HomeMy WebLinkAbout09-29-06
ijEV-1500 EX (&-00)
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2,994,822.88
41,186.68
2,953,636.20
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2,953,636.20
50,257.22
0.00
0.00
50,257.22
COMMONWEALTH OF
PENNSYLVANIA
IEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG. PA 17128-0601
REV.1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
~L
COlMY CODE
0ECECENrS NAt.E (LAST, FIRST, AND M1DOlE INITIAl) SOCIAL SECURITY NUMBER
Groene, Jr. Blaer A 159-24-8784
DAle OF DEA 1H (MtM)D-YEAR) DAle OF BIRTH (MM-DO-YEAR) ntIS RETURN MUST BE FILED IN DUPUCATE WITH THE
1/1/2006 5/20/1929 REGISTER OF WILLS
(IF APPUCASLE) SURVMNG SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INIllAL) SOCIAL SECURITY NUMBER
SidDe L. Groene
t [i] 1. Original Retum D 2. Supplemental Retum D 3. Remainder Retum (dele of deeth prior 1012-13-82)
~ ~ [i] 4. Limited Estate (j] 4a. Futul1llntel1lst Compromise (dele of deeth after 12-12-&) (j] 5. Federal Estate Tax Retum Required
III QO r=1 r.;"1
GIfB UU 6. Decedent Died Testate (Attach copyofWiR) L6..J 7. Decedent Maintained a Living Trust (Attach copy of TIUIt) L 8. Total Number of Safe Deposit Boxes
~ D 9. Litigation Proceeds Received D 10. Spousal PoY8ltyCredlt (dale of ....Ih_..n 12-31-8111111 l.t.lIll) D 11. Election to tax under See. 9113(A)(A1_SchO)
iTHlsatt:l'iON MU$T8EaOl4PLE1EO..ALLCOft.~SflONDENCEAkttC~FtOeNfW.1:~;.' ~1'I6N_LOi.ijN~ijt()!
NAME COf.Pl.E1E MAJUNG ADDRESS
Linda J. Lundber P .0. Boz 308
FIRM NAME (If ApplICable)
PRe Wealth Kana eaent
lELEPHOI'E NUMBER
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717-730-2265
CaB Bill, PA 17011
0.00
131,848.25
0.00
0.00
107,106.98
0.00
-0
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1. Re8l Estate (Schedule A)
(1 )
(2)
(12)
> > BESUFlE TO~SWERALL QyESTlONs ONR~EflsE SlOE AND. RECHECK ~tH < <
0.00
20. 0
CHECK HERE If YO,) ARE REQUESTING A REFUND Of AN OVE RPAYMENT
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or SoIe-Proprietorshlp (3)
4. Mortgages & Notes Recelvable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E) (5)
z
o
t=
:s
::t
t:
Q.
C1
w
D::
6. J~ Owned Property (Schedule F)
U Separate Bllng Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
(6)
3W4645 1.000
2,755,867.65
8. To'" Gross Aue.. (total Lines 1-7)
(8)
36,624.80
4,561.88
9. Funeral Expenses & AdminlstratNe Costa (Schedule H) (9)
1 O. Debts of Decedent, Mortgage Liabilities. & Liens (Schedule I) (10)
11. Towl Deductions (tota. Lines 9 & 10)
(11 )
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
(13)
14. Net Va'ue Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE S'DE FOR APPUCABLE RATES
(14)
15. Amount of Line 14 taxable at the spousal tax 1,836,809.04 x .0 L.. (15)
Z rate, or transfers under See. 9116 (a)(1.2)
0
j::: 16. Amount of Line 14 taxable at Rneal rate 1,116,827.16 x .0 45 (16)
<C
....
::) 0.00
CL 17. Amount of Line 14 taxable at s1bUng rate x.12 (17)
2!
0 0.00 (18)
(.) 18. Amount of Line 14 taxable at collateral rate x.15
)(
<C 19. Tax Due (19)
....
Decedent's Com lete Address:
" S11ET ADDRESS
438 L Poat Lane
eu.ber1ancS Count ,
CllY
C.. Bill
..
STATE
PA
1Yi'
17011-
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
50,257.22
0.00
47,500.00
2,500.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C) (2)
50,000.00
0.00
0.00
Total I nte resUPenalty (D + E) (3) 0.00
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) 257.22
A. Enter the interest on the tax due. (5A) 0.00
B. Enter the total of Line 5 + 5A This is the BALANCE DUE. (5B) 257.22
Make Check Pa able to: REGlSTEROFWI.LS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Old decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;. . . . . . . . . . . . . . . [i] D
b. retain the right to designate who shall use the property transferred or its income; . [iJ D
c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . . . D [j
d. receive the promise for life of either payments, benefits or care? . . . . . . . . . . . D Ci
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . .. D [j
3. Did decedent own an "In trust for" or payable upon death bank account or security at his or her death? 0 []I
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D [j
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES. YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penelll.. of perjul)'. I declare that I h8\18 e.nlned this relum, Indudlng 1CCOIIIP8Ily!ng schedulelll1d statements, II1d to the bll8l of my knowledge and belief, n Is true, correct II1d complete.
Decl.....lon of preparer oth... than the ~a1 representallw Is based on a111nfonnallon of which Preplnr has any knowledge.
U RE1\JRN an ,
~ ~ \.tt- ~ ~.t:6 ~ :..u
BY:
DA
<\
~'tt~~
DA
AOORESS
- ""'fl)
For dates of death on or after July 1, 1994 and before Janual)' " 1995, the tax rate Imposed on the net value of transfers to or for the use of the SUrvMng spouse is 3%
(72 P.S. 6 9916 (a) (1 .1) (I)].
For dates of death on or after January " 1995, the tax rate Imposed on the net value of transfers to odor the use of the sul'oliving spouse Is 0% (72 P.S. ~ 9116 (a) (1.1) (ii))
The statute does not exemDt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are stHI applicable eYen if
the surviving spouse Is the only benetlciary.
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 ~rs of age or younger at death to or for the use of a natural parent, an adOptillB 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 decedenfsllneal beneficiaries Is 4.5%, except as noted in 72 P.S. 6 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 decedenfs siblings Is 12% (72 P.S. 6 9116(a)(1.3)]. A sibling is defined, under Section 9102, asan
Individual who has at least one parent in common with the decedent, whether by blood or adoption.
3W4646 1.000
REV.1l503 EX + (8-88)
.
SCHEDULE B
STOCKS & BONDS
to
COMMONVVEAL. TH OF PENNSYlVANIA
MERlTANCE TAX RETURN
RESIJENT DECEDENT
ESTATE OF
FILE NUMBER
B1.er A Groene. Jr.
21 06 0209
All property JOlntly-owned with right of survivorship must be dlscloaed on Schedule F.
ITEM
NUMBER DESCRIPTION
1.The assets listed below were owned
by the decedent and his wife,
Sidney L. Groene, a. tenants by
the entirety. Under date of
3/24/06, Sidney L. Groene
disclaimed her intere.t in these
a..et..
VAlUE AT DATE
OF OEA n-t
(Copy of Di.claimer attached)
3,306.702 Share.
Delaware Group Bquity Pds I
Del Balncd Cl A
Hutual PuDd., Honey Harket Pds
CUSIP: 246093108
54,362.18
2 2,651.782 Share.
Hf. Pixed Income Tr
HUD Ltd Hat A
Hutua1 PuDd., Honey Harket Pd.
CUSIP: 55272P505
20,471.76
3 3,263.752 Share.
Hf. HUD Ser Tr
Pa HUD Bd Pd A
Hutua1 PuDd., Honey Market Pd.
CUSIP: 55273H798
33,322.91
4 2,239.263 Share.
Hfs Ser Tr Iv
HUD Bd Pd Cl A
Hutua1 PUDd., Honey Harket Pds
CUSIP: 552987505
23,691.40
3W4696 1.000
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
131,848.25
IEV-1508 EX + (8-98)
COMMONWEALTH OF PENNSYLVANIA
NERfTANCE TAX RElURN
RESlDENTOECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
B1mer A Groene, Jr.
ITEM
tlUMBER
Include the proceeds of litigation and the date the proceeds \Y8Ilt receMld by the estate.
AI ntIy~ned with the right of lurvlvorahlp must be dllclosed on Schedule F.
FILE NUMBER
21 06 0209
DESCRIPTION
VAlUE AT DATE
OF DEATH
1
Bew Bngland Pinancial/Met Life
Policy 102996062
Insured - Sidney Groene
Bet value as of 1/1/06
(See 712 attached)
4,190.73
The asset listed below was owned
by the decedent and his wife,
Sidney L. Groene, as tenants by
the entirety. Under date of
3/24/06, Sidney L. Groene
disclatmed her interest in these
assets.
(Copy of disclaimer attached)
2
PRC Bank, H .A.
Saving Certificate 131100255720
Interest accrued to 1/1/2006
Balance as of 1/1/06
(See letter attached)
102,699.95
216.30
3W46AD 1.000
TOTAL (Also enter on line 5 Recaoitulation) $
(If more space is needed. insert additional sheets of the same size)
107,106.98
.~EV.1510 EX + (~98)
.
COMMCINWEAL 11-1 OF PENNSYlVANIA
NiERlTANCE TAX RETURN
· RESlDENTOECEDENT
ESTATE OF
Blaer A Gro.ne, Jr.
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
FILE NUMBER
21 06 0209
ITEM
NUMBEFi
1.
DESCRlPTlON OF PROPERTY
IICUIlElIE1WEOFlIE1IWIBFEREE, TIEIR RELATlOHSHPTO DECeDENT Me
lIE 1>>.1E OF llWflFER. ATTACHAtXJPf OF lIE DEED FOR REAL ESTAlE.
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DAlE OF DEATH
VALUE OF ASSET
%OFDECD'S
MEREST
B1..r A. Groene, Jr. created a
R.vocable Trust UDder Agr....nt
dated September 16, 2004 with
hias.lf and PRC Bank, R.I.. as
trust..s. The ass.t. of this
tru.t have been valued as of
date of death (1/1/06) and are
listed as items #1-112 below:
200 Share.
Bershey roods Corp
COIIIROn
Rew York Stock Bxchange
CUSIP: 427866108
11,005.50 100.0000
2 106 Share.
Weight Watcher. Intl Inc Rew
Common
Rew York Stock Bxchange
CUSIP: 948626106
5,245.41 100.0000
3 220 Shares
AT&T Inc
CUSIP: 002606r10
5,386.70 100.0000
4 110 Share.
Abbott Lab.
Common
Rew York Stock Bxchange
CUSIP: 002824100
4,351.33 100.0000
5 220 Shares
Alb.rtsons Inc
CUSIP: 013104104
4,749.25 100.0000
6 175 Shares
Alcoa Inc
C~on
R.w York Stock Bxchange
CUSIP: 013817101
5,191.81 100.0000
Total from continuation sched~les . . . . . . . . .
TOTAL (Also enter on line 7, Recapitulation) $
3W46AF 1.000
(If more space is needed, insert additional sheets of the same size)
EXCLUSION
IF APPLICAIlLE\
0.00
0.00
0.00
0.00
0.00
0.00
TAXABLE
VALUE
11,005.50
5,245.41
5,386.70
4,351.33
4,749.25
5,191.81
2,719,937.65
2.755.867.65
.
.
B.tate of: B1aer A Groene, Jr.
159-24-8784
.
Schedule G (Page 2)
It...
10. Description
DOD Value
of Asset 'Intere.t
Exclusion
Taxable
Value
7 95 Share.
Allergan Inc
COIalon
R.. York Stock Exchange
CUSIP: 018490102 10,355.00 100.0000 0.00 10,355.00
8 500 Shares
Alltel Corp
COIalOn
Hew York Stock Exchange
CUSIP: 020039103 31,582.50 100.0000 0.00 31,582.50
Dividend accrued on 1/1/2006 192.50 100.0000 192.50
9 300 Share.
American Intl Group Inc
Common
Rew York Stock Bxchange
CUSIP: 026874107 20,566.50 100.0000 0.00 20,566.50
10 300 Shares
AIIlgen Inc
CUSIP: 031162100 23,777.25 100.0000 0.00 23,777.25
11 490 Shares
Anheuser Busch C08 Inc
COIIIIlon
Rew York Stock Exchange
CUSIP: 035229103 21,153.30 100.0000 0.00 21,153.30
12 122 Share.
Apollo Group Inc
Cl A
RUDAQ Stocks
CUSIP: 037604105 7,363.92 100.0000 0.00 7,363.92
13 581.745 Share.
Artisan Pds Inc
S. Cap Val
Mutual Pund., Money Market Pds
CUSIP: 04314B501 10,035.10 100.0000 0.00 10,035.10
14 300 Share.
As.ociated Banc Corp
Common
RUDAQ Stocks
CUSIP: 045487105 9,749.25 100.0000 0.00 9,749.25
Total (Carry forward to aain schedule)
134,775.32
.
Bstate of: Blaer A Groene, Jr.
Schedule G (Page 3)
It..
10. De.cription
15 600 Share.
Auto.atic Data prooe..ing
C~n
.e. York Stock Bxchange
COSIP: 053015103
16 70 Shares
Avery Denni.on Corp
Comaon
Hew York Stock Bxchange
CUSIP: 053611109
17 110 Share.
Avon Prod. Inc
COJIIIIlon
Hew York Stock Bxchange
CUSIP: 05~303102
18 700 Share.
Ball Corp
Co.mon
Be. York Stock Exchange
COSIP: 058~98106
19 600 Share.
Bank ADler Corp
Co.mon
Be. York Stock Exchange
CUSIP: 06050510~
20 ~12.969 Share.
Baron Asset I'd
Saall Cap P'd
Mutual Punds, Money llarket I'ds
CUSIP: 068278308
21 135 Share.
Baxter Intl Inc
COJIlJIlOn
Hew York Stock Exchange
CUSIPI 071813109
Dividend accrued on 1/1/2006
22 205 Shares
Bellsouth Corp
COJIlJIlOn
Be. York Stock Bxchange
CUSIPI 079860102
Total (Carry forward to main schedule)
DOD Value
of Asset 'Interest
27,683.99 100.0000
3,897.25 100.0000
3,139.68 100.0000
27,902.00 100.0000
27,681.00 100.0000
9,568.~9 100.0000
5,119.88 100.0000
79.57 100.0000
5,565.75 100.0000
.
Bxclu.ion
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
159-24-8784
Taxable
Value
27,683.99
3,897.25
3,139.68
27,902.00
27,681.00
9,568.49
5,119.88
79.57
5,565.75
110,637.61
.
.state ofa B1mer A Groene, Jr.
Schedule G (Page 4)
It..
10. Description
23 6 Shares
Berkshire Bathaway Inc Del
Cl B
Bew York Stock Exchange
CUSIPa 084670207
24 1,370.332 Shares
Blackrock Fds
International CP Eq Ins
CUSIPa 091929109
25 205 Shares
Bristol Myers Squibb Co
Common
Bew York Stock Exchange
CUSIP: 110122108
26 120 Shares
Cit Group Inc
Common
Bew York Stock Exchange
CUSIP: 125581108
27 800 Shares
Cvs Corp
COJIIaOn
Bew York Stock Exchange
CUSIP: 126650100
28 546.431 Shares
Calamos Invt Tr Bew
Growth Pd
Mutual Funds, Money Market Pds
CUSIPa 128119302
29 98 Shares
Chevrontexaco Corp
Common
Bew York Stock Exchange
CUSIPa 166764100
30 24 Shares
Chicago Mercantile Exchange
Cl A
Bew York Stock Exchange
CUSIPa 167760107
Total (Carry forward to main schedule)
DOD Value
of Asset 'Interest
17,640.00 100.0000
50,496.73 100.0000
4,726.27 100.0000
6,232.50 100.0000
21,206.00 100.0000
30,086.49 100.0000
5,616.38 100.0000
8,771.21 100.0000
.
Exclusion
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
159-24-8784
Taxable
Value
17,640.00
50,496.73
4,726.27
6,232.50
21,206.00
30,086.49
5,616.38
8,771.21
144,775.58
Bstate of. B1aer A Groene, Jr.
It..
10. De.cription
31 510 Share.
Citigroup Inc
C~n
Rew York Stock Bxchange
CUSIP. 172967101
32 560 Share.
Coca Cola Co
COIIIaOn
Rew York Stock Bxchange
CUSIP. 191216100
33 1,000 Share.
Coaca.t Corp Rew
C1 A
RASDAQ Stocks
CUSIP, 20030R101
34 400 Share.
Danaher Corp
She Ben Int
Rev York Stock Bxchange
CUSIP: 235851102
Dividend accrued on 1/1/2006
35 200 Share.
Dell Inc
COIRIIlon
RASDAQ
CUSIP, 24702R101
36 100 Share.
Du Pont B I De R..our. & Co
Co.mon
Rew York Stock Bxchange
CUSIPI 263534109
37 223 Share.
Bbay Inc
COIRIIlon
HUDAQ Stocks
CUSIP, 278642103
38 75 Share.
Balerson Blec Co
COIRIIlon
Hew York Stock Bxchange
CUSIP, 291011104
.
Schedule G (Page 5)
Total (Carry forward to main schedule)
DOD Value
of As.et 'Interest
24,788.55 100.0000
22,741.60 100.0000
25,907.50 100.0000
22,424.00 100.0000
8.00 100.0000
5,999.00 100.0000
4,275.00 100.0000
9,731.16 100.0000
5,600.81 100.0000
.
Bxclusion
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
159-24-8784
Taxable
Value
24,788.55
22,741.60
25,907.50
22,424.00
8.00
5,999.00
4,275.00
9,731.16
5,600.81
121,475.62
Bstate ofl B1mer A Groene, Jr.
Item
10. Description
39 300 Share.
Bxelon Corp
Common
Hew York Stock Bxchange
CUSIPI 30161H101
"0 12" Share.
Bxpeditors IntI Wash Inc
COIIIIROn
HASDAQ Stocks
CUSIPI 302130109
"1 "70 Share.
Bxxon Mobil Corp
Common
Hew York Stock Bxchange
CUSIPI 30231G102
"2 600 Shares
pp1 Group Inc
Common
Hew York Stock Exchange
CUSIP: 302571104
43 602 Shares
Pirst Data Corp
Common
Hew York Stock Exchange
CUSIPI 319963104
"4 410 Share.
Pord Mtr Co Del
Coa Par $0.01
Hew York Stock Bxchange
CUSIP: 345370860
45 200 Shares
Portune Brands Inc
Common
Hew York Stock Bxchange
CUSIPI 3"9631101
46 134 Shares
Genentech Inc
Coa Hew
Hew York Stock Bxchange
CUSIPr 368710406
.
Schedule G (Page 6)
Total (Carry forward to main schedule)
DOD Value
of Asset 'Interest
16,034.25 100.0000
8,379.30 100.0000
26,714.80 100.0000
24,980.52 100.0000
25,744.53 100.0000
3,179.55 100.0000
15,562.50 100.0000
12,378.25 100.0000
.
Bxclusion
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
159-2"-8784
Taxable
Value
16,034.25
8,379.30
26,714.80
24,980.52
25,744.53
3,179.55
15,562.50
12,378.25
132,973.70
.
Bstate ofl Blaer A Groene, Jr.
Schedule G (Page 7)
Item
Ro. Description
"7 2,400 Shares
General B1ec Co
CcmIIIlOn
Bew York Stock Exchange
CUSIPI 369604103
Dividend accrued on 1/1/2006
48 95 Shares
General Ills Inc
Common
Bew York Stock Exchange
CUSIPI 370334104
49 1,000 Shares
General IItrs Corp
Sr Bt7.25\ 4/41
Bew York Stock Exchange
CUSIPI 370"42816
Dividend accrued on 1/1/2006
50 1,933.138 Shares
Harbor I'd
Int1 I'd Inst
Mutual Funds, lIoney Market I'd.
CUSIPI 411511306
51 65 Shares
Hartford I'inl Svcs Group Inc
Comaon
Bew York Stock Exchange
CUSIPI 416515104
Dividend accrued on 1/1/2006
52 225 Shares
Hewlett Packard Co
COIIIROn
Hew York Stock Bxchange
CUSIPI 428236103
53 130 Shares
Honeywell Int1 Ina
Common
Hew York Stock Bxahange
CUSIP: 438516106
Total (Carry forward to main schedule)
DOD Value
of Asset \ Interest
84,240.00 100.0000
600.00 100.0000
4,698.23 100.0000
13,872.50 100.0000
453.10 100.0000
95,342.37 100.0000
5,616.16 100.0000
19.50 100.0000
6,456.38 100.0000
4,840.55 100.0000
.
Exclusion
0.00
0.00
0.00
0.00
0.00
0.00
0.00
159-24-8784
Taxable
Value
84,240.00
600.00
4,698.23
13,872.50
453.10
95,342.37
5,616.16
19.50
6,456.38
4,840.55
216,138.79
.
.
.state ofa Blaer A Groene, Jr.
159-2"-878"
Schedule G (Page 8)
It..
10. Description
DOD Value
of Asset 'Interest
Exclusion
Taxable
Value
5" "00 Share.
Itt Inds Inc Ind
Comaon
Rew York Stock Exchange
CUSIPa "50911102 "1,302.00 100.0000 0.00 "1,302.00
55 200 Shares
International Busine.. bchs
COIIIIIlon
Rew York Stock Exchange
CUSIP: "59200101 16,370.50 100.0000 0.00 16,370.50
56 250 Shares
International G..e Tech
COIIIIIlon
Bew York Stock Exchange
CUSIPa "59902102 7,692.50 100.0000 0.00 7,692.50
Dividend accrued on 1/1/2006 31.25 100.0000 31.25
57 125 Shares
International Paper Co
COIIIIIlon
Bew York Stock Exchange
CUSIPa 460146103 ",207.50 100.0000 0.00 4,207.50
58 1"8 Shares
Intuit Inc
COIIIIIlon
BASDAQ Stocks
CUSIPa "61202103 7,900.98 100.0000 0.00 7,900.98
59 1"5 Shares
J P Horgan Cha.e Ie Co
C~n
Bew York Stock Bxchange
CUSIP: 46625B100 5,761.21 100.0000 0.00 5,761.21
60 "75 Share.
Johnson Ie Johnson
Comaon
Hew York Stock Bxchange
CUSIPa "7816010" 28,877.63 100.0000 0.00 28,877.63
61 60 Shares
Kimberly Clark Corp
Comaon
Bew York Stock Bxchange
CUSIP: 49"368103 3,570.00 100.0000 0.00 3,570.00
Total (Carry forward to main schedule) 115,713.57
.
.
..tate ofa .~er A Groene, Jr.
159-24-8784
Bstate ofa Blmer A Groene, Jr.
It..
Ro. De.oription
70 125 Share.
Masoo Corp
COIIIROn
Be. York Stook Bxohange
CUSIPa 574599106
71 135 Share.
MatteI Ino
COIIIIIlOn
B.. York Stook bohange
CUSIPa 577081102
72 300 Share.
Mooor.mick & Co Inc
Bon Voting Com
Be. York Stock Bxchange
CUSIPa 579780206
Dividend accrued on 1/1/2006
73 100 Shar..
Mcgraw Bill Inc
COJDIIlon
Be. York Stock Bxchange
CUSIPa 580645109
74 135 Share.
Mead...tvaco Corp
COJDIIlon
B.. York Stook Bxchange
CUSIPa 583334107
75 400 Share.
Medtronic Inc
COJDIIlon
Be. York Stock Bxchange
CUSIPa 585055106
76 1,043 Shar..
Microsoft Corp
COIIIIIlon
BASDAQ Stook.
CUSIPa 594918104
.
Sohedu1e G (Page 10)
Total (Carry forward to main .chedule)
DOD Value
of As.et 'Interest
3,801.88 100.0000
2,120.85 100.0000
9,259.50 100.0000
54.00 100.0000
5,181.75 100.0000
3,771.90 100.0000
23,051.00 100.0000
27,511.99 100.0000
.
BxclusioD
0.00
0.00
0.00
0.00
0.00
0.00
0.00
159-24-8784
Taxable
Value
3,801.88
2,120.85
9,259.50
54.00
5,181.75
3,771.90
23,051.00
27,511. 99
74,752.87
.state of: .~er A Groene, Jr.
It_
10. Desaription
77 739 Shares
Noodys Corp
C~n
Bew York Stoak Bxahange
CUSIP: 615369105
78 90 Shares
Norgan Stanley
Coa Rew
Re. York Stoak Bxahange
CUSIP: 617446448
79 148 Shares
Ravteq Corp
CUSIP: 639361100
80 180 Shares
Rewe11 Rubbermaid Ina
COJIIIIlOn
Bew York Stoak Bxahange
CUSIP: 651229106
81 320 Shares
Rokia Corp
Adr Sponsored
Be. York Stoak Exahange
CUSIP: 654902204
82 300 Shares
Pp1 Corp
Common
Re. York Stoak Bxahange
CUSIP: 69351T106
83 223 Shares
Payahex Ina
COJIIIIlOn
BASDAQ Stoaks
CUSIP: 704326107
84 400 Shares
Pepsiao Ina
Common
Rew York Stoak Exahange
CUSIP: 713448108
Dividend aaarued on 1/1/2006
.
Sahedule G (Page 11)
Total (Carry forward to main sahedule)
DOD Value
of Asset 'Interest
45,733.02 100.0000
5,141.70 100.0000
6,472.41 100.0000
4,290.30 100.0000
5,904.80 100.0000
8,868.75 100.0000
8,551.49 100.0000
23,712.00 100.0000
104.00 100.0000
.
Bxalusion
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
159-24-8784
Taxable
Value
45,733.02
5,141.70
6,472.41
4,290.30
5,904.80
8,868.75
8,551.49
23,712.00
104.00
108,778.47
.
.
.state ofa .~er A Groene, Jr.
159-24-8784
Schedule G (Page 12)
It...
Ro. Description
DOD Value
of Asset 'Interest
Bxclusion
Taxable
Value
85 195 Shares
Pfizer Inc
COIIIIIlOn
Hew York Stock Bxchange
CUSIPa 717081103 4,551.30 100.0000 0.00 4,551.30
86 100 Shares
Pitney Bowes Inc
COIIIIIlOn
Hew York Stock Bxchange
CUSIPa 724479100 4,255.00 100.0000 0.00 4,255.00
87 162 Shares
Praxair Inc
Common
Hew York Stock Exchange
CUSIPa 74005PI04 8,609.49 100.0000 0.00 8,609.49
88 849 Shares
Procter & Gamble Co
Common
Bew York Stock Bxchange
CUSIPa 742718109 49,452.13 100.0000 0.00 49,452.13
89 345 Shares
QualcODlJll Inc
CODIJIlon
BASDAQ Stocks
CUSIPa 747525103 14,985.08 100.0000 0.00 14,985.08
Dividend accrued on 1/1/2006 31.05 100.0000 31. 05
90 983.726 Shares
Rowe T Price Md-Cp VI I'd Inc
CODIJIlon
Mutual Funds, Money Market I'd.
CUSIP: 77957YI06 22,999.51 100.0000 0.00 22,999.51
91 500 Shares
Safeco Corp
Common
NASDAQ Stocks
CUS:IPI 786429100 28",387.50 100.0000 0.00 28,387.50
92 220 Shares
Sandisk Corp
COJIIIlon
RASDAQ Stocks
CUSIP: 80004C101 14,133.90 100.0000 0.00 14,133.90
Total (Carry forward to main schedule) 147,404.96
.
.
Bstate ofa B1aer A Groene, Jr.
159-24:-8784
Sohedu1e G (Page 13)
It..
Ro. Desoription
DOD Value
of Asset 'Interest
Bxolusion
Taxable
Value
93 200 Shares
Sara Lee Corp
Comaaon
Bew York Stock Bxchange
CUSIPa 803111103 3,814:.50 100.0000 0.00 3,814:.50
Dividend accrued on 1/1/2006 39.50 100.0000 39.50
94: 258 Share.
Sprint Corp
Ca.mon
Be. York Stock Bxchange
CUSIPa 852061100 6,027.53 100.0000 0.00 6,027.53
95 392 Shares
Staples Inc
Comaaon
BASDAQ Stocks
CUSIPa 855030102 8,869.98 100.0000 0.00 8,869.98
96 800 Shares
Stryker Corp
Comaaon
Be. York Stock Bxchange
CUSIPa 863667101 35,551.80 100.0000 0.00 35,551.80
Dividend accrued on 1/1/2006 88.00 100.0000 88.00
97 310 Shares
3M Co
Common
Bew York Stock Bxchange
CUSIPa 88579Y101 24:,206.35 100.0000 0.00 24:,206.35
98 111 Shares
United Parcel Svc Inc
Cl B
Bew York Stock Bxchange
CUSIPa 911312106 8,333.02 100.0000 0.00 8,333.02
Dividend accrued on 1/1/2006 36.63 100.0000 36.63
99 600 Share.
United Technologies Corp
Common
Hew York Stock Bxchange
CUSIPa 913017109 33,575.63 100.0000 0.00 33,575.63
Total (Carry forward to main schedule)
120,542.94
.
B.tate ofa B~er A Groene, Jr.
Item
Ro. De.cription
1001"2 Share.
unit.dbealth Group Inc
COIImon
Hew York Stock Bxchange
CUSIPa 9132"Pl02
101600 Share.
Varian Ned Sy. Inc
Common
Bew York Stock Bxchange
CUSIPa 92220Pl05
102125 Share.
Verizon Communication.
Common
Bew York Stock Bxchange
CUSIP: 92343Vl0"
103100 Shares
Wachovia Corp
Common
Bew York Stock Bxchange
CUSIP: 929903102
10"433 Shares
Wal Mart Store. Inc
Common
Hew York Stock Bxchange
CUSIP: 931142103
Dividend accrued on 1/1/2006
105192 Share.
Walgreen Co
Common
Bew York Stock Bxchange
CUSIP: 931422109
106300 Share.
Well. Pargo & Co Bew
Common
.ew York Stock Bxchange
CUSIP: 949746101
107223 Share.
Xm Satellite Radio Inc
Cl A
BASDAQ Stocks
CUSIP: 983759101
Schedule G (Page 14)
Total (Carry forward to main .chedule)
DOD Value
of As.et 'Intere.t
8,806.8" 100.0000
30,108.00 100.0000
3,773.44 100.0000
5,312.50 100.0000
20,183.21 100.0000
64.95 100.0000
8,547.26 100.0000
18,825.00 100.0000
6,139.19 100.0000
.
Bxclu.ion
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
159-2"-878"
Taxable
Value
8,806.8"
30,108.00
3,773.4"
5,312.50
20,183.21
64.95
8,5"7.26
18,825.00
6,139.19
101,760.39
Bstate ofa B!mer A Groene, Jr.
It_
Ro. Desoription
10896 Shares
Z~er Bo1dings Ino
CUSIPa 98956p102
109200 Shares
Ingersoll-Rand Company Ltd
Cl A
Rew York Stook Exohange
CUSIPa G4776G101
110500 Share.
Plextronios Intl Ltd
Ord
NASDAQ Stooks
CUSIPa Y2573F102
11147,968.02 Shares
Blaokrook Fund.
PA Munioipal Money Mkt
CUSIP: 992710442
Dividend aoorued on 1/1/2006
112Bartford Life Insuranoe Co
Variable Annuity
Contraot . 910913095
Value as of 1/1/06
Payable to Sidney L. Groene
(See attaohed)
113AmerUs Annuity Group Co
Policy '169003
Value as of 1/1/06
Payable to Sidney L. Groene
(See letter attaohed)
114IRG Contract '1026037-0D
IRA Annuity
Comprised of
IRG Ltd Mat Bd 12,030.50
IRG NFS Tot Ret 6,883.40
IRQ PIMeO Hi Yld 6,315.76
Payable to Sidney L. Groene
(See letter attaohed)
1150ppenheiaer Funds
IRA Trus t
.
Schedule G (Page 15)
Total (Carry forward to main schedule)
DOD Value
of Aaset 'Interest
6,482.64 100.0000
8,068.00 100.0000
5,192.50 100.0000
47,968.02 100.0000
99.64 100.0000
134,580.25 100.0000
74,335.24 100.0000
25,229.66 100.0000
789,238.14 100.0000
.
Bxclusion
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
159-24-8784
Taxable
Value
6,482.64
8,068.00
5,192.50
47,968.02
99.64
134,580.25
74,335.24
25,229.66
789,238.14.
1,091,194.09
.
Bstate ofa B1mer A Groene, Jr.
Schedule G (Page 16)
It_
Ro. Description
Coaprised of
Cha.pion Inc Pd A
Core Bd Pd A
Main St Pd A
Payable to Sidney
(See attached)
292,320.85
274,522.07
222,395.22
L. Groene
116Por Information Purposes Only
Under date of January 25, 1992,
B1aer A. Groene created an
Irrevocable Agreement of Trust
with Willi.. B. Miller, Jr.,
Trustee. Decedent did not retain
any rights to or powers over
principal that would subject the
trust assets to tax.
(Copy of Agreement attached)
Total (Carry forward to main schedule)
DOD Value
of Asset 'Interest
0.00 100.0000
.
Bxclu8ion
0.00
159-24-8784
Taxable
Value
0.00
0.00
REV-1511 EX + (12-99)
COMMONWEALTH OF PENNSYlVANIA
If+ERITANCETAX RETURN
RESIDENT DECEDENT
&STATE OF
B1_~r A GroAnA. Jr.
.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21 06 0209
ITEM
NUMBER DESCRlPTlON AMOUNT
A. FUNERAL.. EXPENSES:
1. Reill PUDeral Bame
PUDeral .ervioe. 11,310.80
B. ADMNISTRATIVE COSTS:
1. Personal Representative's Commissions 15,000.00
Name of Personal Representative(s) PRC Bank, R.A.
Social Security Number(s) I EIN Number of Personal Representative(s) - -
Street Address 4242 Carli.le Pike
City Camp Bill State PA Zip 17011
Vear(s) Commission Paid: To be paid
2. Attorney Fees 10,000.00
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 314.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
RODe
TOTAL (Also enter on line 9, Recapitulation) $ 36.624.80
3W46AG 1.000
(If more space Is needed, insert additional sheets of the same size)
~EV-1512 EX + (12..03)
.
COMMONwEALTH OF PENNSYlVANIA
HERlTANCE TAX REnJRN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
.1_-r A Groene. Jr.
FILE NUMBER
21 06 0209
R.port d.bts Incurred by the d.c.d.nt prior to d.ath which remained unpaid as of the date of death, Including unrelmbursed medical .xpen....
IlEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
Harrisburg Phar.macy
Balance due
224.88
2 Hospice of Central PA
Bospice services
3 Medical Staffers
Rursing services
4 PA Deparc.ent of aevenue
Balance due 2005 PA State :Incoae
Tax
5 West Shore BIIS
Balance due
2,000.00
1,200.00
737.00
400.00
3W46AH 2.000
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, Insert additional sheets of the same size)
4,561. 88
REV.1513 EX+ (9-00)
.
SCHEDULE J
BENEFICIARIES
COMt.<<:INWEALlli OF PENNSYLVANIA
NlERITANCE TAX RETURN
RESlDENTDECEDENT
ESTATE OF
Blaer A GrftAI'lA J.....
N.JMBER NAME AN> ADDRESS OF PERSON(S) RECEMNG PROPERlY
I TAXABLE DISTRIBUTIONS Pnclude outright spousal distributions, and transfers
under Sec. 9116 (8) (1.2)]
1 J. Scott Groene
1304 Chatham Road
Camp Bill, PA 17011-6001
FILE NUMBER
21 06 0209
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
1/2 remainder sh of B1mer A.
Groene Bypass Trust
Son
558,413.58
2 Sidney L. Groene
438 Lamp Post LaDe
Camp Bill, PA 17011
Schedule B '1
4,190.73
Annuities valued at
IRA a/cs valued at
Life estate per K
208,915.49
814,467.78
809,235.02
Surviving Spouse
1,836,809.04
ENTER DOLLAR AMOUNTS FOR D1SlRIBUllONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE. ON REV-1500 COVER SHEET
II NON- TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRlBUTlONS UNDER SECllON 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
3W46A11.000
TOTAL Of PART". ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
(If more space is needed. insert additional sheets of the same size)
$
0.00
.
.
..tate ofl .~er A Groene, Jr.
159-24-8784
Sohedu1e J Part 1 (Page 2)
It_
Bo.
De.oription
Relation
Amount
3 Debora L. Levin
507 Joel Drive
Meohaniosburg, PA 17050-7235
1/2 remainder sh of B~er A.
Groene Bypass Trust
Daughter
558,413.58
Estate of Elmer A. Groene, Jr.
File No: 21-06-0209
Date of Death: 1/1/2006
.
Gross Estate
Less: Schedules H & I
Subtotal
Less: Property passing directly to spouse
Schedule E #1
Annuities
IRA accounts
Residue
Sidney L. Groene b. 4/17/32; age 74
AFR for January 2006 = 5.4
Life Estate factor Table 5(5.4)
for person age 74 = .42015
Value of life estate of Sidney L. Groene
Remainder Value of Trust
Calculation of Shares
Calculation of Residue
($4,190.73)
($208,915.49)
($814,467.80)
x $
Sidney L. Groene
New England FinanciaVMet Life Policy of life of Sidney L. Groe
Annuities - Schedule G #112&113
IRA accounts - Schedule G #114&115
Value of life estate in Trust
J.Scott Groene & Issue
1/2 Remainder value of trust
Debora L. Levin & Issue
1/2 Remainder value of trust
Total
.
$2,994,822.88
($41.186.68)
$2,953,636.20
($1.027.574.02)
$1,926,062.18
0.42015
$809,235.02
$1,116,827.16
$4,190.73
$208,915.49
$814,467.80
$809,235.02 $1,836,809.04
$558,413.58 $558,413.58
$558,413.58 $558,413.58
$2,953,636.20
REV-1514 EX+ (12-03)
. SCHEDULE K
LIFE ESTATE, ANNUITY
& TERM CERTAIN
COMMONWEAllH OF PENNSYlVANIA
INERlTANCE TAX RElURN
RESlDENTOECEDENT
ESTATE OF
Check Box 4 n REV.1500 Cover Sheet
FILE NUMBER
Bl.er A Groene, Jr. 21060209
This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5-1-89,
actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit.
Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99,
and in Aleph Volume for dates of death from 5-1-99 and thereafter.
Indicate the type of instrument which created the future interest below and attach a copy to the tax return.
o Will [i] Intervlv08 Dud of Trust 0 Other
LIFE ESTATE INTEREST CALCULATION
NAME(S) OF LIFE TENANT(S)
DATE OF BIRTH NEAREST AGE AT
DATE OF DEATH
TERM OF YEARS
LIFE ESTATE IS PAYABLE
8idDe L. Groene
04/17/1932
74
Term of Years
Term of Years
Term of Years
Term of Years
Life or
1. Value of fund from which life estate is payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
2. Actuarial factor per ap~riate table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Interest table rate - U 3 1/2% 0 60k 0 10% [!] Variable Rate 5.40000 %
3. Value of life estate (Line 1 multiplied by Line 2) ............................. $
Term of Years
1,926,062.18
0.42015
809,235.02
ANNUITY INTEREST CALCULATION
NAME(S) OF LIFE ANNUITANT(S)
DATE OF BIRTH NEAREST AGE AT
DATE OF DEATH
TERM OF YEARS
ANNUITY IS PAYABLE
1. Value of fund from which annuity is payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
2. Check appropriate block below and enter corresponding (number) . . . . . . . . . . . . . . . . . . .
Frequency of paY.Qut -0 Weekly (52) B Bi-weekly (2IDD Monthly (12)
o Quarterly (4) D Semi-annually (2) Annually (1) OOther' ) 0
3. Amount of payout per period ....................................... $
4. Aggregate annual payment, Line 2 multiplied by Line 3 . . . . . . . . . . . . . . . . . . . . . . . . .
5. Annuity Factor (see Instructions)
Interest table rate -0 3 1/2% 0 60/0 0 10% D Variable Rate 0 . 00000 %
6. Adjustment Factor (see instructions) ...................................
7. Value of annuity -If using 3 1/2%, 6%, 10%, or if variable rate and period
payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 . . . . . . . . . . . . . . . . . . . . $
If using variable rate and period payout is at beginning of period, calculation is:
(Line 4 x Line 5 x Line 6) + Line 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Term of Years
Term of Years
Term of Years
Term of Years
0.00
0.000
0.00
0.00
0.00000
0.00000
0.00
0.00
NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through
G of this tax return. The resulting lite or annuity interest(s) should be reported at the appropriate tax rate on Lines 13 and 15 through 18.
(If more space is needed. insert additional sheets of the same size)
3W46AJ 3.000
.REV.1647 EX+ (9-00)
.
SCHEDULE M
FUTURE INTEREST COMPROMISE
.
CCIMMONWEAL lli OF PENNSYlVANIA
HERlTANCE TAX RElURN
RESIDENT DECEDENT
Check Box 4a on Rev-1500 Cover Sheet,
ESTATE OF
FILE NUMBER
Blaer A Groene. Jr. 2106 0209
Thl. .chedule .. appropriate only for e.tat.. of decedents dying after December 12, 1982-
This schedule is to be used for all future Interests where the rate of tax which will be applicable when the future interest vests In possession
and enjoyment cannot be established with certainty.
Indicate below the type of instrument which created the future Interest and attach a copy to the tax return.
D Will [iJ Trust D Other
I. Beneflci8t1e.
AGE TO
NAME OF BENEFICIARY RB.AllONSHIP DATE OF BIRTH NEAREST BIRTHDAY
1.Groene, J. Scott Son 6/2/1957 0&8
2.Groene, Sidnev L SurvivinG" SDouse 0&/17/1932 70&
3.Levin, Debora L Daughter 1/8/1963 0&3
4.
5.
II. For decendents dying on or after July 1, 1994, If a surviving spouse exercised or intends to exercise a right of withdrawal within 9 months
of the decedent's death, check the appropriate block and attach a copy of the document in which the surviving spouse exerclses such
withdrawal right. n Limited rlaht of withdrawal
n Unlimited right of withdrawal
III. Explanation of Compromise Offer:
Residue of the probate estate of
Blaer Groene passes to the
trustees of his Revocable Trust
Agreeaent. Article rv of the
Agreeaent provides for a Bypass
Trust to take advantage of the
"Applicable Credit Mount.. for
federal estate tax purposes. The
reaainder, if any, is distributed
outright to the decedent-s wife,
Sidney L. Groene.
At the decedent-s death all of his
assets were in joint naaes with
his wife, in his Trust, or in the
IV. Summary of Compromise Offer:
1. Amount of Future Interest . . .. . . . . .. . .. . . . . . . . . .. . .. .. .. . . . . .. .. .. . .. . . . . . . .. .. .. $ 1,926,062.18
2. Value of Line 1 exempt from tax as amount passing to charities, etc.
(also include as part of total shown on Line 13 of Cover Sheet). . . . . . $ 0.00
3. Value of Line 13ssing [j;se ~te tax rate
Check One 6%, 3%, X OOA............. . . . $ 809,235.02
(also include as part of total shown on Line 15 of Cover Sheet)
4. Value of Line 1 taxable at lineal rate
Check one D 6% [i] 4.5% . . . . . . . . . . . . . . . . $ 1,116,827.16
(also include as part of total shown on Line 16 of CoY8l' Sheet)
5. Value of Line 1 taxable at sibling rate (12%)
(also include as part of total shown on Line 17 of CoY8l' Sheet). . . . . . $ 0.00
6. Value of Line 1 taxable at collateral rate (15%)
(also include as part of total shown on Line 18 of Cover Sheet). . . . . . $ 0.00
7. Total value of Future Interest (sum of Lines 2 thru 6 must equal Line 1) . . . . . . . . . . . . . . . . . . . . $ 1,926,062.18
3W046AN 1.000
(If more space is needed, insert additional sheets of the same size)
.
- Bstate of. Blmer A Groene, Jr.
Schedule M Part 2 (Page 2)
fora of Individual
Retir..ent Accounts and
annuities all payable to
his wife. Sidney L.
Groene executed qualified
disclaimers with regard
to saae of the decedent's
jointly owned property in
order to take advantage
of the "Applicable Credit
Amount" for federal
estate tax purposes. She
also discla~ed the
special power of
appoinCDent over the
Bypass Trust that was
granted to her under
Article V(3) of the Trust
Agre..ent (copy of the
disclai.ers are
attached).
Income from the Bypass
Trust is to be
distributed to the
decedent's wife and
children in such shares
and proportions as the
Trustee in its sole
dscretion deteraine for
aedical care, education,
support and aaintenance
of the decedent's wife
and children, taking into
consideration to the
extent the Trustee de..s
advisable, any income or
resources of decedent's
wife and children,
considering that the
decedent's wife is the
pr~ary object of the
decedent's bounty.
Principal .ay also be
expended in the Trustee's
discretion in such shares
and proportions as in its
sole discretion shall be
necessary or advisable
.
159-24-8184
.
.
- Bstate ofa B1mer A Groene, Jr.
.
Sohedule M Part 2 (Page 2)
fram ttme to ttae for the
.edioal care, eduoation
aDd support aDd
maintenaDoe of the
deoedent's wife aDd
ohildren taking into
oonsideration to the
extent the Trustee deems
advisable, aDy other
inoome or resouroes of
the deoedent's wife aDd
children known to the
Trustee, considering that
the deoedent's wife is
the prtmary objeot of the
deoedent's bOUDty.
At the death of the
deoedent's wife, Sidney
L. Groene, the remaining
prinoipal of the Bypass
Trust shall be divided
into two separate shares
so as to provide one
share for eaoh
then-living child (or one
share for eaoh deoeased
child of the deoedent who
shall leave issue then
living). The share
provided for each living
ohild is to be
distributed to suoh
ohild. The share provided
for a deceased child
shall be distributed per
stirpes to suoh issue. If
at the death of Sidney L.
Groene all of the
decedent's issue are
deoeased one-half of the
remainder shall pass to
the those heirs entitled
to take UDder the
intestaoy law then in
effeot in the
Commonwealth of PA aDd
one-half to the Caap Bill
Presbyterian Churoh.
.
159-24-8784
.
.
. Bstat. oft B~.r A Gro.n., Jr.
.
Sch.dul. N Part 2 (pag. 2)
Th. unc.rtainty in
d.t.naining the
iDh.ri tanc. tax is
wh.th.r any, and how
much, incom. and/or
principal will b.
distribut.d to the
deced.nt's wire and/or
childr.n. As indicat.d in
Articl. V of the
d.c.d.nt's Trust
Agr....nt, the d.c.dent's
wife is the primary
obj.ct of his bounty. Th.
dec.d.nt's two childr.n
are adults and self
suffici.nt and do not
require any financial
assistance from this
trust to maintain their
standard of living.
Sidney L. Groene, as
m.ntioned in the Trust
Agreem.nt is the priaary
object of the decedent's
bounty so it is
anticiapted that incom.
from this trust will be
distributed to her. She
is also the beneficiary
of various annuities and
XRA accounts of the
decedent so it is
anticipated that no
principal will be n.eded
to distributed to Sidney
to maintain her current
standard of living.
Pursuant to the above the
Bxecutor proposes a
compromise based on a
life estate in the Bypass
trust to decedent's wife,
Sidney L. Groene, and the
remainder passing to the
d.cedent's two children.
.
159-24-8784
,....
- .
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MILLER & N~oWms,':-pc
" 1822 Market $_
" '
. Camp Hill, PA 17011
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LAST WILL AND TESTAMENT
OF
ELMER A. GROENE, JR.
I, ELMER A. GROENE, JR., of Camp Hill, Hampden Township, Cumberland
County, Pennsylvania, declare this to be my last Will and revoke all prior Wills and
Codicils made by me.
FIRST: I am married to SIDNEY L GROENE, and aI, ,references to my wife in
this Will are to her. I have two children: J. SCOTT GROENE (born 2 June 1957) and
DEBORA L. LEVIN (born 8 January 1963). These persons and any children born to or
adopted by them are described in this Will as "my issue." Provided, however, no
adopted person shall benefit hereunder unless the order or decree of adoption is
.
entered before such adopted person attains the age of twenty-one (21) years.
SECOND: I give all my tangible personal property and any insurance thereon to
(
my wife, if she survives me, or, if she does not, to be divided among/my children who
survive me in as nearly equal shares as practical. I have complete confidence that my
wife, my surviving children and my Executors will honor any written instructions that I
may leave with regard to said tangible personal property. Any such property not so
distributed shall be sold, and the proceeds added to my residuary estate to pass as -
hereafter described.
THIRD: I giYE! the r.~t and remainder of my estate, real and personal, to the
then acting Trustees under my Revocable Agreement of Trust bearing the same date
as this Will and executed by me before this Will, as it may be amended at my death
(hereinafter my "Trust Agreement"), to be added to the principal held thereunder. In
any instance where a share of my estate would be distributable to a beneficiary of such
trust when received by the Trustees, the Executors may make distribution directly to
such beneficiary. In the event the said Trust Agreement had been revoked prior to my
date of death, then I give the rest and remainder of my estate to the beneficiaries as set
forth in said Trust Agreement.
Last Will and Testament of f:1mIIr A r.~ Ir
DGfta" ,.# n
~"
.
.
FOURTH: The Internal Revenue Code permits Executors to make elections with
respect to various taxes. I direct the Executors to make or not to make such elections,
and to exercise such other discretionary authority granted by the Code, only as the
Trustees u~de~ !Tly Trust Agreement instruct in writing pursuant to the terms of such
Agreement.
FIFTH: My wife shall have a special power to appoint all or any portion of the
Trust during her lifetime by written documen~ delivered to my'Trustees, referring
expressly to this Article, or by Will, validly executed and attested referring expressly to
this Article, among such other person or persons hereinafter named or described,
absolutely or in trust, as she may indicate. This special power of appointment is
exercisable only in favor of J. SCOTT GROENE and DEBORA L. LEVIN or their issue.
.
My wife shall have no power to appoint the principal of this fund or income accumulated
thereon to herself, her estate, to her creditors, or to the creditors of her estate. My
(
Trustees may rely upon an attested Will probated in any state that otherwise meets the
requirements of this Paragraph.
SIXTH: No beneficiary may assign or transfer his or her interest under this Will,
and no person with a claim against a beneficiary may reach any such interest before it
is distributed to the beneficiary.
SEVENTH: Unless paid directly from any principal held under my Trust
Agreement pursuaDt to ~ direction or discretion given in that instrument, the Executors
shall pay as an administration expense from the principal of my residuary estate before
its division into any shares or trusts all estate and inheritance taxes payable by reason
of my death with respect to all property comprising my gross taxable estate, whether or
not passing under this Will, including any tax with respect to any trust or similar
arrangement (or portion thereof) which, although created by my wife, is deemed for
Pennsylvania Inheritance Tax purposes to be a transfer by me. The foregoing direction
shall include interest and penalties on any particular tax as a part of the tax itself.
I _ 'Ana ..... T....t. ......... "'" c.......6 ~ Ir
PanA ., nf Q
.
.
.
EIGHTH: Powers of Fiduciaries and Self-Dealing.
A. In addition to powers given them by law, all fiduciaries acting hereunder,
whether or not n~med herein. shall have the following discretion_ary powers
applicable to all property held by them, effective without court order and until
actual distribution.
(1) To retain any property received by them, without regard to any principle
of investment diversification. " ".
(2) To invest in all forms of property, without restriction to investments
authorized by law and without regard to any principle of investment
diversification.
(3) To operate any business; to cause or join in any incorporation,
.
partnership, or other form of association, recapitalization. merger, '
reorganization, liquidation or voting trust plan; to deposit investments
(
under agreements and pay assessments; to delegate discretionary
authority with respect to any of such actions and generally to exercise
all rights of investors.
(4 ) To compromise controversies.
(5) To buy, exchange, or self real or personal property publicly or privately,
for such prices and on such terms as they deem proper; to lease for any
term regardless of the d~ation of any trust hereunder; and to give
... ..... .
options for these purposes without obligation to repudiate them in favor
of a higher offer.
(6) To abandon any property which the disinterested fiduciary, in such
fiduciary's sole discretioOr deems to be in the best interests of the trust
and its beneficiaries.
(7) To borrow money from any source, and to mortgage or pledge estate
assets as security.
last WUI and Testament af EIrMr A GrnanA. Jr.
Pane 3 of 9
.
.
(8) To use principal or income to which any beneficiary is entitled for the
beneficiary's exclusive benefit if they deem the beneficiary incapable of
receiving the same by reason of any illness, infirmity or legal incapacity.
(9) To exercise any discretionary power to use principal or income for a
beneficiary by paying the beneficiary's expenses directly or by making
payment to the beneficiary, notwithstanding any legal incapacity, or to
any other person or organization they select, ~o disburse the same for
the beneficiary's exclusive benefit.
(10) To hold investments in the name of a nominee.
(11) To employ and compensate as they deem appropriate, without
diminution of any fiduciary's compensation hereunder, any brokers,
.
advisors, professional persons, and other agents and, in their discretion,
to delegate revocably investment and management discretion to any
(
. such broker, advisor, professional person or agent. J
(12) To make distributions in cash or in kind or partly in each at fair market
values 'On the date of distribution.
(13) To disclaim on my behalf any interest the Executors deem advisable.
B. No rule of law against self-dealing, divided loyalty, or conflict of interest shall
be applied to render any transaction effected by the fiduciaries void,
voidableJ or o,~herwise subject to attack solely for violation of such rule, nor
shall the fiduciaries incur any liability, nor shall any fiduciary's commissions
for acting hereunder be reduced, solely for violation of such rule. Any
transaction which involves self-dealing, divided loyalty, or cc;mflict of interest
by the fiduciaries shall be judged by the rules of law which would apply to the
same transaction at arm's length between strangers free of any element of
self-dealing, divided loyalty, or conflict of interest. Thus, by way of illustration
I _ _A. ..nll __~ ...._-.a.-.__.-. _.I!!'-_ A ,,__ ..
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~
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.
.
and not of limitation, all fiduciaries are authorized, without giving any notice
required by statute, to:
(1) Employ and compensate any fiduciary or any affiliate as broker, agent, or
. professional advisor for any purpose.
(2) Borrow from the commercial department of any corporate fiduciary or any
affiliate at current interest rates.
(3) Buy, retain, and sell any debt or equity security"issued. or underwritten by
any corporate fiduciary or any affiliate and any debt security secured,
supported, and/or otherwise enhanced by a letter of credit issued by any
corporate fiduciary or any affiliate.
(4) Buy, retain, and sell any security of any investment company or trust
.
registered under the Invesbnent Company Act of 1940 to which any.
corporate fiduciary or any affiliate renders service for compensation.
(
(5) Buy any property from or sell property to any beneficfary or fiduciary
acting hereunder or otherwise on arm's length terms.
An "affiliate" means any entity which owns, directly or indirectly, an interest in any
corporate fiduciary, any entity in which any corporate fiduciary owns an interest, directly
or indirectly, and any entity in common control with any corporate fiduciary.
NINTH: 'IN THIS WILL:
,
A. "Fiduciaries" shall be deemed to refer to the Executors or Guardians of the
".
estates of minors acting hereunder, as the context may require, and plural references
thereto shall be deemed singular where only one is acting or where, in context, only
one is permitted to exercise discretion or to act. Likewise, such references in the
singular shall also include the plural where more than one is acting and where, in
context, more than one is permitted to exercise disaetion or to act
. B. The "Code" shall m.ean the Internal Revenue Code of 1986, as amended, and
shall include corresponding provisions of future law.
C. References to a "Will" (inclucflllg "this Wilr) or an "instrument" (including .
"this instrumenr), shall include any codicil hereto.
8..... _ e _6"
.
.
TENTH: APPOINTMENT OF FIDUCIARIES.
A. I appoin~ my wife, SIDNEY L. GROENE, and PNC BANK, N.A., Co-Executors
of this my Will. In the event my wife for any reason does not ad or continue to act as
Executrix, then I appoint as substitute and successor my son, J. SCOTT GROENE, as
my Co-Executor. In the event that my son is unable or unwilling to so serve as Co-
Executor, then I appoint as substitute and successor my daughter, DEBORA L. LEVIN,
as my Co-Executrix with the same powers and duties. ',<< .
B. Without the permission of any court the corporate fiduciary acting hereunder
may resign by a writing lodged with the permanent records hereunder, effective (1)
after thirty days' written notice to each adult income beneficiary and (2) a successor
corporate fiduciary's execution of acceptance of appointment to act hereunder following
.
the resignation. Such successor corporate fiduciary may be located in or out of the
Commonwealth of Pennsylvania and shall be appointed by the then acting fiduciaries,
including the corpJate fiduciary who wishes to resign, even if such corporate fiduciary
is then acting alone.
C. The corporate fiduciary acting hereunder shall be compensated as provided
from time to time in accordance with its published schedule of fees.
D.. Individual fiduciaries shall be entitled to compensation in an amount equal to
one-half (1/2) of the compensation payable to the corporate fiduciary, to be divided, if
more than one individual fiduciary is acting, as such individuals agree. Compensation
.... '.
payable to an individual fiduciary shall be in addition to that payable to the corporate
fiduciary.
E. All fiduciary compensation shall be allocated to principal and/orincome as
the corporate fiduciary deems fair and equitable.
F. I appoint the Trustees ading from time to time under my Trust Agreement as
Guardians of the estate of any minor who has no other Guardian of his or her estate,
with power to hold for the minor all property payable by law to a Guardian appointed
hereunder and to use the same for the minor's exclusive benefit, after considering oth~r
Last ww and Teet.mlllt of E/mer A. Groene. Jr.
Page 8 of 9
.
.
available resources and economies of taxation. No Guardian acting under this Will
shall participate in any discretionary decision to use principal or income for any person
whom such guardian is legally obligated to support. Guardians shall represent any
minor in any division of tangible persona. property under a prior provision of this Will.
Guardians shall have no duty to make any tangible personal property income-
producing and may distribute any articles thereof, without further responsibility, to the
minor or to any person whom Guardians choose to hold the. property for the minor.
G. No fiduciary acting under this Will shall be required to post bond or enter
security in any jurisdiction.
IN WITNESS WHEREOF, I have set my hand and seal on this my Last Will and
Testament this /6 day of SErre/JOt)(. .2004.
j~bI fl ~,,~
ELMER A. GROENE, JR.v,
(
(S EAL)
Attestation Cla'use. The foregoing Will was this II, day ofSff7f/f~fl- ,2004,
signed, sealed, published and declared by the Testator as and for his Last Will and
Testament in our presence, and we, at his request and in his presence, and in the
presence of each oth~r, have hereunto subscribed our names as witnesses on the
above date. "
Of~~~
of P A/c. f5.;4/\/ I<.. ~ J4 .
.
- tAl' ';-Jtr; V "if ~ 0-
of f 4/e.. k,e ,//. /I. .
list WID and Testament of Elmer A. Growle. Jr.
PanA 7 nfQ
.
e
SELF-PROVING AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
: 55.
COUNTY OF CUMBERLAND
I, ELMER A. GROENE, JR., Testator, whose name is signed to the attached or
foregoing instrument, having been duly sworn according to .'.." dq h.ereby acknowl-
edge that I signed and executed the attached instrument as my Last Will and
Testament; that I signed it willingly; and that I signed it as my free and voluntary act for
the purposes therein expressed, on this the /6 day of yPrHtd$~ . ,2004.
~f~~~
(
. ...
'.
Subscribed, sworn to, and acknowledged before me by ELMER A. GROENE,
JR., the Testator, this /r'dayof ~~""/~tt'r ,2004.
\
S ;
DENISE C. . GER. ~
Ha~ ~ CuInIJeNnd CoUnty
My eom....G:xprea Nat. 22. 2004
.
.
-
--'.--.-. ..'....-.-.-.----- ...., .~.._---~- .........-.... .
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
55.
We, the witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, do depose and say that we were
present and saw ELMER A. GROENE, JR. execute the inst~ment as his Last Will and
t.. ...
Testament; that he signed willingly and that he executed it as his-free and voluntary act
for the purposes therein expressed, that each of us in the hearing and sight of
ELMER A. GROENE, JR., signed the Last Will and Testament as witnesses; and that,
to the best of our knowledge ELMER A. GROENE, JR. was at the time eighteen (18)
years of age, of sound mind, and under no constraint or undue influence.
.,
--- - z/
Witness - - -
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".
-~~~~~
Witnes
Subscribed, sworn to, and acknowledged before me by!Jtubt~. JW~.I/1. ,
1>.1 U L ?ll51IeCALLIN I and {' A rr;( In - V ore. Iso... r the v:.itn~sses, this
/d??<day Of~~.-:?~("~ ,2004.
Page 9 of 9
Last WII and Testament of Elmer A. Groene, Jr.
II'
,
.
.
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
;::::?
IN RE: ESTATE OF
NO. 2006-00209
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ELMER A. GROENE, JR., DECEASED
PA No. 21-06-0209
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DISCLAIMER AND RENUNCIATION , ::i';;: _.' 33
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THE UNDERSIGNED, SIDNEY L. GROENE, surviving spouse of ELMER A. GRGENE'," ",2
. JR., the above-named decedent, hereby irrevocably and unqualifiedly disclaims and ren&ihces,
for no consideration, in accordance with Section 6201 and other applicable provisions of the
Penns~ylvania Probate, Estates and Fiduciaries Code and the Internal Revenue Code, any and
all interest she had, has or might have as the appointee of the special power of appointment as
granted to me in Item FIFTH of the Last Will and Testament of my late husband, Elmer A.
Groene, Jr., dated 16 September 2004, duly admitted to probate by the Register of Wills of
Cumberland County, Pennsylvania, and docketed to No. 2006-00209. The undersigned hereby
affirms that no part of the aforementioned special power of appointment has heretofore been
exercised by me. '
WITNESS my, hand and seal on this the 24th day of March, 2006.
'f .
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SIDN"'EY L. GROENE
438 Lamp Post Lane
Camp Hill, PA 17011
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
55.
ON THIS, the 24th day of March, 2006, before me, the underSigned officer, personally
appeared SIDNEY L. GROENE, known to me (or satisfactorily proven) to be the person whose
name is subscribed to the within instrument, and acknowledged that she executed the same for
the pU'"P.oses therein contained.
IN WITNESS WHEREOF, I hereunder set my hand and official seal.
~Jm~chfW}0
Notary Public
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REGISTER OF WillS OF CUMBERLAND COUNTY, PENNSYLVANIA
.~
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..1.......,...
IN RE: ESTATE OF
NO. 2006-00209
ELMER A GROENE, JR., DECEASED
PA No. 21-06-0209
..' .~
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DISCLAJMER AND RENUNCIATION, AND SUGGESTION OF BENEFrCIARY ~
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THE UNDERSIGNED. SIDNEY L GROENE, surviving spouse of ELMER A GROENE,
JR., the above-named decedent. hereby irrevocably and unqualifiedly disclaims and renounces,
for no consideration, in accordance with Section 6201 and other applicable provisions of the
Pennsylvania Probate, Estates and Fiduciaries Code and the Internal Revenue Code. any and
all interest she had, has or might have in and to that certain Delaware Balanced Fund A Class
regular investment account, Fund Code and Account Number 00215021419889, issued and
managed through Delaware InvestmentS, a member of Lincoln Financial Group, registered in
the names of Elmer A. Groene, Jr., and Sidney L. Groene, as tenants by the entireties, j
including, specifically, the interest in said account and all of its shares and reinvested dividends
as the surviving joint tenant with right of survivorship, and suggests to the Register of Wills of
Cumberland County, Pennsylvania. that my interest in the said Delaware Balanced Fund A
Class regular investr;nent account be transferred and assigned in full to the ESTATE OF
ELMER A. GROENE, JR., DECEASED. The undersigned hereby affirms that no part of the
aforementioned interest or its benefits have been accepted by her.
WITNESS my hand and seal on this the 24th day of March, 2006.
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SIDNEY L. GftOENE/
438 Lamp Post Lane
Camp Hill, PA 17011
".
COMMONWEALTH Of. PENNSYl V ANfA
55.
COUNTY OF CUMBERLAND
~
ON THIS, the 24th day of March, 2006, before me, the undersigned officer, personally
appeared SIDNEY L. GROENE, known to me (or satisfactorily proven) to be the person whose
name is subscribed to the within instrument, and acknowledged' that she executed the same for
the purposes therein contained. .
IN WITNESS WHEREOF, I hereunder set my hand and official seal.
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No~ry Public' ~
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REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA~"
,-' '.
IN RE: ESTATE OF
NO. 2006-00209
PA No. 21-06-0209
1-.: .~
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ELMER A. GROENE, JR., DECEASED
DISCLAIMER AND RENUNCIATION, AND SUGGESTION OF BENEFICIARY
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THE UNDERSIGNED, ~IDNEY L. GROENE, surviving spouse of ELMER A. GROENE,
JR., the above-named decedent, hereby irrevocably and unqualifiedly disclaims 'and renounces,
for n9 consideration, in accordance with Section-6201' and other applicable provisions of the
Pennsylvania Probate, Estates and Fiduciaries Code and the Internal Revenue Code, any'and
all interest she had, has or might have in and to that certain Certificate of Deposit, Account No.
31100255720, issued by PNC Bank, N.A., registered in the names of Elmer A. Groene, Jr., and
Sidney L. Groene, as tenants by the entireties, including, specifically, the interest in said
Certificate of Deposit as the surviving joint tenant with right of survivorship, and suggests to, the
Register of Wills of Cumberland County, Pennsylvania, that my interest in the said Certifi~te of
Deposit be transferred and assigned in full to the ESTATE OF ELMER A. GROENE, JR.,
DEGEASED. The undersigned hereby affirms that no part of the aforementioned interest or its
benefits have been accepted by her.
WITNESS my hand and seal on this the 24th day of March, 2006.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS.
ON THIS, the 24th day of March, 2006, before me, .the undersigned officer, personally
appeared SIDNEY L. GROENE, known to me (or satisfactorily proven) to be the person whose
name is subscribed to the within instrument, and acknowledged that she executed the same for
the purposes thereIn contained.
. -
IN WITNESS WHEREOF, I hereunder set my hand and offi~ial seal.
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REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYL VANJA--:i
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IN RE: ESTATE OF NO. 2006-00209 ii:;;~~
ELMER A. GROENE, JR., DECEASED PA No. 21-06-0209 8~"~
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DISCLAIMER AND RENUNCIATION, AND SUGGESTION OF BENEFICIARY
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THE UNDERSIGNED; SJDNEY L. GROENE, surviving spouse of ELMER A. GROENE,
JR., the above-named decedent, hereby irrevocably and unqualifiedly disclaims and renou,nces,
for no consideration I in accordance with Section 6201 and otb~r applicable provisions of the
Pennsylvania Probate, Estates and Fiduciaries Code and the Internal Revenue Code, any and
all interest she had, has or might have in and to those three (3) certain municipal bond funds,
MFS Municipal Bond Fund-A, Account Number 0017-00060226216, MFS Pennsylvania Muni
Bond Fund-A, Account Number 0030-00060226604, and MFS Municipal Limited Maturity Fund-
A, Account Number 0037-00060226682, registered in the names of Elmer A. Groene, Jr., and
Sidney L. Groene, as joint tenants with right of survivorship, including, specifically, the interest
in said mutual fund accounts as the surviving joint tenant with right of survivorship, and
suggests to the Register of Wills of Cumberland County, Pennsylvania, that my interest in the
said mutual fund accounts be transferred and assigned in full to the ESTATE OF ELMER A,
GROENE, JR., DECEASED. The undersigned hereby affirms that no part of the afore-
mentioned interests or their benefits have been accepted by her.
WITNESS my hand and seal on this the 7th day of April, 2006.
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438 Lamp Post Lane
Camp Hill, PA 17011
COMMONWEALTH .OF PENNSYl V ANfA
COUNTY OF CUMBERLAND
SS.
ON THIS, the 7th day of April, 2006, before me, the undersigned- officer, personally
appeared SIDNEY L. GROENE, known to me (or satisfactorily proven) to be the person whose
name is subscribed to the within instrument, and acknowledged that she executed the same for
the purposes therein contained.
IN WITNESS WHEREOF, I hereunder set my hand and official seal.
Llcu-dG~ n . bh/Wird
Notary Public ~
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__ Uvlng Insured
,- (File w1lh Form 709, UniIsd" GIft.nd~Tnnfar)T.. ~_boflocl wllh;""'1OI, u__
Estate (and GeneraUon-SklPPIfTransfer) Tax Retum, or Form 708-NA, United ~ta~tate (and GeneratIon-SkIppIng Transfer) Tax
Retum. Estate d nonresident not a clUzen of the United States. whent decedent owned Insurance on life d another.)
SECTION A - GenerallnfonnatJon
36 First name and middle Initial of donor (or decedent) 37 Last name 38 Social Security number
Elmer A. Groene Jr 159-24-8784
39 Date of gift for which valuation data submitted . . . . . .. . . . . .. .. .. . . . . . . . .. . .. . .. . .. .... . . . . . . . .. ~
40 Date of decedenfs death for wtW::h valuation data submitted ................. ..... ............ . 01/0112006
41 Name of Insured
Sldne L. Groene
44 Name and address of Insurance company
New England'Flnanclal/1letUfe
700 Quaker Lane
Warwick RI 02886
42 Sex
Female
43 Date of birth
05120/1929
45 Type of policy 146 Policy number 47 Face amount 48 Issue date
Whole life 02996062 5.000.00 09/22/1965
49 Gross Premium 50 Frequency of payment
106.20 Annual
51 Assignee's name 52 Date assigned
53 If irrevocable designation of beneficiary made, name of 54 Sex 55 Date of birth, 56 Date
beneficiary If known designated
57 If other than Simple designation, quote in full. (Attach additional sheets if necessary.)
58 If policy Is not paid up:
a Interpolated terminal reserve on date of death, assignment, or Irrevocable
designation of beneficiary . ; . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58a $ 3,458.44
b Add proportion of gross premium paid beyond date of death, assignment, or
Irrevocable designation of beneficiary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... 58b $ 77.00
c Add adjustment on account of dividends to credit of policy. . . . . . . . . . . . . . . .. .... 58c $ 655.30
d Total (add lines 58a, b, and c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
e Outstanding indebtedness against policy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
f Net to~1 value of the ~licy (for gift or estate tax purposes) (subtract line 58e from line 58d) . . . . . . . . . . . ..
59 If policy is either paid-up or a single-premium:
a Total cost, on date of death, assignment, or Irrevocable designation of beneficiary, of
a single premium policy on life of insured at attained age, for original face amount
plus any additional paid-up insurance (additional face amount $-> 59a $
(If a single-premium policy for-the total face amount would not have been Issued on
the life of the insured as of the date specified, nevertheless, assume that such a
policy could then have been purchased by the Insured and state the cost thereof,
using for such purpose the same formula and basis employed, on the date specified,
by the company in calculating single premiums.)
b Adjustment pn account of dividends to credit of policy. . . . . . . . . . . . . . . . . . . . . . . . .. 59b $
c Total (add lines 59a and 59b). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5ge
d Outstanding indebtedness against policy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 59d
· Net total value of policy (for gift or estate tax purposes) (subtract line 59d from line 59c) . . . . . . . . . . . . . . .. 59.
The undersigned officer of the above-named Insurance company (or appropriate Federal agency or retirement system official) hereby certifies that this
statement sets forth true and correct information.
SIgnature · (J k& J,
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Fonn 712 (Rev. 5-2000)
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February 13, 2006
Ms. Judith Hafd
PNC Advisors
Camp Hill, P A 170 II
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RE: Estate of Elmer A Groene (Deceased)
SSN: 159-24-8784
DOD: 01-01-2006
Dear Ms. Haftl:
In response to your request (or Date of Death balances for the customer noted above, our
records show the following:
Certificate of Deposit
Account #31100255720 Established 02-07-2005
ELMER A GROENE JR
SIDNEY L GROENE
DOD balance: $102,699.95 + S216.30 accrued interest
Checking ACCOunt
Account #5140024824 Established 01-01-1978
ELMER A GROENE lR
SIDNEY L GROE?>..'E
DOD balance: $5,935.02 + $0.05 accrued interest
Savings Account
Account #51JO 1 046$2
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Established 12-01-1982
ELMER A GROENE JR
SIDNEY GROENE
DOD balance: S130,748.31 + $11.47 accrued interest
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THE ELMER A. GROENE, JR.
REVOCABLE AGREEMENT OF TRUST
THIS AGREEMENT, made this J.L day of Stl'r&!16el\ , 2004, between
ELMER A. GROENE, JR., of Camp HHI, Hampden Township, Cumberland County,
Pennsylvania (the "Settlor'), and ELMER A. GROENE, JR. and PNC BANK, N.A.
(hereinafter sometimes referred to as both the -Trustee" and "Trustees").
WHEREAS, the Settlor is married to SIDNEY L. GROENE, and all references to
his "wife" in this Trust Agreement are to her.
WHEREAS, the Settlor and his wife have two children: J. SCOTT GROENE
(born 2 June 1957) and DEBORA L. LEVIN (born 8 January 1963).
WHEREAS, Settlor desires to establish this Trust for the benefit of Settlor,
Settlor's wife and Settlor's children.
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WIT N E SSE T H:
ARTICLE I
Description of Property Transferred. The Settlor has paid over, assigned,
granted, conveyed, transferred and delivered, and by this Agreement does hereby
payover, assign, grant, convey, transfer and deliver unto the Trustee the property
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described in Schepule f\j.annexed hereto and made a part hereof, and has caused or
will cause the Trustee to be designated as beneficiary of those life insurance policies
described in Schedule B, annexed hereto and made a part hereof. These insurance
policies, and any other insurance policies that may be delivered to the Trustee here-
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under or under which the Trustee may be designated as beneficiary, the proceeds of all
such policies being payable to the Trustee, and any other property that may be
received or which has been received by the Trustee hereunder, as invested and
reinvested (hereinafter referred to as the "Trust Estate"), shalf be held IN TRUST, and
administered and distributed by the Trustee as hereinafter set forth.
Elmer A. Groene, Jr.. Revocable Agreement of Trust
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ARTICLE II
Settlor's Riqhts to Amend. Chanae or Revoke the Trust Aareement. The
Settlor may, by signed instruments delivered to the Trustee during the Settlor's life: (1)
withdraw property from this Trust in any amount and at any time upon giving reason-
able notice in writing to the Trustee; (2) add other property to the Trust; (3) change the
beneficiaries, their respective shares and the plan of distribution; (4) amend this Trust
Agreement in any other respect; (5) revoke this Trust in its entirety or any provision
therein; provided, however, the duties or responsibilities of the Trustee shall not be
enlarged without the Trustee's consent nor without satisfactory adjustment of the
Trustee's compensati.on.
ARTICLE III
Trust for Life. During Settlor's lifetime, Settlor shall be paid the net income and
so much of the principal as Settlor may from time to time request in writing. Alterna-
tively, the corporate Trustee may use income and/or principal for the support: mainte-
nance and health care of Settlor and Settlor's wife, and to pay any taxes for which the
Trustee believes either are liable if such Trustee concludes that conditions warrant
such action in any of these cases.
ARTICLE IV
Distributiori*Upo'l1 Settlor's Death. Upon the death of the Settlor, the Trust
Estate (which shall include any property which may be added from the Settlor's general
estate) shall be held, administered and distributed under the Bypass Trust as herein-
after set forth.
A. BVDass Trust. If Settlor's wife shall survive Settlor, which in the
absence of contrary proof she shall be deemed to have done so for purposes of
this Article, Settk)r directs Settlor's Trustee to retain, IN FURTHER TRUST
Elmer A. Groene. Jr., Revocable Agreement ot Trust
Page 2 of 15
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NEVERTHELESS, cash, securities or other property in the amount specified
below, to be known as the "Bypass Trust"
(1) The amount of the Bypass Trust shall be $1,500,000,
subject, however, to paragraphs (2) and (3) below.
(2) This amount shall increase or decrease, based upon the
availability of Settlor's federal applicable exclusion amount for estate and
gift taxes and the maximum allowable federal estate tax credit for state
death taxes (but only to the extent that the use of such state death tax
credit does not increase the death tax payable to any state), whether due
to statutory changes, lifetime gifts in excess of the.federal unified estate
and gift tax exemption-equivalent amounts, or any other transfer which
affects the availability of Settlor's federal credits aforesaid.
(3) This bequest shalf decrease, even to zero, if necessary to
reduce to zero that federal estate tax payable as a result of Settlor's
death, considering that Settlors intention is to fund the Bypass Trust by
using Settlor's available federal applicable exdusion amount for estate
and gift taxes and Settlor's federal estate tax credit for state death taxes
and to eliminate federal estate tax on the balance of Settlor's federal
taxable estate by using the federal estate tax unlimited marital deduction.
B. Remainder of Trust Estate. Settlor directs that the remainder of tt)e
Trust Estat~, including any amounts added to the Trust Estate from Settlor's
estate, be distributed outright to Settlor's wife or as she might otherwise direct.
Should Settlor's wife not survive Settlor, Settlor directs that the remainder of the
Trust Estate, including any amounts added to the Trust Estate from Settlor's
Estate, be distributed and held IN FURTHER TRUST NEVERTHELESS, to be
. held, administered and distributed for alf purposes as part of the Bypass Trust.
Elmer A. Groene, Jr., Revocable Agreement of Trust
Page 3 of 15
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ARTICLE V
Administration of the Bvpass Trust. The Bypass Trust shall be held, adminis-
tered and distributed as follows:
(1) The Trustee shall pay to or apply for the benefit of anyone or more
of Settlor's wife and children until division into shares pursuant to para-
graph (4) below, all of the net income from the Bypass Trust in convenient
installments in such shares and proportions as the Trustee in its sole discretion
shall determine primarily for the medical care, education, support and mainte-
nance of Settlor's wife and children, taking into consideration to the extent the
Trustee deems advisable, any other income or resources of Settlor's wife and
children known to the Trustee, considering that Settlor's wife is the primary
object of Settlor's bounty.
(2) Prior to division into shares pursuant to paragraph (4) below, the
Trustee may pay to or apply for the benefit of anyone or more of Settlor's wife
and children such sums from the principal of the Bypass Trust in such shares
and proportions as in its sole discretion shall be necessary or advisable from
time to time for the medical care, education, support and maintenance of
Settlor's wife and children taking into consideration to the extent the Trustee
deems advisable, any other income or resources of Settlor's wife and children
known to the Trustee, considering that Settlor's wife is the primary object of
Settlor's bounty. Any payment or application of benefits for a beneficiary
pUrsuant to this paragraph shall be charged against this Trust as a whole rather
than against the ultimate distributive share of such beneficiary to whom or for
whose benefit the payment is made. .
(3) Settlor's wife shall have a special power to appoint all or any
portion of the Bypass Trust during her lifetime by written document, delivered to
the Trustee, referring expressly to this Article, or by Will, validly executed and
attested referring expressly to this Article, among such other person or persons
Elmer A. Groene, Jr., Revocable Agreement ot Trust
Page 4 of 15
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hereinafter named or described, absolutely or in trust, as she may indicate. This
special power of appointment is exercisable only in favor of a child of Settlor as
described in this Will. Settlor's wife shalf have no power to appoint the principal
of this Bypass Trust or income accumulated thereon to herself, her estate, to her
creditors, or to the creditors of her estate. The Trustee may rely upon an at-
tested Will probated in any state that otherwise meets the requirements of this
paragraph.
(4) In default of the exercise of such power of appointment by Settlor's
wife, or insofar as any part of the Bypass Trust shalf not be effectively appointed,
then upon the death of Settlor's wife, or upon Settlor's death if Settlor's wife did
not survive Settlor, the entire remaining principal of the Bypass Trust, or the part
of such trust not effectively appointed, shalf be divided into two (2) equal
separate shares so as to provide one (1) share for each then-living child of
Settlor (or pne (1) share for each deceased child of Settlor who shall leave issue
then living). The share provided for a living chifd of Settlor shall be distributed
outright to such child. The share provided for a deceased child of Settlor who
shall leave issue then living shalf be distri~uted per stirpes to such issue.
(5) If at the time of Settlor's death, or at any later time prior to final
distribution hereunder, Settlor's wife, chifdren, and alf of Settlor's issue are
deceased anc;J no other disposition of the property is directed by this Trust
Estate, thert and"i,,'that event only, the then-remaining property of this Trust,
together with any undistributed income. shalf be paid over and distributed one-
half C~) to those persons then Jiving who would then be Settlor's heirs, their
identities and respective shares to be determined in accoPdance with the law
then in effect in the Commonwealth of Pennsylvania, as if Settlor had then died
. intestate, and one-half (%) to the Camp HiIf Presbyterian Church. 23rd and
Walnut Streets, Camp HiIf, Pennsylvania, unrestricted as to use.
. (6) If any share hereunder becomes distributable to a beneficiary who
has not attained the age of thirty (30) years, then such share shalf immediately
Elmer A. Groene, Jr., Revocable Agreement of Trust
Page 5 of 15
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vest in such beneficiary, but notwithstanding the provisions herein, the Trustee
shall retain possession of such share in trust for such beneficiary until such
beneficiary attains the age of thirty (30) years, using so much of the net income
and principal of such share as the Trustee deems necessary to provide for the
proper medical care, education, support and maintenance in reasonable comfort
of such beneficiary, taking into consideration to the extent the Trustee deems
advisable any other income or resources of such beneficiary or his or her
parents known to the Trustee. Any income not so paid or applied shall be
accumulated and added to principal. Such beneficiary's share shall be paid over
and distributed to such beneficiary upon attaining the age of thirty (30) years, or,
if he or she shall sooner die, to his or her executors or administrators. Settlor
recommends that the Trustee consider distributing all income from such share to
such further beneficiaries when such beneficiaries attain the age of twenty-one
(21) years pnd further that the Trustee distribute one-half (%) of such share to'
such beneficiary when such benefiCiary attains the age of twenty-five (25) years.
The Trustee shall have with respect to each share so retained all the powers
and discretions had with respect to the trusts created herein generally.
ARTICLE VI
Discretionary Provisions for Trustee to Deal with Settlor's Estate and Make
Payment of Debts~ and"Taxes. After the Settlor's death, the Trustee, if in its discretion
it deems it advisable, may pay all or any part of the Settlor's funeral expenses, legally
enforceable claims against the Settlor or the Settlor's estate, reasonable expenses of
administration of the Settlor's estate, any aUowances by court order to those dependent
upon the Settlof, any estate, inheritance, succession, death or similar taxes payable by
reason of the Settlor's death, together with any interest thereon or other additions'
. thereto, without reimbursement from the Settlor's personal representatives, from any
beneficiary of insurance upon the Settlor's life, or from any other person. All such
Elmer A. Groene, Jr., Revocable Agreement ot Trust
Page 6 of 15
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payments, except of interest, shall be charged generally against the principal of the
Trust Estate includable in the Settlor's estate for Federal estate tax purposes and any
interest so paid shall be charged generally against the income thereof; provided,
however, any such payments of estate, inheritance, succession, death or similar taxes
shall be charged against the principal constituting the non-Bypass Trust of this Trust
Estate and any interest so paid shall be charged against the income thereof. The
Trustee may make such payments directly or may pay over the amounts thereof to the
personal representatives of the Settlors estate. Written statements by the personal
representatives of such sums due and payable by the Settlor shall be sufficient
evidence of their amount and propriety for the protection of the Trustee and the Trustee
shall be under no duty to see to the application of any such payments.
ARTICLE VII
Appointment of Trustees.
A. During Settlors lifetime, Settlor may appoint anyone or more successor
or additional Trustees, remove anyone or more Trustees and arrange for the compen-
sation of all Trustees and the allocation of such compensation between principal and
in~ome. All other paragraphs of this Item shall be subject to any contrary exercise of
the foregoing powers reserved to the Settlor. Upon the death of Settlor, or upon
Settlor's resignation, without the appointment of a successor, Settlor's son, J. SCOTT
GROENE, shallb~come Co-Trustee. In the event that Settlors son is unable or
unwilling to so serve as Co-Trustee herein, then Settlor names as substitute and
successor Co Trustee, Settlors daughter, DEBORA l. LEVIN.
B. There shall always be at least'one individual Trust~e acting hereunder. If
at any time a vacancy occurs, the then acting Trustees, or, if none, the majority of
Settlor's wife and the members of the most senior generation of the issue of a de-
ceased child, who are then legally competent and entitled to income hereunder shall fill
the vacancy by written appointment.
Elmer A. Groene. Jr., Revocable Agreement of Trust
Page 7 of 15
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C. The individual Trustee at any time acting hereunder may appoint one or
more persons to act with them, and each individual Trustee may appoint his or her
successor, which shall be considered upon each Trustee's assuming his or her duties.
Any successor appointment under paragraph A., above, shall prevail over any succes-
sor appointment under this paragraph. Any appointment of a successor Trustee may
be revoked and another substituted until the person making it ceases to act hereunder.
whereupon his or her current appointment shall take effect. The Trustees appointed
under this Item shall assume the office to which appointed without responsibility for any
prior act of any predecessor.
D. Without the permission of any court, any individual Trustee acting here-
under may resign by a writing lodged with the permanent records hereunder, provided
that no resignation shall be effective unless, after the resignation, the requirements of
paragraph B above are met.
E. Withput the permission of any court the corporate Trustee acting here-
under may resign by a writing lodged with the permanent records hereunder, effective
after thirty days' written notice to each individual Trustee and each adult income
beneficiary and a successor corporate Trustee's execution of acceptance of the
appointment to act hereunder following the resignation. Such a successor corporate
Trustee may be located in or out of the Commonwealth of Pennsylvania, and shall be
appointed by the the~ acting Trustees, including the corporate Trustee who wishes to
resign, even jf such corporate Trustee is then acting alone.
F. Any corporate Trustee acting hereunder shall be compensated as pro
vided from time to time in accordance with its published schedule of fees.
G. Individual Trustees shall be entitled to compensation in an amount equal
to one-half (1/2) of the compensation payable to the corporate Trustee, to be divided, if
more than one individual Trustee is acting, as such individuals agree. Compensation
payable to an individual Trustee shall be in addition to that payable to the corporate
Trustee.
Elmer A. Groene, Jr., Revocable Agreement of Trust
Page 8 of 15
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H. All Trustee compensation shall be allocated to income and/or principal as
the disinterested Trustee determines to be fair and equitable.
/. No Trustee acting under this instrument shall be required to post bond or
enter security ir any jurisdiction.
J. . No Trustee acting under this instrument shall participate in any discretion
ary decision to use principal or income for such Trustee or for any person whom such
Trustee is legally obligated to support.
ARTICLE VIII
Simultaneous Death. If any beneficiary and Settlor should die under such
circumstances that would render it doubtful whether the beneficiary or Settlor died first,
then it shall be conclusively presumed for the purposes of this Trust that said benefi-
ciary predeceased Settlor; provided, however, that if Settlor's wife shall die with Settlor
as aforesaid, Sett~r directs that Settlor's wife shall be conclusively presumed to have
survived Settlor.
ARTICLE IX
RiQhts of Settlor and Trustee in Insurance Policies. During the Settlor's
lifetime, the Settlor shalf have alf rights under any life insurance policies payable to the
Trustee, including the right to change the beneficiary, to receive any dividend or other
earnings of such 'policies without accountability therefor to the Trustee or any benefi-
ciary hereunder and may assign any policies to any fender, including the Trustee, as
security for any loan to the Settlor or any other person; and the Trustee shall have no
responsibility With respect to any policies, for the payment of premiums or otherwise,
except to hold any policies received by the Trustee in safekeeping and to deliver them
upon the Settlor's written request and upon the payment to the Trustee of reasonable
compensation for services. The rights of any assignee of any policy shall be superior
to the rights of the Trustee. If any policy is surrendered, or, if the beneficiary of any
Elmer A. Groene, Jr.. Revocable Agreemer.t d Trust
Page 9 of 15
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policy is changed: this Trust shall be revoked with respect to such policy. However, no
revocation of the Trust with respect to any policy, whether pursuant to the provisions of
the preceding sentence or otherwise, shall be effective unless the surrender or change
in beneficiary of the policy is accepted by the insurance company. Upon the death of
the insured under any policy held by or known to, and payable to, the Trustee, or upon
the occurrence of some event prior to the death of the Settlor that matures any such
policy, the Trustee, in its discretion, either may coffect the net proceeds and hold them
as part of the principal of the Trust Estate, or may exercise any optional method of
settlement avail:able to it, and the Trustee shall deliver any policies on the Settlor's life
held by it and payable to any other beneficiaries as those beneficiaries may direct.
Payment to, anu the receipt of, the Trustee shall be a full discharge of the liability of
any insurance company, which need not take notice of this Agreement or see to the
application of any payment. The Trustee need not engage in litigation to enforce
payment of any P91icy without indemnification satisfactory to it for any resulting
expenses.
ARTICLE X
Adopted Persons. For all purposes of this instrument:
A. Ary person adopted as a minor shall be deemed a natural child of his or
her adopting pa~'ent pr parents.
B. Ar~y persoh adopted as an adult shall be deemed a natural child of his or
her adopting parent or parents if a parent-child relationship existed between the
adopter or adopters and the adoptee during the adoptee's minority.
ARTICLE XI
. Concernina the Trustees.
A. Powers. In addition t.o powers given by law, all Trustees acting here-
under, whether or not named herein, shall have the following discretionary powers
Elmer A. Groene. Jr., Re'/ocable Agreement of Trust
Page 10 of 15
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applicable to all property held by the Trustee effective without court order and until
actual distribution:
(1 ) To retain any property received by them.
(2) To invest in all forms of property without restriction to investments_
authorized by law. .
(3'; To operate any business; to cause or join in any incorporation,
partnerst'ip, or other form of association, recapitalization, merger, reorganiza-
tion. liquidation or voting trust plan. to deposit invesbnents under agreements
and pay assessments; to delegate discretionary authority with respect to any of
such actions and generally to exercise all rights of investors.
(4 ) To compromise controversies.
(5) To buy, exchange, or sell real or personal property publicly or
privately, for such prices and on such terms as they deem proper; to lease for
any term rer9ardless of the duration of any trust hereunder; and to give options
for these purposes without obligation to repudiate them in favor of a higher offer.
(6:: To abandon any property which the disinterested fiduciary, in such
fiduciary'.; sole discretion, deems to be in the best interests of the trust and its
beneficiaries.
(7) To borrow money from any source, and to mortgage or pledge
security.
(8)' '. To t:Js'e principal or income to which any beneficiary is entitled for
the beneficiary's exclusive benefit if they de~m the beneficiary incapable of
receiving the same by reason of any illness. infirmity or legal incapacity.
(9) To exercise any discretionary power to use principal or income for
a beneficiary by paying the beneficiary's expenses directly or by making pay-
ment to ttle beneficiary, notwithstanding any legal incapacity, or to any other
person or, organization they select to disburse the same for the beneficiary's
exclusive, benefit.
Elmer A Groene. Jr., Revocable Agreerr.ant of Trust
Page 11 of 15
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(10) To hold investments in the name of a nominee.
(1:1) To employ and compensate as they deem appropriate, any
brokers, advisors, professional persons, and other agents and, in their discre-
tion, to delegate revocably investment and management discretion to any such
broker, advisor, professional person or agent.
(12) To make distributions in cash or in kind or partly in each at fair
market values on the date of distribution.
(13) In any division of principal into separate trusts or shares, and in
any distribution of trusts or shares, to allocate to any trust, share, or beneficiary,
property different from the property allocated to another trust, share, or benefi-
ciary, as ',the disinterested Trustees, using fair market values on the date of
division qr distribution, deems appropriate; provided, however, that this power
shall not be exercised in a manner contrary to any specific allocation of property
elsewhere jn this instrument or in a manner that renders ineligible all or any part
of any gift for any tax deduction.
B. Concerning Self-Dealing, etc. No rule of law against self-dealing, divided
loyalty, or conflict of interest shall be applied to render any transaction effected by the
Trustees void, voidable, or otherwise subject to attack solely for violation of such rule,
nor shall the Trustees incur any liability, nor shall any Trustee's commission for acting
hereunder be reduc~, solely for violation of such rule. Any transaction which involves
self-dealing, divided loyalty, or conflict of interest by the Trustees shall be judged by
the rules of law which would apply to the same transaction at arm's length between
strangers free of any element of self-dealing, divided loyalty, or conflict of interest.
Thus, by way of illustration and not of limitation, the Trustees are authorized, without
giving any notice required by statute, to:
(1) Employ and compensate any Trustee or any affiliate as broker,
agent, or professional advisor for any purpose.
(2) Borrow from the commercial department of any corporate Trustee
or any affiliate at current interest rates.
Elmer A. Groene, Jr., RElvocable Agreement of Trust
Page 12 of 15
..
.
.
(3) Buy, retain, and sell any debt or equity security issued or under
written by any corporate Trustee or any affiliate and any debt security secured,
supported, and/or otherwise enhanced by a letter of credit issued by any
corporate Trustee or any affiliate.
. (4) Buy, retain, and sell any security of any investment company or
trust registered under the Investment Company Act of 1940 to which any corpo-
rate Trustee or any affiliate renders services for compensation.
(5) Buy any property from or sell any property to any beneficiary or
Trustee acting hereunder or otherwise on arm's length terms.
An "affiliate" means any entity which owns, directly or indirectly, an interest in
any corporate Trustee, any entity in which any corporate Trustee owns an interest,
directly or indirectly, and any entity in common control with any corporate Trustee.
f
ARTICLE XII
Accelerated Termination. If the disinterested Trustees determine that any
fund held hereunder is for any reason uneconomical to administer as a separate fund,
such Trustees, without further responsibility, may require the Trustees to pay the fund
(in whole or in part) to the person or persons then entitled to the income therefrom or to
have the income applied for their benefit. Property payable under this Item to a minor
may be paid to the minor or to a guardian of the minor's estate or may be distributed to
and registered in" tlie name of any person who is acting or agrees to act as Custodian
for the minor under the Uniform Transfers to Minors. Act or may be deposited in an
interest bearing account or certificate of deposit in the minor's name, and the pass-
book, account statement, or certificate delivered to the minor's parent.
ARTICLE XIII
Governina Law and Situs. The administration, construction and validity of all
trusts created by this Agreement shall be governed by Pennsylvania law. The situs of
Elmer A. Groene, Jr., Revocable Agreement of Trust
Page 13 of 15
.
.
all trusts hereunder shall be Cumberland County, Pennsylvania. The Trustee may at
any time change the situs of any trust hereunder.
ARTICLE XIV
- -
Spendthrift Provision. Except as otherwise provided herein, all payments of
principal and income payable, or to become payable, to the beneficiary of any trust
created hereunder shall not be subject to anticipation, assignment, pledge, sale or
transfer in any manner, nor shall any beneficiary have the power to anticipate or
encumber such interest, nor shall such interest, while in the possession of the fiduciary
hereunder, be liable for, or subject to, the debts, contracts, obligations, liabilities or
. torts of any beneficiary.
IN WITNESS WHEREOF, the Settlor and the Trustees have hereunto set ttJeir
respective hands and seals and duly executed this Trust on the day and year first
written above. (
WITNESS:
~
- --//
jL~tl4cP1--' l (SEAL)
ELMER A. GROENE,/.JR., Settlor
The trusts set forth ~re hereby accepted:
ATTEST:
".
PNC BANK, N.A., TRUSTEE
~lhro
V-p.
WITNESS:
1'~#4~
(S EAL)
ELMER A. GROEN ,JR., Trustee
Elmer A. Groene, Jr., Revocable Agreement of Trust
Page 14 of 15
. .
.
.
ACKNOWLEDGMENTS
COMMONWEAL TH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
55.
On this, the /&'Tday of -.C~ ' 2004, before me, the undersigned officer,
personally appeared ELMER A. GROENE, JR., Settlor and Trustee, known to me (or
satisfactorily proven) to be the person whose name is subscribed to the within instru-
ment, and acknowledged that he executed the same for the purposes therein con-
tained.
IN WITNESS WHEREOF, I hereunder set my hand and
; r
My Commission Expires:
COMMONWEAL TH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
On this the/~y'of - ~~ ~004, before me, a Notary Public, the
undersigned officer, appeared ~;./ ~/ ~ ~A / . I who acknowledged
himself/herself to be the (Senior) Vice Presid~t t Trust Officer of PNC BANK, N.A.,
and that he/she as such (Senior) Vice Preside'riB: Trust Officer, being authorized to do
so, executed the foregoing document for the purposes therein contained by signing
his/her name as',such.
: S5.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
Elmer A. Groene, Jr., Revocable Agreement of Trust
Page 15 of 15
My Commission Expires:
FLORENCE R CLIFFORD
CITIGROUP GLOBAL MARKETS, INC.
PO BOX 12057 2ND FL
HARRISBURG. PA 17108
02547
ELMER GROENE
438 LAMP POST LN
tAMP HILL PA 17011-1457
I
i
06256
Annuity Client Service Center 1-800-862-6668 Monday through Thursday 8:00 a.m. to 7:00 p.m.
and Friday 9:15 a.m. to 6:0.0 p.m., Eastern time
Transaction Detail PAGE 1 OF 1
Trade Date Sub-Account Name
Transaction Description
Dollar Amount Unit Value
Units
Transacted
12/31/05 FIXED ACC
12/31/05 FIXED ACC
INT. RATE CHANGE
INT. RATE CHANGE
$61. 31
$61. 31 @ 4.00%
As Of: 01/03/06 Value By Sub-Account
Sub-Account Name Total Units x Unit Value
=
Current Value
CAP APPREC
INTERN'L OPPS
FIXED ACC
(
7563.076
20913.759
11.822967
2.156519
$89,418.00
$45,100.92
$61. 33
* FIXED ACC VALUES ~~OWN AS DOLLARS
Payment By Mail' .,
..........;~.~~~~~~~~...................p;~~~.~~......._.Ai~.ti~~..~f.Pi"e.ase..us.e..ihis.siu6.to.nl"ai"(e.addltiona.i.pay.ments........... .............................................................."'-
Name Allocation this Payment
Total Contract Value
$134,580.25
Contract Number:
CAP APPREC
INTERN'L OPPS
FIXED ACC 100.00%
ELMER GROENE
438 LAMP POST LN
CAMP HILL PA 17011-1457
910913095
.
Purchase Amount $
Please make your checks payable to:
Hartford Life
Total
100%
100%
D Invest this payment as shown Under "Present Allocation" in the chart to
the left.
D Invest only this payment as I have indicated in the chart to the left.
Please retain my .Present Allocation" instructions as shown. g
D Invest this payment as I have indicated to the left and invest any future.
payments in accordance with this new allocation.
D Changing Address? Check box, note new address on reverse, and
return to us in the enclosed envelope THE
HARTFORD
! ()t::11 c
AmerUs Annuity Group Co.
555 South Kansas Ave
Topeka. KS 66603
1-8()()-ANNUITY
.
.
RECEIVED
PNCADVISORS
APR 1 1 lU06
April7,2006
AMERUS
Annuity Group
PNC Advisors
Linda Lundberg-
Po Box 308
Camp Hill PA 17001-0308
RE: Policy #169003
American Investors Life
Annuitant: Elmer Groene
Dear Ms. Lundberg:
Thank you for your recent request for information regarding the annuity referenced
above.
r
The date of death value as of January 1, 2006 is $74,335.24. Due to the fact that the
policy is being paid out the address of record will not be changed as requested since
the file will be closed and no further correspondence will be forthcoming.
Should you have any questions or need additional information, please contact our office
at 1-888-ANNUITY (1-888-266-8489).
Sincerely,
(),.I '?:II( cJIY.!-
'f.
Amy Bledsoe
Claims Specialist
AMERICAN INVESTORS LIFE
.. AMERvs,,-,
AMERUS
Life
1-888-252-5530
(CUSmMER SERVICE)
1-888-ANNUITY
(CUSmMER SERVICE)
ING.-aJ
ING USA Annuity and Life Insuran.pany
P.O. Box 9271
Des Moines, fA 50306-9271
1-800-366-0066
,.
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Page 1 of
Confirmation Notice .
GoldenSelect OVA Plus (Deferred Variable Annuity)
December 20, 2005
1111111.. .111. .....11...11...11.1. .1.1.1.1...11111.1111. 111.11
.....-AUTO.. MIXED MDC 500
0?0ooooo70??oo1697
ELMER A. GROENE
438 LAMP POST LN
CAMP HILL. PA 17011
Your Financial Adviser Phone: (717) 652-2070
Contract Number: .
Contract Date:
AnnuItant Name:
Qualified Type:
1026037-00
March 23, 1998
ELMER A. GROENE
Traditional IRA
ERIC DELONGE PETTIS
ING FINANCIAL PARTNERS. INC CAREER
2090 L1NGlESTOWN RD STE 201
HARRISBURG. PA 17110-9428
1Jr;m4~ ~ _ ~~
eM L"n ,e-rJ- /k.r, e -
........g..~!~!!~~.':J~~~.~.~~!.~.f~?[.~~!~~~!:~.s~.~!'.8.~: ..~;~!.!!~!.~~!!!.!!!~.~~.~~~fi!~.~.~!.r.~I!!1.~~!.~!!.~~~~.~~::~.~:I)~!l.l:l.~:..~.~~..~.~~.~~.~!~t~~.4~!:'.i!!:-...m..... ...... .............. ............. .............. ...... .._.... ......
Transactionlsl Effective December 20.2005
TransactIon
IRA Withdrawal
Division
ING Limited Maturity Bond (S)
ING MFS Total Return (S)
ING PIMCO High Yield Portfolio (S)
Amount
Allocated From
$566.45
'. $324.10
$297.38
Amount
Allocated To
Value Effective December 20. 2005
Division
ING limited Maturity Bond (S)
ING MFS Total Return (S)
ING PIMCO High Yield Porlfolio (S)
# of Units
573.62110
274.26993
568.66859
Value of Unit
20.97290372
25.09717324
11.10622276
Value
$12,030.50
$6,883.40
$6,315.76
$25,229.66
TOTAL VALUE:
. '.
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;;"j:jl~"_'f1"\~i#1' ':"J ,. f'~' ;<~;o: HJ' 'j",,;;, 'iln~J;,!o:i;l'!':; ';A~'d11 ,:'.\li~ ~: ~ lh, ; 'fI""~/'ii:""j\", '%16' iY :>. "t;3%'<',/Lt
/WG ,,' ;'" ""'~ A-' Yc^' ,",,,. . ,,,,,ffi ,ff"", ", """>,,,,' . ."M.%' I. f
(~*(I ';11\' ,', r fW .'i't;'!"''',,: "*"'1\' t~ '. . !'J1'Q r~ '~!'"iW''''''''ii ;J^"'~t!>~ 0 illi;"
Wi/i, ;11)' 'f: 1 .j~~' - , 140 ~ ~ . -. ,d, " ' ~.~..lJ.j';J! 'J 'g\'i
F I ,~~ :..t> :, ~ (., " '?'~2''WF .", 'f' . . {' >+'1'/ 'Mrm:i1tYi$ ~% '
~.. ,1" ,!Jttt5~!itr~" t ;;;", 11 ~~~l , . .:~ili:; k "~ffi'u~I",,l,'~ "~~J~;>J;': t$f&1
~
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Contract Number: 1026037-00
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~ The Right Way to Invest n
<; ~ J. t'\~ - /', ,'mAry
hO Co n I- j h y0Yl +
RPSS TR IRA
FBD ELMER A GROENE
438 LAMP POST LN
CAMP HIli PA 17011-1457
014780
'".11'11.11,." 11I11'1111'1111,1"1,1.1.',, .1,,11,11111111.11
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Total Portfolio Value
Market Value on December 31, 2085
Market Value on September 30, 2005
Change since last statement
$789,238.14
$816,680.76
-$27,442.62
.
Annual Statement
Statement Period: January 01, 2005 . December 31, 200S
Page 1 ot 3
Your FInancIal Advisor.
ERIC PETTIS
ING FINANCIAL PARTNERS INC
2090 L1NGLESTOWN RD STE 201
HARRISBURG, PA 17110-9428
(717) 652-2070
o Visit us anln, at www.oppenhelmerfunds.com
...
ro
24-hour automat,d servlc,: 1-800-CALL-OPP (225-5677)
R,pr,sentatlv,s available Mon. . Fri. 8 am . 9 pm fT
and Sat. fO am - 4 pm ET (Jan. . Apr.)
Year-to-Date Portfolio Summary
Portfolio Type
Retirement
Total
&farleet V.lue CNI
January 1. 20115
$799.299.42
$799,299.42
Withdrawals
- $36,314.06
- $36,314.06
Additions
+ $0.00
+ $0.00
Chan,e/n
Value/Eam/n,s.
+ $26,252.78
+ $26, 252 . 78
Mal1cet V.lue on
December 31, 2005
= $789.238.14
= $789,238.14
· Does not include year-to-date dividends and/or capital gains paid in cash (not reinvested) totaling: $27.73
(
Year-to-Date Summary of Accounts
Percenta,e
AArlcetV.'ueCNI M.rleetValueon otTot.1
January 1,2005 December 3.. 2005 Portfolio Fund ~te,ory
Account Number Oppenhe/merFund Hule & Class
Retirement
190 1900761156
285 2850250899
700 7007058744
855 8550566115
Champion Income Fund A
Core Bond Fund A
Maln Street Fund A
Umited- Term Government Fund A
$284,757.77
$274.120.29
$210.326.13
$30,095.23
-'.
$292,320.85
$274,522.07
$222,395.22
$0.00
37% Taxable Bond
35% Taxable Bond
28% Core
< 1% Taxable Bond
,...
. :-',
100%
~
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OppenhelmerFunds News
Annual IRA contributions for tax-year 2005 can be made until April 15th of 2006. The maximum individual contribution across all of your IRAs is $4000 or $4500
if you are age 50 or older. Talk to your financial advisor or call l.BOO.CAlLOPP for additional information or assistance. '
III. .1 11m 11111 II~ 1111
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~ The Right Way to Invest
.
Annual Statement
Statement Period: January 01, 2005 - December 31, 2005
Plge 2 of 3
OppenheimerFunds Account Detail - Retirement
Oppenheimer Champion Income Fund Class A
Account Numb" 190 1900761156
Account R,glstratlon RPSS TR IRA FBO ELMER A GROENE
Tax 10 Numb" 159-24-8784
Fund Symbol OPCHX
Fund Cat,gory . Taxable Bon d
Year-ta-Date Transaction Detail
TrwnsactlCHI
DoIte
Tnlnsacf'CHI Description
Dividend Reinvested
Dividend Reinvested
DiVidend Reinvested
Dividend Reinvested
Dividend Reinvested
Dividend Reinvested
Dividend Reinvested
Dividend Reinvested
Dividend Reinvested
Dividend Reinvested
Dividend Reinvested
Dividend Reinvested .
Value on December 31, 2005
Mtrk,t Valu, $292,320.85
SItIm Own,d 31,331.281
san Pric, $9.33
Year- To-Date Summary $19,203.99
fIrtdInds
DoIIw Share Humber Endln"
A~ ~ of Sh.tres Share s"anee
-
$1.496.45 $9.66 +154.912 29,450.979
$1,357.31 $9.75 +139.211 29,590.190
$1,641.21 $9.44 +173.857 29,764.047
$1,596.49 $9.28 +172.036 29,936.083
$1,684.18 $9.38 +179.550 30,115.633
$1,588.77 $9.46 +167.946 30,283.579
$1,599.~ $9.54 +167.655 30,451.234
$1,606.19 $9.52 +168.717 30,619.951
$1,717.81 $9.40 +182.746 30,802.697
$1,554.41 $9.27 +167.682 30,970.379
$1,699.00 $9.30 +182.688 31,153.067
$1,662.74 $9.33 +178.214 31,331.281
01/31/05
02128/05
03/31/05
04/29/05
05/31/05
06/30/05
07/29/05
08/31/05
09/30/05
10/31/05
11/30/05
12/29/05
The Fair Market Value of your IRA can be found under 'Market Value'. If you have multiple accounts, the 'Market Value' section can be found under
'OppenheimerFunds Account Detail'. The Trustee of your IRA is Oppenheimer Trust Company, C/O ~heimerFunds Services. P.O. Box 5270, Denver, CO 80217-5270.
We are required to furnish this information to the IRS.
(
Oppenheimer Core Bond Fund Class A Value on December 31, 2005
,**,t Vatu, $274,522.07
Account Number 285 2850250899 SItIru OWn,d 26,808.796
Account R,gistratlon RPSS TR IRA FBO ELMER A GROENE SAar, Price $10.24
Tax 10 Numblf 159-24-8784
Fund Symbol OPIGX Year- To-Date Summary
Fund Catlgory Taxable Bond IJfidInds $11,786.46
Year-ta-Date Transaction Detail
TlMsacf'CHI DoIW Share Humber EnQlng
Oate TIMNctlCHI Description Amomt Price of Sh.tres Sh.tre s."nce
~
01/31/05 DIvIdend Reinvested $883.14 $10.48 +84.269 26,341.002 ei
02128/05 DIvIdend Reinvested '. $829.50 $10.41 +79.683 26,420.685 ill
03/31/05 Dividend Reinvested $955.09 $10.30 +92.727 26,513.412
04/29/05 Dividend ReInvested $992.82 $10.38 +95.647 26,609.059
05/31/05 Dividend Reinvested $935.56 $10.45 +89.527 26,698.586
06/30/05 Dividend Reinvested $986.41 $10.45 +94.393 26,792.979
07/29/05 Dividend Reinvested $878.65 $10.38 +84.648 26,877 .627
08/31/05 Dividend Reinvested $998.79 $10.43 +95.761 26,973.388
09/30/05 Dividend Reinvested $998.49 $10.31 +96.847 27,070.235
10/31/05 DIvidend Reinvested $874.27 $10.20 +85.713 . 27,155.948
11/30/05 Dividend Reinvested $997.34 $10. 19 +97.874 27,253.822
11/30/05 RedemptiOn (Reportable) $5,982.69 $10.19 -587.114 26,666.708
12/29/05 Dividend Reinvested $1,456.40 $10.25 +142.088 26,808.796
I mlm IIIII 11111111111
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~ The Right Way to Invest
.
Annual Statement
Statement Period: January 01, 2005 - December 31, 2005
Page 3 o( 3
OppenheimerFunds Account Detail - Retirement (continued)
Oppenheimer Main Street Fund Class A
Account Numblr 700 7007058744
Account R'gistratlon RPSS TR IRA FBO ELMER A GROENE
Tax 10 Number 159-24-8784
Fund Symbol MSIGX
Fund Category . Cor-e.
Value on December 31, 2005
Mark,t Value
Shares OWned
Shar, Price
Year-To-Date Summary
Dividends
Vear-to-DateTransacllon Detail
TlUsactlon
Date
12/01/05
Dollar SIMre
Amount PrIce
$2,190.51 $37.59
Number
of Shares
+58.274
Tmrsactlon Description
Dividend Reinvested at .369310 per Share
$222,395.22
5;989.637
$37.13
$2,190.51
EIIettn.
Share &Ilance
5,989.637
Oppenheimer Limited-Term Government Fund Class A
AcCtJl/nt Numblr 855 8550566115
Account Registration RPSS TR IRA FBO ELMER A GROENE
Tax 10 Number 159-24-8784
Fund Symbol OPGVX
Fund Category Taxable Bond
Value on December 31, 2005
Marlcet Vllue
Shar, Price
Year- To-Date Summary
OivIdfnds
Year-la-Date Transaction Detail
Transactlon Dollar Share Number
Date TIUSllCUon Description Amount PrIce of Shares
01/31/05 Dividend Reinvested ( $65.81 $10.13 +6.497
. 02128/05 Dividend Reinvested $70.91 $10.09 +7.028
03/31/05 Dividend Reinvested $83.55 $10.05 +8.313
04/29/05 Dividend Reinvested $85.41 $10.08 +8.473
05/31/05 Dividend Reinvested $78.71 $10.09 +7.801
06/30/05 Dividend Reinvested $81. 34 $10.08 +8.069
07/29/05 Dividend Reinvested $83.33 $10.04 +8.300
08/26/05 2005 Annual Fee $10.00 $10.03 -0.997
08/31/05 Dividend Reinvested $86.30 $10.06 +8.579
09/30/05 Dividend Reinvested $89.17 $10.00 +8.917
10/31/05 Dividend Reinvested $82.62 $9.97 +8.287
11/10/05 Redemption (Reportable) $30,349.10 $9.96 -3.044.314
11/10/05 Dividend $27.73
$0.00
$9.97
$834.88
ElldlRfI
Sh.18 &I1anc:e
2,971.544
2,978.572
2,986.885
2.995.358
3,003.159
3,011.228
3,019.528
3,018.531
3,027.110
3.036.027
3.044.314
0.000
...,MPORTANT... Please retain this 2005 Mnual accoont statement tor your records. You will generally not receive a Form 1099-DIV if you have a retirement
account. or if your account earned less.tha.n $10.00 in. dividends in 2005. .
".
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IRREVOCABLE
AGREEMENT OF TRUST
OF ELMER A. GROENE. JR.
NOW, on January ~5 , 1992, ELMER A. GROENE, JR., of Hampden
Township, Cumberland County, Pennsylvania, as Settlor, by this
Agreement and desiring to establish a Trust, hereby assigns to
WILLIAM E. MILLER, JR. of Upper Allen Township, Cumberland
County, Pennsylvania, as Trustee, hereinafter referred to in the
singular and neuter gender, the property described in Schedule A
to be held, together with such additional property as may be
transferred or bequeathed hereto by Settlor or any other person,
upon the following terms of trust:
FIRST: DISPOSITIVE PROVISIONS
A. During the lifetime of Settlor and/or Settlor's wife:
1. Each of Settlor's children during the lifetime of
Settlor and/or Settlor's wife (as the case may be) shall have the
absolute right (anything to the contrary appearing in Item THIRD
hereof notwithstanding), exercisable in his or her sole discre-
tion, to withdraw 4~rin9 each calendar year in which an addition
. ~
~
or additions are made to this Trust, an amount computed by
dividing the aggregate amount of the additions made in such year
by the number of Settlor's children who are living upon the date
-
of the most recent such addition or additions. Anything herein-
before to the contrary notwithstanding, each such person's
withdrawals for any calendar year shall not exceed an aggregate
---
..
03/10/2006 17:07
71 7737921.
MILLERASSOCIATES ~
PAGE 133/17
of Ten Thousand Dollars ($lO,OOO), and such rights of withdrawal
shall be non-cumulative from year to year.
2. Trustee shall notify each beneficiary of ~ny
transfer or other contribution to the Trust as soon as is practi-
cal after the contribution or transfer has been made but not
later than December 31 of the year in which the contribution or
transfer has been made.
3. All withdrawals shall be made by written demand
signed by the withdrawing person and delivered to the Trustee not
more than thirty (30) days after the date of Trustee's notifica-
tion to beneficiaries of any transfer or other contribution to
the Trust. Withdrawals shall be paid by the Trustee not more
than sixty (60) days after the date of such written demand. For
purposes of this special right of 'withdrawal, assets originally
transferred to this Trust shall be deemed to be an addition in
the year in which the transfer occurs.
4. Such rights of withdrawal shall constitute a first
charge against the principal of this Trust and during the contin-
uance of this Trust shall take precedence over all other distri-
butions and all other beneficial interests hereunder.
5. In creating this power of withdrawal,. it is the
intention of Settlor to create an annual non-cumulative power of
invasion which will qualify any transfer of property hereto as a
transfer of a present interest under Section 2503(b) of the
Internal Revenue Code of 1986, as amended, and which will not be
-2-
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.
.
treated as a release of such a power as that term is defined in
Section 2514(e) of said Code.
6. Subject to the ri9hts of withdrawal herein~efore
set forth, -as much of the principal as the Trustee, in its sole
and absolute discretion, shall determine, may be used to pay
premiums on life insurance policies owned by this Trust, but the
Trustee shall not be obligated at any time to pay any such
premiums. Trustee shall not use trust income to pay premiums on
any policies of insurance on the life of the Settlor or of his
wife.
7. The Trustee shall pay to or apply for the benefit
of anyone or more of Settlor's children as the Trustee, in its
(
sole and a~solute discretion, shall select, in such proportions
and at such times as the Trustee determines, without being
required to maintain equality among beneficiaries, as much of the
net income and, if income shall be insufficient therefor, as much
ot the principal, as the Trustee, in its sole discretion both as
to income and principal, shall deem necessary for such
beneficiarie~i maintenance, support and education (including
secondary, vocational, baccalaureate, professional and graduate
studies); provided, however, that before making any such payments
of principal to any child of Settlor, the Trustee may take into
account other property and income available to such person, and
in so doing the decision of the Trustee as to the amount of
principal so used and the extent to which other resources are
considered shall be conclusive as to all parties in interest.
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Any income not expended may be accumulated and added to princi-
pal.
B. Upon the death of the survivor of Settlor and his wife:
1. Trustee shall divide the then remaining principal,
together with any accumulated or undistributed income, into as
many equal and separate shares as there shall be children of
Settlor then living and then dead and thereafter:
a. Trustee shall hold one such share in Trust
for each child of Settlor then living, and during the lifetime of
each child:
(1) All of the net income 'shall be paid to
or for the benefit of such child in quarterly or other convenient
installments;'and
(2) As much of the principal of each child's
share as the Trustee, in its sole and absolute discretion, may
from time to time deem proper for such child's maintenance,
support and education (including secondary, vocational, baccalau-
reate, professi~nal and graduate stUdies) shall be paid to such
>.,
child or appiied directly tor his or her benefit; and
(3) Each child shall have the right to
withdraw from the Trust held for his or her benefit in the
following manner:
(a) Any accumulated or undistributed
income, upon attaining the age of twenty-one (21) years, including
income accrued or accumulated at any time thereafter:
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. . .-- --.. r
(b) One-half (1/2) of the then remain-
ing principal, upon attaining the age of twenty-five (25) years:
and
(c) The entire balance remaining upon
attaining the age of thirty (30) years.
Such rights of withdrawal shall be cumulative
and may be exercised in whole or in part and from time to time
after the right accrues but only in the chronological order in
which they are herein set forth.
2. In the event a child of Settlor dies before the
time for setting apart separate shares, or in the event a chi~d
of Settlor for whom a Trust has been set apart dies thereafter
(
but before the entire principal of his or her Trust has been
withdrawn, such equal share or the then remaining principal,
together with any accumulated or undistributed income, of such
Trust (as the case may be) shall be distributed as follows:
a. To the beneficiary or beneficiaries (includ-
ing such child'~ estate, such child's creditors or the creditors
of such child(s estate), in the amounts or proportions, whether
absolute or in trust, as such child may direct by his or her Last
Will, provided such Last Will contains a specific reference to
this general power of appointment; or
b. In default of such appointment, or to the
extent it is not effectively exercised, then to such child's
estate.
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.
M!~~~~~~U~~Hr~
~~~~ ~(I!(
SECOND: EARLY TERMINATION OF TRUSTS
A. Notwithstanding any other provisions hereof, Trustee
may, in its sole discretion, terminate any or all of the trusts
created herein. Upon such termination, Trustee shall pay the
principal and any accumulated or undistributed income of any such
trust share to the person or persons entitled to receive the
income therefrom in the proportions to which they were then
entitled to receive the income. If no such fixed proportions
then exist among beneficiaries, payment shall be made in equal
shares, per capita, among the persons to whom the income may then
be paid, and upon such termination the rights of all other
persons who might otherwise have interests as succeeding life
r
tenants or remaindermen shall cease.
B. Any and all trusts created herein shall terminate in
any event, and every final distribution or payment of the princi-
p~l of the trust estates shall be made, not later than twenty-one
(21) years after the death of the survivor of the beneficiaries
named or provided ~~r herein who are living at the date hereof,
. ...
~
. .
in the event that these trusts shall have not terminated previ-
ously in accordance with the terms hereof. In the event of the
termination of these trusts as provided for in this paragraph,
the Trustee shall pay over and deliver the principal, together
with any accumulated or undistributed income, free and discharged
of any trust, to the person or persons then entitled to receive
the income thereof in t~e proportions to which they were then
entitled to receive the income.
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THIRD: MINORITY AND DISABILITY PROVISIONS
Unless otherwise provided for herein, any income or princi-
pal payable to any beneficiary who may be then a minor (for all
purposes.o~.this Trust, a minor shall be deemed to be a person
who has not attained the age of twenty-one (21) years) or, who
may then be, in the opinion of the Trustee, mentally or physical-
ly disabled, shall be held in a separate trust by Trustee during
such minority or disability unless the trust share is sooner
principal may be accumulated or expended for the maintenance,
support and education (including secondary, vocational, baccalau-
reate, professional and graduate studies) of such beneficiary, as
Trustee, in its sole discretion, may determine. The Trustee, in
the expenditu~e of income and/or principal for such purposes,
may, in its discretion, apply the same directly without interven-
tion of a guardian, or pay the same to any person having care or
control of said beneficiary, or with whom the beneficiary re-
sides, without the duty on the part of the Trustee to see to or
inquire into th~ application of the funds by any person to whom
any payment is so "made. The balance of such income and/or
principal shall be paid to said beneficiary when the disability
-
or minority ceases, or to said beneficiary's estate in the event
of death_prior thereto.
FOURTH: PROTECTIVE PROVISION
. All principal and income Shall, until actual distribution to
a beneficiary, be free of the debts, contracts, alienations,
torts and anticipations of any beneficiary, and the same shall
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not be liable to any levy, attachment, execution or sequestration
while in the possession of Trustee.
FIFTH: INSURANCE POLICIES
A. . ~he Trustee shall not be under any obligation to pay
premiums on insurance policies held hereunder and shall have no
responsibility to see that such policies are kept in force, or to
review the financial status of such insurance companies.
B. No life insurance company shall be responsible to see
to the execution or performance of this Trust or to the applica-
tion of insurance proceeds paid to this Trust.
C. Trustee may, without incurring liability, compromis~
and settle any questions relating to any insurance policy upon
r
such terms as it deems wise. Trustee need not institute litiga-
tion to collect the proceeds of any policy unless it is reason-
ably indemnified for costs, counsel fees and other expenses of
such litigation.
SIXTH: POWERS OF TRUSTEE
In additiqn to the powers hereinbefore provided and those
given by law., "the ".Trustee, and any additional or successor
Trustee, without any order of court and in its sole discretion,
may:
A. - Hold and retain the property now or hereafter compris-
ing a part of this trust, for such length of time as in its sole
discretion it may deem wise, or sell any part thereof, without
liability of any kind by reason of such retention or sale and
invest and reinvest, alter, vary and change investments from time
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,.
or credit, without liability on the part of the purchaser to see
to the application of the purchase money; provided, however, that
no sale hereunder shall be made at a price less than that which
the Trustee acting in good faith shall consider to represent
adequate and full consideration:
J. Borrow money from any source, including any Trustee,
mortgage or pledge any property and purchase a~sets from Set-
tlor's estate and/or from the estate of Settlor's wife at fair
market value and loan money to any person or entity or to either
said estate: provided, however, that appropriate interest and
collateral shall be required for such loans;
K. After the death of Settlor or of Settlorts wife, to
(
merge any trust created hereunder with any other trust or trusts
created by Settlor or by Settlor's wife under will or trust, if
the terms of such trusts are then substantially similar and held
for the primary benefit of the same person;
L. Compromise claims;
M. Regis~er securities in the name of a nominee in such
manner that title 'shall pass by delivery;
N. Employ attorneys, investment counsel, accountants and
agents in connection with the discharge of its duties, and
determine and pay to them reasonable compensation;
O. Pool the assets of all trusts created hereunder or any
of them for investment purposes, allocating to each trust an
undivided interest in all of the assets so held;
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;
I ...,___ ."".. f
-" -.
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to time, in such manner and in such property, real, personal or
otherwise, including any common or diversified trust funds
for leases;
c. Make distribution hereunder either in cash or in kind
.
or partly in each, and cause any share to be composed of property
d~fferent in kind trom any other shares, without regard to the
r
basis of such property;
D. Purchase investments at a premium;
E. Vote in person, or by proxy, all stocks or other
securities held;
F. Exercise any rights or warrants to subscribe for stocks
or bonds or other allotments received by reason of securities
held, or sell them" for such prices as it may deem best;
G. Deposit, surrender or exchange stocks or pay any
assessments in connection with any reorganization or merger or
similar ~roceedinqs as it may deem best:
H. Exercise any option, right or privilege granted in any
insurance policy;
I. Sell any real or personal property at public or private
sale to any person or entity, or qive options therefor tor cash
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.
"
P. Add to the principal ot any trust created hereunder any
property received from any person by Deed, Will or in any other
manner:
Q. In the exercise of its discretion with respect to the
use of principal for any beneficiary, Trustee may take into
account other property and income available to such beneficiary:
in so doing, Trustee may conclusively rely on written represen-
tations made to it by such beneficiary, and the judqment of the
Trustee as to the amount of principal so used and the extent to
which other resources are considered shall be conclusive as to
all parties in interest:
R. Anything herein to the contrary notwithstanding, no
r
individual Trustee hereunder shall make or participate in any
decision of the Trustee required for the discretionary termina-
tion of any trust hereunder or to authorize the discretionary
payment of income or principal in cases where such terminated
trust or such principal or income (as the case may be) would be
distributable ~o or for the benefit of himself, herself, or
. '.
anyone such Trustee is legally obligated to support;
s. Exercise all power, authority and discretion given by
this Trust after termination of any trust created herein until
the same is fully distributed:
T. Accept property or not, in the Trustee's sole discre-
tion, by bequest or lifetime transfer from any person, estate or
trust, subject to the payment of, or liability for, state and/or
federal gift, estate, transfer, succession, inheritance or other
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...-- --'oAt.
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death taxes, including any interest or penalties thereon, and
sign any required consent or acknowledgement of liability for
such taxes and/or lien against such property;
U. . Anything hereinbefore to the contrary notwithstanding,
Trustee shall not exercise any power, authority or discretion if
the exercise of such power, authority or discretion would cause
the assets of this trust to be included in the "gross estate" of
Settlor, or of Settlor's wife, as such term is defined in the
Internal Revenue Code of 1986, as amended.
SEVENTH: APPOINTMENT OF ADDITIONAL AND SUCCESSOR TRUSTEES
A. During the term of all trusts herein, WILLIAM E.
MILLER, JR., may at any time and from time to time resign;
provided, however, that he shall immediately thereafter designate
some other attorney(s) and/or a qualified bank or trust company
as successor Trustee. Should he be unable or unwilling to act in
this capacity, the law firm with which he is associated, or with
which he was last associated, may designate an attorney to act in
such capacity. .
"
B. Any Trustee acting hereunder may resign at any time
without court approval, to become effective upon delivery of a
written.instrument signed by the resigning Trustee, and when such
is filed-with the clerk of the court having jurisdiction of this
Trust, with no requirement of approval by such court.
EIGHTH: WAIVER OF BOND
Settlor directs that the Trustee and any alternates or
successors thereto shall not be required to file a bond to secure
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the faithful performance of the duties of their office in any
jurisdiction.
NINTH: IRREVOCABILITY
This Trust shall be irrevocable, and Settlor hereby express-
ly waives all rights and powers to alter, amend, revoke or
terminate the Trust or any of its terms in whole or in part.
Settlor hereby renounces any interest, either vested or contin-
gent, including any reversionar.y interest or possibility ot
reverter, in the income or principal of this Trust.
TENTH: GOVERNING LAW/SITUS
This Trust is created under, governed by, "and is to be
construed and administered according to the laws of the Common-
f
wealth of Pennsylvania. The situs of this Trust shall be
Cumberland County, Pennsylvania.
ELEVENTH: DEFINITIONS
A. Wherever the words "child," "children" or "issue" are
used in this instrument, they shall include those both naturally
born and legal~y adopted, provided that the order or decree of
adoption is entered before any such adopted person attains the
age of twenty-one (21) years.
B. Throughout this Agreement, nouns, pronouns and verbs
shall be construed as mascul ine, feminine, neuter, si.ngular or
plural, whichever shall be applicable.
TWELFTH: COMPENSATION OF TRUSTEE
Any Trustee acting hereunder shall be entitled to reasonable
compensation.
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IN WITNESS WHEREOF, the parties hereto have executed this
Agreement on the day and year first above written.
~...
r- ~/ \ .
~'__~<t. ~ .
WITNESS
'-. _./
Trustee hereby accepts:
f?({~_
WITNESS
r .
"
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COMMONWEALTH OF PENNSYLVANIA
55.
COUNTY OF CUMBERLAND
On the
. ~ 6'1'h
.."\.. ..
day of January, 1992, before me, the sUb-
scriber, a notary public in and for the Commonwealth of Pennsyl-
vania, personally appeared the above-named WILLIAM E- MILLER, JR.
and in due form of law acknowledged that he executed the foreqo-
ing document for the purposes expressed therein.
WITNESS my hand and notarial seal the day and year afore-
said.
rJOTAp.!.\L SEAL
MAp.JOr'~I.E l. JOHNSON. I~Mary Public
M Mp.ehcn'C.!ibVr'1. Cvmt:;(~r'c.I;d Ccunr-/
CommIS::,/I'n f.~c'ms JMlJll 30, 1995
tvV.\A~C \It ,~
Notary Public
\ I I \ ..... \ !
"-, '\ vk' i-
.: ............. t .
COMMONWEALTH OF PENNSYLVANIA
SSe
COUNTY OF CUMBERLAND
.
.'
,~, .::-11-\
On the C(.) day of January, 1992, before me, the sub-
scriber, a np1;ary... public in and for the Commonwealth of Pennsyl":"
vania, personally appeared the above-named ELMER A. GROENE, JR..
and in due form of law acknowledged the foregoing Agreement of
Trust to be his voluntary act and deed for the purposes expressed
therein.
WITNESS my hand and notarial seal the day and year afore-
said.
MAFlJ NOTAR'^L SEAL
M ~roe L JOHNSON. Notary Public
M ;c ',"'Cl'lburg. CumbCrlarod County
v t)f'/lml~.~il'>" Fwolr~s ..lNlUfllrv 30, 19'}(S
J~.'~C\;' t)~\~( ~ ,-)C; h. Y\,.J.(jy\.)
Notary Public .
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SCHEDULE A
IRREVOCABLE AGREEMENT OF TRUST OF ELMER A. GROENE, JR.
INTERNAL REVENUE SERVICE TAXPAYER IDENTIFICATION NO. 25-6383462
I. One_D~llar ($1)
II. Survivorship Ordinary Life Insurance Policy
Issued by: New England Mutual Life Insurance Company
Policy NUmber: 8677949
Face Amount: Five Hundred Thousand Dollars ($500,000)
Owner:
William E. Miller, Jr., Trustee under Irrevocable
Agreement of Trust of Elmer A. Groene, Jr., dated
January 25, 1992
Named Insured: Elmer A. Groene, Jr. and
Sidney L. Groene, Husband and Wife
(
~
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