HomeMy WebLinkAbout03-08-06 (2)
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OFFICIAL USE ONLY
REV-1500 EX + (6-00)
X 1. Original Return 2. Supplemental Return
CAP B 4. Limited Estate 4a. Future Interest Compromise (date of death after 12-12-82)
~ ~ ~ 5 X 6. Decedent Died Testate X 7. Decedent Maintained a Living Trust
~ S ~ ~ (Attach copy of Will) (Attach copy of Trust)
E S D 9. Litigation Proceeds Received D 10. Spousal Poverty Credit 0 11. Election to tax under Sec. 9113(A)
(date of death between 12-31-91 and 1-1-95) (Attach Sch 0)
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Hoffman Florence K.
DATE OF DEATH (MM-DD-YEAR)
2005-00583
NUMBER
COUNTYCODE YEAR
SOCIAL SECURITY NUMBER
136-01-8986
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
DATE OF BIRTH (MM-DD-YEAR)
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
1
3. date of death
. Remainder Return prior to 12-13-82)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
Ruth Ann McMillen
FIRM NAME (If Applicable)
Manufacturers and Traders Trust Com an
TELEPHONE NUMBER
213 Market Street
Harrisburg, PA 17101
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71 255-2109
1. Real Estate (Schedule A) (1) None
2. Stocks and Bonds (Schedule B) (2) 164 , 787 . 10
3. Closely Held Corporation, Partnership or (3) None
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D) (4) None
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 162,310.48
(Schedule E)
6. Jointly Owned Property (Schedule F) (6) None
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 264,037 .46
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7) (8)
9. Funeral Expenses & Administrative Costs (Schedule H) (9) 28,352. 76
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule J) (10) 7 ,180.56
11. Total Deductions (total Lines 9 & 10) (11)
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 (13)
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
555,601.72
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OFFICI~k.)tJSE ONLY
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591,135.04
35.533.32
555,601.72
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(aX1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20. 1i~)~~~r;~1.~~i~fj1~gij1~R~1_~~~$11~~~:~~6~F~8~[~~:M~~PY.~~~y..,gl1l1ll
"":"::::::::::'::;;~;':;;::;:,::'::""""":i:ill::Hi~i:~:::jijeisQA~i~~:l~$W~8!}~f~l!Q~e.$T1QN$:iQN1~~~g$e.!:$t.p.e::I.NQ1:1t<>i~RI~I~~IHM~1tIj::!~::~l:![[:I:!l:I:m:::!:ill::::!:!!:!!:;::!:: ...... ........
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0.00
555,601.72
0.00
(15)
(16)
(17)
(18)
(19)
.0 0
.0 45
.12
.15
0.00
0.00
66,672.21
0.00
66,672.21
x
X
X
X
Copyright (c) 2000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
"
.
Decedent's Complete Address:
STREET ADDRESS
325 Wesley Drive
CITY I STATE I ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
66,672.21
0.00
52,250.00
2,750.00
Total Credits ( A + B + C) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
55,000.00
Total Interest/Penalty ( D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4) 0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 11,672.21
A. Enter the interest on the tax due. (SA) 0.00
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B) 11,672.21
Make Check Payable to: .... _RE.~.I.S.T~R. ~F: .~.I~L~, .~~~.~T . . . .' . ., . '.' ..' . . ,. . .' . .' . . . . . . . . . .. . ._.' ..' .' . .... .... .'
imim:l:iii::::ll~~l~~~~li~~~W~~il~~~I:~i~EE~Wf~~ii:~~~:~~~~l!~m~~:i~EX~lii!~i'~~iiil~~i!!m~~:i:f~i~ii!~:~i~~i~ii~~~:i~E~~j~~ii,mmmi
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; . . . . . . . . . . . . . ~ ~x~
b. retain the right to designate who shall use the property transferred or its income; .
c. retain a reversionary interest; or. . . . . . . . . . . . . . . . . . . . . . . . . .
d. receive the promise for life of either payments, benefits or care? . . . . . . . . .
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3. Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [!] 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.
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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, it is true,
mplete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
S N RE PO BLE FOR FILI,\G RETURN Manufacturers and Traders Trust Company 3DAT~E A~
213 Market Street
-----------------------------------------------------
Harrisbur , PA 17101
Manufacturers and Traders Trust Company DATE
213 Market Street
-----------------------------------------------------
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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. 9116 (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. 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 return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 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. 9116(1.2)
[72 P.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. 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.
Copyright (c) 2000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
t 1
REV - 1503 EX + (1 -97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
Florence K. Hoffman
55ft 136-01-8986
06/10/2005
2005-00583
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM UNIT VALUE VALUE AT DATE
DESCRIPTION
NUMBER OF DEATH
1 139 shares Delphi Corporation 4.665035 648.44
2 3,617.082 shares Dryden Muni Bond Fund A 11.05000 39,968.76
3 3,271 shares Dryden National Muni Fund B 15.40 50,373.40
4 200 shares General Motors Corp 33.665 6,733.00
5 900 shares Ingersoll-Rand Company Class A 74.515 67,063.50
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TOTAL (Also enter on line 2, Recapitulation) 164,787.10
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc.
Form REV-1503 EX (Rev. 1-97)
REV-1508 EX + (1-97)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Florence K. Hoffman SS# 136-01-8986 06/10/2005 2005-00583
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 VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 $13,579.37 M&T Bank Certificate of Deposit #031003914525258 1.98% 13,579.37
due 12/9/05 - Date of Death Value
Accrued Interest
2.95
2
$20,696.86 M&T Bank Certificate of Deposit #031003913913925 1.78%
due 8/25/05 - Date of Death Value
Accrued Interest
20,696.86
19.18
3
$23,801.59 M&T Bank Certificate of Deposit #031003914624240 1.78%
due 9/5/05 - Date of Death Value
Accrued Interest
23,801.59
9.29
4
$33,997.65 M&T Bank Certificate of Deposit #031003914612823 1.78%
due 9/16/05 - Date of Death Value
Accrued Interest
33,997.65
147.88
5
Cash found in Safe Deposit Box and Room
75.08
6
Cash found in Apartment
6.00
7
Delphi Corporation - Uncashed Dividend Check
9.73
8
First Clearing LLC/Wachovia Securities - Dryden Muni Bond Fund -
Uncashed Dividend Check
116.99
9
First Clearing LLC/Wachovia Securities - Dryden National Muni
Fund - Uncashed Dividend Check
162.83
10
General Motors Corp - Uncashed Dividends
100.00
11
General Motors Corp - Uncashed Dividend Check payable 3/10
100.00
12
M&T Bank Checking Account #43358039 - Date of Death Value
Accrued Interest
18,328.89
1.41
13
PNC Checking Account #5070075668 - Date of Death Balance
Accrued Interest
13,433.52
0.98
14
Received from State Auto - Refund on Homeowners Policy #HPA806442
21.00
Total of Continuation Schedule(s)
37,699.28
TOTAL (Also enter on line 5, Recapitulation) $ 162 ,310.48
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97)
" .
REV-1510 EX + (1-97)
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Florence K. Hoffman
FILE NUMBER
2005-00583
SS1I 136-01-8986
06/10/2005
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
DESCRIPTION OF PROPERTY
ITEM RELAW8kM~I~ ~~b~~~5r~ltWJ~~~1ffl~E6F ~~~~RSFER.
NUMBER ATTACH A COPY OF THE DEED FOR REAL ESTATE.
Amended and Restated Revocable
Agreement of Trust dated
November 9, 1995 "The Florence
K. Hoffman Trust"
% OF
DATE OF DEATH DECD'S EXCLUSION
VALUE OF ASSET INTEREST (IF APPLICABLE)
TAXABLE VALUE
1
409.085 shares CRM Mid Cap
Value Fd-Instl 1132
10,664.85
10,664.85
2
667.166 shares Evergreen
International Bond Fund
-In, CUSIP 11299908830
7,545.65
7,545.65
3
425.712 shares Goldman
Sachs High Yield Fd 11527,
CUSIP 1I38141W679
3,367.38
3,367.38
4
1,869.463 shares MTB Short
Duration Government Bond
Inst I Fund 11120, CUSIP
1155376T221
Accrued Interest
17,965.54
17,965.54
12.58
12.58
5
2,372.184 shares MTB
International Equity-Inst I
Fund 11270
25,595.87
25,595.87
6
1,406.644 shares MTB Large
Cap Value-Inst I Fund 11327,
CUSIP 1I55376T668
16,134.21
16,134.21
7
1,308.079 shares MTB Short
Term Corporation Bd-Inst
1-11518, CUSIP 1I55376T189
Accrued Interest
12.60
12,832.25
12,832.25
12.60
8
3,084.707 shares MTB Small
Cap Stock-Inst I Fund 11571,
CUSIP 1I55376Tl14
27,330.50
27,330.50
9
3,079.681 shares MTB
Intermediate Term Bond-Inst
I Fund #220, CUSIP
1I55376T817
Accrued Interest
30,796.81
30,796.81
37.50
37.50
Total of Continuation Schedule(s)
111,741.72
TOTAL (Also enter on line 7, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc.
264,037.46
Form REV-1510 EX (Rev. 1-97)
Estate of: Florence K. Hoffman
Soc See #: 136-01-8986
Date of Death: 06/10/2005
Item
11
Continuation of Schedule G
(Inter-Vivos Transfers & Misc. Non-Probate Property)
Description of Property
Date of Death % Decd Exclusion
Value of Asset Intrst
Taxable Value
10
4,927.376 shares MTB Large
Cap Stock Inst I Fund #315,
CUSIP #55376T692
42,818.90
11
MTB Money Market-Inst I
Fund #420 - Principal Cash
as of Date of Death
Accrued Interest
14,261.50
11.50
12
MTB Money Market-Inst I
Fund #420 - Income Cash as
of Date of Death
1,235.49
13
424.93 shares Northeast
Investors Trust, CUSIP
/1664210101
3,208.22
14
580.087 shares The Boston
Co. International Small Cap
Fund, CUSIP #58552D762
10,522.78
15
527.093 shares Thompson
Plumb Growth Fund, CUSIP
#884891300
23,719.19
16
145.287 shares Vanguard #94
Institutional Index Fund,
CUSIP #922040100
15,964.14
'1: Annuity
The United Methodist
Stewardship Foundation -
Gift Annuity
Survivor Annuitant -
Ruth E. Kuhn
100.00%
* "The decedent made a
completed gift of the
survivorship annuity on
April 13, 1997, more than
one year prior to her date
42,818.90
14,261.50
11.50
1,235.49
3,208.22
10,522.78
23,719.19
15,964.14
0.00
-
Estate of: Florence K. Hoffman
Soc Sec #: 136-01-8986
Date of Death: 06/10/2005
Continuation of Schedule G
(Inter-Vivos Transfers & Misc. Non-Probate Property)
Item Description of Property
#
Date of Death % Decd Exclusion Taxable Value
Value of Asset Intrst
of death. As a completed
gift, no part of the
successor annuity is
taxable in the decedent's
Estate."
111,741.72
.
Estate of: Florence K. Hoffman
Soc Sec #: 136-01-8986
Date of Death: 06/10/2005
Continuation of Schedule H-B4
(Probate Fees)
Item
II
Description
Amount
1
Rhoads & Sinon, LLP - Reimbursement for Probate Cost plus Short
Certificates
145.00
145.00
REV-1j11 EX + (1~7)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Florence K. Hoffman
SS# 136-01-8986
06/10/2005
FILE NUMBER
2005-00583
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
B.
AMOUNT
DESCRIPTION
1
FUNERAL EXPENSES:
James R. Gingrich Memorials - Inscription Expense
100.00
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) Manufacturers and Traders Trust Company
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address 213 Market Street
City Harrisburg State PA Zip 17101
15,083.90
Year(s) Commission Paid:
2.
3.
Attorney's Fees Rhoads & Sinon, LLP
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
12,500.00
City
Relationship of Claimant to Decedent
State
Zip
4.
Probate Fees
Register of Wills
145.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
1
Other Administrative Costs
Computershare - Fee for Lost Certificate of 100 shares GM
68.28
2
Cumberland County Register of Wills - Six Short Certificates
24.00
3
Cumberland County Register of Wills - One Short Certificate
4.00
4
First Clearing LLC/Wachovia Securities - First Clearing Transfer
Fee
95.00
5
George Haar Auctioneer - Appraisal of Personal Property
60.00
6
Rhoads & Sinon - Reimbursement for Cost of Advertising and Proof
245.58
Total of Continuation Schedule(s)
27.00
TOTAL (Also enter on line 9, Recapitulation) $ 28,352. 76
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97)
.
.
Estate of: Florence K. Hoffman
Soc Sec #: 136-01-8986
Date of Death: 06/10/2005
Continuation of Schedule H-B7
(Other Administrative Costs)
Item
If
Description
Amount
of Publication
7
Vital Records - Three Death Certificates
27.00
27.00
REV-1~12 EX + (1 ~7)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Florence K. Hoffman
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
SS1ft 136-01-8986
06/10/2005
FILE NUMBER
2005-00583
Include unreimbursed medical expenses.
ITEM
NUMBER
1
DESCRIPTION
Alert Pharmacy Services, Inc. - Pharmaceuticals
AMOUNT
135.74
2
Bethany Assisted Living - Nursing Home Expense
260.58
3
Bethany Village - Nursing Home Expense
6,342.44
4
Metro Med Services Care - Medical Expense
90.00
5
PNC Bank Checking Account #5070075668 - Outstanding Check #371
$25.00
25.00
6
PNC Bank Checking Account #5070075668 - Service Charge
4.00
7
State Employees Retirement - Reimbursement of Overpayment of
Retirement 6/11/05-6/30/05
322.80
TOTAL (Also enter on line 10, Recapitulation) $ 7 ,180.56
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97)
REV -1i 13 EX + (9i>0)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Florence K. Hoffman
SCHEDULE J
BENEFICIAR IES
SS1I 136-01-8986
06/10/2005
FILE NUMBER
2005-00583
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116(a)(1.2)]
1 Ruth E. Kuhn
Bethany Village West
5225 Wilson Lane Apt. 27
Mechanicsburg, PA 17055
Sister Entire Residue
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET S
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 2000 form software only The Lackner Group, Inc.
0.00
Form REV-1513 EX (Rev. 9-00)
LAST WILL AND TESTAMENT
OF
FLORENCE K. HOFFMAN
I, FLORENCE K. HOFFMAN, of Mechanicsburg, cumberland
County, Pennsylvania, being of sound and disposing mind and
memory, do make, publish and declare this to be my Last Will and
Testament, hereby revoking all Wills and Codicils by me at any
time previously made.
1. TANGIBLE PROPERTY. I give and b~queath all of my
household furniture' and furnishings, autornobil,eS, books, pictures,
jewelry, china, crystal, appliances, silverware, wearing apparel,
articles of household or personal use or adornment, collections
and artworks, together with all policies of' insurance thereon, to
my sister, RUTH E. KUHN, if she survives me by thirty days. If m}
sister does not survive me by thirty days, I direct that said
tangible personalty be sold and the proceeds thereof distributed
in accordance with ITEM 2 of this Will.
2. RESIDUE. I give, devise and bequeath all the rest
and residue of my property, real, personal and mixed, not disposed
of in the preceding portions of this Will, including all property
over which I hold a power of appointment (which powers of
appointment I hereby exercise in favor of my estate), to the then
Page 1 of 6 pages
~~;;::.~~:2~EE~~-rr;~~~;~-~?&i2~~~~~~-- .
Trustee of "The Florence K. Hoffman Revocable Trust", as amended,
created on July 28, 1992 and amended and restated on the same date
as this will between me, as Settlor, and Dauphin Deposit Bank and
Trust Company, as Trustee.
3. SPENDTHRIFT PROVISION. No interest in income or
principal of my estate shall be subject to attachment, levy or
seizure by any creditor, spouse, assignee or trustee or receiver
in bankruptcy of any beneficiary of my estate prior to the
beneficiary's actual receipt thereof. My Executor shall pay over
the net income and the principal to the beneficiaries herein
designated, as their interests may appear, without regard to any
attempted anticipation (except as may be specifically provided
herein), pledging or assignment by any beneficiary of my estate
and wi thout . ~ega:rd to any.clail11.,.._tl'1ereto or at tempted levy,
attachment, seizur:e or other process against said beneficlary.
..
4. SURVIVAL PRESUMPTIONS. Any person who shall have
died at the same time as r--or-..under such circumstances that it is
difficult tir i~po~~ible tbCdei~imine who shall have died first,
shall be deemed to have predeceased me.
5. FIDUCIARY POWERS. In the settlement of my estate,
my Executor shall possess, among others, the following powers,
exercisable without prior court approval, but in all cases to be
exercised for the best interests of the beneficiaries:
(a) To retain any investments I may have at my
death so long as my Executor may deem it advisable to my
estate so to do, including securities owned, issued or
Page 2 of 6 pages
~~'[r1" ~. -.- i
underwritten by any corporate Executor or any of its
affiliates.
(b) To vary investments, when deemed desirable by
my Executor, and to invest in such bonds, stocks, notes,
real estate mortgages or other securities or in such
other real or personal property, including securities
owned, issued or underwritten by any corporate Executor
or any of its affiliates, as my Executor shall deem
wise, without being restricted to so-called "legal
investments".
(c) In order to effect a division of the principal
of my estate or for any other purpose, including any
final distribution of my estate, my Executor is
authorized to make said divisions or distributions of
the personalty and realty partly or wholly in kind. If
such division or distribution is made in kind, said
assets shall be divided or distributed at their
respective values on the date or dates of their division
or distribution. In making any division or distribution
in kind, my Executor shall divide or distribute said
assets in a manner which will fairly allocate any
unrealized appreciation among the beneficiaries.
(d). To sell either at public or private sale and
UpGn. strch).:1Eerrns and conditions as my Executor may deem.
advan.tag~9~ls to my estate, any or all real or personal
estat-e~. or.'~fliferest therein owned by my estate severally
or in conjunction with other persons or acquired after
my death by my Executor, and to consummate said sale or
sales__py s~~ficient deeds or other instruments to the
purcha.s~er-~~Or purchasers, c6nveying a fee simple title.,
free. 'ap.d .clear of all trust and without obligation or
liabilit~8f 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 my Executor in this paragraph or
elsewhere in this Will.
~.;,
(e) To mortgage real estate and to make leases of
real estate for any term.
(f) To borrow money from any party, including my
Executor, to pay indebtedness of mine or of my estate,
expenses of administration, Death Taxes or other taxes.
Page 3 of 6 pages
_G"'" j -WT.tf
(g) To pay all costs, expenses, legally
enforceable debts, funeral expenses and charges in
connection with the administration of my estate.
(h) To vote any shares of stock which form a part
of my estate or trust and to otherwise exercise all the
powers incident to the ownership of such stock and to
actively manage and operate any incorporated or
unincorporated business, including any joint ventures
and partnerships, and to incorporate any such
unincorporated business, with all the rights and powers
of any owner thereof.
(i) In the discretion of my Executor to unite with
any other owners of similar property in carrying out any
plans for the reorganization of any corporation or
company whose securities form a part of my estate.
(j) To assign to and hold in my estate an
undivided portion of any asset.
(k) To hold investments in the name of a nominee.
(1) To compromise controversies.
-(m) To disclaim, in whole. or.:.iri '.part, any and .:~l-j>:':
i.nterests in property owned by me. at the time of my.'.2~-.."o
death, including those passing to me py 'Will, intestac.y';.
contract, j oint ownership, operation of law or : -.
otherwise.
.. f. :-. - .:"""'..." .~
-(n) To designate one or more persons or a
corporation to act as ancillary' fiduciary in any _.-
jurisdiction in which ancillary administration may be
necessary, such ancillary fiduciary to serve without
bond or security and to have all the powers, authorities
and discretions conferred hereunder.
(0) To employ and compensate from income or
principal, in the discretion of my Executor, investment
and legal counsel, accountants, brokers and other
specialists, and, whenever there shall be no corporate
Executor in office, a corporate custodian, and to
delegate to investment counsel discretion with respect
to the investment and reinvestment of any or all of the
assets held hereunder.
Page 4 of 6 pages
.
6. EXCULPATORY CLAUSES. In the settlement of my
estate:
(a) My Executor shall not be personally liable for
any loss to my estate or to any beneficiary of my estate
resulting from an election made in good faith to claim a
deduction as an income tax deduction or as an estate tax
deduction.
(b) In valuing property in my gross estate for the
purposes of any Death Tax, my Executor shall not be
personally liable for any loss to my estate or to any
beneficiary of my estate resulting from my Executor's
decision made in good faith to use a particular
valuation date.
7. TAX CLAUSE. All inheritance, estate and similar
taxes becoming due by reason of my death ("Death Taxesl1), whether
such Death Taxes shall be payable by my estate or by any recipient
of any property, shall be paid by my Executor out of the property
passing under ITEM 2- of .this"~-:Will""a-s- an:~expe~f?e": a"nd cost of
administration of my estate.. My Executor s~~ll have no duty or
obligation to obtain reimbursement for any Death Taxes paid by my
Executor, even though paid with respect to prgceeds of insurance
or other property not passing under this Will.
8. EXECUTOR APPOINTMENT. I hereby appoint DAUPHIN
DEPOSIT BANK AND TRUST COMPANY as Executor of this Will.
9. WAIVER OF BOND: FIDUCIARY FEES. My Executor shall
qualify and serve without the duty or obligation of filing any
bond or other security and shall be entitled to compensation for
services in accordance with the standard schedule of fees in
effect when the services are rendered.
Page 5 of 6 pages
. -""=-=
,. ..
..
IN WITNESS WHEREOF, I have set my hand and seal to this,
my Last will and Testament, consisting of this and the preceding
five (5) pages, this
" l L day 0 f
,. ;,' -,. '"C...
J.~, _ _'
1995.
Page 6 of 6 pages
,. : J
- { ,"--;.' . . " . . " :"';:"-;'-:;"'_;;-' '~A.:. -.J SEAL)
Florence K. Hoffman
We, the undersigned, hereby certify that the foregoing
Will was signed, sealed, published and declared by the above-named
Testatrix as and for her Last will and Testament, in the presence
of us, who, at her request and in her presence and in the presence
of each other, have hereunto set our hands and seals the day and
year above written, and we certify that at the time of the
execution thereof, the said Testatrix was of sound and disposing
mind and memory.
(SEAL) .
Residing at :--Y;.L:~ VAl1~c. ~
VG~ r:' {) A \ l '-t li"-f .
l-~ '_j' ,....'.
Residing at: ~~ 11~:ry;ff:.,-f..:J((.(G?, - -- -.
. -1 . I r I f I f
A;,) -:,4 :. fi..uc~l/J, )rl) ~'f;-' 70) J
- /" ' I' A'
Re,siding at: o;qoc~ IOt..ru.l1L.K(.LL~/(j:f .
~\, ~J ','
I 'I"'! 1,..'1. /,.., . ,v
II.._.....""'~I-L___ ( IT . r LIt.,
.....J
(SEAL)-
JIOOS()q &5)
Ho~)~I~
AMENDED AND RESTATED
REVOCABLE AGREEMENT OF TRUST
liThe Florence K. Hoffman Revocable Truett!
THIS AMENDED AND RESTATED REVOCABLE AGREEMENT OF TRUST
( "Agreement" ) is made and entered into this q 4. day of
J;.~;; b d b
~;'L4"....&--"/-r.,J:"J--' I 1995, Y an etween FLORENCE K. HOFFMAN, of
Mechanicsburg, Cumberland County, Pennsylvania (the "settlor"), and
DAUPHIN DEPOSIT BANK AND TRUST COMPANY, a banking corporation with
its principal offices located at 213 Market Street, Harrisburg,
Pennsylvania (the "Trustee") I
WITNESSETH:
WHEREAS, the Settlor, by Agreement of Trust dated July
28, 1992 entered into an Agreement of Trust with Dauphin Deposit
Bank and Trust CompanYi and
WHEREAS, ARTICLE THIRD of said Agreement of Trust
reserved unto the Settlor the right to amend or revoke said
Agreement of Trust, in whole or in part; and
WHEREAS, the Settlor desires to amend and restate said
Agreement of Trust in full upon the terms and conditions hereafter
set forth, which amendment and restatement is acceptable to the
Trustee; and
JUN. 16.2005 7: 23AM
M&T TRUST SALES
NO.5211 P. 3
WHEREAS, the Settlor desires that the Trustee continue to
hold the assets identified on Schedule 'IA", attached hereto and
incorporated by reference herein, upon the terms and conditions
hereafter set forth; and
WHEREAS, the Settlor may in the future place the active
management and control of certain other property in the hands of
the Trustee.
NOW, THEREFORE 1 for and in consideration of their mutual
covenants and promises, the parties agree as follows:
ARTICLE I
Amendment and Restatement
The Settlor hereby revokes ARTICLES FIRST through NINTH
of the Agreement of Trust dated July 281 1992 and in lieu thereof
provides the following ARTICLES.
ARTICLE II
Trust. Assets
The Settlor, or any other party o~ person, may from time
to time make policies of insurance on the Settlor's life,
individual retirement account benefits, and/or qualified or non-
qualified retirement plan benefits payable to the Trustee, or may
-2-
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p, 4
- --w--~"''''_.~_'-
transfer other assets to the Trustee, subject to the terms of this
Agreement, by inter vivos grant or by Will. The trust assets shall
include the proceeds of any insurance policies payable to the
Trustee and all such other benefits or added assets (collectively
the "Trust Assets If), which shall be held, administered, distributed
and governed by the Trustee, IN TRUST NEVERTHELESS, in accordance
with the provisions of this Agreement and any amendments hereto.
ARTICLE III
Durina the Settlor's Lifetime
During the Settlor's lifetime, the Trustee shall:
(A) Have, hold, manage, invest and reinvest the
Trust Assets, collect the income and pay over the net
income to the Settlor during the Settlor's lifetime in
quarterly installments, after payment of all proper
charges and expenses. In addition, the Trustee shall pay
such portion or all of the principal of the Trust Assets
to the Settlor as the Settlor may from time to time
request. Any income not distributed to the Settlor
during the calendar year shall be added to Trust
principal.
(B) Pay and use such portion or all of the
principal of the Trust Assets a.s the Trustee, in the
Trustee's sole discretion, from time to time shall deem
necessary to provide for the proper maintenance, suppo:rt.
medical, hospital, nursing or nurs~ng home care of the
Settlor.
(C) Pay either from the principal or income of the
Trust Assets any outstanding bills or obligations owing
by the Settlor.
(D) Whenever and as often as, in the sole judgment
of the Trustee, the Settlor, to whom payments of income
and principal are herein directed to be made, shall be
unable to act, or shall lack ability or shall otherwise
-3-
JUN. 16. 2005 7: 23AM
M&T TRUST SALES
NO.5211 P. 5
"
be unable to apply such payments to the Settlor's own
best interest and advantage, the Trustee, in the
Trustee's sole discretion, may make all or any portion of
such payments in anyone or more of the following ways:
(1) directly to the Settlor;
(2) to the legal guardian or duly
authorized attorney-in-fact of the Settlor; or
(3) by the Trustee expending the same
for the benefit of the Settlor.
ARTICLE IV
Uoon the Settlor's Death
Upon the death of the Settlor, the Trustee shall
distribute the Trust Assets to the Settlor's sister, RUTH E. KUHN,
if she survives the Settlor by thirty (30) days. If the Settlor's
sister does not survive the Settlor ~y thirty (30) days, the
Trustee shall divide and distribute the Trust Assets as follows:
(A) Twenty-five percent (25%) thereof to CHRIST
LUTHERAN CHURCH, now of 124 South 13th Street,
Harrisburg I Pennsylvania 17104 I to be applied to the
Church's trust and memorial fund; provided, however, that
said distribution to the Church shall be made only in the
event the Church is operating, at the time of the
Settlor's death, at its 124 South 13th Street location.
If at the time of the Settlor's death said Church is not
operating at 124 South 13th Street, Harrisburg,
Pennsylvania, this distribution to the Church shall lapse
and instead pass to the beneficiary identified under
subparagraph (B) hereof. .
(B) The balance thereof to
RETIREMENT CENTER., now of 325
Mechanicsburg, Pennsylvania 17055.
BETHANY
Wesley
VILLAGE
Drive,
-4-
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NO. 5211
p, 6
..
\.. ,.. .~I : \_,. ... _'.. ......:....tIf""J.......... -v \., '-11". ....... .. .'1..... _ .,"_ ...... .
ARTICLE V
Spendthrift Provision
No part of the income or principal of the property held
under any trust created hereunder shall be subject to attachment,
levy or seizure by any creditor, spouse, assignee or trustee or
receiver in bankruptcy of any beneficiary prior to his or her
actual receipt thereof. The Trustee shall pay over the net income
and the principal to the parties herein designated, as their
interests may appear, without regard to any attempted anticipation
(except as specifically provided herein), pledging or assignment by
any beneficiary under any trust created hereunder, and without
regard to any claim thereto or attempted levy, attachment, seizure
or other process against said beneficiary.
ARTICLE VI
Trustee Powers
During the continuance of any trust created hereunder,
the Trustee shall possess I among others, the following powers,
exercisable without prior court approval, but in all cases to be
exercised for the best interests of the beneficiaries:
(A) To retain any investments so long as the
Trustee may deem it advisable So to do, including
securities owned, issued or underwritten by any corporate
Trustee or any of its affiliates.
(B) To vary investments, when deemed desirable by
the Trustee, and to invest in such bonds, stocks, notes,
real estate mortgages or other securities or in such
-5-
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M&T TRUST SALES
NO, 5211
p, 7
other real or personal property, including securities
owned, issued or underwritten by any corporate Trustee or
any of its affiliates, as the Trustee shall deem wise,
without being restricted to so called Illegal
investments. II
(C) To exercise any outstanding stock option in
effect at the Settlor's death, and to borrow any
necessary funds from any person or institution, including
the Trustee, to mortgage or pledge any or all real or
personal property as the Trustee in the Trustee's sole
discretion shall choose without regard for the disposi-
tive provisions of this Agreement.
(D) In order to effect a division of the principal
of any trust or for any other purpose, including the
final distribution of any trust, the Trustee is
authorized to make said divisions or distributions of the
personalty and realty partly or wholly in kind. If such
division or distribution is made in kind, said assets
shall be divided or distributed at their respective
values on the date or dates of their division or
distribution. In making any division or distribution in
kind, the Trustee shall div-ide and distribute said assets
in a manner which will fairly allocate any unrealized
appreciation among the beneficiaries.
(E) To sell either at public or private sale and
upon such terms and conditions as the Trustee may deem
advantageous to any trust, any or all real or personal
estate or interest therein owned by any trust severally
or in conjunction with other persons or acquired by the
Trustee (including selling "short" any right, privilege,
option or asset) I 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 t:he powers conferred upon the Trustee
in this paragraph or elsewhere in this Agreement.
(F) To make leases of real estate for any term.
-6-
JUN. 16.2005 7:24AM
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~
..' .. .'.,.":l', ~=4.~#~"'~~a;.:>~lIiiII'~- .-.
(G) To borrow money from any party, including the
Trustee, to pay an indebtedness of the Settlor or of the
Settlor's estate or trust, expenses of administration,
all estate, inheritance and similar taxes ("Death Taxes ff)
and other taxes.
(H) To pay, in the Trustee's discretion, without
reimbursement, all costs; Death Taxes or other taxes,
expenses and charges in connection with the administra-
tion of the Settlor's estate or trust, and to pay the
funeral expenses and the e~enses of the last illness of
the Settlor.
(I) To vote any shares of stock which form a part
of any trust and to otherwise exercise all the powers
incident to the ownership of such stock; to actively
manage and operate any incorporated or unincorporated
business, including any joint ventures and partnerships,
and to incorporate any such unincorporated business, with
all the rights and powers of any owner thereof.
(J) In the discretion of the Trustee, 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 any trust.
(K) To assign to and hold in any trust an undivided
portion of any asset4
(L) To select, employ and compensate any person,
firm or corporation engaged in rendering investment
counsel advi~e to advise the Trustee in making invest-
ments, managing securities or making decisions concerning
the purchase, retention, sale Or other disposition of any
part of any trust estate hereunder; and to select, employ
and compensate any attorney or firm of attorneys to
render legal services to the Trustee with respect to any
trust estate hereunder.
ARTICLE VII
Survival Presu~tions
Any person who shall have died at the same time as the
Settlor or under such circumstances that it is difficult or
-7-
JUN, 16, 2005 7: 24AM
M&T TRUST SALES
NO, 5211
P. 9
. -;"---;',t .A.I.... _ """..,# 1. --. I
.....-
I' #,,~ I -. . \-^,-,)f ,". _~:':~..\ ..JPjl.la~.. -~."Zl;:.......4'''',,, ,_ ~_..".. <QIIU"~~
impossible to determine who shall have died first, shall be deemed
to have predeceased the Settlor.
ARTICLE VIII
Surety and Comp~nsation of Trustee
The Trustee shall serve without the duty or obligation of
filing any bond or other security and shall be entitled to
compensation for services in accordance with the standard schedule
of fees in effect when the services are rendered.
ARTICLE IX
Revocability
The Settlor may, by inst"rument in writing delivered to
the Trustee, modify, alter or revoke this Agreement in whole or in
part; provided, however, that the duties, powers, compensation and
liability of the Trustee shall not be changed without the written
consent of the Trustee,
ARTICLE X
Situs
This Agreement and any trust created hereunder shall be
governed by the laws of Pennsylvania and shall have its situs in
Dauphin County, Pennsylvania.
-8-
JUN. 16. 2005 7: 24AM
M&T TRUST SALES
NO.5211 P,10
..
~ .'~:"\:"...u.,,..'tJJII.~......~~~_ lJ
~"J _'_ LJ~ 1.......P-,.'Jo:..,....'\"""...~~ ___ ~
.... -
IN WITNESS WHEREOF I FLORENCE K. HOFFMAN, as Settlor, has
hereunto affixed her hand and seal, and DAUPHIN DEPOSIT BANK AND
TRUST COMPANY, as Trustee, has caused this Revocable Agreement of
Trust to be signed by its duly authorized officers and its
corporate seal affixed, all as of the day and year first above
written.
WITNESS:
SETTLOR;
.~(L{ y, ~l~\~
,.
, I
~i~~~_1!/~
Florence K. Hof
TRUSTEE:
DAUPHIN DEPOSIT ~ANK AND TRUST
COMPANY
( SEAL)
ATTEST~
13", -~"':"" ;~Q-ll ~
(Assiat~rtt) Seer ary
(SEAL)
By: U~:vg~
~(Vice) President
-9-
JUN, 16, 2005 7: 24AM
~A & T T R U S T S ALE S
NO.5211 P. 11
.
..
j
The Amended and Restated Florence K. Hoffman Revocable Trust
SCHEDULE " A II
WITNESS:
SETTLOR:
--3w~ c,. tGA 1~4
" ~ I
F~~~-;; "K. H~:1J#. 'Uoel'-
TRUSTEE;
DAUPHIN DEPOSIT BANK AND TRUST
CO~PANY
( SEAL)
ATTEST:
13D~ -r: ~V.~I~
(Aseistant) See ary
(SEAL)
By: b~ y dA~
S~. (Vice) President
JUN. 16.2005 7: 25AM
M&T TRUST SALES
NO.5211 P. 12
,
~
I . Tl JLJ
_Ll ~~11 If
:.- ...........,.--"''-. n.....'l1i.~......'-~"~: .' ...~.~.,,: Hi.
COMMONWE1l.L~F PENNS~LVANIA ss :
COUNTY OF ~t.fA~ '
'7~
before me, a notary public, the undersigned officer, personally
On this,
the
c;l!,
day .of
I 1995,
appeared FLORENCE K. HOFFMAN, known to me (or satisfactorily
proven) to be the person whose name is subscribed to the ~ithin
Agreement, and acknowledged that she executed the same for the
purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official
seal.
Expires:
(SEAL)
NOTAAIAL SEAL
JUDITH L. KRAPE, NclaJy PubHc
City of Harrtsburg, o.,phln County
My Commission 5cpJree Oct 14. 1999
JUN. 16.2005 7: 25AM
~~~T TRUST SALES
NO.5211 P.13
...~". ~ '.i\':":::""'~'~ f'........ :....,... ~u :';':">LI. ~~ hL~'''()''q ,
. .lIt...-.... ~ 1., .A I I ~
~ ~"~
~ - ~ -.
~
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ~#/I;/
ss:
On this, the5~ day 0
, 1995,
~fore ;n;..' I' .Jh~ undersigned, off' cer, personally appeared
~~)11~, who acknowledged himself/herself to be the
DAUPHIN DEPOSIT BANK AND TRUST COMPANY, a banking corporation, and
that he/she as such officer, being authorized to do so, executed
the foregoing Agreement for the purposes therein contained by
signing the same on behalf of the corporation by himself/herself as
such officer.
IN WITNESS WHEREOF, I hereunto set my hand and official
seal.
~~?d~'
NC}ta Public
My Commission Expires:
(SEAL)
Notarial Seal
Mary Ann Andersol1. NotarY PubUc
t-\an1sbur9. Dauphin County
My CommlsSion Explrss OCt 30. 1998
I .
-~.~rAaA.~otNomrle9
~.~ '
~-P_Y~EX+~' '*
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG. PA 17128-0601
.
.
Please Print or Type
~ DECEDENrS NAME (LAST. ARSi. MIDDLE)
Hoffman, Florence K
. ADDRESS OF DECEDENT (STREET) (CITY)
Bethany Village 325 Wesley Drive Mechanicsburg
NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX
(NAME)
Stanley A. Smith, Esquire clo Rhoads & Sinon, LLP
(STREET NAME) (CITY)
One South Market Square Harrisburg
NAME, ADDRESS AND RELATIONSHIP (IF ANY) TO DECEDENT, OF PERSON(S) PRESENT AT THE BOX OPENING
a. (NAME) (RELATIONSHIP)
Ruth Ann McMillen, M& T Investment Group, Executor none
(STREET NAME) (CITY)
213 Market Street Harrisburg
b. (NAME) (RELATIONSHIP)
Stanley A. Smith, Esquire Rhoads & Sinon, LLP none
(STREET N~E) (CITY)
-_-'-0-" One-South Market Square Harrisburg
c. (NAME) __ (RELATIONSHIP)
Sharon Bradnick, M& T Investment Group, Executor none
(STREET NAME)-____ (CITY)
213 Market Street Harrisburg
· NAME AND ADDRESS 6i= -FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED
(NAME)
PNC Bank
(STREET NAME)
325 Wesley Drive
I NAME OF PERSON MAKING LAST ENTRY
Florence K. Hoffman
DATE OF CONTRACT TO RENT BOX NUMBER OF BOX
07/23/2001 807
~AME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX
a. (NAME)
Florence K. Hoffman
(STREET ADDRESS)
325 Wesley Drive
(CITY) (STATE)
Mechanicsburg PA
. NAME AND TITLE OF EMPLOYEE TAKING THE INVENTORY
Stanley A. Smith, Esquire
DATE OF DEATH
06/10/2005
(STATE)
PA
(STATE)
PA
SAFE DEPOSIT BOX
INVENTORY
MUST BE COMPLETED BY REPRESENTATIVE OF FINANCIAL INsmUTION WHERE SAFE DEPOSIT BOX IS LOCATED AND RETURNED TO ABOVE ADDRESS
COUNTY CODE FILE NUMBER SOCIAL SECURITY (ReQuired) OR DEATH CERTIACATE NUMBER (only if SSN is unknown}
22 00583-2005 136-01-8986
(STATE)
PA
(STATE)
PA
(STATE)
PA
(CITY) (STATE)
Mechanicsburg PA
DATE AND TIME OF LAST ENTRY
4/8/20052:32 pm
· TITLE UNDER WHICH BOX IS REQUESTED
Florence K Hoffman
b. (NAME)
(STREET ADDRESS)
(ZIP CODE)
17055
(CITY)
(STATE)
WAS A WILL IN THE BOX? 0 YES 6a NO If yes, a. Date of will:
b. Name and address of personal representative, if named in the will
(NAME)
(STREET NAME)
(CITY)
(STATE)
c. Name and address of attorney, if any
(NAME)
(STREET NAME)
( CITY')
(STATE)
(ZIP COO E)
17055
(ZIP CODE)
17101
(ZIP COO E)
17101
(ZIP CODE)
17101' ~
: .:.;..~:..~ -..:-;o:-~,}.t:j:;~~ C";: ~~:~~~~~:;~
_.~._. :_---'1-.-
(ZIP cooe) -
17101
- . (ZIP COOE)~.__ .___ ____.-:
17055 ---
(ZIP CODE)
(ZIP COOE)
(ZIP CODE)
I . .,<:-:-~:-~:~. -,,--"
,
.
SAF~EPOSIT BOX INVE~ORY Page
INSTRUCTIONS
The Department is authorized under federal law , 42 U.S.C. ~ 405(c), to use the decedent's Social Security number in
administering this state tax law. The Department uses Social Security numbers to establish a decedent's identity and
ensure proper credit for tax payments.
(1) Cash: Report total only.
(2) Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be
designated by name of company, certificate number, date of certificate, nalJ1e in which stock is registered, and
number of shares and class of stock..
(3) Obligations of U.S. Government: Number of items, date of issue, face value, names in which registered and
type of ownership, Le., jointly held, payable on death, etc.
(4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds)
(5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book,
name of bank. and branch, and balance.
(6) Jewelry, Coins, Stamps, Manuscripts, ete: list and describe as fully as possible.
(7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: list and describe as fully
as possible.
(8) All other contents.
of
ITEM
NO.
Z
2
2
2
ITEM DESCRIPTION
100 shares General Motors Corp Common stock - cert #J867 -64 7 - 4/411969
300 shares Ingersoll-Rand Corp Common stock - cert #NB99393 - 8/19/1997
300 shares Ingersoll-Rand Corp Common stock -'cert #NB133054 - 8/20/1987
300 shares Ingersoll-Rand Corp Common stock - cert #NB156803 - 6/1/1992
-"< 6
6
6
10 ~ $1.00 coins - datea 2000
11 - $2.00 bills
3 - $' .00 Susan B Anthony coins - dated 1979
8 Global Combined Insurance Company - policy #6000925519
8 AAA Central Penn Automobile Club Accidental Death Policy
8 Wesley Affiliated Services - Gift Annuity Agreement
8 mise papers
PERSON RECEMNG COpy OF
SAFE DEPOSIT BOX INVENTORY:
SIGNAiURE
PRINT NAME
PRINT NAME AND CHECK APPROPRIATE BOX BELOW:
CHECK APPROPRIATE BOx.:
o Executorttrix) 0 Admlnistrator(trix)
ria Estate Representative 0 JDint owner of safe deposit box
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~08/~5/200~ 15:10
7177956187
WINDSOR PARK
:;:;',;:.~~ Erica L Schlegel
08/15/2005 11: 13 AM
To: Lynn A Niner/ConsumerISCPIPNC@PNC
cc:
Subject: Date of death balance
Estate of Florence K Hoffman (Deceased)
SS# 136-01-8986
DOD 06-10-2005
ACCOUNT NUMBER * DATE OF DEATH BALANCE + ACCRUED INTEREST
DDA #5070075668
$13,433.52
$0.98
/
+
Jfyou selected the balances to be sent to the "Branch" they will only be sent to
The requestor by Lotus Notes.
Have a great Day! !! :-)
... .., IMfi_Ji,t J... ,,",t"'-. ... ,. wIIi"'fTr" ., ~ .--.
PAGE 131
.
.
.{
Sovereign Bank
ESTATE OF
SOCIAL SECURITY #:
DATE OF DEATH:
Florence K. Hoffman
136-01-8986
June 10, 2005
Account #: 1685211359 Type: CD
In the name of: Florence K. Hoffman
Date of Death Balance: $35,681.71
Int.(YTD) from 1/1/2005 to 2/26/2005
Accrued interest to date of death: $215.07
Other Info: currently 2.05%, next maturity 2/26/06
Open date: 7/26/1997
$180.72
Page 1 of 1
.,
.J
MANDT ~4liECORDS
PAGE 01/03
499 Mitchell Road
MiIlsboro, DE 19966
MaU code OB-MB-12
Phone; 886-502-4349
F~ 302-934-2955
I F! ~Bank I
Fax
To: M&T Trust Dept Sharon Bradnick
From: Nancy Clagett
Fax: 717/231-2636
Re;
Estate of Florence K Hoffman
Date: July 13, 2005
. Social Security: 136-01-8986
Date of Death: June 10t 2005
Pages: .3
Dear Sir or. Madam.:
Per your inquiry dated. June 3D, 2005, please be advised that at the time of death, the
above-named decedent had on deposit with this bank the following:
1.
Type of Account
Checking Account
Account Number
43358039
Ownership (Names of)
Florence K Hoffman *
Ruth E Kuhn, PDA
Opening Date
07/28/80
BaJance on Date of Death
$18,328.89 ./
-- --
Accrued Interest
$
1.41 /
Total .
$18,330.30
2.
Type of Account
Certificate of Deposit -J
Account Number
031003913913925
Ownership (Names of)
Opening Date
Florence K Hoffman '"
Balance on Date of Death
11/25/98
$20,696.86 /
Accrued Interest
$
19.18 /
Total
$20~716.04
Rate
1. 78000
Maturity Date
08/25/05
Interest Payable
Monthly
. ..
~
'L.W-..c;;.: -"-... "RECORnS
'-:~". .~'.,"",",M"'-AND T BA~ . .
3. Type of Account Certificate of Deposit ./
Account Number 031003914525258
Ownership (Names of) Florence K Hoffman *
Opening Date 07/09/96
Balance on Date of Death $13,579.37 ../
Accrued Interest $ 2.95 /
Total $13,582.32
Rate 1.98000
Maturity Date 12/09/05
Interest Payable Monthly
4. Type of Account Certificate of Deposit v
AccountNumber _ 031003914612823
Ownership (Names of) Florence K Hoffman ..
Opening Date 06/16/98
Balance on Date of Death $33,997.65 v'
Accrued Interest $ 147.88 /
Total $34,145.53
Rate 1.78000
Maturity Date 09/16/05
Interest Payable Monthly
..r
,---------
. ~. M AND T BAN.RECORDS
PAGE 03/03
~'-'" "~
", "", ", ~ .~..",' "i.'.. " .
:~5:':{'~.' .~;.; ":-.~".-~;~
5. 1Ype of .A.ccount Certificate of Deposit /
Account Number. 031003914624240
Ownership (Names of) Florence K Hoffman *
Opening Date 10/05}98
Balance on Date of Death $23,801.59 /
Accrued Interest $ 9.29 /
Total $23,810.88
Rate 1.78000
Maturity Date 09/05/05
Interest Payable Monthly
This letter does not inc:lud~ any accounts in which the deceased may have been listed as
POW'er of Attorney, Custodian of Uniform Transfers, Representative Pa.yee~ or Trustee under a
Written Agreement) Administrator to Estate, etc. .
* For fUrther account informationt regarding OWJ1ershi'lt. clOSures and/or reimbursement of
fimds, etc., please Cill:the7:Mechanicsburg Otlice f 717..255-2031.
Thank you for your anticipated assistance. If you have any questions, please do not hesitate
to caU me at 888-502-4349, option 2, then option 3.
Have a great day!
Nancy Clagett, Records Department, @ M & T Bank
~~~
Estate Valuation
~
~
~
Date of Death: 06/10/2005
Valuation Date: 06/10/2005
Processing Date: 06/14/2005
Estate of: Florence Hoffman
Report Type: Date of Death
Number of Securities: :4
File IO: Benz.Miriam
Shares
or Par
Security
Description
High/Ask
Low/Bid
Mean and/or Oiv and Int Security
Adjustments Accruals Value
1) 409.085 WT MUT FD (92934R769)
CRM MDCP VAL I
Mutual Fund (as quoted by NASDAQ)
06/10/2005 26.07000 Mkt ,
26.070000 10,664.85
2) 2372.184 MTB GROUP FDS (55376T775)
INTL EQTY I I
Mutual Fund (as quoted by NASDAQ)
06/10/2005 10.79000 Mkt "
10.790000 25,595.87 .
3) 4927.376 MTB GROUP FDS (55376T692)
LCP STK I I
Mutual Fund (as quoted by NASDAQ)
06/10/2005 8.69000 Mkt 42,818.90 ,~-/
8.690000
4 ) 1406.644 MTB GROUP FDS (55376T668)
LCP VAL INST I
Mutual Fund (as quoted by NASDAQ)
06/10/2005 11.47000 Mkt
11. 47 0000 16,134.21 '/
5) 3084.707 MTB GROUP FDS (55376Tl14)
SMCP 5T INST I
Mutual Fund -{as quoted by NASDAQ)
06/10/2005 8.86000 Mkt 27,330.50 -/
8.860000 .
6) 580.087 MELLON INSTL FDS INVT TR (58552D762)
BO INTL 5 CAP
Mutual Fund (as quoted by NASDAQ)
-06/10/2005 18.14000 Mkt 10 , 522 . 78 ./
18.140000
71 527.093 THOMPSON PLUMB FDS INC (884891300)
GROWTH FD
Mutual Fund (as quoted by NASDAQ)
06/10/2005 45.00000 Mkt .;
45.000000 23,719.19
8) 145.287 VANGU~~D INSTL INDEX FD (922040100)
SH BEN INT
Mutual Fund (as quoted by NASDAQ)
06/10/2005 109.88000 Mkt 15, 964.14 ~
109.880000
9) 667.166 EVERGREEN SELECT FIXED INCOME (299908830)
SELECT INTL I
Mutual Fund (as quoted by NASDAQ)
06110/2005 11. 31000 Mkt
11. 310000 7,54.5.65 ~/
10) 425.712 GOLDMAN SACHS TR (3814.1W679)
HI YLD INSTL
Mutual Fund (as quoted by NASDAQ)
06/10/2005 7.91000 Mkt 3,367.38 ./
7.910000
11) 3079.681 MTB GROUP FDS (55376T817)
INTRM BD I I
Mutual Fund (as quoted by NASDAQ)
06/10/2005 10.00000 Mkt
10.000000 30,796.81 0/
12 ) 1869.463 MTB GROUP FDS (55376T221)
SHR DUR GV I I
Mutual Fund (as quoted by NASDAQ)
06/10/2005 9.61000 Mkt ./
9.610000 17,965.54
Page 1
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 7.0.3)
t
.
-
of Death: 06/10/2005
~ation Date: 06/10/2005
R;~cessing Date: 06/14/2005
Shares
or Par
Security
Description
13)
1308.079 MTB GROUP FDS (55376T189)
STRM CORP SD I I
Mutual Fund (as quoted by NASDAQ)
06/10/2005
14)
424.93 NORTHEAST INVS TR (664210101)
SH BEN INT
Mutual Fund (as quoted by NASDAQ)
06/10/2005
Total Value
Total Accrual
Total $248,466.29
High/Ask
Page 2
Low/Bid
9.81000 Mkt
7.55000 Mkt
-
,
Estate of: Florence Hoffman
Report Type: Date of Death
Number of Securities: 14
File ID: Benz.Miriam
Mean and/or Div and lnt Security
Adjustments Accruals Value
9.810000
12,832.25 .(
7.550000
3,208.22 Y"
$248,466.29
$0.00
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 7.0.3)
-
,
.
Estate Valuation
06/10/2005
06/10/2005
09/19/2005
Shares
or Par
Security
Description
High/Ask
1)
200 GENERAL MTRS CORP (370442105; GM)
COM
New York stock Exchange
06/10/2005
35.34000
2)
900 INGERSOLL-RAND COMPANY LTD (456866102)
CL A
New York Stock Exchange
06/10/2005 75.03000
3)
3617.082 DRYDEN MUN BD FD (74435L301; PMIAX)
INSD SER CL A
Mutual Fund (as quoted by NASDAQ)
06/10/2005
4 )
3271 DRYDEN NATL MUNS FD INC (743918104i PBHMX)
CL B
Mutual Fund (as quoted by NASDAQ)
06/10/2005
5 )
139 DELPHI CORP (247126105)
COM
New York Stock Exchange
06/10/2005
4.85000
Total Value
Total Accrual
Total $164,787.10
Page 1
Low/Bid
31.99000 H/L
74.00000 HIL
11.05000 Mkt
15.40000 Mkt
4.48000 H/L
Estate of: Florence Hoffman
Report Type: Date of Death
Number of Securities: 5
File ID: fhoffman
Mean and/or Div and Int Security
Adjustments Accruals Value
33.665000
74.515000
11.050000
15.400000
4.665000
6,733.00
67,063.50
39,968.76
50,373.40
648.44
$164,787.10
$0.00
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 7.0.3)
The Collins Finar \ Group
., · of Wachovia Sec. .es
Wachovia Securities, LLC
Three Lemoyne Drive
Lemoyne, PA 17043
Fax 717 975-8426
800 468-8685
..
'~~~4
~~
August II, 2005
M & T Investment Group
M&TBank
213 Market Street
Harrisburg, PA 17101-2127
RE: Estate of Florence K. Hoffman
Dear Sharon:
Listed below is the date of death values for the above mentioned account:
3617.082 shares Dryden Mum Bond Fund A 11.05 per share $39,968.76
3271 shares Dryden National Muni Fund B $15.40 per share $$50,373.40
The account was opened on December 6, 1988
If I can be of further assistance, please call me.
,.....-,
,/ I
Sinc7rely, !
. ~
[iyn a ,-. eff, Assistant to
Russel 0/:. Collins
Merrt.x..- NYSE/SIPC
Russell W. Coillins, CfP"l! CRPC
First Vice President - Investments
Tel 717 975-8405
russell.collins@Wachoviasec.colll
Vincent P. Cantelupe, MBA
Financial Consultant
Tel 717 975-8406
vincent.p.cantelupe@wachoviasec.com
WACHOVIA. SECURITIES
Sue Collins
Registered Account Administrator
Tel 717 975-8456
sue. co II i ns@wachoviasec.com
~~
l~. .
.
.
GEORGE HAAR AUCTIONEER
93-3 W. SIDDONSBURG RD.
DILLSBURG, PA 17019
FLORENCE HOFFMAN ESTATE
ROOM 330
BETHNEY VILLAGE
5225. WILSON LANE
MECHANICSBURG, PA. 17055
LISTED BELOW IS MY APPRAISAL OF HOUSEHOLD
ABOVE NAMED ESTATE
SINGLE MAPLE BED COMPLETE
MAPLE CHEST & CONTENTS
MAHOGANY CHEST & CONTENTS
MAHOGANY CHAIR
ZENITH COLOR TV TABLE MODEL
MAHOGANY DESK & CONTENTS
BRASS KETTLE
MAHOGANY NITE STAND & CONTENTS
TABLE LIGHT & ELEC CLOCK
TELEPHONE & CLOCK
CANE WALKER
PICTURE
IRONING BOARD
3 SMALL METAL BOXES
3PCS LUGGAGE
CARD SHUFFLERS
SEWING BASKETS
BLANKETS, PILLOWS, SHEETS ETC
MIse CLOSET ITEMS
GIRL FIGURINE, VASE, CLOCK
2-SEWING BOXES
BLANKETS, PILLOW, SHEETS
STORAGE BOX & CONTENTS
SMALL STORAGE CHEST & CONTENTS
MIse ITEMS
JEWEL BOX & COSTUME JEWELRY
NECKLACES
ZENITH COLOR TV
CLOCK
UMBRELLA STAND, UMBRELLAS, CANES
LOVE SEAT
RECLINER CHAIR BLUE
RECLINER CHAIR RED
2-FLOOR LAMPS
MAHOGANY CORNER CUPBOARD & CONTENTS
MAPLE DESK CHAIR
MAHOGANY DESK KNEEHOLE & CONTENTS
BRIDGE LIGHT
3-RINGS
WATCH
BRACELET
FURNISHINGS FOR THE
35.00
55.00
125.00
10.00
30.00
125.00
20.00
30.00
1.50
2.00
1.00
1.00
3.00
6.00
3.00
.50
1.00
10.00
4.00
4.50
5.00
4.00
'6.00
10.00
6.00
25.00
10.00
40.00
5.00
7.50
45.00
30.00
30.00
5.00
250.00
5.00
65.00
1.00
20.00
5.00
4.00
,"
1
/'
/..... .
JEWEL BOX & COSTUME JEWELRY
~....' . BOX EAR RINGS
,,' 4-BAGS SMALL COSTUME' JEWELRY
. .' GLASS NECKLACE BOX & NECKLACES
4 CLOCKS
WALKER ON WHEELS
13ATHROOM SEAT
3 STOOLS
CLOTHES HAMPER
2 WASTE CANS
TOWELS ETC
MIse BATHROOM ITEMS
7 FIGURINES 20.00 EA
5 FIGURINES 5.00 EA
9 FIGURINES 3.00 EA
5 FIGURINES 20.00 EA
3 PICTURES
DOG DOOR STOP
DESK LIGHT
2-FOOT STOOLS
2-TABLE LIGHTS
MAHOGANY END TABLE
2-WASTE CANS
SMALL CHEST
SMALL MAHOGANY CHEST & CONTENTS
CAT DOOR STOP
TABLE LIGHT
8 FOLDING CHAIRS
FOLDING WALKER
CARD TABLE
CLOCK, MIse DESK ITEMS
ELECTRIC IRON
MIse KITCHEN ITEMS, SILVERWARE ETC
MISC KETTLES, GLASSES ETC
5 MISC PCS COSTUME JEWELRY
MIse ITEMS
.
30 ..00
10.00
20;00
7.50
4.00
10.00
'3.00
3.00
3.00
1.00
2.00
5.00
140.00
25.00
27.00
100.00
1.50
10.00
1.00
16.00
4.00
4.00
.50
1.50
65.00
3.00
1.00
16.00
3.00
3.00
5.00
1.00
10.00
3.00
7.50
10.00
TOTAL APPRAISEMENT. ~
A~~ JJ a.ft1./ ~ 641.60
GEORGE AUCTIONEER
933 W. S DDONSBURG RD.
DILLSBURG, PA. 17019
PHONE 717-432-3815
2
. .. .. .
_~QSH/P Th 'd h d'
.:i-'r"" ~06 e Unzte Met 0 tst
(~:o::J STEWARDSHIP Fo UNDATI 0 N of Central Pennsylvania
-:-- ~ <;;. 303 Mulberry Drive · Suite 300 · Mechanicsburg, Pennsylvania 17050-3141
planned giving (717) 766-7343 · (800) 272-0113 · Fax: (717) 766-1673 · Email: sfcpa@netrax.net
Is joyful sharing
August 24, 2005
M & T Bank
Attn: Ruth Ann McMillen 2nd Floor Trust
PO Box 2961
Harrisburg PA 17105
Dear Ruth:
As requested, I'm writing to inform you that the fair market value of the charitable
gift annuity in the name of Florence K. Hoffman, with her sister Ruth E. Kuhn as
co-owner, as of the date of Florence's death, June 10th, was $10,659.83. This
would have been the value as of May 31 , 2005, as we revalue our accounts at
month end.
Please contact me if you have any questions regarding the above or if I can be of
further assistance.
Sincerely,
~--1:f~
Sandy Brandt
Trust Accountant
"Investment Management and Stewardship Services))