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HomeMy WebLinkAbout07-19-05 REV.1500EX'(6-00j REV-1500 '* COMMONWEAlTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 05 0365 COUNTY CODE YEAR NUMBER DECEDENTS NAME (LAST. FIRST, AND MIDDLE INITIAL) YINGLING, DOROTHY T. SOCIAL SECURITY NUMBER 184-26-5038 I- Z W C W o W C DATE OF BIRTH (MM-DD-YEAR) 04/18/1912 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER DATE OF DEATH {MM-DD- YEAR) 04/12/2005 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST. AND MIDDLE INITIAL) N/A w ,.., ~:$II) o<<~ w4.0 %00 o<<....l 4.m 4. 4: o 1. Original Return o 4. Limited Estate o 6, Decedent Died Testate (Altach copy 01 Willi o 9. Litigation Proceeds Received o 2, Supplemental Return o 4a. Future Interest Compromise (date 01 death afte, 12,12-82J o 7, Decedent Maintained a Living T rust (Atlach copy ofTrust) o 10. Spousal Poverty Credit (date 01 death between 12,31,91 ami 1-1-95J 03. Remainder Return (ua\e ol"uea\h prior to 12-13-82) o 5. Federal Estate Tax Return Required ~ 8, Total Number of Safe Deposit Boxes o 11, Election to tax under See, 9113(A) (Altach Soh 01 s; w o z o 4. II) ll! << o o THIS SECTION MUST BE COMPLETED. AlL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS John D. Killian 218 Pine Street FIRM NAME (II Applicable) PO Bo 886 Killian & Gephart ". x , TELEPHONE NUMBER Harnsburg, Pennsylvania 17108 (717) 232-1851 '" c:;::;> (::::1 -:0 1. Real Estate (Schedule A) 2, Stocks and Bonds (Schedule B) (1) (2) (3) (4) (5) 0.00 178,517.88 0.00 0.00 141,200.26 ) 0.00 559,387.36 (8) 34,152.16 6,758.08 (11) (12) (13) (14) ;= r.c:: C') CJ ::u '."J i~.\\ C:J ('~) : ~.;~1 -t:"S )"'1+'1 ,-::> -': 1 " ,,_,:'J z o 5 ::;) l- ii: <t o w a:: 3, Closely Held Corporation, Partnership or Sole-Proprietorship 4, Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6, Jointly Owned Properly (Schedule F) o Separate Billing Requested 7, Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8, Total Gross Assets (total Lines 1-7) 9, Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabil~ies, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8. minus Line 11) 13, Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 40,910.24 838,195.26 838,195.26 o C)"\ (6) (7) 879,105.50 (9) (10) 14, Net Value Subject to Tax (Line 12 minus Line 13) 0.00 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o ~ .... ::J a. ~ o o ~ 15, Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(l.2) ___ x ,0 (15) ,___ x ,0 (16) 16_ Amount of Line 14 taxable at lineal rate ____ x ,12 (17) 17, Amount of Line 14 taxable at sibling rate x ,15 (18) (19) 18. Amount of Line 14 taxable at collateral rate 0.00 19. Tax Due 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < . Decedent's Complete Address' STREET ADDRESS 77 Oak Circle CITY Newville I STATEpA I ZIP 17241 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditsfPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 Total Credits ( A + B + C ) (2) 0.00 3. InteresllPenalty if applicable D. Interest E. Penalty B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 0.00 0.00 0.00 0.00 Total InteresllPenally ( D + E ) (3) 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) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS ..... 0 IKI IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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? ............................................................ Ves IKI o o o ........... 0 ............ IKI No o IKI [iJ [iJ [iJ o DATE ~ l{fo;;- DATE QJ I oe,I ~5" ADD S ~~t-J()rth ~econd Street. Harrisbur9. Pennsylvania 17110 For dates of death on or after July 1, 1994 an<! 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. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for thl The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disc ~ e.. the surviving spouse is the only beneficiary. p ':\ For dates of death on or after July 1, 2000: C The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger ft P D or a stepparent of the child is 0% [72 P.S. 99116(a)(12)] -- ._^ M ~9116 (a) (1.1) (ii)] 3lo0 . Cf:) II applicable even if 310 .eX) 50 . <:0 an adoptive parent, The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, The lax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P individual who has at least one parent \n common wilh the decedent, whether by blood or adoption. 99116(a)(1)]. j,~ ~ L17~Section 9102, as an REV-1503 EX+ {6-9B. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF YINGLING, DOROTHY T. FILE NUMBER 21-05-0365 All property joinUy-owned with right of survivonlhip must be dlsclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Janney Montgomery Scott - brokerage account # RK20 8236-4793 VALUE AT DATE OF DEATH 178,517.88 48 East Market Street, York, Pennsylvania 17401 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of !he same size) 178,517.88 ...... :z~, ':f~;l ~:'..~. .':~"" ," ; ~ ,- ,'.' " i ,', ,I " " '.:\ . .,I." ,t,' ,~: ' ,,' , . , :,. J> , , .:n, " i'.: . :;1. ,t~, , . , ' :1:'.. ~.: . :,~, 0 : ~I . t~ " .... . < ' :, '~..~ ";.'. . :::':.: ',if '. ~p' .,. , ,t, . $'.. " " ' .....:/. !'.. ':''':,' ~ :" :('" . " ...... )';0::' . ..~;. : , " ' ,,' . .". '0' ~i~~. . "', . . ;j -: ' JlL -I!I&-2I1llil5 16: 29 Janney'Montgomery Scott LLC r.~"c;H:. ~, .r~11111e)~ -- -'I', "'_ offic:i:l ~ of ywr ic::ouot cd is SIlt:j~ to 'I'hb iAfc::m~ Ia DOt.t'!e c:.wi ~mot be Mf4mIt:cd as I:. it:le..:::-..:rr.';y Ui' dlaages. ettOIS ODd ~ ::-~ ~ ~ =:cum ::....:vmv~L'i cmnPk?'..ma. yCU! ~~~t~-d. This jl)for.ill2tioo is no~ a !II.'ll:&;I!t:t: :'fit A"'" 25 2005 ~~[~ )Wl cJ1i;;hl ~ j~Ji S;iJ:kLou. '1~ &:lovo maY;;01 1>;: ~ t....vc ........n , GI!lcrlmP.lrta9linfOlm~ iJl"""-wk!c rDl.......~....lwl'cpdiu.lfyour tut'Clpultill&~~w ,..--- The L.IIw Ann of ~ & CepIwt. ~t 10 you by malJ,. AtIn: Jahn 0 KIlen 218 Pine Str8et PO Box 886 ttarrIIbu'g, PA 17108-088lS Deer John 0 KIllIn. Per ycu ~_1atId .... is the data fJl death infDrmItion for Ihe......, on 00...... T VfnaIng. .... ,...ad .., an 04It2lDJ5. Account TIle: n.... T YIngling Accaunt Trpe: individual ~ Open Dale: 0712511_ s.cura, Bv"IlG8I88 af04l1212OO5: ft. .-.. 1000 2338 D88 100 538.842 6658.223 1000 200 535 ........ AE8 TR I" CNV 8.76% PFD AUNCElANSTN GRTH & IHe 8 COOPER INDUSTRleslTD A NWEEN PA PREll 'He F02 PIONEED HGH YlD FO CLB PIONEER MUNICIPAL HIGH TYCO INTLlm NEW CYAN KAMral PA QUAl MUM eu-...., . .edst *- 008CJ8N.20-2 46.85 45.850.00 018597-20-3 3.85 8,5:18.86 024182-10.0 ..08 8.808.00 670811=-10.1 15,07 8.120.35 723e88-2o.s 11.23 62...38 723713-1G-8 14.04 14.040.00 902124-1D-3 33._ 8,779.00 920824-1Q.4 14.52 7.788.20 1.000 18,131-28 $ 178,517.88 T.. Aaccu1I Vafue Should yau need My other i lfonnM;..n or,.,. &ny QuIItfons COIJCelI.~ the iJ~ IIuatr8ted by tI'II8 ...... you may c:onr..t Judith 1IuIIer, FirBICieJ ConIuIIant or myaeff at 717....5-5811 or 800- 999-0503. ,~. RegillallN ScIlla AnfU~...l 48 Eaoa Miort.:t ffcn:c.. ~O. Polo ~Jo. '"trl;. 1'A l74lJ!J..n'l6 . 717~.56J I . "~dinr..t'Ol1\ loIcmhcr N.... Vnd::IIotrt ~ ldo:. _ tMllo:t- prindpal...........1fJI!S ~..~...........~D-.~I..._.._.._ TOTA... P. 82 REV-1508 EX+ (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF YINGLING, DOROTHY T. FILE NUMBER 21-05-0365 Include the proceeds of I~igation and the date the proceeds were received by the estate. All property joinUy-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 . Cash - found at residence DESCRIPTION VALUE AT DATE OF DEATH 471.87 2. M&T Bank - checking account #1197568 3. M&T Bank - checking account #15004200060660 4. M&T Bank - checking account #9836644477 59,779.34 44,607.74 31,638.42 3,527.00 321.00 5. Internal Revenue Service - 2004 federal income tax refund 6. Donegal Insurance - refund of homeowners's insurance policy 7. Tri State Imaging - refund 23.31 8. Sprint Communications - refund 12.69 9. PHI - refund of prepaid expenses at Green Ridge Village 98.29 720.60 10. PHI - refund of prepaid expenses at Green Ridge Village TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, Insert additional sheets of the same size) 141,200.26 ~AMES.sfATHES :Re: "F>.rOci - Daleof Death"R uest ~a .Y From: To: Date: Subject: DATE OF DEATH REQUESTS STATHES, JAMES 4/2512005 1 :17:07 PM Re: Prod - Date of Death Request The balance on the Date of death: 04112/2005 for deceased customer: DOROTHY T YINGLING TIN # 184-26-5038 1.) Account Number: 1197568 Balance $59,779.34 + $ 0.00 accrued interest =$59,779.34 Total 2.) Account Number: 15004200060660 Balance $44,580.47 + $27.27 accrued interest =$44,607.74 Total 3.) Account Number: 9836644477 Balance $31,637.34 + $ 1.08 accrued interest =$31,638.42 Total Records Dept / DOD Balance 888-502-4349 opt 2, opt 3 fax (302) 934-2955 >>> <EBRNU1 P> 04/19/05 1 :27 PM >>> Account Information Date of death: 04/12/2005 Account Number: 1197568 Product Type: Deposit Account Account Number: 15004200060660 Product Type: Deposit Account Account Number: 9836644477 Product Type: Deposit Account Request Details Deliver to: Requestor Delivery Options: E-mail Delivery Details: EBRNU1 P REV-1Sl0 EX+ (6-98*, COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF YINGLING, DOROTHY T. FILE NUMBER 21-05-0365 This schedule must be completed and fited if the answer to any of questions 1 through 4 on the reverse side of the REV-I500 COVER SHEET is yes. DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE ITEM INCLUDE 11-fE NAME OF THE TRANSFEREE, THEIR RElATIONSHIP TO DECEDENT AND NUMBEF THE DATE OF TRANSFER. ATTACH A COPY Of THE DEED FOR REAl ESTATE. VALUE OF ASSET INTEREST (IF APPliCABlE) VALUE 1. Charitable Annuity (Agreement #20040317); Date established:04/28/04; 95,631.31 95,631.31 95,631.31 Sponsor: Presbyterian Foundation; Beneficiary:Presbyterian Homes, Inc., Monaghan Presbyterian Church, and The Alban Institute, Inc. 2. Charitable Annuity (Agreement #20020125); Date established: 05/16/02; 157,398.87 157,398.87 157,398.87 Sponsor: Presbyterian Foundation; Beneficiary: The Alban Institute, Inc. 3. Charitable Annuity (Agreement #2001 0104); Date established: 03/31/01; 163,062.92 163,062.92 163,062.92 Sponsor: Presbyterian Foundation; Beneficiary: Monaghan Presbyterian Ch. 4. Charitable Annuity (Agreement #19991007); Date established: 12120/99 ; 142,294.26 143,294.26 143.294.26 Sponsor: Presbyterian Foundation; Beneficiary: Presbyterian Homes, Inc. TOTAL (Also enter on line 7 Recapitulation) S 559,387.36 .. (If more space IS needed, Insert additional sheets of the same size) ~ : 1ofH:'r' E I'UTH PIOE NJ. : 215402920B Jun. 29 2B05 09:15PM P2 .............lMilbax Sent by. Cindy v... oet28I2OO5 04:42 PM To: PIlule ~_f:OUIld8tionctPCUSA_Found8tion cc: Subject DOD VlIIIMS for Daralhy YInglIng P8u1a, The F"'"~ only values tmIIUity ~u.cDt pools at the end ofeech JJIODth. n....4b...,. the Vllue ofDorotby V-Ving'S sift _HH- as ofMardl31. 200S, the IDOIItb-ead v8Iue prior to bor death on .April 12. 200S In as foI1owa: Apement II 20040S,., 20020125 20010104 ,.....007 Value.. of 3IJ 1105 86831.3100 313112005 187388.8700 Ml11200S 1~.9200 313112005 1a2M.2eOO 313112005 geIow 818 0lIIIfe8 Gf.... .... thIIl....... to John KiIIBn. P"'-Iet me Ilnow" you need .......... int'ann&fion. Cindy REV-1511 EX+ (12-99)W COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF YINGLING, DOROTHY T. FILE NUMBER 21-05-0365 Debts of decedent must be reported on Schedule I. DESCRIPTION AMOUNT ITEM NUMBER A. FUNERAL EXPENSES: Auer Memorial Home Cremation Services, Inc. Lois Hinebaugh - organist Monaghan Presbyterian Church Monaghan Kitchen Fund - funeral luncheon 1. 2. 3. 4. S. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) John D. Killian Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 218 Pine Street City Harrisburg Year(s) Commission Paid: 2005 . Stale PA Zip 17108 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 6. Tax Return Preparer's Fees 7. Deluxe Checks - purchase of checks 8. AT&T 9. Sprint Telephone 10. George W. Weaver & Sons - transport furniture 11. PPL - electricity Subtotal from page 2 of Schedule H 1,147.00 125.00 125.00 106.79 15,000.00 8,000.00 364.00 23.50 37.60 39.87 6,780.97 61.36 2,341.07 $ 34,152.16 TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-99)* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF YINGLING. DOROTHY T. ALE NUMBER 21-05-0365 DebtlI of dllc:edent must be repoI1ed on Schedule L ITEM NUMBER A. FUNERAL EXPENSES: 1. DESCRIPTION AMOUNT B. ADMINISTRATIVE COSTS: 1 . Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City . State PA 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 Stale . Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Relum Preparer's Fees 7. 12. Relocation Consulting & Management, Inc. - transport personalty The Cumberland Journal - publish legal notice The Sentinel - publish legal notice 2,100.00 75.00 166.07 13. 14. TOTAL (Also enter on line 9, Recapnulation) $ (If more space is needed, insert additional sheets Qf the same size) 2,341.07 REV-1512 EX+ (12-03) . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE UABIUTIES, & UENS COMMONWEAlTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT OECEOENT ESTATE OF YINGLING, DOROTHY T. ALE NUMBER 21-05-0365 Report debts incurred by the decedent prior to deeth which remained unpaid as 01 the date of death, Including unreimbursed medical expensea. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. HealthCare of Maryland, LLC 2. Comfort Keepers - companion 1,201.00 298.98 3. Continuing Care Rx - perscription medication 291.01 4. Highmark Blue Shield - health care insurance premium 578.55 5. Presbyterian Homes, Inc. . nursing care 4,124.41 23.31 6. Andorra Radiology Associates - medical expense 7. Sprint Communications 39.89 8. PPL - electric bill 122.14 9. Omega Medical Laboratories, Inc. - medical expense 37.30 10. Presbyterian Homes, Inc. . telephone expense at nursing facility 41.49 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 6,758.08 REV-1513 EX + (!>OO) * SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF YINGLING. DOROTHY T. FILE NUMBER 21-05-0365 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS pndude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 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 1. Presbyterian Homes, Inc. - benefICiary of non-probate charitable annuity 174,171.36 2. Monaghan Presbyterian Church - beneficiary of non-probate charitable annuity 194,940.02 3. The Alban Institute, Inc. - beneficiary of non-probate charitable annuity 189,275.97 4. Presbyterian Church (USA) Foundation 279,807.91 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 838,195.26 (If more space is needed, insert additional sheets of the same size) LAST 1IZLL AB'D TBSTAJIBJIT OF DORO'fJIY 'J.'. YDGLIHQ I, DORO'rBY T. 'lDlQloIJIQ, declare this to be my Last Will and Testament and hereby revoke all prior wills and codicils made by me. I'ZRST: My Executor shall pay from the residue of my estate all my debts, funeral, and adJojp;.stration expenses and all estate, inheritance, succession, and transfer taxes imposed by the united States or any state, territory, or possession which shall become payable by reason of my death. It shall not be necessary to file any claims therefor, nor to have them allowed by any court. SBCOJID. I give, devise and bequeath to the PUSBY'nCllUaR CB'DRCB (U.S.A.) P01JJlIDA'1'ZOJI, a pennsylvania non-profit corporation, incorporated in 1799, with its prmcipal office located at 200 Bast Twelfth street, Jeffersonville, Indiana 47130 (-Foundation-), all of the rest, residue and rE'mainder of my property and estate, real and personal, of whatever nature and wherever situated, in accordance with the following provisions: (a) I direct that my bequest shall be divided into three (3) equal shares and that each share shall be permanently held by the Foundation as a named endowment fund to be known as the Reverend william Yingling and Dorothy Yingling Permanent Endowment Fund LAST WILL AND TESTAMENT OF DOROTHY T. YINGLING for the benefit of the following entities: &r.Il"" IBSTI~, DlC., PBl:, and KOlD.aBD PUSB~TJU' CIlURCII. Hereafter, the above- listed organizations shall be referred to collectively as "Charitable Beneficiaries. and individually as "'Charitable Beneficiary.- (b) The Foundation shall invest and reinvest each share of my bequest in its sole and absolute discretion and shall pay the net income from each permanent endowment fund quarterly (hereinafter the WNet Income.) after the expiration of each calendar quarter (or at any other regular time interval as established by the Board of Trustees of the Foundation from time to time), to the named Charitable Beneficiaries or their respective successors, to be used only for the purposes of the Charitable Beneficiary. If, at the time of my death, any share of my bequest designated as a separate permanent endowment fund does not meet the then current min;1mJlIlfl established by the Foundation to create a permanent endowment. fund, such share shall be paid in its entirety, less the customary handling fees of the Foundation, to the Charitable Beneficiary. (c) If a Charitable Beneficiary or its successors ceases to exist or ceases to be a charitable entity as described in Section 501(c) (3) of the Internal Revenue Code of 1986. as amended (or 2 LAST WILL AND "TESTAMENT OF DOROTHY T. YIHGLIHG any successor provision of federal law hereafter promulgated), or if a Charitable Beneficiary was a member church of or related to the Presbyterian Church (U.S.A.) but bas ceased to be a member church of or related to the Presbyterian Church (U.S.A.), or should the charitable purpose of any permanent endowment fund become, within the sole discretion of the Foundation (and without the approval of any court, person, organization or entity). impossible or impracticable of fulfillment, then the Foundation shall admi 1"); ster the Net Income for purposes which parallel, to the extent possible, my original intentions, in the judgment and sole discretion of the Foundation. (d) Other entities or individuals have the right. at any time hereafter to irrevocably gift to the Foundation additional assets that are acceptable to the Foundation to be added to any permanent endowment fund. SUch gifts shall be subject to the terms creating the per-r-n~nt endowment funds as described herein. (e) For purposes of pooling of investments, the Foundation may, in its sole discretion, c~i1)gle this bequest (and the net proceeds therefrom, if applicable), with other endowment funds held by the Foundation or invest in mutual funds provided by entities related to the Foundation for which it is compensated for investment advisory and/or other sources. Expenses incurred 3 LAST WILL AND TESTAMENT OF DOROTHY T. YINGLING by the Foundation in the management and administration of permanent endowment funds shall be chargeable to said funds, as determined by the Foundation's Board of Trustees from time to time. (f) The interpretation and enforcibility of the permanent fund created by this bequest shall be governed by and construed in accordance with the laws of the Commnnwealth of Pennsylvania. THIRD: I nominate, constitute, and appoint JOHN D. lULL::rAN, Executor of this my Last Will and Testament, to serve without bond or security, and to make distribution of my estate in cash or in kind, or partly in cash and partly in kind, and in such manner as he may determine. I authorize, empower, and direct him to sell and convey, by good and sufficient deed, in fee simple estate, any and a11. of my real. estate, at pub1.ic or private sa1.e, for such price or prices, uPon such terms and conditions, as in his judgment is best for my estate, and to that end to sign, seal., execute, acknowledge, and deliver all deeds or other instruments necessary therefor, as effective1.y as I cou1.d do if I were personal1.y present. 4 LAST WILL AND TESTAMENT OF DOROTHY T _ YINCLI~JC IN WITJlESS WJmRROF iI, MilOT!!! T _ YINgL:r~G, the - . . . >'~~"" r.... T- -..,.... -- -- .L._~~<A.~..l.......L..-^-: have to this my Last Will and Testament, set my hand and seal this 2~~day of April, 2004. -------- 7i~:/::z~fi:..-1 (SEAL) Signed, sealed, published, and declared by the above named Testatrix as and for her Last Will and Testament, in the presence of us I who have hereunto subscribed our names at her request as witnesses hereto, in the presence of the said Testatrix and of each other. The preceding document consists of this and four (4) other consecutively numbered typewritten pages. ?Y(~ ~ '-I~ f'---- -". \.,~~'~D residing at Nd() j1A1~Jh:/I~R~ $t,?"~~t.(,,~ residing at 7i!p4 A/U),4zP4..L ~~ U/~",b~'~ I ?A. H4>~~ 5 . . A~KHO~mun.~IT COMMONWEALTH OF PRm!SYLV:~~JTA. COUNTY OF ~\..tM&2~ ) ss.; ) I, DOROTHY T. YINGLING, 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 my Last will and Testament; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknow!~ged before me by DOROTHY T. YINGLING, the Testatrix, this "2.-~ day of April, 2004. 9JU~/'~1 T tatr .~~/9t~ Notary Public (SEAL) CO~THOFPENNSYLVANlA NoIariaI Seal Vicki L t-llllJUIS. Nr*lIY P\dC West P\,a..sbOIO Twp.. CUmbeIland county My Cul.'~ ElIpinlS.Ian. 15, 2llO6 Member. ~ AssOOi8- Of Nota<ieS ;:0 =~"':"'~......-..... ~:; .:..:.:,g,y..1..i.. -- -- f~fjf'O'E~101r=tIE2\Ij7H OF DVl\JN~Y!:l.fl'~f..!~'n,. tit:' , ; ----- ---' -'- - '-- ~ -;...._~_". _ ~ :-~ ~_?_-: "......;--/'- ~~ f ft.: }...: ..".."": /'! r it'i!8: .__~__!;.'_.o:.~..:t ~-= ~~~-~ ...;..:~~ ~_- rA;",,:_~...; /l:~E-jY_.~.Fi the wit.ilE:sBe~ WDORe !:lames are signed to th.e .fC~J::"8gGi:uy in.S~I~;..lrrlE::C.i.-l.. f b6i(~g Gtlly ~u.alified ai."]c()~cding t-e} law ~ de depnse ~lnij say th.at ~~le ;:..!"~"""""" .....--r-~~n~ ';;'l"""H'~ P-;::1,... i-h~ "r-.,:._........,.......-~..,.- .:,< ~ an Ana- evoro-'Jlt-e .-t-'o .._O-~ I c::: !;'_t:::_ __~~'-_. =-.J..___ _'^"..~ \....~_ __ v~~a.'--,,-.i-X 0J....~__ .~...."._ ...._._.......v v ..I. iJlstr~ruent a~ her Last Will and Testament: ttJ.at LIlt:: Testatrix sigrlf3<l willingly and exec11t-ed it as !1.er free and volunta.Lj" act. fer the pULposes Lherein expressed; that each subscribing witness in the hearing and sight of the Testatrix signed the Will as a witness; and that to the best of our knowJ.edge, the Testatrix was at that time 18 or more years of age, of sound mind, and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me by may-~ j.. R'-.rc..~ and PAVCo.A A. }{G.~ witnes es, this . day of April, 2004. , --:l>4~tn~s ~ c;--' ~ ( ) ,( . --- .; ... l ~_ "_ L'~ witness ~,/#~ Notary PubJ.ic (SEAL) COMMONWEAlTH OF PENNSYLVANIA Notarial Seal Vldci L HDpIcins. NoIary PublIc West Pe.lonSbu.o lWp., CIImbeIfand Counly My COl...Iissiu.. Elcplre:i.la'l. 15, 2008 Member. Pennsylvenia AssocialiOn Of Notaries