HomeMy WebLinkAbout08-28-06
21/ OFFICIAL USE ONLY
REV-1S00 EX (6-00) COMMONWEALTH OF REV-1 500
PENNSYLVANIA
DEPARTMENT OF REVENUE INHERITANCE TAX RETURN
DEPT, 280601 FILE NUMBER 21-05-0576
HARRISBURG, PA 17128-0601 RESIDENT DECEDENT -
COUNTY CODE YEAR NUMBER
D>::CEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
I- Smith. Edwin A. 184-12-4350
z
w DATE OF DEATH (MM-DD-YEAR) IDATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
C
W 6/12/2005 1 /31 /1922 REGISTER OF WILLS
u
w (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
C
w 0 1. Original Return 0 2 Supplemental Return 03 Remainder Return (date of death prior to 12-13-82)
I-
<t en 0 04a Os
'" "' '" 4, Future Interest Compromise (date of death after 12-12-82)
u 0- U limited Estate Federal Estate Tax Return Required
w 0 0
J: ll: ...J 0 0
U 0- <Xl 6, Decedent Died Testate (Attach copy of Will) 7 Decedent Maintained a Living Trust (Attach copy of Trust) 0 8. Total Number of Safe Deposit Boxes
0-
<t 0 010 011
9. Litigation Proceeds Received Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) Election to tax under Sec. 9113(A) (Attach Sch 0)
I- "f'Hi$$g(@IQNMQ$[l#g@gMI:@~tgti.AW4PQRRg$PQNP$Nql$,ti.ijpqQNPIPl$~[I.6MtA*'NFQRMAt@NSH9l.)4t)ElgpIREctebtQ:
z NAME
w COMPLETE MAILING ADDRESS
c South Street
z Robert G. Frev 5 Hanover
0 NAME (If Applicable)
a. FIRM Carlisle, PA 17013
en
w F rev & Tilev
c::
c:: TELEPHONE NUMBER
0
U
717-243-5838
OFFICIAL USE ONLY
1. Real Estate (Schedule A) (1) 145,000
2. Stocks and Bonds (Schedule B) (2) NONE
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) NONE
4. Mortgages & Notes Receivable (Schedule D) (4) NONE
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E) (5) 15,629 '.-.-
6. Jointly Owned Properly (Schedule F) (6) 575
z Dseparate Billing Requested
0
i=
<l: 7. Inter-Vivos Transfer & Miscellaneous Non-Probate Property
..J NONE
::> (Schedule G or L) (7)
l-
ii:
<l: 8. TOTAL GROSS ASSETS (total Lines 1-7) (8) 161 ,204
u
w
c:: 9 Funeral Expenses & Administrative Costs (Schedule H) (9) 30,400
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) NONE
11. TOTAL DEDUCTIONS (total Lines 9 & 10) (11) 30,400
12. NET VALUE OF ESTATE (Line 8 minus Line 11) (12) 130,804
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not
been made (Schedule J) (13) 0
14, Net Value SUbject to Tax (Line 12 minus Line 13) (14) 130,804
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate or transfers under Sec.9116 (a)(1.2) 0 x .0 0 (15) 0
Z
0
i= 16. Amount of Line 14 taxable at lineal rate 130,804 X .0 ~ (16) 5,886
<l:
I-
::>
a.
:E 17. Amount of Line 14 taxable at sibling rate x .12 (17) 0
0
U
>< .15 (18) 0
<l: 18. Amount of Line 14 taxable at collateral rate x
I-
19. Tax Due (19) 5,886
200 cA~G~la~~~II~Ii(QI.J..li.~~I~~(JIlI~$tIIN~IAI~~~IlIN~I(;)FI"'NI(;)~~i~A~M~NTii
",?a~SURE[QANSWlSRAI..:LQl.J~SJ"IQlIISClNREVlSR.Sl=SlQE2ANPRlSQHE2GKI\IlATH.;:}:
217
Smith, Edwin A.
184-12-4350
Decedent's Complete Address:
STREET ADDRESS
449 Berkshire Lane
CITY I~TATE IZIP
Mechanicsburq PA 17070
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2 Credits/Payments
A Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
6,500
294
Total Credits (A + B + C ) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
4.
Total Interest/Penalty ( 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
(3)
o
5.
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.
B. Enter the total of Line 5 + 5A This is the BALANCE DUE.
(4)
(5)
(5A)
(5B)
AGENT
5,886
6,794
908
o
Make Check
to: REGISTER OF
o
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE BLOCKS
1.
Did decedent make a transfer and:
a. retain the use or income of the property transferred;
b. retain the right to designate who shall use the property transferred or its income;
c. retain a reversionary interest; or
Yes
D
D
D
D
D
D
2
d. receive the promise for life of either payments. benefits or care?
If death occurred after December 12, 1982,did decedent transfer property within one year of death
without receiving adequate consideration?
Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?
3.
4.
Did decedent own an Individual Retirement Account, annuity or other non-probate property which
contains a beneficiary designation?
D
o
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
No
o
o
o
o
o
o
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,
and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge
SIGNATURE OF PERSON RESPONSIBLtt FOR FlUNG RETURN DATE
//
ADD~SS -
J.-,,./ \.... I'j."" ---){' ' ~_ /'/( _" ,i
Ii DATE
jf\ '--' <~\ '--' ') r
I
.J
ADDRESS
5 South Hanover Street
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 PS Seclion 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 orfor the use of the surviving spouse is 0% [72 P.S. Section 9116 (a)(11 )(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. Section 9116(a)(1.2)].
I i.{ , L c (, (,
(
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 45%, except as noted in 72 P.S. Section 9116(1.2) [72 P S Section 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. Section 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
217
REV-1502 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
FILE NUMBER
Smith, Edwin A. 21-05-0576
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property
would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
House and lot of ground, 449 Berkshire Lane, Mechanicsburg, PA
See HUD-1 settlement statement attached.
VALUE AT DATE
OF DEATH
145,000
TOTAL (Also enter on line 1, Recaoitulation)
(If more space is needed, insert additional sheets of the same size)
$
145,000
217
REV-1508 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Smith, Edwin A.
FILE NUMBER
21-05-0576
Include the proceeds of litigation and the date the proceeds were received by the estate
All property iointly-owned with riaht of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1
2
3
4
5
6
7
DESCRIPTION
Real estate taxes and sewer charges prorated at settlement. See HUD-1 statement
PNC account no. 5003816657
Auction proceeds for sale of personal property
Miscellaneous additional auction proceeds
Down payment released for real estate sale
Refund from Susquehanna Oil
Miscellaneous refunds
VALUE AT DATE
OF DEATH
685
7,543
4,942
118
1,797
320
224
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
15,629
217
REV-1509 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
Smith, Edwin A.
FILE NUMBER
21-05-0576
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. Miriam A. Smith
Spouse
B.
C
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY '!oOF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VALUE OF
JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE VALUE OF ASSET
NUMBER TENANT INTEREST DECEDENTS INTEREST
1 A 8/14/89 PNC account no. 5070085073 1,149 50.00% 575
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
TOTAL (Also enter on line 6, Recapitulation' $ 575
(If more space is needed, insert additional sheets of the same size)
217
REV-1511 EX+(12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Smith, Edwin A.
FILE NUMBER
21-05-0576
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Myers-Harner Funeral Home 2,594
2. Gingrich Memorials 2,315
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) Aileen Roth
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address 308 Summit Road
City New Cumberland State PA Zip 17070
Year(s) Commission Paid: 2006 8,000
2. Attorney Fees 3,500
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 298
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Final medical expenses 688
8. Expenses of real estate sold 12,683
9 George Clauser, real estate appraisal 300
10. Final bill to Verizon 3
11. Bank fees and returned items 19
TOTAL (Also enter on line 9, Recapitulation\ $ 30,400
Debts of decedent must be reported on Schedule I.
(If more space is needed, insert additional sheets of the same size)
Expenses of real estate sold
Settlement expenses. See HUD-1 statement
PPL
Hampden Twp. sewer
Water conditioner
Michael Smith, lawn mowing
United Water
PPL
Susquehanna Oil
PPL
United Water
Susquehanna Oil
Susquehanna Oil
Michael Smith, lawn mowing
Hampden Township sewer
Erie Insurance
Marie Huber, tax collector
PPL
United Water
Materials costs for repairs
Faircloth Plumbing
United Water
PPL
Total expenses for Real Estate
9,185
39
115
16
260
14
38
25
34
11
160
160
100
115
89
1,197
24
14
911
130
14
32
12,683
Final Medical Expenses
West Shore EMS
Metro Med Services
West Shore EMS
126
45
517
Total Medical Expenses
688
A ~- --1:n~ DEPARTMENT OF HOUSING and URBAN DEVELOPMENT OMB No 2502.0265 I
SETTLEMENT STATEMENT TiTLEPno
HERITAGE SETTLEMENT Laserprlnl i
SERVICES, LLC B. TYPE OF LOAN
4705 East Trindle Road ,. [ ] FHA 2 [ ] FMHA 3 [ ] CONV Ur'lNS
Mechanicsburg, PA 17050 4. [ ] VA 5 [ ] cmJV INS
6 FILE NUMBER: I 7 LOAN NUMBER
Phone: (717) 975-2117 Fax: (717) 730-9665 993647 122055322
8. MORT. INS. CASE NO
C. NOTE: This form IS furnished to give you a stafement of actual settlement costs Amounts paid to and by the settlement agent are shown. Items marked
'(poc)' were paid outside the closing; they ere shown here for informational purposes and are not Included in the totals.
D NAME AND ADDRESS OF BORROWER E. NAME AND ADDRESS OF SELLER' F. NAME AND ADDRESS OF LENDEr1
Thang Cao Dinh Edvlin A. Smith Estate Countrywide Home Loans,
Muoi Thi Mai , Inc.
I
G PROPERTY LOCATION H. SETTLEMENT AGENT I S" TTLEMENT DA TE
Mechanicsburg, PA 17050
449 Berkshire Lane HERITAGE SETTLEMENT SERVICES, LLC 12/14/05
Hampden Townshlp PLACE OF SETTLEMENT
Cumberland County 4705 E. Trindle Rd. , Mechanicsburg, PA
J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION:
100. GROSS AMOUNT DUE FROM BORROWER 40D GROSS AMOUNT DUE TO SELLER
101 Contract sales price 145000.00 401 Contract sales price 145000.00
102 Personal property I 4D2 Personal property
103. Settlement charges to borrower (line 1400) 4971. 83 4D3
ID4 4D4
105 4D5 I
Adjustments for Items paid by seller In ad,ance Adjustments for items paid by seller in advance I
lOG CilylTown tax to I 406 CilyfTown tax 10
107 Counly lax 12/14/05~12/31/05 13.81 407 County lax 12/ 14 / 05to 12 / c: 1/0 51 13.81 I
108 Assessments 10 <108 Assessments to
1D9 SCl-iOOL 12/14/05~06/30/06 649.50 4D9 SCHOOL 12/14/05~06/10/06 649.50 i
110 Sewer/Ref 12/ 14to 12 . 31 21.59 410 Sewer/Ref 12/14to12.31 21.59 I
111 411 I
112 412 I
"0 GROSS AMOUNT DUE FROM BORROWER 150656.73 420 GROSS AMOUNT DUE TO SELLER 145684.90 i
200 AMOUNTS PAtD BY OR IN BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER
201 DepOSit or earnest money 1000.00 501 Excess deposit (see instructions)
202 Principal amount of new loan(s) 137750.00 502 Seltlement charges to seller (line 1400:, I 8335.00
203 EXlsllng loan(s) taken subject to 503 EXlsllng loan(s) taken subject 10 i I
201l 504 Payoff of First Mortgage Loan I
i ;'JOS 505 Payofl of Second Mortgage Loan I
I
.?Oti 506 I
?O7 Seller assistance ~ 850.00 507 Seller assistance 85G.00 I
?OIl 50B
200 I 509 I
Adjustments jar items unpaid by seller Adjustments lor Items unpaid by seller i
210 CilytTown lax to I 510 City!Town tax 10 i
21 1 County tax to I 511Counly tax to
2\2 Assessments to 512 Assessmenls to
213 SCHOOL to 513 SCHOOL to
21.1 514
2 1 ~) 515
215 1- 516
2\7 517
219 51B
219 519 I
"0 TOTAL PAID BY/FOR BORROWER 139600.00 520 TOTAL REDUCTION AMOUNT DUE SELLER I 9185.00
30D CASH AT SETTLEMENT FROM OR TO BORROWER 600 CASH AT SETTLEMENT TO OR FROM SELLER
301 Gross amount due from borrower (line 120) 150656.73 60LGross amount due to seller (line 420) 145684.90
302 Less amount paid by/for borrower (line 220) 139600.00 5D2.Less reduction amount due seller (line 520) 9185.00 I
303 CASH ([X FROM) ([ ] TO) BORROWER 11056.73 503. CASH ([ XTO) ([ ] FROM) SELLER 136499.90 I
~ ~tl..:" h- [ GLbf fLU!
f
x: -7rI Um " fma(
G:2)' ~., / .,
.' & /<~/',/~/ ' ~
_ -<--C~[, l/ L" ' / //
Seller's Signature
Buyer or Borrower's Signature
HUO-1 Rev. 5/.%
US. DEPARTV1EIH OF HOUSING AND URBAN DEVELOPMENT
SETTLEMENT STATEMENT
OMB No. 2502-0265
, CHARGES
993647
703 Commission paid at Settlement
704 Trans fee
BOO ITEMS PA Y ABLE IN CONNECTION WITH LOAN
801 Loan Origination Fee %
802 Loan Discount %
803. Appraisal Fee to
804 Credll Report to
805 Lenders Inspection Fee
806 Mortgage insurance Application Fee to
807 Assumption Fee
B08 Flood chec
809 Doc re
810
811
900 ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901 Interestlrom 12 14 05 to12/31 05 @$
902 Mortgage Insurance Premium for mo 10
903 Hazard Insurance Premium for yrs to
yrs 10
Landsafe A raisal 320.00
( $ 3 5 , 00 oc )
Lolndsafe Flood
Countr wide Home Loans
26,00
400,00
Iday
i
I
I
I
I
25.00
10,00
373
904
905
1000 RESERVES DEPOSITED WITH LENDER FOR
1001 Hazard Insurance 3 mo. @$
1002 Mortgage Insurance 1 mo @$
1003 Clty(Town lax mo @$
1004 County lax 12 mo @$
1005 Assessments mo @$
lOGE School 8 mo @$
1007 mo @$
1008 A mo @$
40.67 Imo.
89.54 Imo.
Imo
24.71 Imo
Imo
99.78 Imo
Imo
Imo
IIOC TITLE CHARGES
110 I Settlement or closing lee to
1102. Abstract or Iille search to
1103 Tille examination to
1104 Title insurance binder to
1105 Document preparation to
1106 Notary lees to Notar Pub 1 ic
1107 Atlorneys fees to
(Includes above Ilems No)
1108 Tille Insurance to Herita e Settlement Servi
(Includes above Ilems No') 1102, 1103 , 1104
1109 Lende's coverage $ 137 , 750
1110 Owner's coverage $ 145, 000
1111 Endts.
1112 CSL
1113 Courier Servi
1200 GOVERNMENT RECORDING AND TRANSFER CHARGES
1201 Recording lees Deed $ 38.50 Mortgage $ 68,50 Misc. $
1202 Clty/county tax/slamps Deed $ 1450 . 00 Mortgage $
1203 Slatetax/stamps Deed$ 1450. OOMorlgage$
1204 Assi nment Recorder of Deeds
1450,00
27.
1205
1300 ADDITIONAL SETTLEMENT CHARGES
1301. Survey to
1302 Pest Inspection to
1303 Home ins e
1304 Radon ins
1305 Trans fee
Home Paramount
Central Penn
TCS
Ke stone Realt
55.00
185,00
100.00
125 001
4971 83
8335.00
1400 TOTAL SETTLEMENT CHARGES (enler on lines 103 and 502. Sections J and K)
P,]lIIC$ agrct! thai no liability is assumed by Settlemenl Agent for Ihe accuacy 01 inlormatiOn fumished by others as shown on the HUD.l Settlemenl Slalemenl Selllemenl Agent hereby ('.>o:prcssly
reserves Ihe righl 10 deposit any amounls collecled for disbursemenl in an inlerest bearing accounl In a Federally insured inslilulion and 10 credil any inlc.est so €'arned 10 ils own account as addil.onal
CDnlpcnS;Jlion lor Its services In Ihis transacllon
HUD CERTIFICATION OF BUYERS AND SELLERS
I have carelully reviewed the HUD-1 Settlement Statement and 10 the best of my knowledge and belief, il is a true and accurate statement of all receipts and disbursements
made on my account by me in this transaction, her certify that I have received a coPY of the HUD-1 Settlement Statement.
,,-i) \, ", ,~,---{i~7'~1tv! . , ). .
(JIUC7'~~t'C/L--- (A~;~j;[' 6(t/~.
LJuycr or [lOrrOVicr's Signature
Buye,s Address & Phone
Seller's Signature
Seller's New Address & Phone
The) IUD 1 Sclllcment Statp.ment which I have P,ZParCd IS a true and accurate account of thiS Iransactlon I have caused or III cause the lunds 10 be disbursed In accordance WI n thiS slalemenl
- [, II ,-) ~t (l en : L L LAj /2 J rj 0 J--
SetllcmGnl Agenl Date
WM1NIN~~I:~r~ ~ t:i';Qcl~;en~~~~~I~ T~~i ~~~~~~al;;~~8tls0to the United States on this or any similar form. Penalties upon conviction can include a line and imprisonment For ~e~~I.sl s::v 5/86
AUG-11-2005 21:37
PNCBANK
412 768 3458
P.01
o PNCBAN<
August 12, 2005
Robert G. Frey
5 South Hanover Street
Carlisle, PA 17013
RE: Estate of Edwin A. Smith, deceased
SSN: 184-12-4350
DOD: 6/12/2005
Dear Mr. Frey:
In response to your request for Date of Death balances for the customer l10ted above, our
records show the following:
Checking Account
Account #5070085073
Established 08/14/1989
MIRIAM A SMITH
EDWIN A SMITH
DOD balance: $ J, J 48.85 + $.10 accroed interest
Savings Account
Account #5003816657
Established 11/2312001
EDWIN A SMITH
DOD balance: $7,542.36 + $.62 accrued interest
The decedent maintained Credit Line Account (RCA #4003048014463207). For further
infonnation, please call 1-888-762-2265. Select option 1, then option 3, and then 0 (zero).
After pressing zero, please remain on the line to speak to a Loan Service Representative.
(We do not bave access to Lou information, you must contact tbe LoaD Area at the
above number for further assistaDce).
Page 1 of2
AUG-11-2005 21:38
PNCBANI<
412 768 3458
Please note that this office only provides date of death balances for deposit accounts
(IRAs, CDs, Checking and Savmgs accounts). We do not process any financial
transactioDs or provide statements. If you need assistance with any of these items,
please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch
office.
~ iJ}1Jk
Rachelle Wells
1-800-762-1775
P7 -PFSC-04.F
500 first Ave.
Pittsburgh P A 15219
Page 2 of2
Member FDIC
P.02
TOTAL P.02
LAST WILL AND TEST AMENT
OF
EDWIN A. SMITH
I EDWIN A. SMITH married man of Hampden Township, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby
make, publish and declare this as and for my Last Will and Testament hereby revoking
and making void any and all Wills by me at any time heretofore made.
I. I direct my hereinafter named Executor or Executrices to pay all of my
just debts and funeral expenses as soon after my death as may be found convenient to do
so. I further direct that all inheritance, transfer, succession, estate and death taxes,
including interest and penalties thereon, which may be payable on account of my death
shal1 be payable from the residue of my estate regardless of whether the assets upon
which such taxes are based are included in my probate estate.
2. I declare that I am married to Miriam A. Smith and that I have two adult
children, AILEEN C. ROTH and GARTH E. SMITH, I further declare that] have no
other children.
3. All of the rest, residue and remainder of my estate, real, personal and
mixed, and wheresoever the same may be situate, I give, devise and bequeath in equal
shares to such of my' children as shal1 survive me by a period of ninety (90) days, the
share any deceased child would have received shal1 pass to his or her issue, per stirpes,
and if there be no such issue such share shal1 lapse and be added to the remaining share.
At the present time I have tvvo children as aforementioned
4. I hereby nominate, constitute and appoint my daughter, AILEEN ROTH
as Executrix of this my Last Will and Testament, but should she predecease me or fail to
qualify as such, then in such event I nominate, constitute and appoint my son, GARTH E.
SMITH, as Executor, and I further direct that neither of them shall be required to post any
bond to secure the faithful performance of his or her or his duties in the Commonwealth
of Pennsylvania or in any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last
Wil1 and Testament written on one (1) page, this 2l.(Klay of 0/lt...7 ,2005.
_(SEAL)
EDWIN A. SMITH
\
Signed, sealed, published, and decl . ed y EDWIN A. SMITH the Tesfator above
named, as and for his Last Will and Testament, in our presence, who, in his presence, at
his request, and in the presence of each other, have hereunto subscribed our names as
attesting witnesses.
(\J~~ ~ . ~d
tk?xJetft~
Page 1 oj 1