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\ REV 1500 I OFFICIAL USE ONLY
COMMONWEALTH OF ·
'* DEPA:~~;;~~A~~NUEJ INHERITANCE TAX RETURN [ILENUM;E;--~-~254--
_ n~ARRIS~~~~';'~61oi128-0601 _ RESIDENT DE_CEDEN~ _ COUN~ODL-j-;; _ NUMBER_
--l[)ECEDENT'S NAME (LA~Ri)T, AND MIDDLE INITIAW---- ----T SOCiAL SECURITY NUMBE~------
~ ~~T: ~F ~~~H~~~-~b~~~e rt . ~-pATEOFBIRTH (MM-DD-YEAR) -----t T~~ ~E-T~~ -M9U:T~~ FILED IN DUPLICATE WITH THE-
~ r'O'~;'~';;' ~~"G '""'''' """"L,o ,1,; IN~ ~~~ "'TI"'. . - - --I ""'''~~,~~~.~~ OF WILLS
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lo: ~ U) n 4 Limited Estate
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~ f al Ii] 6. Decedent Died Testate (Allach D
"- copy of Will)
_~ _ [] 9. Lltigati~n prOceedS. Rece.ived.... .. / ..[] .1 o.~n~_~~I!ng~~1~5?redit (date of death between 0 11. Election to tax under Sec. 9113(A) (Allach Sch 0)
THIS SECTION MUST 8EcoMPLeTiO.At.I.CQRRl!SPQI\IOEt-4CE At4Q90~,oet4TIAL",AX It4FCR...,AtlQtll$f(P\.I!.Q lile[)lR.e~Ti[).'l'~:.J'
~ f., N~AME.. .... .. COMPLETE MAILING ADDRESS
~ J~mes~. Hughe_~_________
lr FIRM NAME (If applicable)
~ SALZMANN HUGHES PC 354 Alexander Spring Road, Suite 1
.. 8_r;L~;~;E;~~~;33 ..-~-=-__ u_ ... -~:~Iisle, PA 1701~~ gf,i
11.ReaIEstate(SChedUleA) (1) None ~~~~~FIC~U~El~NLY
. 2. Stocks and Bonds (Schedule B) (2) 502,1 83. 21 ~"; S3 ;; : =~J
I 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) ____~o n e_ u' ;; -0
-I,
REV-1500 EX + (5-001
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4a. Future Intarest Compromise (date of death efter
12-12-82)
7. Decedent Maintained a Living Trust (Attach
copy of Trust)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
4. Mortgages & Notes Receivable (Schedule D)
(4)
None
(5) 122,930.45
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5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
[J Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L) Separate Billing Requested
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
(9) 41,925.47
----~--,_._-
(10) 8,902.84
(6) None
(7) None
(8) 625,113.66
11. Total Deductions (total Lines 9 & 10)
(11 )
50,828.31
574,285.35
12. Net Value of Estate (Line 8 minus Line 11)
(12)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has (13) 0.00
not been made (Schedule J)
14. Net Value Subjectto Tax (Line 12 minus Line 13) (14) 574,285.35
---1- -- -... SEE INSTRU~TIONS O~ REVERSE SIDE F~R APPLICABLE AATE~-----.-~--
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15. Amount of Line 14 taxable at the spousal tax rate,
or transfers under Sec. 9116(a)(1.2)
0.00
x .00 (15) 0.00
16. Amount of Line 14 taxable at lineal rate
574,285.35
x .045 (16) 25,842.84
17.Amount of Line 14 taxable at sibling rate
0.00
0.00
x .12 (17) 0.00
x .15 (18) 0.00
(19) 25,842.84
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
,.,. BE SURE TO ANSWER ALL QUESTIONS Ot4 REVERSE SIDE AND RECHECK MAtH ;C~. ,. f;;." . "
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Copyright 2002 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00;
Decedent's Complete Address:
STREET ADDRESS
32 Bullock Circle
CITY Carlisle
--------- _.._--~---------~---:------_._._--_.
ISTATE PA :ZIP 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
0.00
Total Credits (A + B + C)
(2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
TotallnteresVPenalty (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.
(3)
(4)
(5)
(5A)
(5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
25,842.84
0.00
25,842.84
25,842.84
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes
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?.......................... ................. ............... .......... ....... .... ..... ..... .......... ... ........ ... .....
No
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3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... [J i-xl
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property whichu_
contains a beneficiary designation?. ..... .............. ..... ..... ............. ....... ............. ... .... ... ....................... ........ .... ... ...... Cx.1
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 pe~ury, I declare t have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and
~omplete~ De~~~~,i~~!2~~~ue _._ era~~~~ _P~T~()~_~_ re~e~~!~v~_i~,~~~~, C?~ a!l_~nf~r~_at_io~~_~!~~r~~r_~_ ~~~,_~~~o~~~~___._______.___ _____ _______ ._,__.~__
SIGNAT OF PE ADDRESS
/'
I
DATE
354 Alexander Spring Road, Suite 1 .. / '/.'.'0'
Carlisle, PA 17013 I rlS OJ-
-------.- - ----- ------ -------.-- ---.--- - -- bATE n__.
-. ---- ---- -----UJ1-itk9S
ADDRESS
SALZMANN HUGHES PC; 354 Alexander
Spring Road, Suite 1, Carlisle, PA 17013
For dates of 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. 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 the use of the surviving spouse is 0%
[72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure
of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a
natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S.
99116 1.2) [72 P.S. 99116 (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 one parent in common with the decedent, whether by blood or adoption.
"...--"-.--.
Rev-1503 EX+ (6-98)
*'
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Daugherty, RobertM.
FILE NUMBER
21-05-0254
ESTATE OF
All property jolnlly-owned with right of survivorship must be disclosed on Schedule F.
ITEM CUSIP VALUE AT DATE
NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH
1 461308108 7,977.15 shares of Investment Co American - Com 30.72 245,058.05
2 552981409 1,004.32 shares of MFS Series Trust V - Total Retrn CL 15.94 16.008.86
B
3 7,657.45 shares of Royal Alliance Associates Inc. - 15.94 122.059.75
MFS Total Return Fund A
4 6,662.37 shares of Royal Alliance Associates Inc. - 17.87 119,056.55
American Balanced FD Inc.
TOTAL (Also enter on Line 2, Recapitulation) 502,183.21
(If more space is needed, additional pages of the same size)
Copyright (cl 2002 form software only The Lackner Group, Inc.
Form PA-1500 SChedule B (Rev. 6-98)
Rev-1508 EX+ (8.98)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Daugherty, RobertM.
FILE NUMBER
21-05-0254
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM
NUMBER DESCRIPTION
1 Cash
VALUE AT DATE
OF DEATH
328.00
2 Orrstown Bank - checking account #106002267
49.797.45
3 Cumberland Crossings - residency fee refund
70,000.00
4 Miscellaneous personal property
2.805.00
TOTAL (Also enter on Line 5, Recapitulation)
122.930.45
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule E (Rev. 6-98)
REV-1151 EX+ (12.99)
.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Daugherty, RobertM.
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-05-0254
ITEM
NUMBER
A. FUNERAL EXPENSES:
DESCRIPTION
AMOUNT
See continuation schedule(s) attached
6,899.18
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Janes D. Hughes
Social Security Number(s) I EIN Number of Personal Representative(s):
Street Address 354
Carlisle
Alexander Spring Road, Suite 1
State PA Zip 17013
City
Year(s) Commission paid
2006
10,000.00
2.
Attorney's Fees
SALZMANN HUGHES PC
24,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
State
Zip
4.
Probate Fees
502.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
Other Administrative Costs
See continuation schedule(s) attached
524.29
TOTAL (Also enter on line 9, Recapitulation)
41,925.47
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
Rev.1502 EX+ (5-98)
.
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Daugherty, RobertM.
FILE NUMBER
21-05-0254
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Ewing Brothers
6.279.60
2
Flowers
45.58
3
Honorariums
450.00
4
The Washington Post - obituary publication
124.00
Subtotal
6.899.18
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-A (Rev. 6-98)
Rev-1502 EX+ (6-98)
.
SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Daugherty,RobertM.
FILE NUMBER
21-05-0254
ESTATE OF
ITEM
NUMBER DESCRIPTION AMOUNT
1 Cumberland Law Journal - estate notice publication 75.00
2 Masland & Associates - research fee 200.00
3 Register of Wills - filing fee/short certificates 50.00
4 Roy D. Gottshall Auctioneer - appraisal fee 55.00
5 The Sentinel - Legal - estate notice publication 144.29
Subtotal
524.29
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
Rev-1512 EX+ (6-98)
.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Daugherty, RobertM.
FILE NUMBER
21-05-0254
ESTATE OF
Include unrelmbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 Comcast Cable
VALUE AT DATE
OF DEATH
102.75
2 Cumberland Crossings
3.274.28
3 Met-Ed - Met-Ed
251.54
4 Patricia A. Rosendale CPA - prepare final income tax returns
250.00
5 Sprint Telephone
121.86
6 UGI
568.40
7 US Treasury - 2004 income tax due
3.720.00
8 USAA, credit card
614.01
TOTAL (Also enter on Line 10, Recapitulation)
8,902.84
<If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule I (Rev. 6-98)
REV.1513 EX+ (9.00)
.
SCHEDULE .J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
NUMBER
Daugherty, Robert M.
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116(a)(1.2)]
RELATIONSHIP TO
DECEDENT
Do Not List Trusteels)
FILE NUMBER
21-05-0254
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
I.
R. M. Daugherty TUW
354 Alexander Spring Road
Suite 1
Carlisle, PA 17013
f/b/o Joyce
Powers,
daughter
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
The Army War College Foundation Inc.
122 Forbes Avenue
Carlisle, PA 17013-5248
remainder of
Trust
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J (Rev. 6-98)
REV.1647 EX+ (9.00)
.
SCHEDULE M
FUTURE INTEREST COMPROMISE
(Check Box 4a on Rev-1500 Cover Sheet)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Daugherty,RobertM.
This schedule is appropriate only for Estates of decedents dying after December 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
181 Will 0 Trust 0 Other
FILE NUMBER
21-05-0254
ESTATE OF
I. Beneficiaries
NAME OF BENEFICIARY RELATIONSHIP DATE OF BIRTH N3E1O
NEARESTBR1lf)AY
1. Joyce D. Powers daughter 02/11/1944 61
2. The Army War College Foundation Inc.
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.
o Unlimited right of withdrawal o Limited right of withdrawal
III. Explanation of Compromise Offer:
The Trust is established to supplement the income of Ms. Powers in an amount of $300.00 per month
since she is currently a recepient of SSDI. Additionally, the assets in the Trust can be used for her
general welfare, medical and living expenses.
IV. Summary of Compromise Offer:
1. Amount of Future Interest:
2. Value of Line 1 exempt from tax as amount passing to charities, etc.
(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% 03% 00%
(also include as part of total shown on Line 15 of Cover Sheet)
4. Value of Line 1 taxable at lineal rate
06% ~4.5%
(also include as part of total shown on Line 16 of Cover Sheet)
5. Value of Line 1 taxable at sibling rate (12%)
(also include as part of total shown on Line 17 of Cover Sheet)
6. Value of Line 1 taxable at collateral rate (15%)
(also include as part of total shown on Line 18 of Cover Sheet)
7. Total value of Future Interest (sum of Lines 2 thru 6 must equal Line 1)
----- -- - - --
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule M (Rev. 6-98)
LAST ffTILL AND TESL4~~fEjVT
I, ROBERT 1\1. DAUGHERTY, of South lvIiddleton Township, Cumberland County,
Pennsylvania, being of sound mind, disposing memory and full legal age, do hereby make, publish
and declare this to be ~y Last Will and Testament, hereby revoking all Wills and Codicils
heretofore made by me.
ONE. I direct my Executor or Executrix, as the case may be, to pay all of my
debts, funeral and administrative expenses as soon as convenient after my decease. Furthermore,
I direct that all state, inheritance, succession and other death taxes imposed or payable by reason
of my death and interest and penalties thereon with respect to all property composing of my gross
estate for death tax purposes, whether or not such property passes under this Will, shall be paid
by the Executor or Executrix of my estate.
T\VO. My Executor or Executrix may, at his or her discretion, compromise
claims, borrow money, retain property for such length of time as he or she may deem proper;
lease and sell property for such prices, on such terms, at public or private sales, as he or she may
deem proper; and invest estate property and income without restriction to legal investments unless
otherwise provided hereunder. I authorize and empower my Executor or Executrix to sell any
realty and/or personalty owned by me at my death and not specifically devised or bequeathed
herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale
therefor, in fee simple, as I could do if living. My Executor or Executrix is authorized and
empo\-vered to engage in any business in which I may be engaged at my death, for such period of
time after my death as seems expedient to said Executor or Executrix.
j&
THREE.
I hereby give, devise and bequeath all of my estate of \vhatever nature and
wherever situate to my daughter, JOYCE D PO\VERS, absolute, provided however, her share
shall be held in trust subject however to the terms and conditions of Paragraph Four below. In the
event that she predeceases me or disclaims this interest for \vhatever reason, then in that event,
this share shall be given, devised and bequeathed to the U.S. Afu\fY WAR COLLEGE
FOUN'DA TION.
FO DR.
For the lifetime of my daughter, JOYCE D. POW'ERS, her inherited share
pursuant to Paragraph Three above shall be held in trust by the hereinafter mentioned Trustee
according to the follo\ving terms and conditions:
The Trustee, as well as my representative, is hereby authorized to retain,
unconverted, any property, real or personal, that I may own at my death and shall be under
no duty to convert it into legal investments. The Trustee shall have the pmver and
authority to sell, transfer, convey, invest and reinvest and to pay over the net income of
the trust property, to or for the use of my daughter so as to supplement the other readily
available assets and sources of income (including any governmental aid or benefits) then
available to my daughter or to accumulate it in the sole discretion of the Trustee. The
sums so deemed necessary to supplement the other readily available assets or sources of
income (including any governmental aid or benefits), whether all or a part of principal or
interest income, may be accumulated or expended by the Trustee for the use and benefit of
my daughter as in the Trustee's sole discretion seems proper for her support, maintenance,
education, medical care or general welfare, keeping in mind that the main purpose of this
trust is to provide a supplement for my daughter, including support for her guardian to be
used on her behalf, without disqualifYing her from being eligible for any governmental aid
or benefits. In the event that the existence of this trust would disqualifY my daughter trom
eligibility for significant governmental aid or benefits or should any interest hereunder,
whether income or principal, while undistributed and in the possession of the Truste~ be
subject to attachment, execution or sequestration by any creditor, assignee, subrogee or
provider of benefits, aid or care of, to or for my daughter, then this trust may, at the sole
discretion of the herein named Trustee, be immediately terminated and the then remaining
principal and accumulated or undistributed income shall be divided and distributed to the
residual beneficiary of this my Last vVill and Testament as set forth in Paragraph Three
above. To the extent that the Trustee does not elect to terminate this Trust as stated
above, this trust shall continue for the lifetime of my daughter as set forth herein '.'.hereby
:2
~
upon my daughter's death, the then remaIIllng principal and income hereof shall be
distributed to the residual beneficiary set forth in Paragraph Three above.
FIVE. I make the fol1o\ving provisions pertaining to generation-skipping transfers:
A. 1\1y Executor or Executrix, as the case may be, may allocate any part of my
generation-skipping tax exemption which I have not irrevocably utilized during my lifetime in such
manner as my Executor or Executrix shall determine.
B. My Executor or Executrix may elect not to have the deemed allocation
provisions of Section 2632(b) of the Internal Revenue Code of 1986, as amended ("the Internal
Revenue Code") apply to transfers made by me during my lifetime.
C. To the extent that the allocation' of any generation-skipping tax exemption
would not result in a particular trust being completely exempt from the generation-skipping tax,
the Trustee shall separate such trust into two trusts, one of which is exempt from and one of
which is funy subject tot the generation-skipping tax. In the case of a trust .vhich has not received
assets at the time the exemption is allocated, the separation shall occur prior to any funding of the
trust. A trust which is completely exempt from the generation-skipping tax shall be referred to as
an "exempt trust" and a trust which is subject in any part to the generation-skipping tax shall be
referred to as a "non-exempt trust".
D. If the Trustee separates a trust into an exempt trust and a non-exempt trust
under the immediately preceding paragraph:
(1) Any person who has a power of appointment with respect to that trust
may exercise such po\-ver differently as between the exempt trust and the non-exempt trust.
"
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~
(2) The percentage or traction of principal that a beneficiary may \vithdraw
shall be calculated \vith respect to the total principal held in both the exempt and non-exempt
trusts. Ho\vever, so long as there is any principal held in the non-exempt trust, to the maximum
extent possible any \vithdrawal shall be paid from the non-exempt trust.
(3) If the Trustee has the discretionary pO\ver to distribute income of a
trust among "skip persons" and "non-skip persons" as defined in Section 2613(b) of the Internal
Revenue Code, the Trustee may exercise such power differently as between the exempt trust and
the non-exempt trust.
E. In making any distributions hereunder for the vanous beneficiaries my
fiduciaries may allocate among such distributions assets which are exempt from generation-
skipping tax equally or pro rata or on such. other basis as they shall in their sole and absolute
discretion determine, taking into account possible needs of beneficiaries for distributions of
principal, possible appreciation in the value of trust assets during the lifetimes of the beneficiaries
or such other factors as the fiduciaries consider significant.
F. The Trustee may combine into a single trust two exempt trusts for the benefit
of the same beneficiary; similarly, the Trustee may combine non-exempt trusts for the same
beneficiary.
G. )\;0 power to expend principal of an exempt trust for a beneficiary who is a
"non-skip person" as detined in Section 2613(b) of the Internal Revenue Code may be exercised
by the Trustee so long as there is any principal held in a non-exempt trust and in which the trustee
has a similar pO\ver to expend principal for such beneficiary.
4
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H. In addition to all other powers set forth in this my Last \ViII and Testament, if
at the death of a benetlciary, including a person who becomes a beneficiary pursuant to the
exercise of a power of appointment under this Will, there is principal held in a non-exempt trust
for that beneficiary and if in the absence of this power of appointment there would be a taxable
termination with respect to such trust as defined in Section 2612 of the Internal Revenue Code,
such beneficiary shall have the power by will containing a specific reference to this power of
appointment to appoint any part or all of such principal outright to anyone or more of his or her
creditors and the creditors of his or her estate. Upon the beneficiary's death, to the extent he or
she fails to exercise effectively such power of appointment, the Trustee shall pay to the
beneficiary's estate or to the tax authorities an amount equal to any increase in estate, inheritance
and other death taxes, and interest an.d penalties thereon, payable because of the inclusion of the
unappointed principal in the beneficiary's estate for tax purposes. The remaining unappointed
principal shall be distributed in accordance with the terms of the trust.
SIX. I hereby nominate and appoint JAMES D. HUGHES to be the Executor of this my
Last \Vill and Testament. If he has predeceased me, failed to qualify or is not able or does not
serv'e for whatever reason, I then appoint REBECCA R. HUGHES to serve as Executrix of my
estate, whereby the substitute Executrix shall have the same powers as the original Executor
hereunder.
SEVEN. No person(s) shall benefit hereunder unless such beneficiary shall surv'ive
me by sixty (60) days.
EIGHT. No Executrix, Executor, or Trustee acting hereunder shall be required to
post bond or enter security in this or any other jurisdiction.
r
5
NI~E.
No beneficiary may assign or anticipate his or her interest in any income or
principal held or distributable hereunder; and no beneficiary's creditors may attach or othef\vise
reach any such interest.
TEN.
The validity and administration of any trust established hereunder and any
question or disputes relating to the construction or interpretation of any said trusts shall be
governed and construed in,accordance with the laws of the Commonwealth of Pennsylvania.
ELEVEN.
If any person or institution entitled to share in any distribution under the
terms of this my Last \Vill and Testament becomes an adverse party in any proceeding to contest
the probate of this Last Will and Testament, such person or institution shall forfeit his, her or its
entire interest inherited hereunder and all provisions in favor of such person or institution shall be
declared void and of no effe,ct. The share of such person or institution so forfeited shall be
distributed as part of the residue pursuant to Paragraph Three hereof except that if such person or
institution is entitled to share in the said residue, that interest shall be distributed proportionately
to the other residuary distributees,
T"VEL VE. The Trustee, as well as my Executor or Executrix, shall have the following
powers, in addition to those vested in it by lavi, for my property held for the benefit of my
beneficiaries, whether income or principal, exercisable without court approval and effective until
the distribution of all property under the terms of the trusts set forth in Paragraphs Four and Five
above:
The Trustee, at its discretion, may compromise claims, borrow money or retain
property for such length of time as it may deem proper, sell lease, pledge, mortgage, transfer,
exchange, convert or otherwise dispose of or grant option of all or any portion of trust property
,~
/
6
for such prices and on such terms in public or private transactions as it may deem proper; and
invest trust property and income without restrictions to legal investments. The determination of
the Trustee with respect to the advisability of making payments out of the income or principal to
any heir or beneficiary inheriting hereunder shall be conclusive and binding on all persons
howsoever interested in the respective trust. Further, the Trustee shall be authorized to receive
additions to the respective trust of any kind or any property whatsoever from sources other than
my estate and at any time in the sole discretion of the Trustee.
THIRTEEN.
I hereby nominate and appoint JA.\1ES D. HUGHES, or if he is not
able or does not serve for whatever reason, REBECCA R. HUGHES, to serve as Trustee of the
trust created in Paragraph Four hereof
FOURTEEN.
After much consideration, I hereby specifically exclude from this
my Last Will and Testament my grandson, MICHAEL C. CHARLES and his spouse, DIA1"JE
CHARLE S.
IN \VITNESS \VHEREOF, I have hereunto set my hand and seal this 7-.] day of
October, 2003.
~h1U4.Lv~AL)
ROBERT M. DAUGHERTY
7
Signed, sealed, published and declared by the above-named person as and for a
Last Will and Testament, in our presence, who at said person's request, in said person's
presence and in the presence of each other have hereunto set ollr names as subscribing
witnesses.
8
ACKN01VLEDG~~lENT AND AFFIDAVIT
'VE, ROBERT 1H. DAUGHERTY, JA)IES D. HUGHES and ANGELA F.
UNGER, the testator and witnesses respectively, whose names are signed to the 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 Testament, and that he had signed
willingly, and that he executed it as his free and voluntary act for the purpose herein expressed,
and that each of the witnesses, in the presence and hearing of the testator, signed the Will as a
witness and that to the best of their knowledge the testator was, at that time, eighteen years of
CO~lMON'VEALTH OF PENNSYLVANIA
SS:
COUNTY OF CUMBERLAND
Subscribed, sworn to and acknowledged before me by ROBERT M. DAUGHERTY, the
testator herein, and subscribed and sworn to before me by JAMES D. HUGHES and ANGtLA
F. UNGER, witnesses, this.::)3rd day of October, 2003.
Notarial Seal
Tricia L Bailey, Notary Public
South MiddlelOn 1'wp., Cumberland County
My Commissi,.n Expires Sept. 24. 2006
fJ .
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D;.,../ttIO---:' o~ '. fULLer ___
Notary Public Lr-
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--"-/~Q\vv..\:> 3;6~;C:::5'-
AUG 30.2005 9:18AM
CALL CENTER
717 530 2624
p. 1
- FROM:' Timrithea:MObse
Cust.. Service Specialist
P.D.BOX 250
" SHIPPENSBURG Pk17257~0250'
",
, RE:I',EST ATE'OF Robert M Qal,Jgherty
".- -. , " '.
DATE OF DEATWFe~ruarY40,2005
. iTIS'HEREBY CERtiFIED THAT THe'AsoVENAMED:bECEOENTHA'O,>ON1J1r=ABOVEDAr!=,'THE ;, "
FOLLOWING ACC.OUNTSWITHORRSTQWN..BANK; . -' , .., . :.<" " '
, ACCOUNT NO,
, .
CERTIF1CATE$'OFDlipOSIT .;
SAVINGS ACCOUNTS
DATE OPENED.
. '
. " ~
-Df\Tf" Of OtAnI Vlh.l)fS
Holdings by Investor
~---_._._-_. ..-~--- ._._-----~. ~---_.__.._-_._~._----_._--------_.~-~--- ._-~----_.,-~-~---
Robert M Daugherty
32 Bullock Cir
Carlisle, PA 17013
BETTY JEAN O'LEAR
Royal Alliance Associates, Inc.
12450 Fair Lakes Cir
#200
Fairfax, VA 22033
703-818-0800
Combined Account Portfolio
Date 02/20/2005
Created 03/29/2005
Robert M Daugherty
Acct Name: ROBERT M DAUGHERTY 32 BULLOCK CIR CARLISLE PA 17013-7616
Acct No: 00060194812 AcctType: General
MFS TOTAL RETURN FUND-A
MSFRX BLEND
MFS
7,657.45
Account Total:
15.94
122,059.80
$122,059.80
--_.- -------------_.._--_.~._-~_._-----~-~-_._--_._-----"--.._...~_._.._----_._-_._----
Acct Name:
Acct No:
ROBERT M DAUGHERTY 32 BULLOCK CIR CARLISLE PA 17013-7616
00068196404 Acct Type: General
BLEND AMERICAN 6,662.37 17.87 119,056.62
FUNDS
EQUITY AMERICAN 7,977.15 30.72 245,057.89
FUNDS
Account Total: $364,114.52
--~._~--~---_._--~---
AMERICAN BALANCED FD INC ABALX
AMERICAN FUNDS INV CO OF AMER A AIVSX
Acct Name:
Acct No:
ROBERT M DAUGHERTY 32 BULLOCK CIR CARLISLE PA 17013-7616
08189278112 Acct Type: General
MFS TOTAL RETURN FUND-B
MTRBX BLEND
MFS
1 ,004.32
Account Total:
15.94
16,008.88
$16,008.88
$502,183.20
.---------- -----------~._---~~-----_._-~._-
Investor Total:
Incomplete if presented without accompanying disclosure page
Page 1 of 2
___________l!oldin~s bJ!Jnvestor
Combined Account Portfolio
Date 02/20/2005
Created 03/29/2005
Robert M Daugherty
32 Bullock Cir
Carlisle, PA 17013
BETTY JEAN O'LEAR
Royal Alliance Associates, Inc.
12450 Fair Lakes Cir
#200
Fairfax, VA 22033
703-818-0800
. --_._--_._--~- -_._-_._.~--_.~----_.- _.~------_._---.~._~_.._. -._.---- ----------
Disclosure:
The information contained in this report reflects activity for periods shown and is based on sources believed to be accurate, however it cannot be
guaranteed. It is neither an official statement of your account with Royal Alliance Associates, Inc., nor has the data been audited or verified by Royal
Alliance, correspondent, individual sponsor(s) or money manager(s) as to its accuracy. Please refer to the confirmation notices and client statements
that you receive directly from them. The figures may be net of applicable fees, charges and expenses. They may include dividends, distributions,
additional contributions or withdrawals. Prices, yields and total returns will fluctuate. Some securities listed may not be liquid. Prices shown may
reflect an approximate or estimated value, and not necessarily reflect actual selling or market price. Tax deferred accounts/products (such as variable
annuities) have various rules and restrictions that apply regarding accessibility of funds, tax consequences and other factors.
Page 20f2
NA-PD
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