HomeMy WebLinkAbout01-12-06 (3)
REV.1500 EX + (6-00)
COMMONWEALTH OF REV-1500
PENNSYLVANIA __'___ '~,___
DEPARTMENT OF REVENUE INHERITANCE TAX RETURN jFILENUMBER
DEPT. 280601 21 05 0960
--,-- - HAR.RI~~URG'~~2?128-060~_j~ _ _RE_~IDf:_NT DEC,f:DE_~T __ ~ ....QQ.UN~ODE__ yEAFl.____ _llilMB~_
~ -I D=:~~N:';;:M~~~~~I:ST~~D MIDDLE INiTIAL)--~--'----------l-~' ~O~'~L_~~U_R~T~~~~~ER _~---__~__
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~ APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) -- -sociAL S~~~~~~~~~OF WI!-lS - - -
w Original Return [J 2. Supplemental Retur~---- ---, -- [] 3.Remalnder Rei~~n (dal~-feath ~~ior t~~1-3=82)--
>:: ~ '" 4. Limited Estate [] 4a. Future Interest Compromise (date of death after 5_ Federal Estate Tax Ret~rn Required
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(J g: iil 6. Decedent Died Testate (Attach l_~ 7. Decedent Maintained a Living Trust (Attach 8. Total Number of Safe ~eposit Boxes
II. copy of Will) copy of Trust)
q: ] 9. Litigation Proceeds Received 10 Spousal Poverty: Credit (date of death between
. 12-31-91 and 1-1-95)
TI1I$SeCTION MO$T$e CONlPI4ETED,'~l:.CciRRe$PONPeN~l; AtIlQ]9Q'tftfmEiij1!1!A~T..iIN~OR~~r.'-N'$t-lOI.J-LDfiE DII~E_ -.TEDTO:
NAME COMPLETE MAILING ADDRESS
Wm. D. Schrack III
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FIRM NAME (If applicable)
Schrack & linsenbach law Offices
TELEPHONE NUMBER
I OFFICIAL USE ONLY
11. Election to tax under S c. 9113(A) (Attach Sch 0)
124 W. Harrisburg Street
P.O. Box 310
Dillsburg, PA 17019-0310
, 717-432-9733
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SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation. Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash. Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
[.l 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)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
(1 )
(2)
(3)
(4)
None
OFFICIAL USE ONLY
None
None
None
(5) None
~) None
(7) 485,693.29
(8)
1f'85,693.29
(9) 9,230.18
-- --_._.._---~_.,._-
(10) 8,296.09
(11 )
17,526.27
468,167.02
0.00
(12)
13. Charitable and Governmental Bequests/Sec 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)
20. D
468,167.02
15.Amount of Line 14 taxable at the spousal tax rate. 0.00 x .00 (15) 0.00
or transfers under Sec. 9116(a)(1.2) -------1--- - --------' -........------
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i= 16.Amount of Line 14 taxable at lineal rate 468,167.02 x .045 (16) I 21,067.52
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a.. 17.Amount of Line 14 taxable at sibling rate 0.00 x .12 (17) 0.00
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(J 18. Amount of Line 14 taxable at collateral rate 0.00 x .15 (18) 0.00
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~ 19. Tax Due (19) 21,067.52
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Copyright 2002 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00:
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Decedent's Complete Address:
STREET ADDRESS
Messiah Village
100 Mt. Allen Drive
CITY Mechanicsburg
-- --. -----r.:--. --------
I STATE PA
i ZIP 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1 )
20,000.00
-~-~--
1,052.63
Total Credits (A + 8 + C)
(2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT.
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 theTAX DUE.
A. Enter the interest on the tax due.
8. Enter the total of Line 5 + 5A. This is theBALANCE DUE
21,067.52
21,052.63
(3)
(4)
(5) 14.89
(5A)
(58) 14.89
Make Check Payable to: REGISTER OF WILLS, AGENT
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?........
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?..............................n................................................................................ [j [!J
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF tHE RETURN.
Under penalties of perjury. I declare that I have examined this return. including accompanying schedules and statements. and to the best of my knowledge and belief. t is true. correct and
cqrnplete..Qeclar<lli()n of ere1"'rer o'-h~_thal1'-he personal repre~e-"tative is based 011. all information of",hich preparerJ1~~_any knowledgE!._______._. _. . __" . . . _
SIGNATURE OF PERSON RESPONSI~LE FOR FILING RETURN ADDRESS - -- -- - - ------DATE--
Suzanne Erickson', 10 Junction Road 1;1;:
,. Dillsburg, PA 17019 /!).lc!-r_'q!J--
ADDRESS I ATE
.._--_.._---+~
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIAT
1. Did decedent make a transfer and: Y ~s
a. retain the use or income of the property transferred;.............................n.............................................. ~
b. retain the right to designate who shall use the property transferred or its income;................................ ~,....J-
c. retain a reversionary interest; or.............................._.............................................................................
d. receive the promise for life of either payments, benefits or care?........................................................... [J
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?........................... ......... ..................... ...................... ......... ........................
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124 W. Harrisburg Street
Jillsburg, PA 17019-0310
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For dates of death on or after July 1, 1994 ar
surviving spouse is 3% [72 P.S. 99116 (a) (1
For dates of death on or after January 1, 19!
[72 P.S. 99116 (a) (1.1) (ii)]. The statutedoE
of assets and filing a tax return are still appl
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of trc.,,~._. _ twenty-one years of age or younger at death to or fbr the use of a
natural parent, an adoptive parent, or a stepparent of the child is 0% Lr.<: r'.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 ~oted in 72 P.S.
99116 1.2) [72 P.S. 99116 (a) (1)]. ,
I
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)1. 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._
tax rate imposed on the net value of transfers to pr for the use of the
l net value of transfers to or for the use of the surviving spouse is 0%
Irviving spouse from tax, and the statutory require~ents for disclosure
)use is the only beneficiary. '
THE REVOCABLE LIVING TRUST
REVOCABLE
TRUST AGREEMENT
MADE this qil/f day of J ~/1 e..--; 1997 by and between Martha M. Mallery,
individual and resident of York County, Pennsylvania, (hereinafter alternatively referred to as
the "Settlor"), and Martha M. Mallery, individual and resident of York County, Pennsylvania,
as the Trustee (hereinafter alternatively referred to as the "Trustee").
WIT N E SSE T H:
ARTICLE ONE
(A) Establishment of Trust Estate: The Settlor has transferred and delivered to
the Trustee that property more fully described in Schedule "A", attached hereto and made part
hereof (the "Property"). The Trustee shall hold and administer the Property, together with all
other cash or property of any kind which the Trustee at any time may acquire from the Settlor
or from others by inter-vivos transfer or pursuant to beneficiary designations by Last Will and
Testament or otherwise, including, but not limited to, the residue and remainder of Settlor's
Estate as provided for in Settlor's Last Will and Testament ("Additions"), together with the
proceeds, investments and reinvestments with respect thereto as a trust estate ("Trust Estate")
on the terms and conditions hereinafter set forth.
The name of the Trust herein created shall be THE MARTHA M. MALLERY
REVOCABLE LIVING TRUST.
(B) Distributions to Settlor Durine Settlor's Lifetime: During the lifetime of the
Settlor, the Trustee shall pay to the Settlor or expend for the Settlor's benefit the entire net
income produced by the Trust Estate ("Income") in convenient installments or otherwise as
Settlor may from time to time direct, together with such portion of the principal of said Trust
Estate as Settlor may from time to time direct in writing or, if Settlor gives no directions, as the
Trustee deems advisable to provide for the health, welfare and comfortable support of the
Settlor, and to continue Settlor's accustomed pattern of giving to individuals and organizations.
Any unexpended Income shall be added to principal and invested as such.
(C) Distributions of Trust Estate in the Event a Settlor Becomes Incapacitated:
If at any time Settlor is under a legal disability, or if by reasorl of illness or mental or physical
disability Settlor is "incapacitated," as such term is defined below, and is unable to make or
communicate responsible decisions concerning Settlor's affairs, the Trustee shall use the income
and part or all of the principal of the Trust Estate for the care, comfort and support of the
Settlor, or for any other purpose which the Trustee, in their sole and absolute discretion, deem
to be for the best interests of the Settlor.
1
"Incapacity" of a Settlor shall be determined by the existence of one or more of the following:
(1) There is a court order, which such Trustee or beneficiary deems to be
jurisdictionally proper and still concurrently applicable, holding a person to be legally
incapacitated to act on his or her own behalf or appointing a guardian to act for him or her, or
(2) There are duly executed, witnessed, and acknowledged written certificates of a
licensed physician (whom represents that he or she is certified by a recognized medical board),
to the effect that the physician has examined the Settlor and has concluded that such person has
become incapacitated to act rationally and prudently in his or her own financial best interests,
or
(3) There is evidence which such Trustee or beneficiary deems to be creditable and
still currently applicable that the Trustee has disappeared, is unaccountable absent, or is being
detained under duress where he or she is unable effectively and prudently to look after his or
her own best interests.
Given the occurrence of such events or circumstances, the affected Settlor shall be
deemed to have become incapacitated. Such incapacity shall be deemed to continue until such
court order, certificates, and/or circumstances have become inapplicable or have been revoked.
Any physician's aforesaid certificate may be revoked by a similar certificate to the effect
that the person is no longer incapacitated executed either: (a) by the originally certifying
physician(s) or (b) by another licensed, board certified physician. No Trustee shall be under any
duty to institute any inquiry into the person's possible incapacity, but the expense of any such
inquiry reasonably instituted may be paid from the Trust assets. Payment for such inquiry refers
both to a reasonable inquiry as to the incapacity of such individual and to that inquiry as to the
revocation of such a certificate.
(D) Distributions Followine the Death of the Settlor:
1. Income Distribution Upon Death of Settlor:
Upon the death of the Settlor, the Successor Trustee shall pay to the personal representative of
the estate of the Settlor, all Income accrued but undistributed as of the date of death of the
Settlor.
2. Distribution of Principal to Estate of Settlor to Pay "Death Taxes". The
Successor Trustee shall then make payment to the personal representative of the estate of Settlor,
out of the principal of the Trust, an amount equal to the estate, inheritance, transfer, succession
or other death taxes ("death taxes") federal, state and other, payable by reason of the inclusion
of part or all of the trust property in his or her estate. The determination by the personal
2
representative of the estate of the Settlor, of the amount payable hereunder shall be final and
conclusive. The final determination of the amount due hereunder shall be based upon the values
as finally determined for estate tax purposes in the estate of the Settlor. The Settlor hereby
directs the Successor Trustee to pay such amount promptly upon written request of the personal
representative of the estate of the Settlor, and upon payment of the amount finally determined
to be due hereunder, the Successor Trustee shall be discharged from any further liability with
respect to such payment.
3. Power of Appointment Exercisable by the Settlor: Upon the death of the Settlor,
the remaining principal and any accrued or undistributed Income shall be transferred and
delivered to or for the benefit of such one or more persons, corporations or other organizations,
including the estate of the Settlor or to the creditors of the Settlor, in such portions or amounts
and subject to such trusts, terms and conditions as the Settlor, may appoint by specific reference
in the Last Will and Testament of the Settlor to the power of appointment contained in this,
Paragraph (D) 3 of Article One. If the Settlor does not exercise this power in full, the
unappointed principal and accumulated and undistributed Income shall be distributed as
hereinafter provided.
4. Distributions of Remaining Income and Principal: Upon the death of the Settlor,
the remaining principal of the Trust and any accumulated or undistributed income shall be
distributed as follows:
(a) Specific Distributions from the Trust Estate:
Prior to any distribution of the balance of the Trust Estate, the following specific
distributions shall be made by the Successor Trustee.
$
NONE
(b) Distribution of the Balance of the Trust Estate:
After provision has been made for the above-noted specific distributions, the
balance of the Trust Estate shall be distributed as follows:
1) SUZANNE ERIKSON, Settlor's daughter,
shall receive one hundred percent (100%) of the
balance of the Trust Estate.
5. In the event that Settlor's beneficiary named above should predecease the Settlor, or
fail to survive Settlor by a period of thirty (30) days, all of that person's share of the Trust
Estate is to be left in Trust to be equally divided among that person's lineal children, per stirpes,
and bestowed. upon their Twenty-fifth birthday.
3
ARTICLE TWO
(A) Beneficiary Provisions: If any beneficiary who is entitled to receive a share of the
principal of the balance of the Trust Estate pursuant to Paragraph 5 of Section (D) in Article
One, shall not have attained the age of twenty-five (25) years, the Trustees are hereby authorized
and empowered to retain said share in trust and administer, manage and make distribution of
said shares as follows:
1. All income of said share shall be distributed to said beneficiary in annual or,
at the discretion of the Trustee, more frequent installments.
2. The principal of said share shall be distributed at the sole discretion of the
Trustee to or for the benefit of the said beneficiary as the Trustee deems desirable to
provide for the health, welfare, benefit, education and support of said beneficiary, taking
into consideration the beneficiaries other separate resources. .
3. Upon attainment of age twenty-one (21), one half of the then principal amount
of said share shall be distributed to the beneficiary without regard to need.
4. Upon attainment of age twenty-five (25) the remaining balance of principal and
any accumulated income on said share shall be distributed outright to said beneficiary and
such portion of the trust established and managed for such a share shall be terminated.
(B) Perpetuities Savines Provision: Notwithstanding anything to the contrary herein
contained, upon the expiration of twenty-one (21) years following the death of the survivor of
all the beneficiaries herein named or described who are living at the death of the first Settlor to
die, all Trusts remaining hereunder shall terminate, and the principal shall be transferred and
delivered to the person then entitled to the income therefrom.
(e) Spendthrift Clause: Neither the principal nor the Income of any portion of the
Trust Estate shall be liable or subject to the contracts, debts, liabilities or torts, now or hereafter
made, contracted, incurred or committed, or any beneficiary or remainderman; nor shall the
principal or Income of the Trust Estate be liable to attachment by garnishment proceedings or
other legal process; nor shall any assignment or order either of principal or income, given by
any beneficiary or remainderman be valid, but the principal and Income shall be paid by the
Trustee directly to or for the use of the beneficiary entitled thereto, without regard to any
assignment, order, attachment or claim whatever. Every such attempted assignment or other
disposition by any beneficiary or remainderman shall not be merely voidable, but absolutely
void, except that this provision shall not impair or restrict the exercise of any power of
appointment granted hereunder. No payment hereunder shall become the property of any
beneficiary or remainderman until it is received by him or his guardian.
4
(D) Disposition of Accrued Income Followine Death of Income Beneficiary: Upon
the death of any Income beneficiary, any Income accrued or received by the Trustee subsequent
to the last Income payment date shall be paid to the person or persons for whose benefit the
principal producing such Income is continued in trust or to whom such principal is distributed
under the terms hereof.
(E) Stock Dividends Allocated To Principal: Corporate distributions received in shares
of the distributing corporation shall be allocated to principal, regardless of the number of shares
and however described or designated by the distributing corporation.
(F) Characterization of "Income": "Accrued Income": Income accrued on any
property received by the Trustee, either at the inception of the Trust Estate or as an addition
thereto, shall be treated as Income and not as principal; PROVIDED, HOWEVER, that any
lump-sum distribution payable to the Trustee under any employee benefit plan or individual
retirement account in which the Settlor has an interest shall be treated as principal
notwithstanding the options, elections or privileges that may be exercised by the Trustee, the
Settlor or any beneficiary for income, estate or death tax purposes. Upon the death of any
beneficiary of Income, any undistributed income then held by the Trustee for such beneficiary
shall be paid to the person or persons for whose benefit the principal producing such income is
continued in Trust or to whom it is distributed under the terms hereof.
ARTICLE THREE
(A) Powers of the Trustee: The Trustee hereunder shall have the following powers,
in addition to and not in limitation of those granted by law:
1. Accept. Purchase and Retain Assets: To accept assets in kind from the
Settlor, his estate or elsewhere, to purchase assets from the estate and to retain
such assets in kind;
2. Sale and Investment of Other Assets: To sell assets and to invest and reinvest
the proceeds and any other cash in any kind of property, real or personal, or part
interest therein, located in the United States or abroad, including interest bearing
accounts in or certificates issued by any firm, including a corporate fiduciary, and
securities underwritten by syndicates of which the corporate fiduciary is a
member but not purchased from the Trustee, all statutory and other limitations as
to the investment of funds, now or hereafter enacted or in force, being waived;
3. Hold Cash: To hold Income cash uninvested until the next regular payment
date, without liability for interest thereon;
5
4. Purchase Life Insurance: To retain or to purchase policies of life insurance,
to pay premiums thereon from income or principal and to exercise all rights of
ownership thereof;
5. Encumber Assets: To pledge, exchange or mortgage real or personal property
and to lease the same for terms exceeding five (5) years;
6. Give Options: To give options for sales, leases and exchanges;
7. Compromise Claims: To compromise claims and controversies;
8. Vote Common Stock: To vote shares of corporate stock, in person or by
proxy, in favor of or against management proposals;
9. Carry Securities Without Identifying Trust Estate: To carry securities in the
name of a nominee, including that of a clearing corporation or depository, or in
book entry form or unregistered or in such other form as will pass by delivery;
10. Distribution in Kind: To make division or distribution hereunder either in
cash or in kind; and, in connection therewith, to allocate to different kinds of, or
interests in, property and property having different bases for federal income tax
purposes, all as the Trustee deem equitable;
11. Investment of Trust Estate Assets: To invest and reinvest the Trust Estate
funds (or leave them temporarily uninvested), in any type of property and every
kind of investment, without regard to any principle of diversification of risk, and
without being limited to "legal investments", including (but not limited to)
corporate obligations of every kind, preferred or common stocks, securities of
any regulated investment trust, and partnership interests.
12. Participate in Business Operations: To participate in the operation of any
business or other enterprise for whatever period of time the Trustee deed proper,
with full power to do any and all things deemed necessary or appropriate,
including the power to incorporate any unincorporated business; to vote any and
all shares of stock owned in any such business; to borrow and to pledge assets as
security for such borrowing; to assent to, join in, or vote in favor of or against
any merger, reorganization, voting trust plan, or similar action, and to delegate
discretionary duties with respect thereto; to delegate all or any part of the
supervision, management and operation of the business to such person or persons
as may be selected; and to close out, liquidate, or sell the business at such time
and upon such terms as the Trustee deem advisable.
13. Deposit Funds: To deposit Trust Estate funds in any commercial savings or
savings and loan accounts, or in "money market" or similar accounts maintained
by any corporate fiduciary.
6
14. Borrow Funds: To borrow money for any reasonable Trust Estate purpose
from any lender, including the power to borrow from the probate estate of Settlor
for the purpose of payment of taxes or on behalf of any separate trust hereunder
from any other separate trust hereunder, upon such terms, including (but not
limited to) interest rates, security, and loan duration, as they deem advisable.
15. Make Loans: To lend Trust Estate funds to such persons and on such terms,
including (but not limited to) interest rates, security, and loan duration, as the
Trustee deem advisable, including the power to make loans to the Settlor during
his lifetime.
16. Sale of Trust Estate Assets: To sell or otherwise dispose of Trust Estate
assets, including (but not limited to) Trust Estate real Property, for cash or credit,
at public or private sale, and with such warranties or indemnifications as the
Trustee deem advisable.
17. Alteration or Disposal of Trust Estate Assets: To improve, develop, manage, lease,
or abandon and Trust Estate assets, as the Trustee deems advisable.
18. Hold Property Without Identifying Trust Estate: To hold property in the
name of any Trustee or any custodian or nominee, without disclosing this trust,
but the Trustee are responsible for the acts of any custodian or nominee the
Trustee so use.
19. Compensate for Administration: To pay and advance money for the Trust
Estate's protection and for all expenses, losses, and liabilities sustained in its
administration.
20. Act as Legal Representative: To prosecute or defend any action for the
protection of the Trust Estate, the Trustee in the performance of their duties, or
both, and to pay, contest, or settle any claim by or against the Trust Estate or the
Trustee in the performance of their duties.
21. Hire Consultants. etc: To employ and dismiss agents, brokers, investment
advisors, accountants, attorneys and employees, regardless of whether they are
associated with the Trustee, or the Trustee or affiliates or employees thereof, and
to advise or assist them in the performance of their duties.
22. Allocate Between Principal and Income: To determine what is principal or income
and what items shall be charged or credited to either.
23. Execute Binding Legal Instruments: To execute and deliver any instruments
necessary or useful in the exercise of any of the foregoing powers.
7
24. Retain Non-Income Producing Property: To retain, during the lifetime of
the Settlor, for so long as the Trustee may deem advisable any property
whatsoever, regardless of whether or not such property income producing.
25. Retain Settlor's Personal Residence: Following the death of the Settlor, the
Trustee are authorized to retain as part of the Trust Estate for the personal use
of the Settlor, any property occupied by Settlor and the Settlor at the death of
Settlor as their principal place of residence for so long as the Settlor wishes to
occupy said residence. During such period of retention, the Trustee shall pay
from the Income or principal of the separate trusts established hereunder as the
Trustee may deem to be in the best interests of such trusts and their beneficiaries,
all taxes and assessments levied upon or assessed against residence, and all costs
of maintaining, repairing and insuring said residence.
No obligation of rent shall be imposed upon the Settlor during any period of
occupation of said residence. On written or oral request of the Settlor, the
Trustee may sell said residence and replace it with other property which in the
opinion of the Trustee is suitable as a residence for the Settlor, to be retained in
the trust in the same manner as the property which was replaced.
26. Authority to Sign Documents: Either Trustee shall have the power to
execute individually any and all documents necessary to carry out the powers,
functions, and duties of the position of Trustee. Such power shall include, but
shall not be limited to: the signing of checks, the opening of bank or other
financial accounts, the disbursement of Trust funds, the execution of contracts,
and other such fmancial transactions.
(B) Resienation of Trustee: Any Trustee may resign at any time during Settlor's
lifetimes by written notice to Settlor. After the death of the Settlor, a Trustee may resign at
any time, without stating cause, by notice to the remaining Trustee(s); provided, however that
prior to the resignation of a sole remaining individual Trustee, such Trustee's resignation shall
not become effective until after such Trustee has appointed a corporate trustee as successor, and
such corporate trustee has accepted such appointment. Absent such appointment and acceptance,
said Trustee's resignation shall not become effective until said Trustee has petitioned a court of
competent jurisdiction to designate a successor corporate trustee.
(e) Successor Trustee(s): Upon the death, disability, incapacity or resignation of any
Trustee, during the lifetime of the Settlor, the Settlor may appoint one or more successor
Trustees. Upon the death, disability, incapacity or resignation of any individual Trustee
following the death of the Settlor, the then remaining Trustee if any may appoint one or more
successor Trustees, who may either be individuals or a corporate trustee; provided, however,
that such right of appointment shall not exist to the extent a corporate trustee has already been
appointed hereunder.
Unless the Settlor makes other provisions during Settlor's lifetime as is her unlimited
right then upon the death or incapacity of the Settlor, SUZANNE ERIKSON, Settlor's child,
8
shall serve as Successor Trustee without bond. Should SUZANNE ERIKSON fail or cease to
serve, as Successor Trustee, then KEITH M. ERIKSON, Settlor's grandson, is appointed as
contingent Successor Trustee, to serve without bond.
(D) Replacement of A Corporate Trustee: If at any time a corporate trustee has been
appointed during the lifetime of Settlor, the Settlor may replace such corporate trustee by written
notice to said corporate trustee, and may, but shall not be required to, designate a successor
corporate trustee. Following the death of the Settlor, an individual Trustee may replace a
corporate trustee by written notice thereto, and may, but shall not be required to, designate a
successor corporate trustee.
(E) Compensation of Trustee: The Trustee shall be entitled to receive annual
compensation for their services hereunder but not in excess of such compensation as would be
approved by a court of competent jurisdiction. Payment of such compensation to a Trustee, in
his, her or its capacity as such shall not preclude payment to any Trustee for the rendition of
professional services for, or on behalf of, the Trust Estate. For any services performed by the
Trustee in connection with Settlor's estates, which services are normally performed by the
personal representative, the Trustee shall be entitled to such additional compensation as may be
fair and reasonable under the circumstances.
(F) Authority to Terminate Small Trusts: Should the principal of any Trust Estate
herein provided for, be or become too small in the Trustee' discretion to make establishment or
continuance of the Trust Estate advisable, the Trustee may make immediate distribution of the
remaining principal and Income outright to the Income beneficiaries in the proportion to which
they are then entitled to the Income. The receipts and releases of the distributee will terminate
absolutely the right of all persons who might otherwise have a future interest in any portion of
the Trust Estate, whether vested or contingent, without notice to them and without the necessity
of filing an account with the court.
(G) Mereer: The Trustee may merge or consolidate for administrative purposes any
trust established under this Trust Agreement with any other trust established by Settlor of the
Settlor having the same Trustee and substantially the same dispositive provisions.
(II) Division and Deleeation of Duties by Trustee: One or more of the Trustee may,
whenever, as often, and for such period as they shall deem it advisable to do so, delegate to one
or more of the other Trustee, any or all ministerial and administrative duties, including the
keeping of books and records, acting as custodian of the Trust Estate property, and preparing
all necessary tax returns, as well as the authority to exercise in their names and behalf any or
all the powers, authorizations, discretion, and duties vested in or devolving upon them as Trustee
under the provisions of this Trust Estate. Any action taken by the Trustee to which such
division or delegation shall be made shall have the same force and effect as if taken and
exercised by the designating or delegating Trustee(s) acting in conjunction with the designated
or delegated Trustee(s). Any such delegation shall be sufficiently evidenced for any and every
purpose if contained in a writing, signed by the designating Trustee(s) and delivered to the
designated Trustee(s).
9
(n Fiduciary Restrictions. Discretion and Elections: The powers and discretion
granted to the Trustee are exercisable only in a fiduciary capacity and may not be used to shift
or enlarge any beneficial interest except as an incidental consequence of the discharge of
fiduciary duties. The Trustee may make discretionary payments of income and principal in
unequal shares to the beneficiaries of any trust established hereunder, and may, but shall not be
required to, consider other resources available to any beneficiary. The Trustee may make tax
elections without regard to the relative interests of any beneficiaries and may, but shall not be
required to, make equitable adjustments among beneficiaries.
ARTICLE FOUR
(A) Additions to Trust &tate: The Settlor or others may, by Last Will and Testament,
inter-vivos transfer or beneficiary designation, add to the Trust Estate, cash or such property in
kind as is acceptable to the Trustee at any time during the term of the present Trust Agreement.
(B) Settlor's Rimt to Revoke Ae:reement: The Settlor expressly reserves the right at
any time and from time to time to revoke this Agreement, in whole or in part, by written notice
delivered to the Trustee during Settlor's lifetime. The Settlor shall have the right to revoke, in
whole or in part, any portion of the present Trust Agreement relating to the Trust created herein.
Upon the death of the Settlor, the Trust and all of its terms and conditions shall become
irrevocable and not subject to amendment or modification.
(C) Settlor's Ri2ht to Amend Trust A2reement: The Settlor further reserve the right
at any time and from time to time to amend this Agreement at any time during her life by a
proper instrument in writing, executed by the Settlor and delivered to the Trustee during
Settlor's lifetime and accepted by the Trustee. The Settlor shall have the right to amend, in
whole or in part, any provision in the present Trust Agreement relating to the Trust created
herein. Upon the death of the Settlor, the Trust and of its terms and conditions shall not be
subject to amendment or modification.
(D) Life Insurance: If Settlor designate the Trustee as beneficiary of the proceeds of
any policies of insurance on their lives, the duty and responsibility for the payment of premiums
and other charges on such policies during the Settlor's lifetimes shall rest solely upon Settlor.
The only duty of the Trustee shall be the safekeeping of such policies as are deposited with it,
and the Trustee shall be under no duty to notify the Settlor that any such premium or other
charge is due and payable.
All options, rights, privileges and benefits exercisable by or accruing to the Settlor during
their lifetimes by the terms of the policies shall be for the Settlor's sole benefit. The Settlor
agree, however, not to exercise any options whereby the proceeds would be payable to the
Trustee other than in one sum. Upon the written request of the Settlor, the Trustee shall execute
and deliver such consents and instruments as may be requisite to enable the Settlor to exercise
or avail themselves of any option right, privilege or benefit granted by any of the policies.
10
Upon the Settlor's/Settlor's death(s), or at such later time as may be specified in the policies,
the net proceeds of any policies then payable to the Trustee hereunder shall be collected by the
Trustee; the receipt of the Trustee for such proceeds shall release the insurance companies from
liability on the policies, and the insurance companies shall be under no duty to see to the
application of such proceeds. The Trustee may take all steps necessary in their opinion to
enforce payment of said policies and shall be entitled to indemnify themselves out of any
property held hereunder against all expenses incurred in taking such action.
(E) Employee Death Benefits: The Settlor may designate the Trustee as beneficiary
of certain employee death benefits. In such case the Trustee shall collect the proceeds receivable
therefrom upon the Settlor's death and hold them as part of the Trust Estate. The receipt of the
Trustee for such proceeds shall be a full acquittance to the administrator of such benefit, and
said administrators shall not be liable to see to the application of such proceeds. To the extent
that such proceeds are not included in the Settlor's estate for federal estate tax purposes, they
shall not be used for the payment of death taxes or any administration expenses of Settlor's
estate. The Trustee may select any option available to it as to the time and method of payment
of such proceeds and may also exercise any option with respect to the income or death taxes
thereon as they in their sole discretion deem advisable, and their decision in these matters shall
be binding upon, and shall not be subject to question by, the beneficiaries.
ARTICLE FIVE
(A) Incontestability: The beneficial provisions of this instrument (and of Settlor's Last
Will and Testament) are intended to be in lieu of any other rights, claims, or interests of
whatsoever nature, whether statutory or otherwise, except bona fide pre-death debts, which any
beneficiary hereunder may have against or in Settlor's estate of the properties in Trust
hereunder. Accordingly, if any
beneficiary hereunder asserts any claim (except a legally enforceable debt), statutory election,
or other right or interest against or in Settlor's estate, Settlor's Will, or any properties of said
Will, or directly or indirectly contests, disputes, or calls into question, before any court, the
validity of this instrument or of said Will, then;
(a) Such beneficiary shall thereby absolutely forfeit any and all beneficial
interests of whatsoever kind and nature which such beneficiary might otherwise
have under this instrument and the interests of the other beneficiaries hereunder
shall thereupon be appropriately and proportionally increased and/or advanced.
(b) All of the provisions of this instrument, to the extent that they confer any
benefits, powers, or rights whatsoever upon such claiming, electing or contesting
beneficiary, shall thereuppn become absolutely void and revoked, and
(c) Such claiming, electing, or contesting beneficiary, if then acting as a Trustee
hereunder, shall automatically cease to be a Trustee and shall thereafter be
11
ineligible either to select, remove, or become a Trustee hereunder. The foregoing shall not be
construed, however, to limit the appearance of any beneficiary as a witness in any proceeding
involving this instrument or said Will nor limit any beneficiary's appearance in any capacity in
any proceeding solely for the construction of either of said documents.
(B) Payment of Debts. Taxes and Other Charees upon Settlor's Death: Upon each
Settlor's death, the Trustee may pay to or upon the order of Settlor's personal representative
funds needed to pay Settlor's debts, funeral and burial expenses, costs of administration, death
taxes and specific bequests, if any, under the Settlor's Last Will and Testament. The Trustee
may rely upon Settlor's personal representative as to the amount of such charges. The decision
of the Trustee about whether to provide funds shall be final, except that the Trustee shall use
any U.S. Treasury securities that may be redeemed at par to pay federal estate taxes for that
purpose. Assets that are not included in Settlor's gross estate for federal estate tax purposes
shall not be used for such payments.
(C) Payment of Taxes at the Settlor's Death: If the Settlor does not negate this
provision by specific reference to this paragraph in the Last Will and Testament of the Settlor,
the Trustee shall, upon the death of the Settlor, pay to the estate of Settlor from the principal
of the Trust a sum sufficient to cover the estate and inheritance taxes payable by reason of the
death of the Settlor and attributable to the principal of the Trust.
(D) Disclaimer: Any beneficiary hereunder, or the legal representative of any such
beneficiary shall have the right, within the time prescribed by law, to disclaim any benefit or
power under this Trust Agreement.
(E) Word Meanines: The words "herein", hereinbefore", "hereinafter" and
"hereunder" refer to this Agreement as a whole and not merely to a subdivision in which such
words appear, unless the context requires otherwise. The singular shall include the plural, the
plural the singular, and the use of any gender shall be applicable to all genders. The terms
"child" "children" and "issue" and similar terms shall include adopted children, regardless of
the date of adoption, with full effect as if they were the natural children of the adopting parents.
The term "minor" shall mean any person under the age of twenty-one (21) years, regardless of
the age of the majority provided by statute.
(F) Paraeravh or Article Headines: Headings contained in this Trust Agreement are
inserted only as a matter of convenience and for reference, and shall not be construed in any
way to define, limit, extend or describe the scope of any of the provisions hereof.
(G) Governine Law: This Agreement shall be deemed to have been delivered to and
accepted by the Trustee in the State of Pennsylvania, regardless of the jurisdiction in which
actual execution may have occurred, and shall be interpreted and governed in all respects by the
laws of said State which shall be applied to any dispute arising hereunder.
12
. ,
(II) Enforceability: The invalidity or enforceability of any particular provisions of
this Agreement shall not affect the other provisions hereof and this Agreement shall be construed
in all respects as if such invalid or unenforceable provision was omitted.
(n Chanee of Aereement: Except as otherwise specifically provided herein, no
change, modification, amendment of, or waiver under, this Agreement shall be valid unless the
same be in writing and signed by all of the parties hereto.
(J) Notices: Any notice, request, direction, instruction or other communication
permitted or requested to be made hereunder by any party to the other shall be in writing
(including telex, telegram or telecopier ["fax"], signed by the party giving such notice and shall
be delivered personally, sent by registered or certified mail, postage prepaid, or by telex,
telegram or fax (in each such case followed by written confirmation) to the other parties, to the
addresses indicated below (or to such other address as any or all of said undersigned may have
submitted therefor by written notification. The date of personal delivery, the date of receipt (if
mailed), when delivered by the telegraph company or in the case of telex or fax, when received,
as the case may be, shall be the effective date of such notice. Whenever under the terms hereof
the time for giving notice or performing an act falls upon a Saturday, Sunday or holiday, such
time shall be extended to the next business day.
Mrs. Martha M. Mallery
9 Belair Drive
Dillsburg, PA 17019
IN WITNESS WHEREOF, with the intentions to be legally bound hereby, the Settlor
and the Trustee have executed this Trust Agreement on the day and year first above written.
W
SETTWR:
~fvl.~~.
MARTHA M. MALLERY
WITNESS:
~E/~
TRUSTEE:
~'m:~
MARTHA M. MALLERY
13
COMMONWEALTH OF PENNSYLVANIA )
) SS:
COUNTY OF ~ )
On this, the L/ -111 day of 6il~' ,1991, before me, a Notary Public,
personally appeared MARTHA M. MALL RY, known to me or satlsfactonly proven to be the
person whose name is subscribed to the within instrument as the Settlor and the Trustee and
acknowledged that she executed the same for the purposes therein contained.
J I i-b..
IN WITNESS WHEREOF I hereunto set my hand and official seal this..., day of
<1 UJl...A- , 199 L.
51aa.1";] /iJwfe nJLJ
Notary Pub ic
My Commission Expires:
14
DECLARATION OF INTENT
The undersigned, MALLERY M. MALLERY, hereby declares that, as Trustee of THE
MARTHA M. MALLERY REVOCABLE TRUST, that she is acquiring and will hold in the
name of MARTHA M. MALLERY, but without further reference to their fiduciary capacity,
all items listed on Schedule A attached hereto and incorporated herein as amended from time to
time as well as household furnishings, automobiles, jewelry, bank accounts, securities, bonds,
clothing and other personal property of any kind in her name and henceforth such assets shall
and will belong to said Trust and not to her individually. She further declares that, except to
the extent of the interest provided to her under the terms and provisions of said Trust, she has
no personal interest in any of the above itemized personal properties, it being intended that this
Declaration constitutes an affirmation of Trust ownership which shall be binding on her heirs,
administrators, executors and assigns.
IN WITNESS WHEREOF, the undersigned has executed this instrument this
q lLA-( , 1991.
BY: Y11~I?1. rJ1~
MARTHA M. MALLERY ·
L.j'f-iJ... day of
TRUSTEE/SETTLOR
COMMONWEALTH OF PENNSYLVANIA
)
)
SS:
COUNTY OF Lf' K )
On this, the '-I t!J day of EiJ..I.LJ'L1 , 1997, before me, a Notary Public,
personally appeared MARTHA M. MALL Y, known to me or satisfactonly proven to be the
person whose name is subscribed to the within instrument as the Settlor and the Trustee and
acknowledged that she executed the same for the purposes therein contained.
IN WITNESS WHEREOF I hereunto set my hand and official seal this 4 i:h. day of
tJ U_A\~_L , 1991.
sjJ~ /L/fl+1Xuu
Notary Pu ic
My Commission Expires:
Notarial Seal .
S Dawn Gladfelter, Notary PubliC
. DmS~urg BoErop' Ylr~~ ~a~urr. 2001
My Commission x .
1MmMr, penneylvanla AIIlOclatlon OT Notan"
1
. .
SCHEDULE" A"
PURSUANT TO ARTICLE ONE, (A) OF THE REVOCABLE TRUST
AGREEMENT BETWEEN SETTLORS AND TRUSTEES, AND THE "DECLARATION
OF INTENT" WHICH IS ATTACHED THERETO, THE FOLLOWING IS A LIST OF
THE PROPERTY OF SETTLORS WHICH HAS BEEN TRANSFERRED TO THE
TRUST:
ITEM:
Real Property:
Home
Accounts
Harris Savings Bank Certificate of Deposit
Mellon Bank Checking Account
Mellon Bank Money Market
Mellon Bank Certificate of Deposit
Mellon Bank Certificate of Deposit
Fulton Bank Checking Account
Fulton Bank Certificate of Deposit
Fulton Bank Certificate of Deposit
Other Assets:
General Household Furnishings
1990 Chevrolet
Stocks:
Columbia Gas
Bonds:
Peter Township Sanitary Tax Free
Housing Mortgage Revenue
U. S. Savings Bonds
Brokeraee Accounts:
Wheat First Butcher Singer
Wheat First Butcher Singer
Janney Montgomery Scott
DESCRIPTION:
Location
9 Belair Drive
Dillsburg, P A 17019
Present Acct No: Trust Acct No:
1855303679
2221104215
2200706337
00396604
00396626
3619428243
4622853960
64306496
LN05 5265-4177
LN05 5265-4175
MB665453-5133
FIRST AMENDMENT TO
THE MARTHA M. MALLERY REVOCABLE LIVING TRUST
DATED JUNE 4, 1997
MADE this 5+!L day of August, 1997 by and between MARTHA M.
MALLERY, Settlor of the above named Trust (hereinafter referred to
as Settlor) and SUZANNE ERIKSON, an individual residing in York
County, Pennsylvania, (hereinafter referred to as Co-Trustee),
1. Settlor hereby appoints Co-Trustee to serve in the capacity of
Trustee with regard to the above named Trust during the life time
of Settlor, and to have all powers specifically granted to trustees
by said Trust in addition to all powers granted by law.
2. Co-Trustee hereby agrees to serve in such capacity.
3. Settlor hereby confirms her appointment of SUZANNE ERIKSON, the
above named Co-Trustee as Successor Trustee to serve in that
capacity upon the death or incapacity of the Settlor.
4. Settlor's appointment of the Co-Trustee shall not be
interpreted as a relinquishment of her own powers and/or her
capacity as Trustee of the above named Trust.
IN WITNESS WHEREOF, with the intention to be legally bound hereby,
the Settlor and the Co-Trustee have executed this First Amendment
on the day and year first above written.
WITNE,BS :
/'
SETTLOR:
~
~/Yl./11
~THA M. MALLERY' ~
WITNESS:
(/A" s:- I ~fi.,
"fu;-JL-U:~ C. 1 (.v~/h-.
CO-TRUS:::.v~
_ ERIKS
"
F
. ..
COMMONWEALTH OF PENNSYLVANIA
SS
YORK COUNTY
h' S~h
On t 1S, the - day of August, 1997, before me, a Notary
Public, personally appeared, MARTHA M. MALLERY and SUZANNE ERIKSON,
whose names are subscribed to the within instrument as the Settlor
and Co-Trustee and acknowledged that they executed the same for the
purposes therein contained.
IN WITNESS WHEREOF I hereunto set my hand and seal this ~+~ day
of August, 1997.
<~Q,~1~ iu"-ctj_d J-IA)
OTARY P BLIC
My Commission Expires on:
Notarial Seal .
S Dawn Gladfelter, Notary Public
. Dillsburg Bora, York County 001
My Commission ExpIres May 17. 2
Member, pennsylvania Association ot Notaries
Rev-1510 EX+ (6-98)
.
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mallery, Martha M.
FILE NUMBER
21-05-0960
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 DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE
NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
THE DATE OF TRANSFER. ATTACH A COpy OF THE DEED FOR REAL ESTATE.
1 Citizens Bank CD #6246-061562 20.227.82 20.227.82
2 Citizens Bank Gold Circle ckg acct 31.634.60 31.634.60
#610074-516-3
3 Fulton Bank ckg acct #3619-42824 7.363.50 7.363.50
4 Janney Montgomery Scott investment acct 327.225.23 327.225.23
#5453-513
5 Wachovia Securities acct #5643-1646 99.242.14 99.242.14
TOTAL (Also enter on Line 7, Recapitulation) 485.693.29
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 ScheduleG (Rev. 6-98)
~\,;~~ '''''''''''t''' B' fI
~~~ t,s-QO,I:zens ,'. .,ank
1-800-773-7373
Call Citizens' PhoneBank anytime for account information,
current rates and answers to your questions,
US259 BR319
3
1
LVG TRUST OF MARTHA M MALLERY
C/O SUZANNE ERIKSON
10 JUNCTION RD
DILLSBURG PA 17019
Circle Gold
Account Statement
o OF 4
Beginning July 19, 2005
through August 15, 2005
Contents
Summary
Checking
CDs
Check Images
Page 1
Page 2
Page 3
Page 4
Circle Gold Summary
Account
Account Number
Ba la nce
Last Statement
Balance
This Statement
DEPOSIT BALANCE
Checking
Circle Gold Checking Hi Interest
CDs
11 month CD
610074-516-3
34,376.44
31,634.60
6246-061562
20,170.62
20,227.82
Monthly combined balance to waive monthly fee is
Your monthly combined balance this statement period is
20,000.00
50,725.96
:)It"
:I(,k, ;-(-" tPlfJ/Jr:.;llil ini(),i'f,icl!-nli
LVG TRUST OF MARTHA M MALLERY
MARTHA M MALLERY TTEE
Circle Gold Checking HI Interest
610074-516-3
e
e
Total Deposit Balance
51.862.42
Total RelationshIp Balance
51,862.42
~ c~ ; ",~i iL:'il rd'~ 1(,"" R' ":J' "" ~ ,1
rj II ~ L ~,,!l ~ ,';'1;1 llj..Jl r,~;{j ~f :~ m't'l,
1-800-773-7373
~\6
Call Citizens' PhoneBank anytime for account information,
cur",nt rates and answers to your questions.
Checking
SUMMARY
Balance Calculation
Previous Ba lance
Checks
Withdrawals
Deposits & Additions
Interest Paid
Current Balance
34,376.44
6,207.19 -
.00 -
3,442 . 13 +
23.22 +
31,634.60 =
TRANSACTION DETAILS
Checks. There is a break in check sequence
Check # Amount Date
655 6,121.30 07/20
656 18.40 07/25
Balance
Average Daily Balance
Interest
Current Interest Rate
Annual Percentage Yield Earned
Number of Days Interest Earned
Interest Earned
Interest Paid this Year
Check #
657
Deposits & Additions
Date Amount Description
08/01 3,149.13 US Treasury 312 Civil Serv 080105 F 2222440 W Csf
08/03 293.00 US Treasury 303 Soc Sec 080305
Interest
Date
08/15
Amount Description
23.22 Interest
Daily Balance
Date
07/20
07/25
Balance Date
28,255.14
28,236.74
08/01
08/03
I i I :r ' "ill:;: H"I!~i Ill! ! (~: I d.';
',.,; ;",;,.-,t ,""d ;,..,:, "-"C\-
Balance
Date
08/09
08/15
31,385.87
31,678.87
Amount
67.49
30,265.49
1.00%
1.00%
28
23.22
153.13
Date
08/09
Balance
31,611. 38
31,634.60
Account Statement
o OF 4
Beginning July 19, 2005
through August 15, 2005
LVG TRUST 0 F MARTHA M MALLERY
MARTHA M MALLERY ITEE
Circle Gold Checking Hi Interest
610074-516-3
PrevIous Balance
34,376.44
e
Total Checks
6,207.19
o
Total Deposits & Additions
3,442.13
o
e
Totallnlerest Paid
23.22
~----'~lan
C1,634.60
Fulton Bank
LISTENING.
(717) 291-2437
September 27,2005
Schrack & Linsenbach
124 W. Harrisburg Street
P.O. Box 310
Dillsburg, Pennsylvania 17019
Dear Mr. Schrack III:
RE: Martha M. Mallery, deceased August 7, 2005
In response to your recent inquiry concerning the accounts maintained in the name of
the decedent, please be advised that the following accounts were open at the date of death:
Checking # 3619-42824, open 9/5/1995, balance $7,363.50.
Titled Martha M. Mallery trustee Martha M. Mallery Revocable
Living Trust.
If you should have any further questions, please do not hesitate to contact me.
Very truly yours,
~~~1:cr
Karen D. Hillegas
Credit Inquiry Processor
..;
GUNFlDENTI \..
. . .' '. mattef @t busine~s c
l lArt'!ril"'~ \$ tun"\15itied ;:is ~ . . r",-.fident\a\ L
J'S I'Th'3'I"'~ '_.',,, ',,;;,:.(\1 and is tor '10\.1\ :"'-"""""'rI't \
n"'..../er to 'feU, \\;~;..;"" .\...... '\"""';! or I), \.$ .
It. ;::}''l'' . . ,'_. ,...... q,rJ ~"J\f t\\~t~ U::.;,H\ l . h r"
~~p{}n~ih\hti is 2S)U\ik.,J .~} .' "C'[ tl'i charlOe \ft!ltl~(H:
. T;.~ ll~. - . ,., ." <:;IJ'l\l; . '" .. '"
, ,v . '_ ypre"S8u',;h""
.,.' llnmio\1 here\H e. .~
POBox 4887
Lancaster, PA 17604
fultonbank.com
1-800-FULTON-4
aggey
Janney Man tgomery Scott LLC
September 20, 2005
Schrack & Linsenbach
Attn: William D. Schrack III
PO Box 310
Dillsburg PA 17019
RE: Martha M. Mallery Rev Living Trust
VIA dated 6-4-97
Suzanne Erikson, Succ Ttee
Mr. Schrack:
We are in receipt of your correspondence dated September 13,2005 regarding the above
referenced deceased individual.
Please find enclosed a summary of the account as of August 7, 2005, Mrs. Mallery's date
of death, including accrued interest where applicable.
The account was originally established as a trust with Janney Montgomery Scott in June
of 1997. No changes to the registration of the account occurred prior to Mrs. Mallery's
death; the only change after that time was to add Ms. Erikson as Successor Trustee
pursuant to the terms of the trust. At present time, Janney Montgomery Scott does not
provide a safety deoosit box. service.
Should you require any additional information, please do not hesitate to contact me at
(717) 731-4400.
~SinCerelY' @\f'
J~~./.._.....,... . _ GlL.. ~
~l "l. ). . .
Kristy 1. tehniah
Registered Sales Assistant
20 Erford Road, Suite 315, Lemoyne, PA 17043-1109 . 717.731.4400 . fax: 717.731.4411 . wwwjmsonline.com
Member New York Stock Exchange. Inc. and other principal exchanges
Member Securities Investor Protection Corporation
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REV.1151 EX+ (12-99)
*'
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mallery, Martha M.
FILE NUMBER
21-05-0960
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 4,185.18
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 Schrack & Linsenbach Law Offices 4,500.00
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) 9,230.18
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
Rev.1502 EX+ (6-98)
*'
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mallery, Martha M.
FILE NUMBER
21-05-0960
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Cocklin Funeral Home
4.185.18
Subtotal
4.185.18
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
ESTATE OF
Mallery, Martha M.
FILE NUMBER
I 21-05-0960
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Clerk of Orphans' Court - Release fee
5.00
2
Miscellaneous expense (postage, Notary fees, photocopies, etc.)
25.00
3
Register of Wills - filing fee
15.00
4
Reserve for future administrative expense
500.00
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
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mallery, Martha M.
FILE NUMBER
21-05-0960
Include unrelmbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 Alert Pharmacy - last illness
VALUE AT DATE
OF DEATH
45.56
2 Messiah Village - debt of decedent
7,971.50
3 Mobile X-Ray - last illness
270.05
4 Verizon - debt of decedent
8.98
TOTAL (Also enter on Line 10, Recapitulation)
8,296.09
(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)