IGrf'2.<:::;O ,J. sa and . 0
witnesses to the last will, in the attac ed or for
instrument, who have signed the instrument, havin
qualified according to law do depose and say:
, the
oing
been duly
(a) that I, the testatrix, do hereby acknowledge that I
signed and executed the instrument as my last will, that I
signed it willingly and as my free and voluntary act for the
purposes therein expressed; and
(b) that we, the witnesses, were present and saw the
testatrix sign and execute the instrument as her last will,
that she signed it willingly and executed it as her free and
voluntary act. for the purposes therein expressed; that each
of us in the hearing and sight of the testatrix signed the
will as a witness and that to the best of our knowledge the
testatrix was at that time 18 or more years of age, of sound
mind and under no constraint or undue influence.
Notarial Seal
ThomaS M. Devin. NotaIy PubfKJ
Camp Hm Boro, CUmbel\ard Count'{
My Conm'1isSon Expires Sepl22, 1997
. ~oI NoIaIieS
J(ndJ-~--r; h~r
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Witness ~/
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Witness (
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Signature of officer or
attorney
(Seal and official capacity of
officer or state of admission
of attorney)
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I :\WPWln\WILLS\NewcombK.Coolcll. Wpd
Se~tember 3. 2002
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FIRST CODICIL
OF
KATHRYN T. NEWCOMB
I, KATHRYN T. NEWCOMB, ofLemoyne, Cumberland County, Pennsylvania, being of
sound and disposing mind, memory and understanding, do hereby make, publish and declare this my
\
First Codicil to my Last Will and Testament dated November 23,1994.
1. Any and all references to the name MARY N. PARKER shall be changed to MARY
N. PINES to reflect my daughter's name change.
2. Paragraph SECOND of my Last Will and Testament is hereby revoked and the
following is substituted in its place:
SECOND: F,XF,CUTOR AND SUCCESSOR. I appoint my daughter, MARY N.
PTh~S, executor of this Will. If my daughter, MARY N. PINES, is unable or unwilling to act or
continue as executor, for any reason whatsoever and whether before or after my death, I appoint my son,
PETER E. NEWCOMB, as successor executor.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my First Codicil
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to my Last Will and Testament, consisting of one page, this 0 - day of , ~~~2002.
~Q~/-r( heu~
HRYN NEWCOMB, Testatrix
Signed, sealed, published and declared by the above-named Testatrix, KATHRYN T. NEWCOMB,
as and for the First Codicil to her Last Will and Testament, in the sight and presence of us, who, at her
request, in her sight and presence and in the sight and presence of each other, have hereunto subscribed our
namesaswim~. ~ ~~.
~4~ Address 2"3-,?1 /:h~J)b
Wimess
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Wimess 17
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Se~tember 3, 2002
COMMONWEALTH OF PENNSYLVANIA )
: SS.
COUN1Y OF CUMBERLAND )
I, KATHRYN T. NEWCOMB, THE TESTATRIX, WHOSE NAME IS SIGNED TO THE
FOREGOING INSTRUMENT, HAVING BEEN DULY QUALIFIED ACCORDING TO LAW, DO
HEREBY ACKNOWLEDGE THAT I SIGNED AND EXECUTED THE INSTRUMENT AS THE FIRST
CODICIL TO MY LAST WILL AND TEST A.l\ilENT; THAT I SIGNED IT WILLINGLY; AND THAT I
SIGNED IT AS MY FREE MID VOLUNTARY ACT FOR THE PURPOSES THEREIN EXPRESSED.
SWORN OR AFFlRL\ilED TO AND ACKNOWLEDGED BEFORE 1<IE BY KATHRYN T.
]'iEWCOMB, THE TESTATRIX THIS 3'-'-" DAY OF ~b<--. ,2002.
NOT AFlIAL SEAL
CASSANDRA T. ROSENBAUM, Notary
Camp Hill Boro, Cumberland County
My Commission Expires December 4,
~
COMMONWEALTH OF PENNSYL V MlA
COUNTY OF CUMBERLAND
)
: SS.
)
WE, s.:....~ /.{. (fVt~ AND r!-y/J-Ih,.... J: INe.irne, ,
THE WITNESSES WHOSE NAMES ARE SIGNED TO THE FOREGOING INSTRUMENT, BEING
DULY QUALIFIED ACCORDING TO LAW, DEPOSE AND SAY THAT WE WERE PRESENT AND
SAW THE AFORESAID TESTATRIX SIGN .<\ND EXECUTE THE INSTRUMENT AS THE FIRST
CODICIL TO HER LAST WILL AND TESTAMENT; THAT SHE SIGNED WILLINGLY AND THAT
SHE EXECUTED IT AS HER FREE AND VOLUNTARY ACT FOR THE PURPOSES THEREIN
EXPRESSED; THAT EACH OF US IN THE HEARING AND SIGHT OF THE TESTATRIX SIGNED THE
CODICIL AS WITNESSES; AND THAT TO THE BEST OF OUR KNOWLEDGE THE TESTATRIX
WAS AT THE TIME EIGHTEEN (18) OR MORE YEARS OF AGE, OF SOUND MIND AND UNDER
NO CONSTRAINT OR UNDUE INFLUENCE.
SWORN OR AFFIRMED TO AND SUBSCRIBED TO BEFORE ME, THIS S~ DAY OF
J;/,f"~' J_ ,2002. -
NOTARIAL SEAL itn
CASSANDRA T, ROSENBAUM, Notary PubIlc
Camp Hill Boro, Cumberland Coullly
My Commlsslon Expires December 4, 2004 itness
~~^
Notary Public { -
"
)
REVOCABLE INTERVIVOS TRUST
OF KATHRYN T. NEWCOMB
This trust agreement is made in duplicate this d 3 ~ day
of h/l1~ ,1994, between Kathryn T. Newcomb, hereinafter
called "settlor," and herself, hereinafter called "trustee,' and
is to be called the "LIVING TRUST."
FUNDING OF TRUST
FIRST: Settlor hereby transfers to trustee the proceeds of
any life insurance unless otherwise designated together with the
assets listed in Schedule "A"; said schedule may be modified,
amended or changed at any time by Settlor with the last dated,
notarized document executed by Settlor to govern contents of the
corpus of the Living Trust. Trustee shall hold any other
property which may be added to this trust upon the terms herein
set forth. The Living Trust shall be further funded by the pour
over provisions of settlor's Will.
LIFETIME TRUST
SECOND: During the life of settlor, trustee shall pay and
distribute to settlor any corpus, principal, interest, or income
from the trust estate as settlor may direct in writing lodged
with the trust records. Checks drawn on accounts in the name of
this trust and signed by settlor as trustee shall constitute such
writing. Any gifts to individuals and recognized charities, (IRS
SOl (c) (3) organizations), directed by settlor to be made from
this trust shall be considered a withdrawal by settlor and shall
be deemed to have been made directly by settlor.
.,
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If at any time settlor shall become incapacitated by reason
of age or mental or physical disability, the successor trustees,
in their absolute discretion, may apply the income and principal
hereunder to or for the benefit of settlor for her health,
maintenance and support.
AFTER DEATH OF SETTLOR
THIRD: After my death, my trustee shall distribute the
corpus, principal, interest and income of the Living Trust in
accordance with Schedule "B" herein attached as if fully
incorporated herein to govern the distribution of the trust.
Schedule "B" may be modified, amended or changed at any time by
settlor with the last dated, notarized document executed by
settlor to govern the distribution of the trust.
BENEFICIARY TRUSTS
FOURTH: Any property passing under provisions of "After
Death of Settlor" or under another provision specifically making
applicable these trust provisions to a bequest or devise to a
beneficiary or to another beneficiary, who, at the time of my
death, is under the age of thirty (30) (the "Beneficiary"), shall
be held IN TRUST, nevertheless, by my Trustee, hereinafter named,
for the benefit of such Beneficiary, upon the terms and for the
purposes and uses, as follows:
A. My Trustee shall hold and invest the principal of the
Trust corpus, collect the income therefrom, and expend and apply
so much of the net income (any income not so expended or applied
)
to be accumulated and added to principal), and so much of the
principal and accumulated income, as my Trustee shall deem
necessary or advisable, in the sole and absolute discretion of my
Trustee, for the support, maintenance, and education (including
college education, both graduate and undergraduate) of the
Beneficiary, after taking into consideration other readily
available assets and sources of income. During illness or
emergency, my Trustee may either pay a distribution to the
Beneficiary, or may make a distribution for the benefit of the
Beneficiary.
B. At the time the Beneficiary attains the age of thirty
(30), the Trust pertaining to the Beneficiary shall terminate,
and my Trustee shall distribute the then-remaining principal and
accumulated or undistributed income to the Beneficiary.
c. If .the Beneficiary should die during the existence of
this Trust, it shall be divided and then continued for the
benefit of any then-living issues of the Beneficiary, per
stirpes, with such beneficiaries being substituted for the
Beneficiary for all purposes including distribution at certain
ages as set forth above.
D. If the Beneficiary should die before attaining the age
of thirty (30) without leaving issues surviving as aforesaid,
then that Trust shall terminate, and its assets shall be divided
pursuant to the "Residuary Clause" hereof; provided, however,
that if a Trust established hereunder for any such beneficiaries
exists at the time of such distribution, then such distribution
shall be made to that Trust for such beneficiary.
PROTECTION OF BENEFICIARIES (SPENDTHRIFT PROVISION)
FIFTH: No income or principal shall be assignable by a
beneficiary or available to anyone having a claim against a
beneficiary before actual payment to the beneficiary.
POWERS OF TRUSTEE
SIXTH: Trustee and her successors shall have the following
powers in addition to those given by law to be exercised by her
in her absolute discretion, which powers shall be applicable to
all property held by her, including property held for minors or
incapacitated persons effective without the order of any court,
and until actual distribution of all such property.
A. To retain any investments at discretion;
B. To invest and reinvest at discretion without restriction
to so-called "legal investments", with the specific right to
invest in common and preferred stocks and in such common trust,
diversified, money market and mutual funds as they deem
appropriate;
c. To sell, to grant options for the sale of, or otherwise
convert any real or personal property or interest therein, at
public or private sale, for such prices, at such times, in such
manner and upon such terms as they may think proper, and to
execute and deliver good and sufficient conveyances, assignments
and transfers thereof without liability of any purchaser to see
to the application of the purchase money;
D. To borrow money and to secure its repayment by mortgage
of real or personal property, pledge of investments or otherwise,
without liability on the part of the lenders to see to the
application thereof;
E. To compromise claims by or against settlor's estate or
any trust created hereunder;
F. To make distributions in cash or in kind, or partly in
each;
G. To register investments in the name of a nominee or to
hold the same unregistered in such form that they will pass by
delivery;
H. To join in any recapitalization, merger, reorganization
or voting trust plan affecting investments; to deposit securities
under agreement; to subscribe for stock and bond privileges; and
generally to exercise all rights of security holders;
I. To manage, operate, repair, alter or improve real estate
or other property, and to lease real estate and other property
upon such terms and for such period as trustee deems advisable
even for more than five (5) years and beyond the duration of any
trust;
J. To receive from settlor or from any other source any
real or personal property as additions to this trust by deed,
will or in any other manner;
K. To associate with them in the absence of a corporate
fiduciary, an attorney, an accountant, custodian, investment
advisor and other agents and to compensate them from principal or
)
income or both, as trustees shall determine, such compensation to
be a reduction of the compensation of trustees, if any;
L. To associate with them at any time, in their absolute
discretion and of their choice, a corporate fiduciary which shall
have the same powers as trustee, such designation by trustee and
acceptance by a corporate fiduciary to be in writing;
M. To delegate to a corporate fiduciary the exercise of any
powers, with the same effect as if the trustee delegating such
power had joined in the exercise of such power, and to revoke any
such power, provided, however, that the revocation of any such
delegation shall be in writing delivered to and accepted by the
corporate fiduciary; and
N. To do all other acts and things necessary and
appropriate in the management, administration and distribution of
this trust..
PAYMENT OF TAXES ON SETTLOR'S ESTATE
SEVENTH: Trustee shall pay any estate, inheritance and
other death taxes, together with interest and penalties which
shall be payable by reason of settlor's death upon the property
comprising her gross estate for tax purposes including but not
limited to any taxes to be paid by settlor's executor under her
Will. For such purposes, trustee may advance to the executor of
settlor such amount as may be required by the executor of settlor
for the payment of such taxes. Trustee shall payor advance the
same out of the principal of the Living Trust.
)
A. Generation Skipping Tax: The primary purpose of this
article is to use my federal generation skipping tax exemption
(now $1 million) more effectively if my property ultimately could
be subject to that tax. I direct that:
1. Division of Trusts: Any trust or addition which
otherwise would be partially exempt for federal generation
skipping tax may be divided fractionally to form separate trusts
so that my federal generation skipping tax exemption may be
allocated exactly to one or more trusts. The trusts which have
been divided shall have the same terms unless otherwise specified
in this article but maybe administered differently. Any trust
or addition may be held as a separate trust if it is not possible
to separate it into exempt and non-exempt trusts.
B. Power of Appointment to Reduce Tax: The limited powers
of appointment which are exercisable by a will hereunder shall be
expanded as follows if certain taxes can be reduced:
1. If federal generation skipping tax would be imposed
on any trust of mine upon the death of a beneficiary and at a
rate higher than the marginal federal estate tax rate which would
be imposed on his or her estate (assuming the trust were
includable in the beneficiary's taxable federal estate), then the
beneficiary - specifically referring to this power of appointment
- may also appoint the trust to his or her estate to the extent
the aggregate of the two taxes just mentioned can be reduced; and
2. Any increase in death taxes in the beneficiary's
estate caused by the inclusion of the trust in it for tax
purposes shall be paid out of the unappointed principal of the
trust, and a written statement by his or her personal
representative may be accepted as being correct.
C. Tax Options: My trustee may use administrative or other
expenses of the trusts hereunder as income tax deductions or may
direct my executor to use them as estate tax deductions, and may
compromise taxes on future interests. These decisions may be
made without requiring adjustments between principal and income.
LOANS AND ADVANCES TO EXECUTORS OF SETTLOR'S ESTATE
EIGHTH: Trustee is further authorized in her absolute
discretion, to make such loans, advances or expenditures out of
the principal of the residuary trust as trustee may consider
desirable in order to facilitate the settlement of the settlor's
estate. In exercising such authority, trustee may pay in whole
or in part the expenses of settlor's last illness and burial,
debts, income taxes, estate or inheritance taxes, legacies,
commissions, counsel fees and other administration expenses,
owing by settlor or by reason of her death, which payments may be
made directly by trustee or to the executor of settlor, and
neither said executor nor any beneficiary shall be required to
reimburse the trustee for any funds so loaned, advanced or
expended.
RIGHT TO REVOKE OR AMEND TRUST RESERVED
NINTH: Settlor reserves the right to revoke or amend this
trust agreement in whole or in part at any time and from time to
time by written instrument delivered to the trust records during
the lifetime of settlor. The duties, powers and liabilities of
trustee shall not be changed without her written consent.
APPOINTMENT OF SUBSTITUTED TRUSTEE
TENTH: Following the resignation, incapacity or death of
settlor, Peter E. Newcomb and Carol W. Newcomb and Mary N.
Parker, by signifying their acceptance in writing delivered to
the trust records, shall become cotrustees hereunder. If Peter
E. Newcomb, Carol W. Newcomb or Mary N. Parker are unable or
unwilling to act or to continue to act, then Peter E. Newcomb,
Jr. and Leslie W. Newcomb, by signifying their acceptance in
writing delivered to the trust records, shall become cotrustees
hereunder in their place. On the concurrence of the accepting
trustee, a corporate trustee may be appointed. Trustees shall
serve without bond.
DEFINITION OF INCAPACITY
ELEVENTH: In determining whether settlor has become
incapacitated and the successor trustee is authorized to exercise
his/her or their authority as set forth herein, the successor
trustee shall obtain certificates signed by two licensed
physicians, stating that settlor is physically or mentally
incapable of handling her own financial affairs and shall lodge
such certificate with the trust records.
I waive any physician-patient privilege in my favor, and I
authorize physicians to examine me and disclose my physical or
mental condition in order to determine my incapacity or capacity
for purposes of establishing alternate trustees.
COMPENSATION OF FIDUCIARIES
TWELFTH: Settlor while acting as trustee shall serve
without compensation. Any alternate trustee of settlor who
serves as a trustee hereunder may accept compensation, but
limited to the fees customarily received by executors for the
administration of an estate for the marshalling for distribution
of real or personal property. However, no trustee fee shall be
paid for the mere distribution of liquid funds such as checking,
savings, brokerage accounts, or similar stocks, bonds or other
similar investments. Any corporate trustee serving hereunder
shall be compensated as such in accordance with its standard
charges for such trust services in effect from time to time
during which such services are performed.
PENNSYLVANIA LAW GOVERNS
THIRTEENTH: Questions pertaining to the validity,
construction and administration of the trusts created under this
instrument shall be determined in accordance with the laws of the
Commonwealth of Pennsylvania.
INTERCHANGEABILITY OF LANGUAGE
FOURTEENTH: Words used in the singular may be read to
include the plural or the plural may be read as the singular.
Similarly, the masculine form may be read to include the feminine
and neuter; the feminine may be read to include the masculine and
neuter; and the neuter may be read to include the masculine and
feminine.
PREEMPTION
FIFTEENTH: This Living Trust shall supersede, replace or
take precedent over the Last Will and Testament of Settlor.
HEADINGS
SIXTEENTH: The headings used on the various paragraphs of
this trust are included for convenience only and shall have no
legal significance.
The settlor/trustee has signed this trust the day and year
first above written.
Signed, sealed and delivered
in the presence of:
Lu!f'le~5eJ2 :
~m
JJA14 L:T
1(~ j; hPJ(R~,}r-
(Settlo s Name)
(Name of Corporate Trustee)
Attest:
By:
. ,.'
Commonwealth of Pennsylvania }
} ss.
County of Cumberland }
On this, the )1yJ day of Jl/!.~ , 1994, before,
m~underSig~ffiCer, personally appeared
~ ~~ , 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.
I have signed my name and affixed my seal.
Notarial Seal
TI-omas M. DevIn, Nolaly Public
Camp Hm Bora, Cumbertand County
My Commisslcn ExpIres Sept. 22, j 997
,,-
72~11c M
Notary Public
My commission expires:
9-~d--17
SCHEDULE "A"
This Schedule "A" shall govern the contents of the corpus of
my Living Trust including but not limited to the following:
1. My real estate located at 808 Riverview Road, Lemoyne,
Pennsylvania.
2. All my savings accounts.
3. All my brokerage accounts or other stocks, bonds, mutual
funds, or treasury bills or other such securities if any.
4. My motor vehicles.
5. All my personal property.
6. Any and all other property or assets held in the name of
Kathryn T. Newcomb.
1I1d.3 / q'<j
DATE I
.~~0~
KA BRYNa. NEWCOMB
Commonwealth of Pennsylvania
}
} ss.
}
County of Cumberland
On this, the ~ day of ~~ , 1994, before,
m~1 the unde signed fficer, personally appeared
~ ~ , 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.
I have signed my name and affixed my seal.
NoIariaI Seal
Thomas M. DevIn, Notary Public
Camp lf~ 80m, Cumberland County
My Commission Expires Sept 22, 1997
Member, PennsylvamaAssodation of Notaries
~h~
Notary Public
My commission expires:
1- ?-d- ~(7
i-
Schedule "B"
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This Schedule "B" shall govern the distribution of the corpus of the Living Trust of the
undersigned Kathryn T. Newcomb as follows:
A. A one-half share thereofto my son, Peter E. Newcomb, now ofPuyallup, Washington,
if he survives me by thirty (30) days. If he does not survive me, then such share shall be distributed
to his wife, Carol W. Newcomb, ifshe so survives me. Ifneither of them so survives me, then such
share shall be distributed in equal shares to their children, Peter E. Newcomb, Jr. and Leslie W.
Newcomb, provided if either of my grandchildren shall predecease me leaving issue who survive me,
then I leave the share of that deceased grandchild to his or her issue, who survive me, per stirpes.
B. A one-half share thereofto my daughter, Mary N. Pines, now ofLemoyne, Pennsylvania,
if she survives me by thirty (30) days. If MaryN. Pines does not survive me, then such share shall
be distributed to Peter E. Newcomb provided that ifhe is not then living, then I leave his share to
his wife Carol W. Newcomb, if she so survives me. If neither of them so survives me, then such
share shall be distributed in equal shares to their children, Peter E. Newcomb, Jr. and Leslie W.
Newcomb, provided if either of my grandchildren shall predecease me leaving issue who survive me,
then I leave the share of that deceased grandchild to his or her issue, who survive me, per stirpes.
Such property shall be divided by my said beneficiaries as they shall agree. As to those items
upon which they shall not agree, distribution shall be determined by my trustee or co-trustees.
C. I give and bequeath the sum ofTen Thousand Dollars ($10,000.00) outright to each of
the following named persons: my grandson, Peter E. Newcomb, Jr., my granddaughter, Leslie W.
1
I'
Newcomb, and my friend, Debra A. Miller of Gardners, P A.
D. My Trustee shall sell my real estate located at 808 Riverview Road, Lemoyne,
Pennsylvania at public or private sale. I devise, bequeath, and give the proceeds from the sale of my
real estate located at 808 Riverview Road, Lemoyne, Pellllsylvania, to my daughter, Mary N. Pines
now ofLemoyne, Pennsylvania, if she survives me by thirty (30) days. If she does not so survive
me, then such real property proceeds shall be distributed under the above provisions A alld E, and
C to the extent that my other assets are not sufficient to provide for such bequests.
/ / /.!.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ..L.i..-- -day of
~4/e114-1.' 2003.
. Z~
./
1\~:g/)~ TI /1).2J/Jc.mfJ;--
KAT RYN NEWCOMB
e~A_X~
COMMONWEALTH OF PENNSYLVANIA )
: SS.
COUNTY OF CUMBERLM'D )
ON THIS 11,/:1- DAY OF ~ J')~ , 2003, BEFORE ME THE UN'DERSIGl\TED
OFFICER, PERSONALLY APPE~ KATHRYN T. NEWCOMB, KNOWN TO ME (OR
SATISFACTORY PROVEN) TO BE THE PERSON WHOSE NAME IS SUBSCRIBED TO THE
FOREGOING INSTRUMENT, AND ACKNOWLEDGED THAT SHE EXECUTED IT FOR THE
PURPOSES THEREIN CONTAINED.
WITNESS MY HM'D AND OFFICIAL SEAL THE DAY AND YEAR AFORESAID.
ARIAL SE
CASSANDRA"'. ROS Nctary PUblic
Camp Hill 80 . ,limo"rland
My Corn . n axplre. Oecember 4,2004
~L-r:~
NOTARY PUBLIC' t
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NOTARIAL SEAL
CASSANDRA T. ROSENeAUM. HoI8ly PublIc
Camp l1iU Boro, Cumberland CountY
My Camllli.llon E~plrel D.c.mbfr 4, 2004
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BILL OF SALE
AND NOW, this
;{ 3 ':!
day of November, 1994, I Kathryn T.
Newcomb fully convey unto the Revocable Intervivos Trust of
Kathryn T. Newcomb the following items for $1.00 consideration,
said consideration which is herein acknowledged as having been
received:
1. All of my tangible personal property;
2. All of my intangible personal property;
3. All of my insurance policies or other securities or
accounts where I have not otherwise named beneficiaries;
4; All of my savings accounts;
5. All of my brokerage accounts or other stocks, bonds,
mutual funds or treasury bills or such other securities, if any;
6. My motor vehicle or vehicles; and
7. All of the residue of my personal and real property.
IN WITNESS THEREOF, and intending to be legally bound, I
have hereunder set my hand and seal by acknowledgment of this
transaction.
;:~
KATHRY T. NEWCOMB
(SEAL)
,
I
ACKNOWLEDGMENT .AND AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
5S:
COUNTY OF CUMBERLAND
On this, the ~ day of November, 1994, before me, the
undersigned officer, personally appeared Kathryn T. Newcomb,
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.
WITNESS my hand and seal the day and year aforesaid.
~;t,,~
otary Public
(NOTARY SEAL)
DATED: 1!?-Y9Lf
NolariaI Seal
Thomes M. Devlin, I~ pubrlC
Camp Hili Boro Cumberland Count!
My Commiss\On 'E>pires Sept 22, 1997
Mamba<, iirsylvanlaAssotialion of
Commonwealth of Pennsylvania
ss:
County of Cumberland
AFFIDAVIT OF WITNESS
REVOCABLE INTERVIVOS TRUST
Before me, the undersigned notary public, personally
appeared Rebecca M. Bloom, formerly Rebecca M. Zehring,
whose address is 124 Diller Road, New Cumberland, PA 17070
and Teresa J. Sasa whose address is 818 Kent Drive,
Mechanicsburg, PA 17055 to me known who being duly sworn
according to law, doth depose and say that they witnessed
the declarant Kathryn T. Newcomb on November 23, 1994,
knowingly and voluntarily sign the Revocable Intervivos
Trust document by signature in their presence. Both
witnesses being 18 years of age or older.
Witness signatures
1~t!1, ~
Rebecca M. Boom
~ i~Ll-t--~ ~AI1. /
Teresa J. asa
e SU~ and sworn to before
- . (!J:- , 1997.
~h,~
Tnomas M. Devlin, Notary Public
me thi~~ day
of
Nota.rial Seal
Thomas M. DeVlin, Notary Public
Camp Hill Bora, Cumberiand County
My Commission Expires Sept 24, 2001
Member, Pennsylvania Association 01 Nolar",s
RRSIGN A TION
The undersigned settlor and trustee, KATHRYN T. NEWCOMB, in accordance with
paragraph TENTH entitled Appointment of Substituted Trustee as set forth in that certain
Amendment to Revocable Inter Vivos Trust of Kathryn T. Newcomb dated October~L., 2003,
which amended paragraph TENTH of the Revocable Inter Vivos Trust ofKatbryn T. Newcomb
date November 23, 1994, hereby resigns as Trustee.
In Witness Whereof, and intending to be legally bound hereby, the undersigned executes
this Resignation the '7 ~ay of October, 2003, the effective date ofthis Resignation.
Witness: /~~
/'
Settlor:
(@J~TJ~
Kathryn! . Newcomb
CeJMMONWEAL TH OF PENNSYLVANIA )
: SS:
COUNTY OF CUMBERLAND )
On this ''/i:i> day of October, 2003, before me the undersigned officer, persona1Jy appeared
KATHRYN T. NEWCOMB, known tome (or satisfactory proven) to be the person whose name
is subscribed to the foregoing Resignation, and acknowledged that he executed it for the purposes
therein contained.
WITNESS my hand and official seal the day and year aforesaid.
~~~
NOTARY PUBLIC L
/~~;,-'~,~ r7-':::;-'i'~"'"
, '... I i. i !!c:::-:/
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AMENDMENT
TO
REVOCABLE INTER VIVOS TRUST
OF KATHRYN T. NEWCOMB
I, KATHRYN T. NEWCOMB, the Settlor under a certain revocable Living Trust dated
November 23, 19~4, hereby desires to amend Article Tenth, Appointment of Substituted Trustee,
of said Living Trust by deleting the present language and the language set forth in an
Amendment dated September 19, 2000 which Amendment I revoke in its entirety, and to
substitute the following:
TENTH: Following the resignation, incapacity or death of settlor, Peter E. Newcomb
and Carol W. Newcomb and Mary N. Pines, by signifying their acceptance in writing delivered
to the trust records, shall become cotrustees hereunder, with the power to serve jointly, as to all
three or two of them, or individually. Except to the extent that Peter E. Newcomb, Carol W.
Newcomb and Mary N. Pines are all unable or unwilling to act or to continue to act, then Peter E.
Newcomb, Jr., and Leslie W. Newcomb, by signifying their acceptance in writing delivered to
the trust records, shall become cotrustees hereunder in their place. On the concurrence of the
accepting trustee, a corporate trustee may be appointed. Trustees shall serve without bond.
In all other respects I ratify and confirm the herein referenced Living Trust.
IN WITNESS WHERE01 )fave set my hjll}d and seal to this Amendment to my
Revocable Inter Vivos Trust this - day of GC/(J ~ ,2003.
Witness:
I{;d-~-l, I~
Kathr ~. Newcomb
\,\u, \\\~'t b\(\~\L.---
COMJ:vIONWEAL TH OF PENNSYLVANIA )
: SS.
COUNTY OF CUMBERLAND )
ON TillS .,+f....-DAY OF SEPTEMBER, 2000, BEFORE ME THE UNDERSIGNED
OFFICER, PERSONALLY APPEARED KATHRYN T. NEWCOMB, KNOWN TO ME (OR
SATISFACTORY PROVEN) TO BE THE PERSON WHOSE NAME IS SUBSCRIBED TO
THE FOREGOING INSTRUMENT, AND ACKNOWLEDGED THAT SHE EXECUTED IT
FOR THE PURPOSES THEREIN CONTAINED.
WITNESS MY HAND AND OFFICIAL SEAL THE DAY AND YEAR AFORESAID.
, ~.~
NOTARIAL SEAL I
CASSANDRA T. ROSENBAUM, Notaty Publ~ NOTARY PUBLIC
Camp Hill Boro, Cumberland County
My Commission E~pires December 4, 2004
~ .'._"'''. ~.".
<\(,CRPTANCR
The undersigned PETER E. NEWCOMB, in accordance with paragraph TENTH
entitled Appointment of Substituted Trustee of the Amendment to Revocable Inter Vivos Trust
of Kathryn T. Newcomb dated October 7, 2003, having been advised of the written resignation
of Kathryn T. Newcomb as Trustee, hereby accepts the appointment of co-trustee and agrees to
abide by the terms of the Revocable Inter Vivos Trust of Kathryn T. Newcomb dated November
23, 1994, and any amendments thereto.
In Witness Whereof, and intending to be legally bound hereby, the undersigned executes
this Acceptance the 1-i:1 day of C:bt-c,l.o~......, 2003.
Witness:
JIL- -
/
COMMONWEALTH OF PENNSYLVANIA)
: SS:
COUNTY OF CUMBERLAND )
On tllls ~ day of October, 2003, before me the undersigned officer, personally appeared
PETER E. NEWCOMB, known to me (or satisfactory proven) to be the person whose name is
subscribed to the foregoing Acceptance, and acknowledged that he executed it for the purposes
therein contained.
WITNESS my hand and official seal the day and year aforesaid.
NOTARIAL SEAL
CASSANORA T. ROSENBAUM, Notary Public
Camp Hill Boro, Cumberland County
MV Commission Expires December 4, 2004
T~~
NOTARY PUBLIC '
~-" .' -
"i"-\'-'(<;'~I ",";"\ /7
, ,-', )" ~-' ,'I
-. ,~~-:':j \..=--:::::...i ! J L.~
ACCEPTANCE
The undersigned CAROL W. NEWCOMB, in accordance with paragraph TENTH
entitled Appointment of Substituted Trustee ofthe Amendment to Revocable Inter Vivos Trust
ofKatbryn T, Newcomb dated October 7, 2003, having been advised of the written resignation
ofKatbryn T, Newcomb as Trustee, hereby accepts tbe appointment of co-trustee and agrees to
abide by the terms of the Revocable Inter Vivos Trust of Kathryn T, Newcomb dated November
23, 1994, and any amendments tbereto,
In Witness Wh9Wf, and intending to be legally bound hereby, the undersigned executes
this Acceptance the ~day of crlr-hnr- ,2003.
Witness:
~L
./
fJ;M~tTP~
Carol W. Newcomb
COMMONWEALTH OF PENNSYL V A1"llA )
: SS:
COUNTY OF CUMBERLAND )
On this 1!!:.. day of October, 2003, before me the undersigned officer, personally appeared
CAROL W. NEWCOMB, known to me (or satisfactory proven) to be the person whose name is
subscribed to the foregoing Acceptance, and acknowledged that she executed it for the purposes
therein contained.
WITNESS my hand and official seal the day and year aforesaid.
NOTARIAL SEAL
CASSANDRA T. ROSENBAUM, NOlary Public
Camp Hill Bo.o, Cumberland County
My Commission Expires December 4, 2004
~~--r~~
-
NOTARY PUBLIC
(?~~/~,:'::'0, r::::"\,~-'
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'.::.- ~/ 11
ACCEPTANCE
The undersigned MARY N, PINES, in accordance with paragraph TENTH entitled
Appointment of Substituted Trustee of the Amendment to Revocable Inter Vivos Trust of
Kathryn T. Newcomb dated October 7, 2003, having been advised of the written resignation of
Kathryn T. Newcomb as Trustee, hereby accepts the appointment of co-trustee and agrees to
abide by the terms of the Revocable Inter Vivos Trust of Kathryn T. Newcomb dated November
23, 1994, and any amendments thereto.
In Witness WherZ2!: and intending to be legally bound hereby, the undersigned executes
this Acceptance the /'- C1ayof Ci:...tt,t;,.o r , 2003.
Witness:
//U--_
/
~'
rYJCVft f). ~
MaryN. p' es
COMMONWEALTH OF PENNSYLVANIA )
: SS:
COUNTY OF CUMBERLAND )
On this 1fj. day of October, 2003, before me the undersigned officer, personally appeared
MARY N. PINES, known to me (or satisfactory proven) to be the person whose name is subscribed
to the foregoing Acceptance, and acknowledged that she executed it for the purposes therein
contained.
WITNESS my hand and official seal the day and year aforesaid.
NOTARIAl-SEAL
CASSANDRA T. ROSENBAUM, Notary Public
Camp HfiI Boro, C~mberland ~n\y
My Commission E~pires December 4, 2004
~T~
NOTARY PUBLIC L
REV-150S EX'" (6-98) .
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Kathrvn T. Newcomb
FILE NUMBER
21 05 0433
Include the proceeds of litigation and the date the proceeds were received by the estme.
All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1
PA Dept of Revenue - tax refund
173
2
Verizon Telephone Co - Refund
14
3W46AD 1000
TOTAL (Also enter on line 5 Recanitulation' $
(If more space is needed. insert additional sheets of the same s'lze)
187
REV-151QEX + (6-98) ,
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
GOMMONWEA~ TH OF PENNSYLVANIA
lNHERlTANCETAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kathryn T. Newcomb
FILE NUMBER
21 05 0433
ITEM
NUMBER
1.
DATE OF DEATH
VALUE OF ASSET
% OF DECO'S
INTEREST
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.
DESCRIP110N OF PROPER1Y
INCLUJE Tf-E NOME OF Tt-E TRANSFEREE, THEIR RHATIDNSHIP TO DECEDENT ANa
THE DATE OF TRANSFER ATTACHACOPV OF THE DEED FOR REAl- ESTATE
TAXABLE
VALUE
Intervivous trust established
on 11-23-1994, see attached
printout for list of assets and
date of death values
Dividend accrued on 2/19/2005
636,305 100.0000
768 100.0000
2 Kathryn T Newcomb Rev Inter
Vivos Tr TUA DTD 11/23/94
M&T Bank
Checking Account # 63531372
21,270 100.0000
3 Transfer within one year of
death, 11,000 to Mary Pines on
2/16/05
11,000 100.0000
4
Transfer within one year of
death, 11,000 to Peter Newcomb
on 2/16/05
11,000 100.0000
TOTAL (Also enter on line 7, Recapitulation) $
<If more space is needed, insert additional sheets of the same size)
3W46AF 100Q
EXCLUSION
(If APPUC;A8LE'
3,000
3,000
o
636,305
768
o
21,270
8,000
8,000
674 343
Estate Valuation
Date of Death:
Valuation Date:
Processing Date:
02119/2005
02/19/2005
OS/25/2005
Estate of: Kathryn Newcomb
Account: Kathryn Newcomb Liv Tr
Report Type: Date of Death
Number of Securities: 9
File 10: Newcomb
Mean and/or oiv and lnt Security
Adjustments Accruals Value
Shares
or Par
Security
Description
High/Ask
LoW/Bid
1)
150 CISCO SYS INC (17275R102)
COM
NASDAQ - Indus:rial
02/18/2005
02/22/2005
17.5B~OJ
17.55000
17.28000 H/L
17.15000 H/L
2)
~750 EXXON MOBIL CORP (30231G102)
COM
New York stock Exchange
02/16/2005
02/22/2005
59.85000
60.C8000
58.02000 H/L
58.25000 ElL
3)
oiv: 0.27 Ex: 02/08/2005 Rec: 02/10/2005 Pay: 03/10/2005
400 INTERNATIONAL BUSINESS ~~CHS (459200101)
COM
New York Stock Exchange
02/18/2005 94.25000
02!22!20~5 93.50000
92.5500C H/L
92.23000 HIL
Div: 0.18 Ex: 02/08/2005 Rec: 02/10/2005 Pay: 03/10/2005
4)
200 JOH~SON & JOHNSON (478160104)
COM
New Yo:k S:ock Exchange
02/18/2005
C2/22/2005
65.59000
65.87000
65.21000 H/L
65.05000 HIL
oiv: 0.285 Ex: 02/11/2005 Re~: 02/:5/2005 Pay: 03/0B/2005
:;0)
7000 JPMORGAN 5: CHASE &: CO (46625El0D)
COM
New York Stc:k Exchange
C2/lS/2005
02/22/2005
36.76000
36.63000
36.30000 H/L
35.90000 H/L
6) 5000 DOYLESTOWN TWP PA G.O. 8DS (261339BL8)
Finan:ial ~imes Ir.teractive Data
OTO: 06/15/199: Mat: 06/15/201: 7%
02/18/2005 101.14600 Mkt
02/22/2005 101.12500 Mkt
Int: 12/15/2004 to 02/l9/2005
7) 15000 GREJI.'IER JCHNSTOWN PA SeH 018'1' GO REF B (392023LJ4)
Financial Times Interactive Data
DTO: 11/15/2001 Mat: OB101/2019 5%
02/18/2005 107.69800 Mkt
02/22/2005 107.69500 Mkt
Tnt: 02/01/2005 to 02/19/2005
8) 10000 LANCASTER CNTY PA HDSP AUT::I RE REV BDS (5140455V6)
Financial TiThes Interactive Data
O~~: 04/15/1998 Mat: 07/01/2006 5%
02/18/2005 103.22100 Mkt
02/22/2005 103.21400 Mkt
Int: 01/01/2005 to 02/19/2005
91
193704.36 Cash ICASH)
Total Value:
Total Acc!"lial:
Total: $637,072.80
Page 1
2,608.54
103,337.50
37,253.00
13,086.00
254,782.5-8
5,056.78
16,154.48
10, 32l. 75
193,704.36
$636,304.91
Th.:s ::eport ",'as p::odu:::ed with EstateVa'..., a pIoduct 0: Esta':e Valuations (; Pricing Systems, Inc. !f vou have questions,
please cont5ct EVP systems at (818) 313-6308 or ww~.evpsys.com. (Revision 7.0.4)-
17 .390250
59.050000
472.50
93.132500
72.00
65.430000
57.00
36.397500
101.:35500
62.22
107.696500
37.50
103.217500
66.67
$767,89
REV-1511 EX+(12-99}
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Kathrvn T. Newcomb
FILE NUMBER
21 05 0433
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER OESCRIPTION AMOUNT
A FUNERAL EXPENSES:
1. Fairview Cemetery
burial charge 375
Total from continuation schedules 1,180
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s}
Social Security Number(s) I EIN Number of Personal Representative(s) - -
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees 4,500
6. Tax Return Preparer's Fees
7.
1 MBNA America
Executor's cost of travel to
burial and funeral 2,133
TOTAL (Also enter on line 9, Recapitulation) $ 8.188
3W46AG1,OOO
(If more space is needed, insert additional sheets of the same size)
Estate of: Kathryn T. Newcomb
156-38-3117
Schedule H Part 1 (Page 2)
Item
No.
Description
Amount
2
Mary Pines
reimbursement for funeral expenses
300
3
Mary Pines
reimbursement for funeral expenses
100
4
Plainfield Granite Works
Monument
780
Total (Carry forward to main schedule)
1,180
REV-1512 EX" (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kathryn T. Newcomb
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
21 05 0433
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death. including unreimbursed medical expenses.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
Elite Staffing Services
Nursing care services for January
432
2
Messiah Village
Nursing home care expense for
January
4,224
3
Messiah Village
Nursing home care expense for
February
3,079
4
Mobile X-Ray Imaging Inc
x-ray expense
12
5
Mobile X-Ray Imaging Inc
x-ray expense
34
6
Verizon Telephone Co
February phone bill
26
7
Waggoner Frutiger & Daub
preparation of 2004 tax return
550
3W46AH 2000
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same site)
B 357
REV-1513 EX+ (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kathr~rn T. Newcomb
SCHEDULE J
BENEFICIARIES
FILE NUMBER
21 05 0433
NUMBER
I
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
1
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers
under Sec. 9116 (a) (1.2)]
Eaton
Place
Leslie N.
16 Arthur
Red Bank,
NJ
07701
Granddaughter
10,000
2 Debra A. Miller
2809 Old Car1~sle Road
Gardners, PA 17324 None 10,000
3 P. Edgerton Newcomb
2021 4th Ave
Apt 609
Seattle, WA 98121 Grandson 10,000
4 Peter E. Newcomb
8707 182nd Street East
Puya11up, WA 98375
50% Residue: 313,993 Son 313,993
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, 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
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
3W46AI1,OOO
TOTAL OF PART". ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
(If more space is needed, insert additional sheets of the same size)
$
o
state of: Kathryn T. Newcomb
Item
~o. Description
Mary N. Pines
30 Miller Street
Apt 4C
Lemoyne, PA 17043
50% Residue: 313,993
Schedule J Part 1 (Page 2)
Daughter
156-38-3117
Relation
Amount
313,993
Estate of: Kathryn T. Newcomb
Item
No. Description
5 Mary N. Pines
30 Miller Street
Apt 4C
Lemoyne, PA 17043
50% Residue: 313,993
Schedule J Part 1 (Page 2)
Daughter
156-38-3117
Relation
Amount
313,993
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
WAGGONER TIMOTHY C
5006 E TRINDLE ROAD
MECHANICSBURG, PA 17050
____u__ lold
ESTATE INFORMATION: SSN: 156-38-3117
FILE NUMBER: 2105-0433
DECEDENT NAME: NEWCOMB KATHRYN T
DATE OF PAYMENT: 06/21/2005
POSTMARK DATE: 06/21/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 02/19/2005
NO. CD 005461
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $2,238.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$2,238.00
REMARKS: NEWCOMB TIMOTHY C
CHECK# 4796
SEAL
INITIALS: SK
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS