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Home My WebLink About04-10-06 COMMONWEALTH OF I REV-1500 1_ O~ICIAL USE ONLY PENNSYLVANIA DEPARTMENT OF REVENUE I. INHERITANCE TAX RETURN I FILE NUMBER DEPT. 280601 I 21 05 0629 __~~RRIS~~~-!A ~128-0~1 ~__ RESI~ENT ~ECEQ~~!_ _~OU~ODE_ YEA~ Ml~ --~ DECEDENTSNAME(LAST:-FiRST :AND MIDDLE INn"IAL~ ----~- --- T-SOCIAl. SECURITY NUMBER I- [Marquis, Martha L. I 129-24-5572 ffi foATfoFDEA TH (MM-::()D-YEARY-- - --OATEOF BIRTH (MM:OD-YEARj-- - - - - -1- THIS RETURN MUST BE FILED IN DUPLICATE WITII THE ~ I ("OA~;,?~,~~~J,eiV"G """"" "^", ("",,0 ,~,:U.io ~~~ "",,,,- - -- - ! 'OC""~~~~~"~: OF WILLS __L__ ___ ____ ____ __ ____ ____ _-1- ______ __ o 3. Remainder Return (date of death prior to 12-13-82) UI ! 1. Original Return U 2. Supplemental Return I- lO: :! Ul 4. Limited Estate [] 4a. Future Interest Compromise (date of death after lil g: ~ 12-12-82) :00 I' I o g: al X j 6_ Decedent Died Testate (Attach ] 7. Decedent Maintained a Living Trust (Attach Q. copy of Will) copy of Trust) --=--_ -- 9. Litigation Proceeds Receive.dc-~.. .....1 O. ;'f-~~~~la~~~~1~5?redit(date of death_~~een ... ... .1..l11. Election to tax under ~e~.9113(A) (Attach Sch 0) ]THIS SECTION MUST _BE COMPL~T~D.Al..L COftRE.PONDEt4Ce;ANDCONFID!!NTIALTAX t~fQRMATtOt4..StfOUL;peED~EC'T~"(); 15 NAME I COMPLETE MAILING ADDRESS ~ Jam~s ~._H~gh~-,--Esq. _____ ____ ~ FIRM NAME (If applicable) ~ I SALZMANN HUGHES PC 0:: -------- -".._~_.- ---- ------ --.--- 8 TELEPHONE NUMBER I . REV-1500 EX + (6-00) *' --------'------- --~-- i----- -..-------- 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship z o i= <C ..J ::l l- ii: <C (J w ~ 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) =-J Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) [~ Separate Billing Requested 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) o 5_ Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 354 Alexander Spring Road, Suite 1 - Carlisle, PA 17013 t..,._.,.... (1) (2) (3) (4) (5) (6) (7) OFFICIA-L .:USE. aNt." None 1,677.12 None None -'--J 429,053.53 c.,,: None [\j 352,236.21 (8) 782,966.86 (9) (10) 11,901.95 -'--- 3,081.73 (11 ) 14,983.68 767,983.18 0.00 (12) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) (14) 767,983.18 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 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) ~- z 0 i= 16. Amount of Line 14 taxable at lineal rate 767,983.18 x .045 (16) 34,559.24 c( I- -- - ::l c.. 17. Amount of Line 14 taxable at sibling rate 0.00 .12 (17) 0.00 :E x 0 (J 18. Amount of Line 14 taxable at collateral rate 0.00 (18) >< x .15 0.00 ~ 19. Tax Due (19) 34,559.24 20. D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. >> BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH<< Copyright 2002 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00; L Decedent's Complete Address: STREET ADDRESS 4905 East Trindle Road CITY Mechanicsburg [STATE PA ZIP 17055 I Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 34,559.24 32~OOO.O'O - ------------~- 1,684.21 Total Credits (A + B + C) (2) 33,684.21 3. InteresUPenalty if applicable D. Interest E. Penalty 4. TotallnteresUPenalty (D + E) 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 If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) 5. (5) (5A) (58) 875.03 875.03 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;...................... ..................... ........................... ~x. b. retain the right to designate who shall use the property transferred or its income;.................................... ~~J c. retain a reversionary interest; or....................................... ........................ ............... x d. receive the promise for life of either payments, benefits or care?.. ..................... ................. 1~~4 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ........................................................ ........................ ............................ x 3. Did decedent own an llin trust for" or payable upon death bank account or security at his or her death?........ [--I 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?.. ................................................................. .................................. IX 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 thai I have examined thiS return. including accompanying schedules and statements. and to the best of my knowledge and belief, It IS true, correct and complete Declaration of preparer other than the personal representative is based on all information of which preparer has any knovvedge. .SI~N~~~~~~F:~~~~;~~f~N~OR FILlNGRET~RN- - - - ADDRESS~~~.~. 'B~:~8-4 ---- P-6~~~~~RN-- --ADDRESS-- _ ~~~!~~'- M~ ~~493 X DATE ADDRESS ~.. ~(O~___ r /ATE Y!~~/tf ~j 354 Alexander Spring Road, Suite 1 Carlisle, PA 17013 f 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 spouse is 3% [72 P.S. !}9116 (a) (11) (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. s9116 (a) (1.1) (ii)l. 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. s9116 (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. s9116 1.2) [72 P.S. s9116 (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. Rev-1503 EX+ (6-98} ~. ~ SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Marquis, Martha L. FILE NUMBER 21-05-0629 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION U.S. Savings Bonds, issued between 05/1990 & 07/1991 -list attached UNIT VALUE VALUE AT DATE OF DEATH 1 1.677.12 C'V~\ . , '. C)5--C~7 ~ [; .f?t:[1 {/ -tlfD Iv z ';1;.4.- 0- '-.1 C I ~-?D ~ )lC~ ~((0lc0 TOTAL (Also enter on line 2, Recapitulation) 1.677 .12 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group. Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev.1508 EX+ (6-98) *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Marquis, Martha L. IFILE NUMBER I 21-05-0629 ESTATE OF InClude the proceeds of litigation and the date the proceeds were received by the estate All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Brookwood Investment Advisors Inc. - individual investment account 383.048.81 2 Orrstown Bank. checking account 14,689.72 3 2001 Cadillac DeVille DTS Sedan 17 ,045.00 4 Miscellaneous jewelry (appraisal attached) 6,270.00 5 Miscellaneous personal property 8.000.00 TOTAL (Also enter on line 5, Recapitulation) 429.053.53 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1510 EX+ (6-98) *' SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Marquis, Martha L. FILE NUMBER 21-05-0629 ESTATE OF This schedule must be completed and filed If the answer '0 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 Brookwood Investment Advisors Inc. - IRA 307,136.21 307.136.21 account; payable to Doug & Carl Marquis 2 Met-Life Total Control Account - #404-8087038 34.500.00 34.500.00 3 Travelers Life & Annuity - acct. #8026625 10.600.00 10.600.00 TOTAL (Also enter on Line 7, Recapitulation) 352.236.21 (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 G (Rev. 6-98) REV.1151 EX+ (12-99) . SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWE.;LTH OF PENNSYLVANIA INf'ERITANCE TAX RETURN RESIDENT DECEDENT Marquis, Martha L. FILE NUMBER 21-05-0629 ESTATE OF Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: Neill Funeral Home 2,656.00 Radisson Hotel - reception 1,071.31 8. 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 6,250.00 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 550.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1,374.64 See continuation schedule(s} attached TOTAL (Also enter on line 9, Recapitulation) 11,901.95 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-B7 OTHER ADMINISTRATIVE COSTS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Marquis, Martha L. IFILE NUMBER 21-05-0629 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Cumberland Law Journal - estate notice publication 75.00 2 Doug Marquis - reimburse expenses 900.10 3 Register of Wills, filing fees 25.00 4 The Sentinel - Legal - estate notice publication 144.29 5 Uhaul - move personal items 130.25 6 Wolf Den Antiques, appraisal fee 100.00 Subtotal 1.374.64 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 Marquis, Martha L. FILE NUMBER 21-05-0629 ESTATE OF Include un reimbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Andrews & Patel 2 Apria Healthcare 3 Associated Cardiologists 4 AT&T 5 Bronste in -Jeffries 6 Carlisle Regional Medical Center 7 Comcast Cable TV 8 Country Meadows 9 ~c::c:. M",n",nDn->ont 10 EKG Associates 11 Heritage Medical Group 12 Holy Spirit Hospital 13 Kantor & Tkatch 14 Masland Assoc. 15 Medco 16 Moffitt Heart Vascular Group 17 Pulmonary & Critical Care VALUE AT DATE OF DEATH 19.19 48.33 1.77 64.23 15.42 31.50 91.32 1,638.04 264.51 1.77 94.55 48.50 110.90 108.25 30.00 96.95 275.95 Total of Continuation Schedule(s) See attached page TOTAL (Also enter on Line 10, Recapitulation) 3,081.73 (I,f more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The l.ackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) Rev-1512 EX+ (6-98) ~ ~ SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Marquis, Martha L. FILE NUMBER 21-05-0629 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 18 Quantum Imaging - medical 43.42 19 Verizon 60.88 20 West Shore Anesthesia 36.25 TOTAL (Also enter on Line 10, Recapitulation) 3.081.73 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV 1513 EX+ (9 00) *' SCHEDULE .J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NUMBER Marquis, Martha L. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec, 9116(a)(12)] RELATIONSHIP TO DECEDENT Do Not List Trustee(s) FILE NUMBER 21-05-0629 SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) I. Carl W. Marquis III 5765-F Burke Centre Parkway Burke, VA 22015 Son 1/2 remainder Douglas vL. Marquis P.O. Box 384 Weston, MA 02493 Son 1/2 remainder Total Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet II. NON-TAXABLE DISTRIBUTIONS: A, SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev, 6-98) 7ti - Q'8"I- lJ377 ~/i ~1J0l;> LAST WILL AND TESTAMENT OF MARTHA L. MARQUIS I, MARTHA L. MARQUIS, of 4905 East Trindle Road, Apartment 69, Mechanicsburg, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament and hereby revoke all Wills and Codicils previously made by me. ITEM 1. I direct my Executor hereinafter named to pay all my legal debts and funeral expenses, including the cost of my gravemarker and administration expenses of my estate, as soon as practicable after my death. ITEM 2. I give and bequeath my tangible property including automobiles, motorcycles, jewelry, wearing apparel, books, pictures, household furniture and furnishings, and all other articles of household and personal adonunent, together with any insurance existing thereon, equally to my beloved children, per stirpes. The share of any of my children deceased at my death, without issue surviving, shall lapse in favor ofthe other surviving siblings and should the other siblings not survive, unto their issue surviving, per stirpes. ITEM 3. I give, devise and bequeath the rest, residue and remainder of my estate, real, personal or mixed, of whatever nature and wheresoever situate, including all lapsed legacies and bequests including my property over which I may have a power of appointment at the time of my death equally to my beloved children, per stirpes. The share of any of my children deceased at my death, without issue surviving, shall lapse in favor of the other surviving siblings and should the other siblings not survive, unto their issue surviving, per stirpes. ITEM 4. My children at the time oftrus ~Vil1 are DOUGLAS vL. M~QUlS and CARL W. MARQillS, III. ITEM 5. Should any beneficiary of my estate be under twenty-one (2l) years of age, I direct that the share of such beneficiary shall be paid unto DOUGLAS vL. MARQUIS, as Trustee for said beneficiary, on the following terms and conditions: (a) My Trustee shall divide this sum into equal shares corresponding in , number to my beneficiaries surviving me, and each share shall be held in a separate trust for each of my surviving beneficiaries. (b) My Trustee shall hold, manage, invest and reinvest the shares so received, and the accumulation of interest, and use and apply from time to time such portion of income and principal thereof as she deems necessary for such beneficiary's health, maintenance, comfortable support and education, or to make payment to any personal guardian of such beneficiary. The telID "education" means technical, preparatory, college, graduate and professional education while emolled in good standing in a recognized ~d,c~tional institution. ~'ti (c) 'Any principal or income not so applied shall be distributed to such beneficiary upon reaching the age of twenty-one (21) years. (d) All shares of principal and income hereby given shall be free from anticipation, assigmnent, pledge or obligation of the beneficiaries and shall not be subject to any execution or attachment. (e) Should any beneficiary die prior to the termination of the trust fund, I direct that any balance remaining in his f1.md shall be distributed to the issue of said beneficiary. If said beneficiary is not survived by issue, I direct that any balance II'\L.t\ remaining in his fund shall be distributed to my surviving beneficiaries in accordance with the ratios set forth in this my Last \-ViII. (1) In the event DOUGLAS vL. MARQUIS, shall predecease me, cease or be unable to act as my Trustee, I appoint CARL W. MARQUIS, III, to act in that capacity. ITEM 6. In the event of my death, I appoint DOUGLAS vL. MARQL1S, as guardian of any property which passes to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so. If DOUGLAS vL. NrARQUIS predeceases me, ceases or is unable to act as guardian, I appoint CARL W. MARQUIS, III, as guardian. ITEM 7. In addition to powers granted by law or by other parts of this Will, my Executor hereinafter named shall have the following powers. (a) To retain any and all assets of my estate, real, personal, or mixed, without regard to any principle of diversification, risk, or productivity, except as may be otherwise expressly provided herein; (b) To sell at public or private sale, to exchange, to lease, to pledge, to mortgage, to transfer, to convert, or otherwise dispose of, and to grant options with respect to, any and all property, real, personal, or mixed, at any time forming part of my estate in such manner, at such time or times, for such purposes, for such price or prices and upon such terms, credits, and conditions as may be deemed advisable or necessary under the circumstances; (c) To invest and reinvest the property in stocks, bonds, mortgages, notes, insurance policies, annuities, COlmnon trust fund participation, or other property of any kind, real, personal, or mixed., irrespective of any statute, case, rule, or custom limiting the investment of trust funds, except as expressly provided otherwise herein; ^~ \ ~ (d) To settle, compromise, contest, prosecute, or abandon claims in favor of or against my estate as may be deemed advisable; (e) To allocate receipts and disbursements to principal or income or partly to both and to ascertain principal or income in accordance with the laws ofllie Commonwealth of Pennsylvania; (f) To make distribution or division of the estate in cash, in kind, or partly in both; and to postpone distribution by agreement with a beneficiary; (g) To exercise any law-given option to treat administration expenses either as income tax or estate tax deductions, without regard to whether the expenses were paid from principal or income, and without requiring reimbursement; and (h) To disclaim any inheritance or transfer. ITEM 8. No bond shall be required by my Executor, but if bond is nevertheless required, it shall be without surety. ITEM 9. All estate, inheritance, legacy, succession or transfer taxes, including any interest and penalties thereon, imposed by any domestic or foreign law with respect to all property taxable under such laws by reason of my death, whether or not such property passes under this Will, by operation of law, by contract or otherwise, shall be paid from my estate as a part of the expenses of administration thereof without any right of reimbursement from any recipient of any such property, without any right of apportionment and without postponement. At. I itA ITEM 10. I appoint DOUGLAS vL. MARQUIS as the EXECUTOR of this my Last Will and Testament. If DOUGLAS vL. MARQUIS predeceases me, ceases or is unable to act as my EXECUTOR, I appoint CARL W. MARQUIS, ill, as EXECUTOR of this my Last Will and Testament. IN WITNESS WHEREOF, I have hereunto set my hand this':?(St- _ day of (Y\ MA , 2005. ~t' I MARTHAL.~7 The preceding instrument consisting of this and five (5) other typewritten pages identified by the signature of the Testatrix was on the date thereof signed, published and declared by MARTHA L. MARQUIS, the Testatrix therein named, as and for her Last Will and Testament, in the presence of us who, at her request, in her presence and in the presence of each other, have subscribed our names as witnes reto. of ~~A-S/C PJJ76/3 , " , fj J.//' .'l / .\~ /~-' /~ ... /0/ >~/ of ,~' C jl 2.. ~ p.c, A.>4-7 A,e L; f I}-Z ~?A 1.1 '{"'-I ':> All. W\ COMMONWEALTH OF PENNSYL V MiA ss COUNTY OF CUMBERLAND We, MARTHA L. MARQUIS, €,,~"" ~ and K-t.cJ\V' S~l dy , the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her last Will and that she had signed willingly (or willingly directed another to sign for her), and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of our knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ~i.x,~~~ Testatrix SWORN to or affirmed and acknowledged before me by the above named Testatrix and witnesses this ~ 1 ~ day of mCl,rc..h , 200S . . ~ . .~ .' ~- 0) GlJCl A. 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(<I' "'\"'."' t"'~"' ~ ~'",", <I'\~\~I\ j\, ~~I\~\e\~\~\~\~\~~g~~\~ ~~ ~\o~\\ ~~~\~\~,~~,~~~~\~~~\~\~~~ o o\r!'o\ 000\00100\000 0 ~ ~ ,:=.: en '" '" '" \'" '" '" '" '" \ '" '" '" '" '" '" C <1l \ ~-U:!! ~ ~g\~~.g \3 g;;;::'; 6 g g ~\g ~ 0 i%j N J\~\N N N\N N N N N % g\% ~ ~ ! n> " ~~~~~~~~~~~~~~:n~~1~'~~ ~~~ z i'3 i . . . . . . . . ~ ~ ~ (]I - ::l J>< ~~ <.' ::l <0 g :5"~ <:. ~~ 0"0 -2. 0 ~ I~. \w\ ~ -.\'~ (jl ~ o o , \s \w\~ ~ <.0 <A. ~ .-.>. N <:. ~ we -~ .~ -.\ .-.>. tv ---___----'i~:_L~~~:'_______u_ ____ OAASTO\VN-l3ANK ~__~""""'''''''''-''''''''''~'':!;;1'''''wc.~~~.~,..~.,.;ji,...-'''''''''''';;''",~~",;;"",-~",,,-,,,,,~~~'~"~>"11:<.":.."'" "'.'."",~,.-'"", '; ''''-''-'-'W'''''._'' 'C", "''''':~W''.'<:1:''_.-,n.o.. '.:_:'~__~'''.,o:~.''':'' "~",-,->,.-",..,.......r"",;;,.4,',""""_h'" ';"._.'",-.. "P'.': ;_,;;,,,,,,_._,,.,,_,.,,,>~ _,r "~,\~, September 21 , 2005 TO: Salzmann Hughes, P.C. Attorneys & Counselors at Law 95 Alexander Spring Road Suite 3 Carlisle, PA 17013 FROM: Timothea Moose Cust. Service Specialist P.O. BOX 250 SHIPPENSBURG PA 17257-0250 RE: ESTATE OF Martha L Marquis DATE OF DEATH: July 9,2005 IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD, ON THE ABOVE DATE, THE FOLLOWING ACCOUNTS WITH ORRSTOWN BANK: CHECKING ACCOUNTS ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST 111000259 Martha L Marquis 5/8/01 14,68!1.72 .24 SAVINGS ACCOUNTS ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST CERTIFICATES OF DEPOSIT ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST --..-. '-..-, -....."" ....~~... .;;)~r-. .1..:::1 U.:::I V~;C::;{P L-. l"lar9u 1. s 'tell 't~U lUl~ p. 1 fficPlierson & ((0.. Gemologists & Appraisers 730 North Front Street, Wormleysburg, f'A 17043 business: (717) 731-3420 fax: (717) 731-34] 9 mcphersonandco@paonline,com APPRAISAL TO WHOM IT MAY CONCERN: This is to certify that we are engaged in the jewelry business, appraising diamonds, watches, jewelry and precious stones of all descriptions. We herewith certify that we have this day carefully examined the following listed and described articles, the property of: Name: Address: Estate of Martha Marquis 4905 East Trindle Road Mechanicsburg Pa. 17055 We estimate the value as listed for insurance or other purposes at the current retail value, excluding Federal and other taxes. In making this Appraisal, we DO NOT agree to purchase or replace the articles. DESCRIPTION APPRAISED V ALOE LADIES PLATINUM DIAMOND WEDDING SET: Ladies platinum diamond wedding set consisting of one platinum diamond engagement ring with a platinwn diamond wedding band attached by a white goldfilled ring guard. The platinum diamond engagement ring consists of one round diamond set in the center with three round diamonds set on each side. The platinum diamond wedding band consists of seven round diamonds. MAJOR DIAMOND: Measurements: Carat Weight: Color Grade: Clarity Grade: One Round Brilliant Cut Diamond 6.85mm. x 6.80mm. x 4.1 Omm. 1. 16ct. (Calculated by formula) H-I VSl ~ ~ MINOR DIAMONDS: Carat Weight: Color Grade: Clarity Grade: Thirteen Round Full Cut Diamonds 13 '''' .52cttw. H-I VSI LADIES PLATINUM DIAMOND ENGAGEMENT RING MOUNTING: Ladies platinum diamond engagement ring mounting consisting of one round diamond set in the center with three round diamonds set on each side. All of the diamonds are prong set. LADIES PLATINUM DIAMOND WEDDING BAND MOUNTING: Ladies platinum diamond wedding band mounting consisting of seven round diamonds that are all prong set. Total Metal & Gem Weight: 7.lms 4.5dwts. FAIR MARKET V ALOE:........................................................................... ,....... ..$6,270.00 Platinum market value $875.00 a troy ounce. Weight and grade estimated insofar as mounting permits. The foregoing Appraisal is made with the understanding that the Appraiser assumes no liability with respect to any action that may be taken on the basis of this Appraisal. -"7 (~~ Brian . McPherson G.G. (GLA), Member of NAJA '1/1-.lp) tJ.Cafc .lc"''''''Y t;p,nJr'DlZr:J. 2)/a-,.,r'fJnL'lJ. .:Oi'.....:. . . , I I @ -.'.". ..'.-....'...'.. ..-....." ."'-"'.;r ;>",,' '!, yr-',,(- . ['--. :l-~f,l:!;! .&~{ ~.t( \:~i'{ 1.. ).~: )" ;L-""'investmEfnt aaVis-ors inc September 16, 2005 Because }our goals should he achieved. ™ Attorney James D. Hughes Salzmann Hughes, P.c. 95 Alexander Spring Road Carlisle, P A 17013 RE: Estate of Martha L Marquis, D/O/D 07/09/05 Dear Jim: This letter is to inform you of the date of death values of Martha L. Marquis' accounts which were held at o.ur broker/dealer, Raymond James. The date of death value for her individual account (#12480318) was $383,048.81 and her IRA account (#60679766) was $307,136.21. If you need any other infonnation in regards to the above, I will be glad to talk with you. Sincerely, JOh~gh Chief Operating Officer/First Vice President Brookwood Investment Advisors, Inc. Registered Investment Advisor Representative Raymond James Financial Services, Inc. JWC:las SECURITlES AND INVESTMENT' A DVISOI.(Y SERVICES OFI;ERED '11 !ROUGH RAYl\;IOND .J~lES FINANCIALSERVICES, INC :\ REGISTERED BROKFI.VDE1\LER. MEMBER NASI)/SIPC. AND /\ FEDERALlY HFUIS'I'H~FI) INV[ST~IE>rr /\DVISOP BRCK )K\V(X)D INVEST>-lE"T ADVISORS AND R:\YMOND JAMES FlN;\NCfAL SERVIces. L',(' A/-1E ,\101'.\1<.\11' /\ND I.-NRFL\rED C( )'.IP;\,,"I1'S. 19 Brookwood Avenue Suite 103 Carlisle PA /7013 9142 717.243.8777 888.230.1480 tollfi-ee 7/7.243.7291 fax