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HomeMy WebLinkAbout01-03-06 (2) REV-1500 EX + (~) OFFICIAL USE ONLY REV.1500 INHERITANCE TAX RETURN RESIDENT DECEDENT COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 * RLE NUMBER II ~\c COUNTY CODE YEAR SOCIAL SECURITY NUMBER ~~\ NUMBER DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Horting, Kenneth F. DATE OF DEATH (MM-DD-YEAR) I- Z W C W o w c 188-10-3832 DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE RLED IN DUPUCATE WITH THE 10-08-2005 05-09-1920 REGISTER OF WILLS SOCIAL SECURITY NUMBER (IF APPLlCA8lE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) [!J 1. Original Return o 4. Limited Estate [!J 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received o o o o o 3. Remainder Return (date of death prior to 12-13-82) o 5. Federal Estate Tax Return Required o 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) 2. Supplemental Return I!! lC<1Il ui2lC wl1.g :cli1...1 Ul1.lD l1. < 4a. Future Inlerest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach copy of Trust) 10 Spousal Poverty Credit (date of death between . 12-31-91 and 1-1-95) .... z w c z o l1. III W a: ~ U NAME Jennifer B. Hipp FIRM NAME (If applicable) Bogar and Hipp Law Offices TELEPHONE NUMBER 717-737-8761 COMPLETE MAILING ADDRESS 1 West Main Street Shiremanstown, PA 17011 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (1) (2) (3) (4) (5) (6) (7) OFFICIAL USE ONLY None 2,320.32 None None 405.69 16,455.52 None (8) 1,325.00 5,295.05 . , ,..;", 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 0 Separate Billing Requested 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) z o i= :s ::::l I- 0:: c( o W 0:: ~9, 181 .53 (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) (11 ) 6,620.05 12,561.48 0.00 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) (14) 12,561.48 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15) z or transfers under Sec. 9116(a)(1.2) 0 (16) i= 16.Amount of Line 14 taxable at lineal rate 0.00 x .045 ~ ::::l ll.. 17. Amount of Line 14 taxable at sibling rate 0.00 x .12 (17) ::E 0 0 18. Amount of Line 14 taxable at collateral rate 12,561.48 .15 (18) >< x ~ 19. Tax Due (19) 0.00 0.00 0.00 1,884.22 1,884.22 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 20. D Copyright 2002 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00; Decedent's Complete Address: STREET ADDRESS 23 W. Green Street CITY Camp Hill STATE PA ZIP 1 7011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 1,884.22 94.21 Total Credits (A + B + C) (2) 94.21 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 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. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B) 1,790.01 1,790.01 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;.................................................................................. DO ~ b. retain the right to designate who shall use the property transferred or its income;.................................... ~ c. retain a reversionary interest; or.................................................................................................................. 0 ~ d. receive the promise for life of either payments, benefits or care?.............................................................. 0 ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?...................................................................... ................................................ 0 ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 0 ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?..................................................................................................................... 0 ~ 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 penatties of pe~ury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, tt is true, correct and ccmplete. Declaration of preparer other than the personal representative is based on all infonnation of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS Marian T. Kerin . - . ~ - .. . -~ ..,. r........., ~ SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE 23 W. Green Street Shiremanstown, PA 17011 tz,. 'Z~-o<r ADDRESS DATE SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE Jennifer B. Hipp ADDRESS DATE 1 West Main Street Shiremanstown, PA 17011 (2 ~l~~ 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 exemot 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 cif 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. 991161.2)[72P.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 COMMON~TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Horting, Kenneth F. FILE NUMBER 21-- All property jolntly-owned with right of survivorship nwst be disclosed on Schedule F. ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 48 shares of MetLife - Shares of Stock 48.34 2,320.32 TOTAL (Also enter on Line 2, Recapitulation) 2,320.32 (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 B (Rev. 6-98) MetLlte- The MetLife Policyholder Trust ("Trust") Transfer Transaction Advice Mellon Investor Services P.O. Box 4444 South Hackensack, NJ 07606 RETAIN THIS DOCUMENT FOR YOUR RECORDS Account Registration: 0000193 02 HB 0.534 HAUTO T3 0 4166 17011-651623 eOl BlMAI _ 23 _ Date: 11/22/2005 '11,11 I ,"I I 111111111 11111,111111,1,11,11,111111 1,1 II 11,1'1111 MARIAN T KERIN 23 W GREEN ST SHfREMANSTOWN PA 17011 For information concerning this advice, please call Mellon Investor Services, MetLife, Inc.'s Transfer Agent, toll free at 1-800-649-3593 Trust Interests (Shares) CUSIP Number 48.0000 Transaction Date 11/1812005 59156R10 Transaction Advice Number 0001514331 Investor 10 125005014325 This Transaction Advice is your record of the indicated Trust Interests being credited to an account on the books of the referenced transfer agent. The Transaction Advice should be kept with your important documents as a record of your ownership of these securities. These Trust Interests are transferable only as permitted under The MetLife Policyholder Trust. Please read the important information on the back of this form and in the Purchase and Sale Brochure. If you wish to request a purchase or sale transaction, detach coupon at the perforation and complete the applicable side of the form. .,;.. ... ... - - -.---.-.......... ...-....---.........-.-.-.----.-.......--.......-...-....................-----.-.. ---... --.-.__ "'_'__.. __01. ....__.______..._ .. __.. .. ............ .. ............. .. ....... . ... ... .... ..... .. .. ....... .... .... .... ...... ......... ....... ................. .... ..._..... ......__ PLEASE BE SURE THIS ADDRESS APPEARS IN THE ENVELOPE WINDOW FOR PURCHASES ONLY Purchase Instructions 1250 0501 4325 Change of Address: (See reverse side to SELL) MARIAN T KERIN Mellon Investor Services P.O. Box 382200 Pittsburgh, PA 15250-8200 ',"11,'" 11,1, 'I 1","111'"'",'," 111111 11111111" 1111,11" Si!:lnature (if address is being changed) Make check in U.S. dollars, payable to: MetLife Purchase Program t Amount Enclosed I Minimum investment $250 (except as described in the Purchase and Sale Brochure) 0000101 102 125005014325 6 Mellon Investor Services P.O. Box 3333 South Hackensack, NJ 07606 November 16, 2005 8 Mellon JENNIFER B RIPP ONE WEST MAIN STREET SRIREMANSTOWN P A 17011 IICompany 'jMETLIFE, INe: IIName J I ._-- .'.:I.A ccount Key IIHORTING-- I KENNFOOOO IlInvestor ill # 11806666519277 I C~ntrol 200511150003709 i Number I , I I ...J i J J RE: ESTATE OF KENNETH F HORTING Dear Sir or Madam: Thank you for contacting Mellon 1nvc3tor Services regarding lite transfer of share~ from the account listed above. This letter contains instructions for transferring shares from an account where the owner is deceased and the estate has not been probated. A non-probated estate has not been administrated in a probate court and therfore would not have an administrator or executor appointed. Our records show that above mentioned account has 48.0000 book entry shares. As 10/08/2005 was not a business day, we are unable to provide the market value ofthe above mentioned stock. However, we are providing you the market value of the above mentioned stock as on 10/0712005 and 1011012005. The closing price of above referenced stock as on 10/0712005 was $ 48.3400 and closing price of above referenced stock as on to/to/2005 was $ 47.7600 per share. In order to complete this transfer, please submit the following required items based on the number of shares being transferred: 50 Shares or Less Submit item 1 (acceptable without a Medallion Silmature Guarantee). More than 50 up to 250 Shares Submit items 1 through 4 More than 250 Shares Submit all items 1 through 5 Required Items 1. Completed Transfer of Met Life Shares form (enclosed) signed by the Surviving Tenant(s)lHeir(s). 2. A completed Waiver of Probate (sent separately) OR you can use a Small Estate Affidavit with signatures of the Surviving Tenant(s)/Heir(s) notarized. You may contact that state Os local probate court for applicable small estate procedures. 3. A photocopy of the death certificate. 4. Inheritance Tax Waiver (if applicable). If the deceased owner resided in one of the following states, please obtain an Inheritance Tax Waiver from the stateos tax department office: AL, CT, IN, MT, NC, NJ, NY, OH, OK, RI, SD, TN and Puerto Rico. 5. Medallion Signature Guarantee on the Transfer of MetLife Shares form. Note: All submitted documents will be kept as part of the permanent record of transfer and will NOT be returned. Please be sure to keep a copy of all submitted documents for your records. Send the required items to: First ClasslRelristered/Certified Mail Mellon Investor Services POBox 4410 South Hackensack NJ 07606-2010 Ovemight/Express Mail (only) Mellon Investor Services 480 Washington Blvd., 27th Floor Jersey City NJ 07310 If you have any additional questions or concerns, please call our Customer Service Center at 1-800-649-3593. You may also access your MetLife, Inc. common stock account on the Internet at www.melloninvestor.com/isd. If this change also applies to your insurance policy or contract, please contact MetLife directly. You may call your account representative or the customer service number found on your billing statement. You may also call the MetLife Directory at 1-800-METLIFE (1-800-638-5433) to reach the proper office. Sincerely, Mellon Investor Services Rev.1508 EX+ (6-98) . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Harting, Kenneth F. FILE NUMBER 21-- Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolnlly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION 1 Capital Blue Cross - Premium Refund VALUE AT DATE OF DEATH 405.69 TOTAL (Also enter on Line 5, Recapitulation) 405.69 (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.1509 EX+ (6.98) *' COMMONw;ALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Horting, Kenneth F. SCHEDULE F JOINTL V-OWNED PROPERTY If an asset waa made Joint within one year of the decedenrs date of death, It must be reported on schedule G. FILE NUMBER 21-- SURVIVING JOINT TENANT(S) NAME A. Marian T. Kerin B. C. JOINTLY OWNED PROPERTY: ADDRESS 23 W. Green St. Shiremanstown, PA 17011 RELATIONSHIP TO DECEDENT Friend DESCRIPTION OF PROPERTY %OF DATE OF DEATH LETTER DATE ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER ATTACH DEED FOR IVALUE OF ASSET INTEREST DECEDENTS INTEREST JOINTLY-HELD REAL ESTATE. 1 A 8/25/2001 PNC Bank - Certificate of Deposit, 6.146.56 50.000% 3.073.28 Account No. 31800246447, date of death balance $6,141.28, accrued interest $5.08 2 A 8/25/2001 PNC Bank - Certificate of Deposit, 2.048.78 50.000% 1.024.39 Account No. 31200247516, date of death balance $2,047.09, accrued interest $1.69 3 A 9/18/1992 PNC Bank - Checking Account No. 24.715.69 50.000% 12.357.85 5070072934, date of death balance $24709.99, accrued interest $5.70 TOTAL (Also enter on Line 6, Recapitulation) 16.455.52 (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 F (Rev. 6-98) ~ PNCBAN< December 1,2005 Jennifer B. Hipp One West Main Street Shiremanstown, PA 17011 RE: Estate of Kenneth F. Horting, deceased SSN: 180MIO-3832 (we have 188-10-3832) 000; 10/8/205 Dear Ms. Hipp: In response to your request for Date of Death balances for the customer noted above, our records show the following: . Certificates of Deposit Account #31800246447 Established 08/25/200 1 KENNETH HORTING MARIAN T KERIN DOD balance: $6,141.28 + $5.08 accrued interest Account #31200247516 Established 08/25/2001 KENNETH HORTING MARIAN T KERIN DOD balance: $2,047.09 + $1.69 accrued interest Checking Account Account #5070072934 Established 09/08/1992 KEN HORTING MARIAN T KERIN DOD balance: $24,709.99 + $5.70 accrued interest Page 1 of2 Please note that this office only provides date of death balances for deposit accounts (!RAs, CDs) Checking and Savings accounts). We do not process any financial transactions or provide statements. If you need assistance with any of these items, please call1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, ~~ UjUh Rachel1e Wells 1-800-762. I 775 P7-PFSC-04-F 500 first Ave. Pittsburgh P A 15219 .cJ Page 2 of2 Member FDIC TOTAL P.02 REV-1151 EX+ (12-99) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Horting, Kenneth F. Debts of decedent must be reported on Schedule I. FilE NUMBER 21-- ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City State Zip - Year(s) Commission paid 2. Attorney's Fees Bogar and Hipp Law Offices 780.00 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. Other Administrative Costs 545.00 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 1,325.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1502 EX+ (8-98) . SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued COMMON~THOFPENNSYlVAN~ INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Horting, Kenneth F. FILE NUMBER 21-- ITEM NUMBER DESCRIPTION AMOUNT 1 RESERVES: - Costs to conclude administration of Estate including filing fee for Pa. Inheritance Tax Return and Inventory; preparation of personal and fiduciary income tax returns 500.00 2 Vital Statistics - Reissue Death Certificates 45.00 Subtotal 545.00 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 ~HERITANCETAXRETURN RESIDENT DECEDENT ESTATE OF Harting, Kenneth F. FILE NUMBER 21-- Include unrelmbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Beverly Enterprises - Final Bill-Final Illness VALUE AT DATE OF DEATH 5.295.05 TOTAL (Also enter on Line 10, Recapitulation) 5,295.05 (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 Horting, Kenneth F. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal Oistributions, and transfers under Sec. 9116(a)(1.2)] FILE NUMBER 21-- RELATIONSHIP TO DECEDENT Do Not List T";lIt88Isl SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) I. 1 Marian T. Kerin 23 W. Green Street Shiremanstown, PA 17011 Friend Rest, residue and remainder Total Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet ll. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) LAST WILL AND TESTAMENT OF KENNETH F. HORTING I, KENNETH F. HORTING, of Cumberland County, Pennsylva- nia, make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils hereto- fore made by me. FIRST: I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon to my friend, MARIAN T. KERIN. SECOND: Should MARIAN T. KERIN predecease me, I devise bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance ), policies thereon, as follows: (A) I give and bequeath my 2004 Chevrolet Impala or any other vehicle that I own at the time of my death to my friend, THOMAS C. MIDDLETON. (B) I give and bequeath the men's gold diamond ring, ;~ the china cabinet located in my basement, the sideboard located J in my basement, the settee located in my basement and the chair ~ ' located in the basement, along with the two (2) matching chairs \) located in my living room, all formerly belonging to my friend, :1' MARIAN T. KERIN, to my friend, TINA ANNE MIDDLETON. (C) I give and bequeath two (2) sofas, two (2) end tables, two (2) lamps, one (1) mirror, a record cabinet, clock and television, located in the basement of my home, as well as my men's Masonic wristwatch, to my grandson, MATTHEW L. SHAFFER. (D) I give and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, in equal shares, to my great-grandchildren. THIRD: No provision is made in this, my Last Will and Testament for my daughter, PATRICIA A. SHAFFER, not necessarily for lack of affection for her, but because she is already well o Should any of my great-grandchildren not have twenty-one (21) years at the time for dis- her, I give, devise and bequeath the share of each such great-grandchild to my hereinafter named Trustee or , Trustees, IN SEPARATE TRUSTS, to hold, manage, invest and rein- 0- \vest the shares so received, and to use and apply from time to ~ t'me such portion of income and principal for the said great- .~ .t grandchild's education (including college, trade school or other \ similar training or education), as my Trustee or Trustees, in their sole discretion, deem advisable. The Trustee or Trustees, in exercising their discretionary authority with respect to the payment of income or principal of the within Trust to my great- grandchildren, shall take into consideration any income or other resources available to my great-grandchildren from sources this Trust. Any income or principal not so applied shall be dis- tributed to each great-grandchild when he or she attains the age of twenty-one (21) years. In the event any of my great-grand- children die prior to the termination of this Trust established provided for. FOURTH: attained the age of tribution to him or herein for their benefit, the interest of said great-grandchild in said Trust shall cease with any income and principal being divided evenly between my surviving great-grandchildren or the Trusts established hereunder for their benefit, in equal shares. 2 FIFTH: In addition to all powers granted to them by law and by other provisions of this Will, I give the fiduciaries acting hereunder the following powers, applicable to all proper- ty, exercisable without court approval and effective until actual distribution of all property: (A) To sell at public or private sale, or to lease, for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms (including credit, with or without security) or conditions as are deemed proper. This includes the power to give legally sufficient instruments for transfer of the property and to receive the proceeds of any disposition of it. (B) To partition, subdivide, or improve real estate enter into agreements concerning the partition, subdivi- sion, improvement, zoning or management of real estate and to impose or extinguish restrictions on real estate. (C) To compromise any claim or controversy and to any property which is of little or no value. (D) To invest in all forms of property, including common trust funds and mortgage investment funds, without restriction to investments authorized for Pennsylvania fiduci- aries, as are deemed proper, without regard to any principle of ~ diversification, risk or productivity. (E) To exercise any option, right or privilege granted in insurance policies or in other investments. (F) To exercise any election or privilege given by the Federal and other tax laws, including, but not necessarily being limited to, personal income, gift and estate or inheritance tax laws. (G) To make distributions to my herein named benefici- aries in cash or in kind or partly in each. 3 ~ (H) To borrow money from themselves or others in order to pay debts, taxes, or estate or trust administration expenses, to protect or improve any property held under my will, and for investment purposes. (I) To select a mode of payment under any qualified retirement plan (pension plan, profit sharing plan, employee stock ownership plan, or any other type of qualified plan) to the extent the plan or the law permits them to do so, and to exercise any other rights which they may have under the plan, in whatever manner they consider advisable. SIXTH: I nominate and appoint my grandson, MATTHEW L. SHAFFER, to serve as Trustee of the hereinabove described Trusts. In the event of the death, resignation or inability to serve for y reason whatsoever of the said MATTHEW L. SHAFFER, I nominate ~ and appoint my granddaughter-in-Iaw, CHER SHAFFER, Trustee of the hereinabove described Trusts. I direct that my Trustee or Trustees shall serve without bond and shall receive fair and reasonable compensation. SEVENTH: I direct that all inheritance, estate, transfer, succession and death taxes, of any kind whatsoever, be payable by reason of my death, whether or not with respect to property passing under this Will, shall be paid out of principal of my residuary estate. EIGHTH: All interests hereunder, whether principal or income, which are undistributed and in the possession of the fiduciaries acting hereunder, even though vested or distribut- able, shall not be subject to attachment, execution or sequestra- tion for any debt, contract, obligation or liability of any beneficiary, and furthermore, shall not be subject to pledge, assignment, conveyance or anticipation. NINTH: I nominate and appoint my friend, MARIAN T. KERIN, Executrix of this, my Last Will and Testament. In the 4 event of the death, resignation or inability to serve for any reason whatsoever of the said MARIAN T. KERIN, I nominate and appoint my friend, TINA ANNE MIDDLETON, Executrix of this, my Last Will and Testament. I direct that my Executrix or Executrixes, Trustee or Trustees, as the case may be, and their successors, shall not be required to post ~ecurity or a bond for the performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set ~ hand and seal to this, my Last Will and Testament, this 17~~ day of /1~.;vJ , 2004. ~ fa;::;- ;p~ q '1HI ~ / (SEAL) F. HORTING Signed, sealed, published and declared by the above- named Testator as and for his Last Will and Testament in our presence, who, at his request, in his presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses. Address Jf;1i~ ~!J~ Address 5 REV-346 EX (8-921 FOR REGISTER'S OFFICE USE ONLY PA DEPARTMENT OF REVENUE County Code I Year I File Number ESTATE INFORMATION SHEET 'OJ... \ ~~~\o '\::)~\ DECEDENT INFORMATION: Enter data as it will appear on all documents submitted to the department. Name (Last, First, Middle) Horting, Kenneth F. Decedent's Social Security Number I Date of Death I Date of Birth 188-10-3832 10/8/2005 5/9/1920 TYPE FILING: Enter mark (x) to Indicate the nature of the return to be filed with the department. o Probate Return o Joint Assets Only 00 Estate Tax Only o Litigation Purposes (No Other Assets) LETTERS GRANTED: Enter mark (x) to indicate the nature of the proceedings at the register of wills office. (Attach additional sheets if explanation is necessary.) 00 Testamentary o Administration o No Letters o Other (Please Explain) ATTORNEY/CORRESPONDENT Enter all data concerning the attorney or other individual to receive all tax information and INFORMATION: corresDondence. Name (Last, First, Middle), Street Address, City, State, and Zip Code Supreme Court 1.0.# Hipp, Jennifer B. 86556 1 West Main Street Telephone Number Shiremanstown, PA 17011 717-737-8761 PERSONAL REPRESENTATIVE Enter all data concerning the personal representative(s) of the estate authorized by the Register INFORMATION: of Wills. Executor/Administrator Name (Last, First, Middle), Street Address, City, State, and Zip Code Social Security Number Kerin, Marian T. 23 W. Green Street Telephone Number Shiremanstown, PA 17011 Co-Executor/Administrator Name (Last, First, Middle), Street Address, City, State, and Zip Code Social Security Number Telephone Number Co-Executor/Administrator Name (Last, First, Middle), Street Address, City, State, and Zip Code Social Security Number Telephone Number I P..pa'" By ~bw .- I- I -' Jennifer B. Hipp \1,.vr--o~ h'l - 1 ',' f:' ~~ l l-) .,) Copyright (c) 2000 form software only The Lackner Group, Inc. . .' Fonn 346 (Rev. 8-92)