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Home My WebLink About12-01-05 REV- ',500 EX (6-00) OFFICIAl USE ONL V COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 20~ _081L __ YEAR NUMBER COUNTY CODE SOCIAL SECURITY NUMBER 193-12-9024 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE I- Z W C W U w c DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Ge1baugh, Donald A. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 09/01/2005 4/20/1925 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Gelbaugh, Isabel C. [Z] 1. Original Retum D 4. Limited Estate 00 6. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received REGISTER OF WILLS SOCIAL SECURITY NUMBER W I- ~~(/) UD::~ wo.U :1:00 UD::..J o.lXI ~ D 2. Supplemental Retum D 3. Remainder Return (dale of dealh prior 1012-13-82) D 4a. Future Interest Compromise (date of death after 12-12-82) D 5. Federal Estate Tax Return Required D 7. Decedent Maintained a Living Trust (Attach copy ofTrust) _ 8. Total Number of Safe Deposit Boxes D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) D 11. Election to tax under Sec. 9113(A) (Allach Sch 0) I- Z W C Z o 0- m w a: a: o o THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS Elyse E. Rogers, Esquire FIRM NAME (If Applicable) Keefer Wood Allen & Rahal, LLP TELEPHONE NUMBER 415 Fallowfield Road Suite 301 Camp Hill, PA 17011 717-612-5801 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) Z 6. Jointly Owned Property (Schedule F) (6) 0 D Separate Billing Requested i= ~ 7. I nter-Vivos Transfers & Miscellaneous Non-Probate Property (7) ::l (Schedule G or L) l- e: 8. Tolal Gross Assets (total Lines 1-7) < U W 9. Funeral Expenses & Administrative Costs (Schedule H) (9) D:: 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11- Total Deductions (total Lines 9 & 10) 0.00 , OFFIOAL USE 6N!:v - ~.. ,,"\ ;~) ; i\ -') I 212,939.29 0.00 0.00 (-~ <<o;~~ 106,964.44 0.00 ~ 1 en .r:- -" -\ 497,174.77 (8) 17,962.57 9,926.04 817,078.50 (11 ) 27,888.61 789,189.89 0.00 12. Net Value of Eslate (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) (12) (13) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 789,189.89 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax 634,724.60 Z rate, or transfers under Sec. 9116 (a)(1.2) x.OO_ (15) 0 ~ 16. Amount of Line 14 taxable at lineal rate 48,413.06 x .045...- (16) I- ::) 43,742.27 0. 17. Amount of Line 14 taxable at sibling rate x .12 (17) :::E 0 62,309.96 U 1 B. Amount of Line 14 1axable a1 collateral rale x .15 (18) )( c:( Tax Due I- 19. (19) 0.00 2,178.59 5,249.07 9,346.49 16,774.15 20. o CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH << 2W4645 1.000 D d C I t Add ece ents om pi e e ress: STI'lEET ADDRESS 21 Cumberland Road CITY I STATE I ZIP Lemovne PA 17043 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 16,774.15 0.00 838.71 0.00 Total Credits (A + 8 + C) (2) 838.71 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 0.00 Total Interest/Penalty (D + E) (3) 0.00 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) 15,935.44 A. Enter the interest on the tax due. (5A) 0.00 8. Enter the total of Line 5 + SA. This is the BALANCE DUE. Make Check Pa able to: REGIS7ER OF WILLS, AGENT (58) 15,935.44 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? . . . . . . . . . . . . . . . . . . . . . . . . . . .. D 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 own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. (ZJ D IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Yes No o o o o !Xl 00 !Xl !Xl [X] [X] Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. DATE II -.;7-.f' -.oS DATE - I/" ,)).-C~ ADDRESS 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.s 9916 (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. S 9116 (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 retum 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. S 9116(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. S 9116(1.2) [72 P.S. S 9116(a)(1 )]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% (72 P.S. S 9116(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. 2W4646 1.000 REV-1503 EX ~ (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gelbaugh, Donald A. SCHEDULE B STOCKS & BONDS FILE NUMBER 21-2005-0811 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. Dell Inc. DESCRIPTION VALUE AT DATE OF DEATH 24,703.00 2 GNMA Pool #161463 3,392.09 3 General Electric Co 33,265.00 4 Liberty All Star Equity Fund 20,295.80 5 Muniyield PA Insd Fund 63,102.00 6 Nuveen Mun Value Fund Inc 19,780.00 7 Pennsylvania Insd Mun Incm Tr 1,361.40 8 Royce Value Trust Inc. 40,950.00 9 Van Kampen PA Value Mun Income 6,090.00 2W46963.000 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 212,939.29 Estate Valuation Date of Death: 09/01/2005 Valuation Date: 09/01/2005 Processing Date: 09/21/2005 Shares or Par Security Description High/ASk 1) 30000 BANCO SANTANDER P R SAN JUAN (059646DCO) Financial Times Interactive Data DTD: 11/20/2003 Mat: 11/20/2023 6% 09/01/2005 Int: OS/20/2005 to 09/01/2005 70000 GNMA PASS-THRU X SINGLE FAMILY (36216DJGl) Financial Times Interactive Data Mat: 07/15/2016 9.000% Fact: 0.04419425 09/01/2005 Int: 08/2005, payable 09/15/2005 prin: 08/2005, payable 09/15/2005 2) 3 ) 700 DELL INC (24702RI0l) COM NASDAQ - Industrial 09/01/2005 35.55000 4) 1000 GENERAL ELEC CO (369604103) COM New York Stock Exchange 09/01/2005 33.53000 5) 2180 LIBERTY ALL STAR EQUITY FD (530158104) SH BEN INT New York Stock Exchange 09/01/2005 9.11000 Low/Bid 98.55530 Mkt 108.89494 A/B 35.03000 H/L 33.00000 H/L 9.05000 H/L Div: 0.08 Ex: 08/03/2005 Rec: 08/05/2005 Pay: 09/26/2005 Div: 0.15 Ex: 08/03/2005 Rec: 08/05/2005 Pay: 09/26/2005 6) 3900 MUNIYIELD PA INSD FD (62630VI09) COM New York Stock Exchange 09/01/2005 16.20000 7) 2000 NUVEEN MUN VALUE FD INC (670928100) COM New York Stock Exchange 09/01/2005 9.92000 8) 2000 ROYCE VALUE TR INC (780910105) COM New York Stock Exchange 09/01/2005 20.15000 Div: 0.400000 Ex: 09/01/2005 Rec: 09/06/2005 Pay: 09/23/2005 20.00000 H/L 9) 400 VAN KAMPEN PA VALUE MUN INCOME (92112TI08) COM New York Stock Exchange 09/01/2005 15.28000 10) 10 PENNSYLVANIA INSD MUNS INCM TR (70884B208) UT SER 88 M Miscellaneous 09/01/2005 Carryover & Daily Interest Page 1 16.16000 H/L 9.86000 H/L 15.17000 H/L 133.27000 A/B Estate of: Estate of Donald Gelbaugh Account: 91611 Report Type: Date of Death Number of Securities: 10 File ID: Gelbaugh, Donald Estate M&B Mean and/or Div and Int Adjustments Accruals Security Value 98.555300 29,566.59 505.00 108.894936 3,368.77 23.32 16.05 35.290000 24,703.00 33.265000 33,265.00 9.080000 19,794.40 174.40 327.00 16.180000 63,102.00 9.890000 19,780.00 20.075000 + 0.400000 20.475000 40,950.00 15.225000 6,090.00 133.270000 1,332.70 28.70 This report was produced with EstateVal, a product of Estate Valuations & pricing Systems, Inc. If you have questions, please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.0.4) Date of Death: 09/01/2005 Valuation Date: 09/01/2005 Processing Date: 09/21/2005 Estate of: Estate of Donald Gelbaugh Account: 91611 Report Type: Date of Death Number of Securities: 10 File ID: Gelbaugh, Donald Estate M&B Total Value: Total Accrual: Total: $243,026.93 $241,968.51 $1,058.42 Page 2 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.0.4) REV-1508 EX +. (1-97) COMMONWEALTH OF PENNSYL VANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Gelbaugh, Donald A. FILE NUMBER 21-2005-0811 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. $30,000 Banco Santander PR San Juan Ctf Dep 6% 11/20/23 VALUE AT DATE OF DEATH 30,071.59 2 Masland & Barrick Money Market 60,430.27 3 AARP refund 132.75 4 Cemetery lots at Zion Cemetery 400.00 5 Check drawn on Brokerage account prior to decedent's date of death and deposited into M&T joint account on day after date of death 14,000.00 6 Court Settlement from Auto Accident 200.00 7 Long term care refund 302.83 8 Social Security Check for August 2005 1,427.00 2W46AD 2.000 TOTAL (Also enter on line 5 Recaoitulationl $ (If more space is needed, insert additional sheets of the same size) 106,964.44 REV-1.510 EX + (1-97) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gelbaugh, Donald A. FILE NUMBER 21-2005-0811 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. ITEM NUMBEF 1. 10 11 2W46AF 2.000 DESCRIPTION OF PROPERTY INCLUDE THE NIlME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REftJ.. ESTATE. Pershing Investment IRA N9B1186 Beneficiary: Decedent's wife, Isabel Gelbaugh DATE OF DEATH VALUE OF ASSET 445,174.77 2 $10,000 Cash transfer to decedent's step-granddaughter, Kathryn Gleeson June 2005 10,000.00 3 $5,000 Cash transfer to decedent's nephew, John Schultz June 2005 5,000.00 4 $5,000 Cash transfer to decedent's neice, Christina May June 2005 5,000.00 5 $10,000 Cash transfer to decedent's step-granddaughter, Danielle Masland June 2005 10,000.00 6 $10,000 Cash transfer to decedent's neice, Kristin Nickel June 2005 10,000.00 7 $5,000 Cash transfer to decedent's neice, Pamela Broderson June 2005 5,000.00 8 $10,000 Cash transfer to decedent's step-granddaughter, Darby Masland June 2005 10,000.00 9 $5,000 Cash transfer to decedent's nephew, Gregory May June 2005 5,000.00 $5,000 Cash transfer to decedent's neice, Catherine Gonzales June 2005 5,000.00 $10,000 Cash transfer to 10,000.00 "10 OF DECD'S INTEREST 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 Total from cont1nuation pages.... TOTAL (Also enter on line 7, Recapitulation) $ (If more space is needed, insert additional sheets of same size.) EXCLUSION IIF APPlJCABLEl 0.00 3,000.00 3,000.00 3,000.00 3,000.00 3,000.00 3,000.00 3,000.00 3,000.00 3,000.00 3,000.00 TAXABLE VALUE 445,174.77 7,000.00 2,000.00 2,000.00 7,000.00 7,000.00 2,000.00 7,000.00 2,000.00 2,000.00 7,000.00 7,000.00 497,174.77 Estate of: Gelbaugh, Donald A. Schedule G -- Inter-vivos Transfers & Misc. Non-probate Property Item No. Description Taxable Value 11 decedent's neice, Kimberly Petrides 06/2005 12 $10,000 Cash transfer to decedent's step-grandson, Christopher Gleeson June 2005 Date of death Value of asset 10,000.00 TOTAL. (Carry forward to main schedule) % of Deed's Interest 100.00 Exclusion (If applicable) 3,000.00 Page 2 21-2005-0811 7,000.00 7,000.00 REV-1511 Ex' + (1-97) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gelbaugh, Donald A. Debts of decedent must be reDorted on Schedule I. ITEM NUMBER A. B. 8 9 2W46AG 2.000 DESCRIPTION 1. FUNERAL EXPENSES: Harrisburg Cemetery 2 Cemetery flowers 3 Myers-Harner Funeral Home 4 Presbyterian Women, funeral luncheon 5 Brachendorf Memorials 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State 2. Year(s) Commission Paid: Attorney Fees Name: Keefer Wood Allen & Rahal, LLP 3. Zip Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Gelbaugh, Isabel C. Street Address 21 Cumberland Road City Lemoyne State PA Relationship of Claimant to Decedent Spouse 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. House sitter The Sentinel, legal advertising Cumberland Law Journal, legal advertising Zip 17043 FILE NUMBER 21-2005-0811 TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of same size) $ AMOUNT 700.00 84.80 7,932.00 400.00 685.00 0.00 4,000.00 3,500.00 356.00 0.00 0.00 100.00 129.77 75.00 17,962.57 REV:1S12 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gelbaugh, Donald A. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21-2005-0811 Include unreimbursed medical eXDenses. ITEM NUMBER 1. Links 2 Care DESCRIPTION AMOUNT 2,729.00 2 Harrisburg Pharmacy 71. 40 3 West Shore Country Club 457.64 4 Links 2 Care 1,008.00 5 Foremost (medical alarm) 35.00 6 West Shore Tax Bureau 10.00 7 Hospice of Central PA 5,600.00 8 VA Administration 15.00 2W46AH 2.000 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 9,926.04 REV-1513 EX+ (9-{)Q) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gelbauah Donald A. NUMBER I. 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Gelbaugh, Isabel C. 21 Cumberland Road Lemoyne, PA 17043 FILE NUMBER 21-2005-0811 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Spouse Step Granddaughter Niece Niece Nephew AMOUNT OR SHARE OF ESTATE 634,724.60 7,000.00 7,000.00 7,000.00 2,000.00 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 2 Gleeson, Kathryn 874 White Oak Road Manheim, PA 17545-8509 2W 46AI 1.000 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 3 Petrides, Kimberly 310 Reeser Drive York Haven, PA 17370-9608 4 Nickel, Kristin 33 Halleck Drive East Berlin, PA 17316-9351 5 Schultz, John 1028 Camino Del Cerritos San Dimas, CA 91773 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. (If more space IS needed, Insert additional sheets of the same size) $ 0.00 Es~ate of: Gelbaugh, Donald A. Schedule J Part 1 -- Beneficiaries Item No. Name and Address of Person(s) receiving property Relationship 6 Gonzales, Catherine 1925 N. 9th Street Grand Junction, CO 81501 Niece 7 Broderson, Pamela 418 W. Santa Clara Avenue Santa Ana, CA 92706 Niece 8 Masland, Danielle 220 Fine View Road Camp Hill, PA 17011 Step Granddaughter 9 Masland, Darby 220 Fine View Road Camp Hill, PA 17011 Step Grandchild 10 Gleeson, Christopher 874 White Oak Road Manheim, PA 17545-8509 Step Grandson 11 May, Christina 920 Rife Run Road Manheim, PA 17545 Niece 12 May, Gregory 920 Rife Run Road Manheim, PA 17545 Nephew 13 Gleeson, Carol M. 874 White Oak Road Manheim, PA 17545-8509 Step-daughter 14 Farnham, Donna Jean 406 Darla Drive Mechanicsburg, PA 17055 Niece 15 May, Jeannine 920 Rife Run Road Manheim, PA 17545 Niece Page 2 21-2005-0811 Amount or Share of Estate 2,000.00 2,000.00 7,000.00 7,000.00 7,000.00 2,000.00 2,000.00 20,413.06 20,413.06 5,832.30 ..... ... Es~ate of: Gelbaugh, Donald A. Schedule J Part 1 -- Beneficiaries Item No. Name and Address of Person(s) receiving property Relationship 16 Baughman, Naomi 1393 Lowther Road Camp Hill, PA 17011-7535 Sister 17 Peck, Marion 1100 Grandon Way, Room 208 Mechanicsburg, PA 17050 Former sister-in-law Page 3 21-2005-0811 Amount or Share of Estate 43,742.27 12,064.60 Last Willi and T estaJlllent OF DONALD A. GELBAUGH I, DONALD A. GELBAUGH, of the Borough of Lemoyne, Cumberland County, Pennsylvania, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils by me at any time made. ITEM 1: I direct that all inheritance and estate taxes becoming due by reason of my death, whether payable by my estate or by any recipient of any property, shall be paid by the Executor out of the residue of my estate, as an expense and cost of administration of my estate. The Executor shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. ITEM II: I direct the Executor to pay the expenses of my last illness and funeral expenses from the residue of my estate as an expense and cost of administration of my estate. ITEM III: I may leave a written'statement or list in my safe deposit box disposing of certain items of my tangible personal property not otherwise specifically disposed of herein. Any such statement or list in existence at the time of my death shall be determinative with respect to all items devised therein. If no written statement or list is found in my safe deposit box or elsewhere and properly identified by the Executor within thirty (30) days after the probate of my Will, it shall be presumed that there is no such statement or list; any subsequently discovered statement or list shall be ignored. Page 1 tJ /t- ITEM IV: If I predecease my wife, ISABEL C. GELBAUGH, alk/a ISABEL C. MASLAND, I give and bequeath to her absolutely and in fee simple all of my household furniture and furnishings, books, pictures, jewelry, silverware, automobiles, wearing apparel and all other articles of household or personal use or adornment and all policies of insurance thereon not disposed of pursuant to the written list referenced in ITEM III. If I do not predecease my said wife, I make saidbe'~uest to the children of my wife living at the time of my death, to be divided among them as they shall agree. Should there be no agreement, such property shall be divided among them by the Executor in as nearly equal portions as is deemed practical in the sole discretion of the Executor, having due regard to the personal preferences of such children. ITEM V: I give my cemetery lots located at the Zion Cemetery on Route 22, Harrisburg, Pennsylvania (adjacent to the Zion Lutheran Church) to my former sister-in-law, MARION PECK, if she survives me. ITEM VI: I give, devise and bequeath all the rest, residue and remainder of my estate, not disposed of in the preceding portions of this Will, and after the payment of all taxes specified in ITEM I, as follows: (a) FIFTEEN PERCENT (15%) to my sister, NAOMI BAUGHMAN, if she survives me. If she does not survive me I make this gift to my niece, DONNA JEAN FARNHAM; (b) FOUR PERCENT (4%) to MARION PECK, if she survives me. If she does not survive me I make this gift to my wife, ISABEL C. GELBAUGH a/k/a ISABEL C. MASLAND; Page 2 t5~ /~. (c) TWO PERCENT (2%) to JEANNINE MAY, if she survives me. If she does not survive me I make this gift to her children, GREGORY and CHRISTINA MAY, to be divided equally between them; (d) SEVEN PERCENT (7%) to my niece, DONNA JEAN FARNHAM, if she survives me. If she does not survive me I make gift to her daughters, KIMBERLY PETRIDES and KRISTIN NICKEL, to be divided equally between them; (e) SEVEN PERCENT (7%) to my step-daughter, CAROL M. GLEESON, if she survives me. If she does not survive me I make this gift to her children, KATHRYN GLEESON and CHRISTOPHER GLEESON, to be divided equally between them; and (f) The balance to my wife, ISABEL C. GELBAUGH a/k/a ISABEL C. MASLAND, if she survives me. If she does not survive, this SIXTY-FIVE PERCENT (65%) shall be distributed as follows: (i) TWENTY-FIVE PERCENT (25%) to the J. DONALD CARPENTER FOUNDATION, created under an Agreement of Trust dated January 31,1997; (ii) TWENTY PERCENT (20%) to the CLEVE J. FREDERICKSEN LIBRARY, Camp Hill, Pennsylvania; and (iii) TWENTY PERCENT (20%) to the AMERICAN CANCER SOCIETY, Harrisburg, Pennsylvania. Page 3 /) /1. &<,; v ITEM VII: In the settlement of my estate, the Executor shall possess, among others, the following powers: (a) To retain any investments I may have at my death, including specifically those consisting of stock of any bank even if I have named such bank as the Executor herein, as long as the Executor may deem it advisable to my estate so to do. (b) To vary investments, when deemed desirable by the Executor, and to invest in such bonds, stocks, notes, real estate mortgages or other securities or in such other property, real or personal, as the Executor shall deem wise, without being restricted to so-called "legal investments", and without being limited by any statute or rule of law regarding investments by fiduciaries. (c) In order to effect a division of the principal of my estate or for any other purpose, including any final distribution, the Executor is authorized to make said divisions or distributions of the personalty and realty partly or wholly in kind, and to allocate specific assets among beneficiaries hereunder so long as the total market value of any share is not affected by such division, distribution or allocation in kind. Should it appear desirable to partition any real estate, the Executor is authorized to make, join in and consummate partitions of lands, voluntarily or involuntarily, including giving of mutual deeds, recognizances or other obligations, with as wide powers as an individual owner in fee simple. Page 4 AO-/f( (d) To sell either at public or private sale and upon such terms and conditions as the Executor may deem advantageous to the estate, any or all real or personal estate or interest therein owned by the estate severally or in conjunction with other persons or acquired after my death by the Executor, and to consummate said sale or sales by sufficient deeds or other instruments to the purchaser or purchasers, conveying a fee simple title, free and clear of all trust and without obligation or liability of the purchaser or purchasers to see to the application of the purchase money or to make inquiry into the validity of said sale or sales; also, to make, execute, acknowledge and deliver any and all deeds, assignments, options or other writings which may be necessary or desirable in carrying out any of the powers conferred upon the Executor in this paragraph or elsewhere in my Will. (e) To mortgage real estate, and to make leases of real estate. (f) To borrow money from any party, including the Executor, to pay indebtedness of mine or of my estate, expenses of administration or inheritance, legacy, estate and other taxes, and to assign and pledge assets of my estate therefor. (g) To pay all costs, taxes, expenses and charges in connection with the administration of my estate. (h) To vote any shares of stock which form a part of the estate, and otherwise to exercise all the powers incident to the ownership of such stock. Page 5 -itJ~ (i) In the discretion of the Executor, to unite with other owners of similar property in carrying out any plans for the reorganization of any corporation or company whose securities form a part of the estate. (j) To disclaim any interest in property which would devolve to me or my estate by whatever means, including but not limited to the following means: as beneficiary under a will, as an appointee under the exercise of a power of appointment, as a person entitled to take by intestacy, as a donee of an inter vivos transfer, and as a donee under a third~party beneficiary contract. (k) To do all other acts in the Executor's judgment deemed necessary or desirable for the proper and advantageous management, investment and distribution of the estate. ITEM VIII: Any person who shall have died at the same time as I shall have, or in a common disaster with me, or under such circumstances that the order of our deaths cannot be established by proof, or within thirty (30) days of my death, shall be deemed to have predeceased me. ITEM IX: If at any time any beneficiary under the age of twenty-five (25) shall be entitled to receive any assets hereunder, the parent of such child who is related to me by blood, or who is the issue of my wife, ISABEL C. MASLAND, shall act as Custodian of the assets payable to such child under the Pennsylvania Uniform Transfers to Minors Act. If such person is unable to act, the other parent of such beneficiary shall serve as Custodian. Such Custodian may receive and administer all assets authorized by law, and shall Page 6 :tL/f have full authority as provided in the Pennsylvania Uniform Transfers to Minors Act to use such funds in the manner it deems advisable for the best interests of such beneficiary. In addition, said Custodian shall have all the rights and privileges as to the Custodianship and its assets as are herein granted to the Executor as to my estate and the assets therein. I also designate said Custodian as successor Custodian of any property for which I am custodian under any Uniform Transfers to Minors Act or Uniform Gifts to Minors Act. ITEM X: I hereby nominate, constitute and appoint my wife, ISABEL C. GELBAUGH, to be the Executrix, herein referred to as 1tExecutor". In the event of her death or her inability or refusal to serve, I nominate, constitute and appoint DONNA JEAN FARNHAM to be the Executor. In the event of the death, inability or refusal of both ISABEL C. GELBAUGH and DONNA JEAN FARNHAM to serve, I nominate, constitute and appoint JOHN C. MASLAND to be the Executor. The Executor and Custodian are specifically relieved from the duty or obligation of filing any bond or other security. IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, consisting of this and the preceding six (6) pages, at the end of each page of which I have also set my initials for greater security and better identification this 8- day of .~ , 20() C dJ~ q.~ (SEAL) DONALD A. GELBA GH Page 7 4?.A!' We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above-named Testator as and for his Last Will and Testament, in the presence of us, who, at his request and in his presence and in the presence of each other, have hereunto set our hands and seals the day and year first above written, and we certify that at the time of the execution thereof, the said Testator was of sound and disposing mind and memory. tAb}; (i I ~ ~ [ ~l (SEAL) ~SEAL) Residing at%/) 4~ ~ I ~;U//U ~ )1cJd~ Residing at '*1'1 J. ~~ ~ /forlu:4cr &d fA- n Q)-; _ ,.__.._.".,....,...~...,_........,.,...._...,."..-"'~~__J~~.!'~_='r."'-"""".....~.:.~"""""~~~,..""'.'-~.;.~.,....~'''.."''''''...:,.,.....",-__"..,..~~~. ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA ) ) SS: COUNTY OF ) I, DONALD A. GELBAUGH, Testator, whose name is signed to the attached or 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; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ~~A: ~~ DONALD A. GEB AUGH (SEAL) Sworn to and subscri~ b~f~re me this &--k.- day of ~. , 20D5. ~~ Notary Pu lic My Commission Expires: (SEAL) COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL CYNTHIA J RULE, Notary Public Camp Hill Boro., Cumberland County My Commission Expires February 3, 2008 . ~~--~_._.- AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) ) SS: COUNTY OF ) i We, J;;it~ ~ ~'bll and ~(( Jef P ~(") ,the Witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator, DONALD A. GELBAUGH, sign and execute the instrument as his Last Will and Testament; that Testator signed willingly and that he executed said Will as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as Witnesses; and that to the best of our knowledge the Testator was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. Witness ~~wff:J) ~ !l d~ Sworn to and. subscri~ before me this ~k day of ~ ,20D5. ~~LL ,. My Commission Expires: (SEAL) 87772 1 COMMONWEALTH OF PENNSYL V AN'A C NOTARIAL SEAL YNTHIA J RULE N Camp H'II B' ,olary Public My commi~SjO~r~~~~~~~~~;~~~60B Due.- 3loO 00 pc\ 310 ,00 9tPD 50. oD ~. u\$X ! (1056)