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Home My WebLink About12-20-06 .-1 15056051047 REV-1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT Date of Birth Decedent's Last Name Suffix Decedent's First Name MI ;r. (If Applicable} Enter Surviving Spouse's Information Below Last Name Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW _ 1. Original Return <:::) 2. Supplemental Return <:::) 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required <:::) 4. Limited Estate <:::) - 6. Decedent Died Testate <:::) (Attach Copy of Will) <:::) 9. Litigation Proceeds Received <:::) 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10, Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) <:::) o 8. Total Number of Safe Deposit Boxes <:::) 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number t..HII- ,IlL ...t" S Ii€' Lj)S I I I I 7 7b b 02. () 9 Firm Name (If Applicable) REGISTER OF WILLS USE ONLY AlA ~ CLOUSER 1(0,4 D r-.." c:~ , C ,') c.' First line of address P,,) <--::r r-'''' , Second line of address C) City or Post Office State ZIP Code DATE FILED " <.._' . 1 1 h1 .t;;" C jJ-f If N I C S Bu R G- b eamerc 5@)e,pi )(. ne. t fI If I 70S; ~ q 7 3-:SJ -., --..; , L./"~ ,--) -';1 (.}j Correspondent's e-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATU~ OF PERSON RESPONSIBLE FOR FILING RETURN )( JSQ'~M.I-tM~ A .~/Jj,",'Acivl./ ADDRESS I'OJ fM/'JD 11. SAlf/P.$o/l/ /l./73 L t{TZ r~u.vN RoA-D, ,'30/l-/N(;- S;PR/NGS~ P/1 /7007 SIGNATUff'pF PI}EPARER OTHE.!1'Ji'lA~ ~JRESENTATIVE ;( (M~g~a ADDRESS CH,f/{LFS F. Sf{/€~t:>s::IlL, cSt!(. ~ CLOUSEIf! ~/f(), MEeH/ffll/eSBlIIl6/ p~ 170S'S- PLEASE USE ORIGINAL FORM ONLY DATE IZl/f 10' DATE l2.h9/D' . Side 1 L 15056051047 15056051047 --.J ~ .-J 15056052048 REV-1500 EX Decedent's Name: Decedent's Social Security Number I q 7 07 752 7 RECAPITULATION 1. Real estate (Schedule A). . . . . . . . . . .. 1. 2. 2. Stocks and Bonds (Schedule B) . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . 6. Jointly Owned Property (Schedule F) c:=> Separate Billing Requested . . 7. Inter.Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c:=> Separate Billing Requested. . 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . 11. Total Deductions (total Lines 9 & 10).. 12. Net Value of Estate (Line 8 minus Line 11) . . . 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . 14. Net Value Subject to Tax (Line 12 minus Line 13) 3. 4. 5. 6. 7. 8. 9. . . 10. .. . . 11. .. . 12. .....13. . 14. .0 0 8' 3b 3.53 .00 ..0 0 ~..C 008 1'13.8"1 .00 .. 0 0 5"/ (P S57..'fO 37 CoS'O.3 . o ~1 fDSO..31 41S'Jol.0/ ..00 J.fl~ 901.0/ TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.;~) xoL 16. Amount of Line 14 taxable at lineal rate X.O 'is 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 /, 'I 33 ".73 3o~ 570.~F: . () 0 . 0 0 19 TAX DUE. . 15. 16. 17. 18. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT NC\~ Side 2 L 15056052048 00 J3q~() b~ t)O 00 13 Q30 bb C> 15056052048 ---I RE.V-1500 EX Page 3 Oecedent's Complete Address: DECEDENT'S NAME - r<.ItY/VtotJD J: File Number :l / - t) {, - .3 9/f SlflUP50N STREET ADDRESS /0 G-I<..EE/IIWI'! Y l)KIYE CITY /JJ~CflAIVICSB t{ I<G- STATE flA ZIP 170S~ Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) ~ 13J 930. fDG, () 1- J:l. 8 ~ 5'. 00 - I .._. ,. fo'15".oo 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits ( A + 8 + C ) (2) I) 3-;500. DO o o B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) 0 (4) 0 (5) ~ lf31J. " (SA) 0 (58) , If 30. ~6 TotallnterestiPenalty ( D + E ) 4. If Line 2 is greater th,m Line 1 + Line 3,. enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;................................................................................... 0 ~ b. retain the right to designate who shall use the property transferred or its income; ...................................... 0 IKl c. retain a reversionary interest; or..................................................................................................................... 0 IX! d. receive the promise for life of either payments, benefits or care? ............................................................ 0 ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 IX! 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......_.. 0 ~ 4. Did decedent own an Individual Retirement Account. annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ 0 IXI IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 PS. 99116(a)( 1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 PS. 99116(1.2) [72 P.S. !l9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 39116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV.1503 Ex + \1-97) ESTATE OF SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESID~NT DECEDENT 54 M PS 0/1/1 1<,4 Y /J1 0 N7:J FILE NUMBER 2/- tJfo - 39'-/ :J. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER VALUE AT DATE OF DEATH 1. DESCRIPTION 1. J) 784 5h. 0 f ISM Corp. Ct>MtYlOJ1 Stvc/<" -' AI/N'J- cu-!/h'ca.1eol 5hares helcl tit (3;l11fJtderShare A-ecJ-. #= /b 755-71 ZoS ,~-k(/K Ytt./Llah~n dtJ.Ja obTained ~IVI Yahoo F,I?anc,'d f-I ;.swrical 1)cJ-a base: ),;jh ~8d.rJ. low 1'i,1.40 ,- 8.:l.lIP x f 8'2. /{g ave. I, 7t t.j sh. 'I- / '/4>/ 573. '1'-/ !ltneric.(),n c e.r\tL\r~ ~tl '1ro9. :l.SO shlU"ts (~)ee Va/kah'on Idhr 1" nve.stMen'fi A etl. No. 0:1.0- 001 3'2l.j Q'3 , . " ;;10.81 pu share. -= a 1tac,hed) ~ (01/ 790.0'1 TOTAL (Also enter on line 2, Recapitulation) $:l,o 8; 3" 3. S 3 IBM: Historical Prices lor INTL BUSINESS MACH - Yahoo! Finance Yahoo' Mv Yahoo! Mail Make Yahoo' your home paqe ~ ~OOr . C E Welcome, devi882001 IAL'1t _" FIN AN [SiQn Out, Mv Account] 7/1106 1:53 PM t;;:;,~.~~t: t ISearCh.! Finance Home - ~ Home Saturday, July 1, 2006, 2:53PM ET - U.S. Markets Closed. Dow'" 0.36% Nasdaq'" 0.11% News & Commentary Retirement & Planning Banking & Credit Loans Taxes My Portfolios Get Quotes I IGO I Symbol Lookup I Finance Search CTrade Smarter ~F~ International Business Machines Corp. (IBM) 59.99 Internet equity trades. iEI AMERITRADI' Historical Prices SET DATE RANGI: Start Date: ~\pr ~ I f171200' Eg. Jan 1, 2003 End Date: [!pr ~j (1812001 I Get prices:1 On )un 30: 76.82 '" 0.77 (0.99%) Get Historical Prices for: ~ @Daily o Weekly o Monthly o Dividends Only Flrstl Plev 11~8Xt I L_ast PRICES Date Open High Low Close Volume Adj Close< 18-Apr-06 81.89 83.53 81.70 83.31 7,905,800 83.01 17-Apr-06 : 81.92 82.92 t 81.40 81.64 4,634,200 81.35 < Close price adjusted for dividends and splits. First I f~lf'\' I .Il rv, Download To Spreadsheet http://tlnance.yahoo.com/q/hp?s~ I BM&a~03&b~ I 7 &c~2006&d~03&e~ I 8&t=2006&g~d ADVERTISEMENT ONLINE CURRENCY TRADING CURRENCY FORECAST I EUR/USD I (.S~ 1,.CiS1 POUND $ USD ~ (.;J~ FREE PRACTICE ACCOUNT % FXCm WWW...-XCM.COM Page 1 of2 July II, 2006 (t American Century Investments Charles E. Shields III Attorney at Law Six Clouser Road Mechanicsburg, P A 17055-9735 Re: Account 020-001329993--Growth, Raymond]. Sampson Dear Mr. Shields: Thank you for your recent correspondence. The value of Raymond J. Sampson's above-referenced account on April 17, 2006, was as follows: Number of Price Per Account Shares Share Value 2,969.250 $20.81 $61,790.09 The account is not an interest-bearing account, and there were no accrued dividends at the time of Mr. Sampson's death. Mr. Sampson did not maintain a safe deposit box with our company. I hope this information is helpful. If you have any questions or if we can be of further assistance, please call our Investor Relations department at 1-800-345-2021. We are available to assist you weekdays from 7 a.m. to 7 p.m. and Saturdays from 9 a.m. to 2 p.m. Central time. Sincerply, J\A~1I.U'- Mary Strahan Correspondence Specialist Document No. 00796131-M8K Amcrican Centurv Investments PO Box .119200. Kansas City, MO 64141-6200 1-1300.345-2021 (lJ H 16-53] -5575 \ \' ww.a rnerlcl1ncen t U f\'.C\ nY\ R~V-1508EX+ (\-97) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INH~;~~~~~i 6:[E~:~~RN PERSONAL PROPERTY ESTATE OF .5/1- fit fJ.5olll; If /J Y /J1 ~A! D :r FILE NUMBER ;< 1- o{o - 39'-/ Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly.owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION NEIJfIJEf6 R/?j/ FE" VERA-/. CREDit UNION fl. 4EGtlUf!? SAYINGS ,4(!(!7: #: ZOI.2/3 -tJtJ 8. r!.GlCTt;:: ~F DEfJtJS. # Zo/ 2/3- Lfc C. /IVJ. fie-eli. 70 ?J.D.,!). oAl I rE/J1 B. D. CE'~TlF. OJ:: lJEfJ"s. .:rI= 21// 2/3 - 'Ilf E /#7-"" Ife(!.~. 71J p. o. D. oJl/ 17E/J1 b. F t!FI27/F. ~F 7Jf::t1oS. #' 2.0/ Z /3- 'I!: G-. / IVT: A-e(!Jl, 70 7). o. D. oN ITE/71 F H. CEI2/IF 1/1= DEPtJ~. -# 201 2/3- fjt;, :.T. /1V7: AeC?-If. 70 D. o. b. eN ITEm f/. v. CEI<:IIF( of zg::;"s. #- 201 ::Z13 - if? /<. /N7: /.reel? 70 ]:).0.]). ~IV 17E/J1 :r. (SEE" OFF/(!IA-L J/lI-tUA-7iIJN LE/TE7C fiTTACHED ;::ietJ/J1 /J1l~/J!l3ms FI/?~ T ) :? tv,tel-/~j/j4 t3/}-A!~ A/, IJ. 3. A.) CE7(.T/~ tiF DErPdS. -It:<. 1/7 4/2 t)(P1 75 3 ~ 13 6..) IN! A-etR., 70 b.o.b. oN /7E/l1 A-. (J€ E OFJ::./C/ A-L {llf-ttrl1 7/tP;/ IE lie< /f T-r/fr!.-Hro HwM tJlI-CH tJ illl1 611-N k.. /IJ. A) A-1)1E"((/{!f/ti/cE FEbc;;e/l-i (J/ZEDIT UN/oN A.) :5H!1-ICE ..5I!-J//A/{;S A-ceJ": IFf) I (3) lilT: l!-e/5/(. 7b D. (). lJ. t//)/ /7E/11 /f. c) ea7iF 0/= pf:P05. #' ro~ (&Jnt 'c!) VALUE AT DATE OF DEATH ~s:- /JD , /iD gl'Z 9~ .. 'f d 3, ~/i 'f! 26/ (PI/OC? 1;;., 7. 79 ,'f( .20.. 075: S9 ~ ;)3. 9'1 'jtf ,?o 7. ~? , % .;; f. J>~ :6 ~ 7?S- 53 'jf /1, lfZ f -701 3 3~. 3'-/ ., 35. <fh 'I 7..3,21( . {)(p r: 43.. 1()7, 62 TOTAL (Also enter on line 5, Recapitulation) $ 30 Y'I /9 3. ~ 7 (If more space is needed, insert additional sheets of the same size) : SeHED, E; ~d'cl I/...=ST OF S,f/J1PSONj ;(1I-Y/J1tJA/~ J: I I lJ.) 1#1 /I ee,t(, If} P.o.}). oft! 17E//1 C. I E.) e~l<.rlr: of IJEfJoS. #tR3 i i F) 1/1/7: /lrJejf, 7b :]),(}, P. ,M) ITEM E. I (.5EG: oFF/CIA-L f/ALW/t- lio/1/ L F7T~ A-7/;.feflGi) I .. _ u . ... ..... .. . /f/IJBICl-/tJ/(!F FElJElVH. (J/(G])IT UNIOAI) 4. C 171 Z.~NS jlA-~/< 1/..) /( It- r /II ~A//) y;. .5-1-/11 flJu 0 II! 7i M F DBJt)-! IT /l--t! f!- T -# F-R.o ff/ 614 /)75" -'2. S.f If 6) jAl{.. .A-ec,f. 7b ]),0, j). [)/[/ /TEm /J. (1) If/tYlPtJl/I~ J; ~A/J1jJso# VAlE /:>EPOSIT Ate;.:# GI'I oj?:{ 9,fS-;Z /),) fAiT- _ !fee/? /0 ]J.o,b. t)/1//7'E/J1 C .(S/EE ?JFEIC//fL t//fLtI/! 7/~AI L.ETTE7( 4TT/'/eI'/GiJ ~//f .. (! II/ z~A/.s.... ./3/fA/j() 5".. S7&UA/~ F/A/ItIf/CIA-L..'!.:K.q. ~EIY//IIJ.. ST/lTG/fAIf./~ 11-.) CPR.. TIE.#: Lf()? ~ 1 /1.) 11/17: AecR. lO /),0.)). PAl /T€/I/ A- e,) (!EI2T/F. # ?/s 000 163 9 7:>.) IN!: A-~c;e 70 /).0. j). (SEE oFAC//fL I//tLl{/f77t)/f) Lf- rrm ~Tm(!,}(67J ,Fi(:fJ1Vt j7e (<LIN' r/A/AN(!,/If(., Co!!./'. / ~lFNIV4. 5m~ SAN):.) ~ ~. /tlJlmlt.A-J) ~f'el:5> 7/Vf.YEt.t..6.7eS CHE'(!,Ks. dl- OtO - 39/.f 1 SC/$: 2S- ., 2(/ 7'3'1..CJ-2 / " :? ;;'-1. (p / 1. ~ 4./~.3h .. f7 '! .3~ 79'7. 70 .;: r 37,39 ,- Lf'J 9J'7.17 K GS', 'IS ~3S; 'It). ft,l{ ~ 31,F. 77 .5) ~ ~ . 00 fv 1st MEMBERS 1st FEDERAL CREDIT UNION dlY<" ',?:^,r.r / ,{-,& ~ REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner CERTIFICATES OF DEPOSIT: Account Number/Suffix Date CElrtificate Established Principal Balance at Date of Death Accrued interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Certificate Established Principal Balance at Date of Death Accruecllnterest to Date of Death Total Principal and Accrued Interest Name of Joint Owner CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Certificate Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner 201213 -00 01/25/2001 $25.00 $.00 $25.00 None 201213 -40 01/29/2001 $16,887.96 $23.69 $16,911.65 None 201213 -44 03/01/2002 $26,441.09 $29.79 $26,470.88 None 201213 -45 04/29/2002 $20,075.59 $23.94 $20,099.53 None 201213 -46 04/29/2002* $24,207.67 $28.86 $24,236.53 None 201213 -47 11/13/2002** $7,775.53 $11 .42 $7,786.95 None *Established by transfer of funds from 201213-00 ""Established by rollover from matured certificate #201213-43 originally established 5/10/01 t.~ .'.~. ERS1ST/;7FED~RAL..CREDITUNIOf\! , /1 . ')1 {z~,(t:J/()L DEmise A. Wolfe '/ Insurance Services Supervisor June 14, 2006 Estate olf: RAYMOND J. SAMPSON Date of Death: 04/17/2006 Social Security Number: 197-07-7527 5000 Louise Drive . Po. Box 40 . Mechanicsburg, Pennsylvania 17055 . (717) 697-1161 . \vww.members1 st.org II! ~~~ WACHOVIA Reference 10: 1632591 Wachovia Bank N.A. Balance Confirmation Services POBox 40028 Roanoke, VA 24022-73 13 May 25, 2006 CHARLES E SHIELDS III ATTORNEY AT LAW 6 CLOUSER ROAD CORNER OF TRINDLE AND CLOUSER ROADS MECHANICSBURG, PA 17055 SUBJECT: Verification / Confirmation of Account and Balance Information provided for: Customer: RAYMOND J SAMPSON (SSN# 197-07-7527) Date of Death: April 17, 2006 Deposit Account Information Account Type Account Number Date of Death Balance Average Balance* Date Opened Maturity Interest Date Rate Accrued YTD Interest Interest Paid Date Closed CERTIFICATE OF DEPOSIT 247412061753613 $20,336.34 5/2/2002 11/2/2006 $35.86 $269.21 LEGAL TITLE: RAYMOND J SAMPSON CHECKING 1010124434321 $100.06 9/8/2005 $000 $0.04 LEGAL TITLE RAYMOND J SAMPSON EVELYN G SAMPSON * Due to system limitations, we can only provide a twelve month average balance on depository accounts. No Safe Deposit Box found for customer. * Date of death balance does not include accrued interest. * If date of d occurrs on a w kend or a holiday, date of death balance does not include any transactions that were made d ng hme per. ,-0 ..~~ / Dena White Servicenter Associate Phone: (540)563-7323 cf; dw ~ AmeriChoice ...... ~ FEDERAL CREDIT UNION Building Relationships For Life May 19, 2006 Charles E. Shields, III Attorney-At-Law 6 Clouser Road Mechanicsburg, PA 17055 RE: Estate of Raymond J. Sampson Account # 17146 & # 30570 SS #197-07-7527 The account is as follows: Account Type #17146 Date Opened Date of Death Balance & Dividend Balance Share (savings) #01 08/09/1972 $ 218.39 $ .53 Money Market #18 10/20/1992 $ 7,113.30 $ 30.13 Certificate of Deposit #60 01/05/2006 $ 16,765.23 $ 194.83 Certificate of Deposit #61 06/14/2004 $ 10,048.88 $ 90.80 The above accounts are held jointly with Evelyn Sampson. Account Type #30570 Date Opened Date of Death Balance & Dividend Balance Share (savings) #01 01/11/1999 $ 28.24 $ .06 Certificate of Deposit #62 02/12/2002 $ 43,107.62 $ 845.25 Certificate of Deposit #63 06/22/2004 $ 24,439.02 $ 222.61 The above accounts are individual accounts. Mr. Sampson did not have a safe deposit box with the credit union. I have enclosed the statements for April 2006. If you have any question please contact me at (717)591-1275. Thank you. Sincerely, fA r l. rY, L ~?\ n C I' j.J2.L't.. I 'I 0) Ltcu~ Beth M. Y orIets . Operations Supervisor Website: www.arnerichoice.org Main Office: 2175 Bumble Bee Hollow Road. Mcchanicsburg, PAI7055 . Phone: (717) 697-3474 . Fax: (717) 697-~)713 ., is} I-NCUJn o H J SAMPSON 10 GREENWAY DR MECHANICSBURG PA 17055-5655 WITH 600 MEMBER REWARD POINTS YOUR NEW LEVEL WILL BE: BLUE RIBBON MEMBERS ASK US HOW MEMBERS GET FREE UNLIMITED ATM TRANSACTIONS. SUMMARY OF YOUR ACCOUNTS Notice: See reverse aide for important information regarding your right to dispute errors on your statement. ACCOUNT NUMBER: 30570 1 SUFFIX 01 SENIOR SHARES SUFFIX 18 MONEY MARKET STATEMENT PERIOD 04/01/06 - 04/30/06 STATEMENT PERIOD 04/01/06 - 04/30/06 BEGINNING BALANCE 28.24 BEGINNING BALANCE .01 DEPOSITS 1 .02 DEPOSITS 0 .00 WITHDRAWALS 0 .00 WITHDRAWALS 0 .00 ENDING BALANCE 28.26 DRAFTS CLEARED 0 .00 ENDING BALANCE .01 DIVIDEND YEAR-TO-DATE .08 DIVIDEND THIS PERIOD .02 DIVIDEND YEAR-TO-DATE .00 AVERAGE DAILY BAl,ANCE 28.24 DIVIDEND THIS PERIOD .00 DAYS DIVIDEND EARNED 30 AVERAGE DAILY BALANCE .01 ANNUAL PERCENTAGE DAYS DIVIDEND EARNED 30 YIELD EARNED 0.87% YTD DIV RECEIVED: 1,067.94 o o - 04/30/06 43,107.62 .00 .00 43,107.62 PAGE NUMBER: 1 of 1 845.25 .00 .00 o 02/12/07 4.750% 24 MOm?H CERT PERIOD 04/01/06 BALANCE SUFFIX 63 STATEMENT BEGINNING DEPOSITS WITHDRAWALS ENDING BALANCE - 04/30/06 24,439.02 .00 .00 24,439.02 o o DIVIDEND YEAR-TO-DATE DIVIDEND THIS PERIOD AVERAGE DAILY BAI,ANCE DAYS DIVIDEND EARNED 222.61 .00 .00 o MATURITY DATE ANNUAL PERCENTAGE RATE 06/22/06 3.728% SUFFIX 01 SlmIOR SHARES HISTORY DATE 4/30/06 TRANSACTION AMOUNT .02 ACCOUNT BALANCE 28.26 DESCRIPTION -- DIVIDEND SUFFIX 18 MONEY MARKET (NO ACTIVITY) SUFFIX 62 12 MONTH CERT (NO ACTIVITY) SUFFIX 63 2,1 MONTH CERT (NO ACTIVITY) For easier and more affordable mortgage loans contact Donna GOBS today at (717)541 89461 SUFFIX 62 STATEMENT BEGINNING DEPOSITS WITHDRAWALS ENDING BALANCE 12 MONTH CERT PERIOD 04/01/06 BALANCE DIVIDEND YEAR-TO-DATE DIVIDEND THIS PERIOD AVERAGE DAILY BALANCE DAYS DIVIDEND EARNED MATURITY DATE ANNUAL PERCENTAGE RATE o :R J SAMPSON 10 GREENWAY DR MECHANICSBURG PA 17055-5655 WITH 600 MEMBER REWARD POINTS YOUR NEW LEVEL WILL BE: BLUE RIBBON MEMBERS ASK US HOW MEMBERS GET FREE UNLIMITED ATM TRANSACTIONS. Notice: See reverse side for important information regarding your right to dispute errors on your statement. ACCOUNT NUMBER: 17146 PAGE NUMBER: YTD DIV RECEIVED: 1 of 2 326.67 For easier and more affordable mortgage loans contact Donna GOBS today at (717)541 89461 SUMMARY OF YOUR ACCOUNTS 1 SUFFIX 01 SENIOR SHARES JOINT: EVELYN SAJVIPSON STATEMENT PERIOD 04/01/06 BEGINNING BALANCE DEPOSITS 1 WITHDRAWALS 0 ENDING BALANCE DIVIDEND YEAR-TO-DATE DIVIDEND THIS PERIOD AVERAGE DAILY BAI,ANCE DAYS DIVIDEND EARNED ANNUAL PERCENTAGE YIELD EARNED SUFFIX 61 24 MON~rH CERT JOINT: EVELYN G. SAMPSON STATEMENT PERIOD 04/01/06 BEGINNING BALANCE DEPOSITS 0 WITHDRAWALS 0 ENDING BALANCE DIVIDEND YEAR-TO-DATE DIVIDEND THIS PERIOD AVERAGE DAILY BALANCE DAYS DIVIDEND EARNED MATURITY DATE ANNUAL PERCENTAGg RATE SUFFIX 01 SgNIOR SHARES HISTORY DATE 4/30/06 DESCRIPTION -- DIVIDEND SUFFIX 18 MONEY MARKET HISTORY DATE 4/07/06 DESCRIPTION -- CERTEGY-MADISON 4/06/06 DIVIDEND 4/30/06 - 04/30/06 218.39 .18 .00 218.57 .71 .18 218.39 30 1.01% - 04/30/06 10,048.88 .00 .00 10,048.88 90.80 .00 .00 o 06/14/06 3.698% SUFFIX 18 MONEY MARKET JOINT: EVELYN SAMPSON STATEMENT PERIOD 04/01/06 - BEGINNING BALANCE DEPOSITS 1 WITHDRAWALS 1 DRAFTS CLEARED 0 ENDING BALANCE DIVIDEND YEAR-TO-DATE DIVIDEND THIS PERIOD AVERAGE DAILY BALANCE DAYS DIVIDEND EARNED ANNUAL PERCENTAGE YIELD EARNED TRANSACTION AMOUNT .18 ACCOUNT BALANCE 218.57 TRANSACTION AMOUNT 162.76- CERTEGY-MADISON 10.20 ACCOUNT BALANCE 7,113.30 CR CD PMT 7,123.50 04/30/06 7,276.06 10.20 162.76 .00 7,123.50 40.33 10.20 7,145.85 30 1.75% I I SUFFIX 60 I STATEMENT I BEGINNING I DEPOSITS I WITHDRAWALS I ENDING BALANCE I I I I I I I I I I I I I I I I I I I I I I I I I I I I 15 MONTH CERT PERIOD 04/01/06 BALANCE DIVIDEND YEAR-TO-DATE DIVIDEND THIS PERIOD AVERAGE DAILY BALANCE DAYS DIVIDEND EARNED ANNUAL PERCENTAGE YIELD EARNED MATURITY DATE ANNUAL PERCENTAGE RATE 1 o - 04/30/06 16,570.40 194.83 .00 16,765.23 194.83 194.83 16,570.40 91 4.80% 04/05/07 4.716% SUFFIX 18 MONEY MARKET (CONTINUED) Notice: See reverse side for important information regarding your right to dispute errors on your statement. ACCOUNT NUMBER: 17146 YTD DIV RECEIVED: 326.67 PAGE NUMBER: 2 of 2 2 DEPOSITS DATE 4/30/06 DESCRIPTION -- DIVIDEND OTHER DEDUCTIONS DATE DESCRIPTION 4/07/06 CERTEGY-MADISON SUFFIX 60 IS MONTH CERT TRANSACTION AMOUNT 10.20 TRANSACTION AMOUNT 162.76 LOCATION LOCATION CERTEGY-MADISON CR CD PMT 4/06/06 HISTORY DATE 4/0S/06 DESCRIPTION -- Dividend Payment TRANSACTION AMOUNT 194.83 SUFFIX 61 2~, MONTH CERT (NO ACTIVITY) ACCOUNT BALANCE 16,765.23 (I " I 525 William Penn Place Suite 153-2618 Pittsburgh, PA 15219 June 1, 2006 CHARLES E SHIELDS III 6 CLOUSER RD MECI-IANICBURG P A 17055 Estate of RAYMOND J SAMPSON Date of Death: Apr 17, 2006 SSN: 197-07-7527 Dear Sir/Madam: In accordance with your request, the attached information sheet has been provided in the above decedent's name as of his/her date of death. For IL or LC accounts, contact our Loan Department at 1-800-708-6680. For all other inquiries, please call 888-999-6884 Sincerely, Pfeil, Mamie Operations Services ~:~ Ci i e Account Number 6140752884 Account Title RA YMOND J SAMPSON Date Opened 12/16/1999 Account Type Time Deposits Ptincipal Balance as of DOD $7616.36 Interest from Last Posting to DOD $.87 Account Balance as of DOD $7617.23 YTD Interest to DOD $104.38 1:~Cii n B k Account Number 6140829852 Account Title RA YMOND J SAMPSON Date Opened 9/5/2001 Account Type Time Deposits Principal Balance as of DOD $32799.70 Interest from Last Posting to DOD $37.39 Account Balance as of DOD $32837.09 YTD Interest to DOD $345.65 ~:~ Ci .. Izen Account Number 6100706591 Account Title RA YMOND J SAMPSON EVELYN G SAMPSON Date Opened 6/6/1966 Account Type Checking Principal Balance as of DOD $10551.63 Interest from Last Posting to DOD $ .00 Account Balance as of DOD $10551.63 YTD Interest to DOD $4.79 (") ::;; 0 3 (") ""Q. Q) :J Q) 0- :J (l) (") (l) 0 -- ..." ;;0 Q) (l) :J (") '< 0 ..." :J C Q. :::4. 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"';;;:;~~6~:A~E~:~'\' :;\:.~.~ t~ ~~-" " _ ',~' ~ ~~1l1!~-,.R!lf~.;litiift)1~Wl}~'~~TjlJlj(~111Y '. ,,_ 'ISSUEO--aY . _c' ,,, " EXPRESSiRAVEL,RE LATEq,SERVtGES,COM PANY, 1 N C. ..~. ,>3~t{0~~rNi','I;:T~"2'::00 iST~""l'T:ES c._ -t, ),J.~ ~:_ _ ,rN AL:.L OTHER COUNTRIES .--...... -!'. .'. . - ~- ."~ ~;-,-:.-:':"~;::::;: ,- -- ~-'yPLL I . ~. '. ,. "fj~'- ICHAIRMAN ,. J:l iH,r1 r1nrTI ,C "1'1..t:'.1:~i'1.r::,,:[c;l$kC.(t.'.q ?J11 REV-1f>ll EX+ (12-99) . ~: ~,~.r'~ .~~.~~~t SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF. "J 5/~MPSlJfV/ j(,4 Y Iff ~ AJ j) J. FILE NUMBER .;&(- at, - .5 9if Debts of decedent must be reported on Schedule l. ITEM NUMBER A. DESCRIPTION AMOUNT FUNERAL EXPENSES 1. II. CrelYlaIu::n - 1J.1ercha.Ilc!,'se re./t:dec/,'feMS B. c.remah'()/1- ob'-fuar/e.r ~r:Pe-1?5es C. l-!o/10rnrllun- ~~er EduNlrd /J1t'ss~rsMd-h . r- ~'r 7/41 SmQ II [). HO/1ora/'lJ.(h! - r-Gt/Y/c E. ~rqtl/1iJt fee F &~fJ' 191 /.3ulleh/t ~/cle~ (.J. FfJ/S(!.pflnl (!/Jt{I'd, tul?men ~ I::? 5'. tJD ;i' 3S~,oo ~ 00.00 ~/s-o,c>o ~ /oo.,po }!) I~,o. ()O ~700.o0 1. B. ADMINISTRATIVE COSTS: I~ersonal Representative's Commissions ~ /4, ()OO, 00 2. 3. 4. 5. 6. 7. &'. '!. IC. If. Name of Personal Representative(s) If It r 1!1 PAl) Ir. S 1I-/J1 p.J()1II Social Security Number(s)/EIN Number of Personal Representative(s) / fjCf- 3 tf- 8:3 (Pf) Street Address /1../73 Lu TZ Tow tV' M/I/J City 130lLlN6 .5(11(11165/ State fJA- Zip /7007 Year(s) Commission Paid: y~ ~ 7.00(, 'It.. ~ 2007 'fJ s: (;00" 10 Attorney Fees C H A!l L ES .E. .:s f.l1 s:z. D S 1D.. ~amily Exemption: (If decedent's address is not the same as claimant's, attach explanation) '? 3... 5'00,00 Claimant J;; J/ IE'L Y N G-. S /I- hJ fJ S 0 IV Street Address 10 GJi!.€/F/vIf)/f Y ])/ZIY/: City f11 G' (!,fI A-IV Ie .5 8 t( I( Cr Relationship of Claimant to Decedent W / 0 pu) State ;/,4 Zip /7055 Probate Fees cu-uI original i 55ue of short cerh"kc.a.relS (; , 1/ S". 00 Accountant's Fees } .[a.ner I3rac.kb;J!j H ~r<. 8Io~k, lY/ecJ1an,'csblo\.r:] Tax Return Preparer's Fees .tvi' c.ID~-oLCt /tJl.f-I), PII-'10J lOlli, P# iff, e:tz:, (c'sh'fI1.) ,. 4 so, bC> /I- Iv////Pl1I,/ jJrPbafe lees. /f dJ/er f,'s,'r! J11 tUJ11/Jtr/llllcl LltuJ .flurna / ltdnrfisillj 111 Ctt,.I,',Sk SellhlJe/ JdJ,'';,fJnlf/ Sh,,.t ee,.t,'f"caft~ f/f/n3 ;::e.t. Ii I<er;shr ,,/ W///5 f If IS; ,,0 '7 s-. 0 tJ '107, 99 ~ j'.oo f'5# /)0 TOTAL (Also enter on line 9, Recapitulation) $ 3 7, '5"0, .39 (If more space is needed, insert additional sheets of the same size) 15tH (;"D. J./) &ltid. I I 5/1 JJf/JJ () Nf /? II r /J! ~ AI 0 :r (:t.! .5erp'/ce lee C/1 c5Clko/ 18/11 sft;ck I /3.1 i3rctertlfle (j/J/4!ISSIt;/J ~ &a/e of 113/J1 Skck I (See Yehh'rClhol1 of eIJl/ryes /1#Ac/'erJ) N.I tt.,'MblArsetnf"nts Ii" CIz~rle-s E. Sh,'d& ZIT "'r&l"hh~,( Mt'U'//"!5, ~J~1t,f/khetJ(l/~$, dZ. ex /-{)t, -37' ~ / s. ()D ~ J7J>, I/o W4. :~. REV-1513 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDI::NT DECEDENT ESTATE OF r5 A A1 ,oJ() ~ /? A Y /J1 ~ AJ ]) ::J. FILE NUMBER NUMBER I RELATIONSHIP TO DECEDENT NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] E~r~LYN c.. S>AMP$ON WlbOW I () G rtEGNWlry ""D~IVf" 1Yl,:eHA-NICS 13 u.RG1 PA /leSS 1. ~. R tf.Y MOAJ D If. SA-MPSolJ IWl:3 Lu. -rz lOW IJ /<J;IH> Bo \ l- \ tJG. 5f'R-IN6>1 III- , 1007 'SON 3. /Ele/e. ;r: 5/t/11 PSorl ;)...807 LIV.sEy OAl~S D/(. 7"etl CK.E1(, GA. 8t>()%t.{ ::>DN .2(- tJ~-.3 9~ AMOUNT OR SHARE OF ESTATE LOJ bat tHF 7iatlns oj:: rN~ Pill.{.. tu,/)~JoI IS A- LIFE 7E#'AAlT f)J: TNE 71i.1Js-r E?S71#-8 I AI / rtFA1 v.' y~ R.emAIIJDE?T<. Y:t IEE/HAINtJ€R ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 TOTAL OF PART II - 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) REV-1514 EX+ (12-03) SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN Check Box 4 on REV-1500 Cover Sheet COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF 5lfAlflsIJA!, Je/fY/IJ/JIf/});:r: FILE NUMBER ,z/ - of&, - 39'1 This schedule is to ~e 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. ~ Will 0 Intervivos Deed of Trust 0 Other LIFE ESTATE INTEREST CALCULATION NAME(S) OF LIFE TENANT(S) DATE OF BIRTH NEAREST AGE AT TERM OF YEARS DATE OF DEATH LIFE ESTATE IS PAYABLE I3VELYN ICT. SIl-MtJS~N , / tj 11'120 35" ~ Life or o Term of Years o Life or o Term of Years o Life or o Term of Years o Life or o Term of Years o Life or o Term of Years 1. Value of fund from which life estate is payable. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$' '-f 78 907. 0 I , 2. Actuarial factor per appropriate table ........................................,........ (). 3 S:3 S 't Interest table rate - 0 3 1/2% 06% 010% 0 Variable Rate % 3. Value of Iife~ estate (Line 1 multiplied by Line 2) .,....................................$ Jh9 33f,.73 I ANNUITY INTEREST CALCULATION NAME(S) OF LIFE ANNUITANT(S) DATE OF BIRTH NEAREST AGE AT TERM OF YEARS DATE OF DEATH ANNUITY IS PAYABLE o Life or o Term of Years o Life or o Term of Years o Life or o Term of Years o Life or o Term of Years - 1. Value of fund from which annuity is payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 2. Check appropriate block below and enter corresponding (number) Frequency of payout - 0 Weekly (52) 0 Bi-weekly (26) o Quarterly (4) 0 Semi-annually (2) 0 Annually (1) o Monthly (12) o Other ( ) 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% 06% 0 10% 0 Variable Rate % 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 ..................................................$ 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 life 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) ; ) LAST WILL AND TESTAMENT OF RAYMOND .T. SAMPSON I, RAYMOND J. SAMPSON, of Upper Allen Township, Cumberland County, Pennsylvania, being of sound and disposing mind, do hereby make, publish, and declare this to be~ i " ~ my Last Will and Testament, hereby revoking and making null and void all prior Wills and Codicils C) made by me at any time heretofore. ITEM I. All federal, state, and other death taxes payable because of my death, with respect to the property forming my gross estate for tax purposes, whether or not passing under this Will, including any interest or penalty imposed thereon, shall be considered an expense of administration of my estate, and shall be paid from my residuary estate under ITEM VI hereof, without apportionment or right of reimbursement. All such taxes on present or future interests shall be paid at such time as my Executor or my Trustee, hereinafter named, may think proper, regardless of whether such taxes are then due. ITEM II. I give and bequeath certain items of tangible personal property that are solely owned by me at the time of my death and that are identified in any separate writing distribution thereof after my death which is dated and is signed by me at the end thereof, to those persons designated in such separate writing who survives me. If any item of tangible personal property is identified by more than one separate writing, I direct that, unless stated to the contrary, the separate writing bearing the last date shall govern the disposition of such item. ITEM III. I bequeath the household and personal effects, jewelry, automobiles, and other tangible personalty of like nature that are solely owned by me at the time of my death, not otherwise disposed of above, to my wife, EVELYN G. SAMPSON (my "Wife"), if she survives me. If my Wife does not so survive me, then I make such bequest of tangible personal prope11y in equal one-half shares to my children, RAYMOND A. SAMPSON and ERIC J. SAMPSON, who survive me by thirty (30) days; provided, however, that if such a child of mine should not so survive me, but leaves issue who do so survive me, then such child's issue shall receive, per stirpes, the share that such child would have received had he so survived me. Such tangible personal property shall be divided as such beneficiaries, or their legal representatives, shall agree; but, if they cannot agree as to any item(s), allocation and distribution thereof shall be made in the sole and absolute discretion of my Executor. Distribution of such items may be made, in the sole discretion of my Executor, outright to, or, if applicable, in trust for, a beneficiary. ITEM IV. If my wife, EVELYN G. SAMPSON, survives me (and I direct that, for the purpose of this Item, she shall be deemed to have survived me, unless it appears unmistakably that she predeceased me), and if the federal estate tax due because of my death will ') 1'-/ I /?ffi'._ Y " 1. , / .' ...- /~ (/ /~L />/z z..-.~t.--;--eY J.-' be reduced by making this gift for her benefit, I give, devise, and bequeath to my Wife, EVELYN G. SAMPSON, absolutely, the least amount (based upon values as finally determined for federal estate tax purposes) as shall be needed for the federal estate tax unlimited marital deduction to reduce the federal estate tax to the lowest possible figure after full use of all other deductions and credits allowable in calculating the federal estate tax, except that such amount shall be calculated without regard to the augmenting of my taxable estate by reason of generation-skipping transfers, and without regard for any credit for state death taxes that would not otherwise be payable. Accordingly, I direct that: A. If the marital deduction, or any similar benefit, is allowable with respect to any property, including property held by entireties, which my Wife has received prior to my death, or at my death will receive otherwise than pursuant to this ITEM IV, the value of such property shall be taken into consideration in calculating the size of the gift under this ITEM IV. B. No property ineligible for the marital deduction, or any similar benefit, shall be distributed to this bequest for my Wife, pursuant to this ITEM IV. C. Either cash or investments or both may be allocated to this bequest under this ITEM IV. D. Any property allocated under this ITEM IV in kind shall be valued at the value at which it is finally included in my gross estate for federal estate tax purposes, provided that the aggregate market value thereof on the date of allocation (plus the value as finally determined for federal estate tax purposes of all other property qualifying for the marital deduction) is at least equal to the dollar value of the marital deduction as finally determined for federal estate tax purposes. E. If any provision of my will shall result in depriving my estate of the marital deduction for federal estate tax purposes, such provision is hereby revoked and my Will shall be read as if any portion thereof inconsistent with allowance of the marital deduction for federal estate tax purposes is null and void. ITEM V. I give, devise, and bequeath all the residue of my estate, not otherwise disposed of above, whether real, personal, or mixed, and wherever situate, including any property over which I shall have any power of appointment other than any such power given to me in any will or inter vivos trust of my Wife, to my Trustee, hereinafter named and defined, IN TRUST NEVERTHELESS, in a "Bypass Trust", for the following uses and purposes. A. My Trustee shall pay the net income therefrom to my Wife, 2 EVELYN G. SAMPSON, for and during her lifetime. However, if the income otherwise payable to my Wife shall at any time exceed the amount which my Trustee deems to be in her best interests (considering her other income and means of support known to my Trustee, induding any income from her other solely-owned assets, her needs, the desirability of augmenting her separate estate, and any other circumstances and factors deemed pertinent), my Trustee may accumulate the same and add it to principal, as my Trustee deems advisable, in my Trustee's sole and absolute discretion. B. My Trustee shall pay as much of the principal of this Trust as my Trustee, in its sole and absolute discretion, may from time to time think advisable for the support or medical care of my Wife, with such payments being made to her or else applied for her benefit by my Trustee, after taking into account her other readily available assets and sources of income and support. C. My Trustee may apply the funds in this Trust directly for the benefit of my Wife should she, by reason of age, illness, or any other cause in the opinion of my Trustee, be incapable of receiving or disbursing funds. D. Upon the death of my Wife, my Trustee shall distribute the remainder of the Trust pursuant to ITEM VI hereof. ITEM VI. Upon the death of my Wife after the Trust under ITEM V has become legally entitled to receive proceeds or has become established, or upon my death if my Wife has not survived me, then the principal and any undistributed income in the Trust, or the residue of my Estate, as appropriate, shall be devised or distributed as follows: A. Fifty (50%) percent of such residue or remainder outright to my son, RA YMOND A. SAMPSON, now of Boiling Springs, Pennsylvania, if he survives me by thirty (30) days; provided, however, that if my son should not so survive me, but leaves issue who do so survive me, then such issue of his shall receive, per stirpes, the share that he would have received had he so survived me. If my son should not so survive me and should not leave any such surviving issue, then my son's interest shall lapse, and such interest shall be distributed proportionately to the other beneficiaries named under this ITEM VI. B. Fifty (50%) percent of such residue or remainder outright to my son, ERIC J. SAMPSON, now of Stone Mountain, Georgia, if he survives me by thirty (30) days; provided, however, that if my son should not so survive me, but leaves 3 issue who do so survive me, then such issue of his shall receive, per stirpes, the share that he would have received had he so survived me. If my son should not so survive me and should not leave any such surviving issue, then my son's interest shall lapse, and such interest shall be distributed proportionately to the other beneficiaries named under this ITEM VI. ITEM VII. I direct that my Executor and Trustee shall be entitled to out-of-pocket expenses, and also to reasonable compensation, considering their efforts and involvement in the administration of my Estate or a trust, as applicable. ITEM VllI. The interest of beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation. ITEM IX. I hereby appoint my son, RAYMOND A. SAMPSON, to serve as the Executor of this, my Last Will and Testament. In the event that my said son is or shall become unable or unwilling to serve as Executor, then I nominate and appoint my other son, ERIC J. SAMPSON, to serve in his place and stead. I direct that the last nominated executor able or entitled to so serve as an Executor shall be entitled to nominate a successor to serve further as such Executor, with the same effect as though set forth by me in this Will. ITEM X. I hereby nominate and appoint my sons, RAYMOND A. SAMPSON and ERIC J. SAMPSON, to serve together in the capacity of Trustees (collectively, my "Trustee"). It is my desire that two such persons always shall serve together, each as a co-trustee, in the capacity of Trustee. In the event that my son, RAYMOND A. SAMPSON, is or shall become unable or unwilling to serve in such capacity as a co-trustee, then I nominate and appoint his son, R. JONATHAN SAMPSON, to be substituted in as Co-Trustee. In the event that my son, ERIC J. SAMPSON, is or shall become unable or unwilling to serve in such capacity as a co-trustee, then I nominate and appoint his son, MARK J. SAMPSON, to be substituted in as Co-Trustee. I further direct that in each instance in each line as set forth above, the last nominated Co-Trustee able or entitled to serve as such co-trustee shall be entitled to nominate a successor to serve further as such co-trustee, with the same effect as though set forth by me in this will. ITEM XI. I direct that my Executor and any Trustee shall not be required to give bond or post any other security for the faithful performance of their duties in any jurisdiction. ITEM XII. Any person, other than my Wife, who shall have died at the same time as me, or in a common disaster with me, or under such circumstances that it is difficult or impossible to determine who died first, shall be deemed to have predeceased me. ITEM XIII. My Executor and any Trustee shall have the following powers in addition to 4 those invested in them by law and by other provisions of my Will applicable to all property, whether principal or income, exercisable without Court approval, and effective until distribution of all property: A. To retain any investments I may have at my death so long as my Executor or Trustee may deem it advisable to my Estate or Trust so to do. B. To vary investments, when deemed desirable by my Executor or Trustee, and to invest in such bonds, common trust funds controlled by my Executor or Trustee, stocks, notes, real estate mortgages, or other securities or in such other property, real or personal, as my Executor or Trustee deem wise, without being restricted to so-called legal investments. C. In order to effect a division of the principal of my Estate or Trust or for any other purpose, including any final distribution, my Executor or Trustee is authorized to make said divisions or distributions of the personalty and realty party or wholly in kind. If such division or distribution is made in kind, said assets are required to be divided or distributed at their respective values on the date or dates of their division or distribution. D. To sell either at public or private sale and upon such terms and conditions as my Executor or Trustee may deem advantageous to my Estate or Trust, any or all real or personal estate or interests therein owned by my Estate or Trust severally or in conjunction with other persons or acquired after my death by my Executor or Trustee, and to consummate said sale or sales by sufficient deeds or other instruments to the purchaser or purchasers, conveying a fee simple title, free and clear of all trust and without obligation or liability of the purchaser or purchasers to see to the application of the purchase money or to make inquiry into the validity of said sale or sales; also, to make, execute, acknowledge, and deliver any and all deeds, assignments, options, or other writings which may be necessary or desirable, in carrying out any of the powers conferred upon my Executor or Trustee in this paragraph or elsewhere herein. E. To mortgage real estate, and to make leases of real estate for any period of time as is deemed reasonable by them. F. To borrow money from any party to pay indebtedness of mine, or of my Estate or Trust, expenses of administration, or inheritance, legacy, estate or other taxes. 5 ......~~........',.;~."";""""_","'"..,.,...._......~,,o,,~,'.~.~.;.., .4.,,' "'""""-~ct""~~'"'TO"payaii ~~sts:t~re~penses: and ~ha;~'1~~~~n~ectrC;~'wrthihe"-"" . administration of my Estate or Trust. My Executor shall pay expenses of my last illness and funeral expenses. H. To vote any shares of stock which form a part of my Estate or Trust, and to otherwise exercise all the powers incident to the ownership of such stock. 1. In the discretion of my Executor or Trustee, to unite with other owners of similar property in carrying out any plans for the reorganization of any entity whose securities form a part of my Estate or Trust. J. To compromise claims and to abandon any property which, in my Executor's opinion, is of little or no value. and})estament, consisting of 4!flelfll-l~ IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will -~~ C(f~_J typewritten pages, this ;241- day of ,1999. J/J / '7 )(~tvr~e-J (SEAL) YMOND J. AMPSON We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above-named Testatory, RAYMOND J. SAMPSON, as and for his Last Will and Testament, in the presence of us, who at his request and in his presence and in the presence of each other, have hereunto set our hands and seals the day and year first above written, and we certify that at the time of the execution thereof, the said Testator was of sound and disposing mind and memory . / . . /<) )1 ~ /~& / // '. 'i./"~ / . ~;1/ {/!"'Jti..-!2.; :;; (~ J1,U;?/.' ~'residing at tb ei!tLt~2-e-L /6( f "'/') /'71/ /":J' /// /j'k) / /. t.,. {t5 Y ,:,/~LP\.ji ?2/~trlL~ _/:/ ctlltt!_ residing at GEORGE M. HOUCK (\912-1991 ) Register of Wills Cumberland County Court House 1 Court Square Carlisle, P A 17013 Dear Register of Wills: CHARLES E. SHIELDS, III ATTORNE}:/\T-LAW 6 CLOUSER ROAD COniC;. of Trindle and Clollser Roads MECHANICSBURG, PA 17055 TELEPHONE (717) 766-0209 FAX (717) 795-7473 December 19, 2006 Re: Estate of Raymond J. Sampson No. 21-06-00394 Please find enclosed for filing 2 copies of the Inheritance Tax Return for the Raymond J. Sampson Estate as well as Check No.1 010, in the amount of $415.00 for additional probate, Check No.1 011 in the amount of$15.00 for the filing fee and Check No. 1012 in the amount of $430.66 for the Inheritance Tax due. Thank you for your kind attention to this matter. CES/mjj Enclosures Very truly yours, ~~. Charles E. Shields, III Attorney-At-Law C) f',,) 1-'::.:J c.:;::::} C""",\ C.::J rTj ~-') r-" o J.:'i"~ L, ~)