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Home My WebLink About07-26-07 ~ REV-1600 EX + (6-00) * w .... ~~Ul OD:~ wA-g ::r::~..J OA-D1 A- c( COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER II 06 COUNTY CODE YEAR SOCIAL SECURITY NUMBER 0380 NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Zugay, Vilma E. DATE OF DEATH (MM-DD-YEAR) I- Z LJJ o LJJ o LJJ o 04-11-2006 (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) [!] 1. Original Return o 4. Limited Estate [!] 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received 174-20-3667 DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPUCATE WITH THE 01-29-1927 REGISTER OF WILLS SOCIAL SECURITY NUMBER o D [!J D o 3. Remaindef Retum (date of death ptiof to 12-13-82) o 5. Federal Estate Tax Return Required o 8. Total Number of Safe Deposit Boxes o 11.Election to tax under Sec. 9113{A) (Attach Sch 0) 2. Supplemental Return 4a. Futura Intefest Compfomise (date of death aftef 12-12-82) 7. Decedent Maintained a Living Trust (Attach copy OfTNst) 10 Spousal PovertY Credit (date of daath between . 12-31-91 and 1-1-{l5) ... z w a z o A- U! W D: D: o o COMPLETE MAILING ADDRESS NAME Matthew J. Parker, Esq. FIRM NAME (If applicable) Marshall, Parker & Associates TELEPHONE NUMBER 570-321-9008 49 East Fourth Street, Suite 200 Williamsport, PA 17701 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 0 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 ) 20,497.28 372,430.64 0.00 z o t= :5 ::> I- 0:: <C o LJJ It: 11. Total Deductions (total Lines 9 & 10) (12) 12. Net Value of Estate (Line 8 minus Line 11) (13) 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 lax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) 372,430.64 0.00 16,759.38 0.00 0.00 16,759.38 20. D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 15.Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15) or transfers under Sec. 9116(a)(1.2) z 0 372,430.64 .045 (16) i= 16.Amount of Line 14 taxable at lineal rate x ~ ~ Q.. 17.Amount of Line 14 taxable at sibling rate 0.00 x .12 (17) ::E 0 0 18. Amount of Line 14 taxable at collateral rate 0.00 x .15 (18) x ~ 19. Tax Due (19) Form REV-1500 EX (Rev. 6-00; Copyright 2002 form software only The Lackner Group, Inc. d\.A ~ Decedent's Complete Address: STREET ADDRESS 251 Cumberland Road CITY Camp Hill ISTATE PA I ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 9,500.00 500.00 Total Credits (A + B + C) 3. InteresVPenalty if applicable D. Interest E. Penalty 297.54 TotallnteresVPenalty (0 + E) 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 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (1 ) 16,759.38 (2) 10,000.00 (3) 297.54 (4) (5) 7,056.92 (SA) (58) 7,056.92 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 ofthe property transferred;.................................................................................. 0 [!] b. retain the right to designate who shall use the property transferred or its income;.................................... 0 [!] c. retain a reversionary interest; or.................................................................................................................. 0 [!J d. receive the promise for life of either payments, benefits or care?.............................................................. 0 [!J 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?....................... ....... ..... ................................................................................... [!] 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?........ [!J 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?..................................................................................................................... [!J 0 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 penallies of perjury. I declare that I have examined this return, including accompanying schedules and statements. end 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. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS DATE cynthi~ Bell 557 Fishing Creek Road .c::!.. - Lewisberry, PA 17339 SIGNATUR OF P S ADDRESS DATE ADDRESS DATE SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE MatthewJ. Pa~Esq. ./7 L ~ cvVlt'A /: (-:' \.. V"'-.. 49 East Fourth Street, Suite 200 Williams port, PA 17701 .,,-~ -Or For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 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 0% [72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 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 4.5%, except as noted in 72 P .5. 99116 1.2) [72 P.S. 99116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% (72 P.S. 99116 (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-15D3 EX+ (6-98) *' SCHEDULE B STOCKS & BONDS COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Zugay, Vilma E. FILE NUMBER 21-06-0380 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 37 shares of MetUfe stock - See valuation calculations, 1.803.38 attached 2 50 shares of Prudential Financial stock - See valuation 3.780.00 calculations, attached TOTAL (Also enter on Line 2, Recapitulation) 5,583.38 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) rting Tools for Looking Up a Security's Exact Closing Price - BigC... 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No Compromises,@ Experience Trading at Your Level. Talk to someone who gets it T"Ik to C':hllr-J< Sz~~ ~r'v\~ Rev-16~ EX+ (6-98) *' SCHEDULE D MORTGAGES & NOTES RECEIVABLE C~~TH~P~N~WMAA INHERITANCE TAX RETURN RESIDENT DECEDENT Zugay, Vilma E. FILE NUMBER 21-06-0380 ESTATE OF All property jolntly-owned with right of llurvlvorshlp mUllt be dlllclOlled on Schedule F. ITEM NUMBER DESCRIPTION 1 Oral, cash loan made to son, Tom Zugay - Balance owed at time of death VALUE AT DATE OF DEATH 19,000.00 TOTAL (Also enter on Line 4, Recapitulation) 19,000.00 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule 0 (Rev. 6-98) , Rev-15GB EX+ (6-98) *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEAl. TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Zugay, Vilma E. FILE NUMBER 21-06-0380 ESTATE OF Include the proceeds of litigation end the dete the proceeds were received by the estate. All property jointly-owned with the right ot survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION 1 M& T Bank checking account No. 93229658 - See date of death value letter attached VALUE AT DATE OF DEATH 3.508.58 2 2000 Ford Focus - See appraisal attached 3.200.00 3 Com cast - Refund 17.02 4 HM Benefits Administrators, Inc. Cobra Admin. - Refund 272.82 5 MetLife - Dividend 21.83 6 State Farm Mutual Automobile Ins Co - Refund unearned premium 99.25 7 United States Treasury - Refund on tax return for tax year ending 12/06 30.00 8 United States Treasury - Refund on tax return for tax year ending 12/05 250.00 9 Verizon - Refund 22.33 10 West Shore A.L.S. - Refund 250.00 TOTAL (Also enter on Line 5, Recapitulation) 7,671.83 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) '--1 .LY;;I.UU.:&Ja.a..LI.~ ACCOUNT NO. ACCOUNT TYPE STATEMENT PERIOD PAGE 93229658 RELATIONSHIP CHECKING WITH INTEREST MAR.18-APR.19,2006 1 OF 2 00 0 06108M NM 017 17740 VILMA E ZUGAV 251 CUMBERLAND RD CAMP HILL PA 17011-6613 INTEREST PAID YEAR TO DATE 2.17 FAIRVIEW BEGINNING BALANCE OTHER CURRENT SUBTRACTIONS INTERESTPD NO. AMOUNT o 0.00 0.52 ENDING BALANCE 1,402.75 POSTING DATE ACTIVITY . DEPOSITS, INTEREST: & OTHER ADDITIONS: CHECKS & OTHER SUBTRACTIONS DAILY BALANCE 03-18-06 BEGINNING BALANCE 03-21-06 CHECK NUMBER 3952 03-22-06 CHECK NUMBER 3953 03-24-06 CHECK NUMBER 3954 03-28-06 CHECK NUMBER 3955 03-31-06 BETHLEHEM STEEL PN PMTS/BG 04-03-06 US TREASURY 303 SOC SEC 04-03-06 CHECK NUMBER 3958 04-03-06 CHECK NUMBER 3956 04-03-06 CHECK NUMBER 3959 04-05-06 CHECK NUMBER 3957 -05-06 UMBER 95.00 63.24 33.56 47.81 $6,913.93 6,818.93 6,755.69 6,722.13 6,674 . 32 6,774.32 100.00 1,134.00 7,710.49 3961 3963 04-14-06 CHECK NUMBER 3962 04-19-06 INTEREST PAYMENT 0.52 1,402.23 1,402.75 ENDING BALANCE $1,402.75 CHECKS · 'PAID SUMMARY 3952 3955 3958 3961 3964 03-21-06 03-28-06 04-03-06 04-14- 06 04-11-06 95.00 47.81 143.19 2,000.00 4,000.00 3953 3956 3959 3962 03-22-06 04-03-06 04-03-06 04-14-06 63.24 37.00 17.64 20.85 3954 3957 3960 3963 03-24-06 ~4-05- 06 04-05-06 04-14- 06 33.56 151.91 50.00 85.50 ANNUAL PERCENTAGE YIELD EARNED = 0.10 X Sc~ [ ~~j LDOSA (1103) fV . L.B. Smith Ford, Inc. 1100 Market Street · Lemoyne, Pennsylvania 17043 Phone: (717) 761-6700 or (800) 422-3673 · FAX: (717) 761-3951 Email: fords@lbsmith.com uJL~ -r:. ..,- I~ -(k fk-"--~! C r" s If. -1k- "20'>0 ;:::t:? /2J)<d F oC-U.f I FA FpsV 3:J y~ 4- 2- '7'1~~ ~ ~(tC~,J \ V.4-luL ~u J cF " Vlr1~ L...,...r L Tt--t /5 ~ 5' LtfP , ~tL T he Win n i n g Comb i n a t ion of S a I e san d S e r vie e 5c'~ e ~n.... ~ . Rev-1S09 EX+ (6-98) *' SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAlI RETURN RESIDENT DECEDENT Zugay, Vilma E. FILE NUMBER 21-06-0380 ESTATE OF If an asset was made Joint within one yaar of tha decedanrs date of death, It must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME A. Cynthia L. Bell ADDRESS RELATIONSHIP TO DECEDENT Daughter Lewisberry, PA 17339 B. C. JOINTLY OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR VALUE OF ASSET INTEREST DECEDENT'S INTEREST JOINTLY-HELD REAL ESTATE. 1 A 10/18/2004 Members 1st Federal Credit Union; 18.310.80 0.500% 9.155.40 Account No. 213270-05 - See Information Notice and Taxpayer Response form attached 2 A 5/20/2002 Members 1st Federal Credit Union; 5.141.51 0.500% 2.570.76 Account No. 213270-11 - See Information Notice and Taxpayer Response form attached TOTAL (Also enter on Line 6, Recapitulation) 11.726.16 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) COMMONWEALTH OF PENNSYLVANIA DEPA~TMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21 06-0380 06133004 07-07-2006 REV-l&~3 EX AFP lD9-DDl EST. OF VILMA E ZUGAY 5.5. NO. 174-20-3667 DATE OF DEATH 04-11-2006 COUNTY CUMBERLAND TYPE OF ACCOUNT IXJ SAVINGS D CHECKING D TRUST D CERTIF. CYNTHIA L BELL 557 FISHING CREEK RD LEWISBERRY PA 17339 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS 1ST FCU has provided the Department with the information listed below which has been used in calculating the potential taK due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this infonlation is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This" account is taKable in accordance with the Inharitance TaK Laws of the Co.monwealth of PennsYlvania. Questions may be answered by calling [7171 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 213270-05 Date 10-18-2004 Established Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x 18,310.80 50.000 9,155.40 .045 411 . 99 TAXPAYER RESPONSE To insure proper credi~ to your account, two (2) copies of this notice Bust accompany your paYBent to the Register of Wills. Make check payable to: nRegister of Wills, Agent". x NOTE: If taK payments are made within three (3) months of the decedent's date of death, you may deduct a S~ discount of the teK due. Any inheritance taK due will become delinquent nine (9) months after the date of death. Tax PART ill A. [ CHECK ] ONE BLOCK B. ONLY c. [] The ebove information and taK due is correct. 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check bOK nA" and return this notice to the Register of Wills and an official assessment will be issued by the PA Depertment of Revenue. ~he above asset has been or will be reported and taK paid with the Pennsylvania Inheritance TaK return to ba filed by the decedent's representative. [] The above information is incorrect and/or debts and daductions were paid by you. You must complete PART ~ and/or PART ~ below. PART I!] DATE PAID DEBTS AND DEDUCTIONS CLAIMED If you indicate a different tax rate, please state your relationship to decedent: PART [!J TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 5 6 7 X 8 PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line 5 of Tax Computation) that the facts I and belief. I $ correct and COMMONWEALTH OF PENNSYLVANIA oEPA~TMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 '* INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO.21 06-0380 06133005 07-07-2006 REV-1543 EX iFP [09-00) EST. OF VILMA E ZUGAY S.S. NO. 174-20-3667 DATE OF DEATH 04-11-2006 COUNTY CUMBERLAND TYPE OF ACCOUNT D SAVINGS [X] CHECKING D TRUST D CERTIF. CYNTHIA L BELL 557 FISHING CREEK RD LEWISBERRY PA 17339 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS 1ST FCU has providad the Departllent with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decadent, YOU were a joint owner/beneficiary of 'this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a COpy to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions may be answered by cal!~ng (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 213270-11 Date 05-20-2002 Established Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x 5,141.51 50.000 2,570.76 .045 115.68 TAXPAYER RESPONSE To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". x NOTE: If tax payments are made within three (3) months of the decedent's date of death, yoU may deduct a 57. discount of the tax due. Any inharitance tax due will become delinquent nine (9) Bonths after the dete of death. Tax PART ill A. [ CHECK ] ONE BLOCK B. ONLY c. r=J The above inforBation and tax due is correct. 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or yoU may check box "A" and return this notice to the Register of _ ~illS and an official assessment will be issued by the PA Department of Revenue. ~he. above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. r=J The above inforBation is incorrect and/or debts and deductions were paid by you. You BUSt complete PART ~ and/or PART ~ below. PART [!] DATE PAID DEBTS AND DEDUCTIONS CLAIMED If you indicate a different tax rate, please state your relationship to decedent: PART ~ TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF 1 2 3 4 5 6 7 8 x TAX ON JOINT/TRUST ACCOUNTS x PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line 5 of Tax Computation) I $ perjury, I declare that the facts I have reported above are true, correct and my knowledge and belief. de, \ Rev.161D EX+ (6.98) . SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Zugay, Vilma E. FILE NUMBER 21-06-0380 This schedule must be completed end filed ff the answer 10 any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM DE:SGRIP IluN OF PRUI-'I:.K I Y DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE THE DATE OF TRANSFER. ATTACH A COpy OF THE DEED FOR REAL ESTATE. 1 Croatian Fraternal Union of America; 133,290.81 133,290.81 beneficiaries all five of her children; Robert W. Zugay, Michele M. Schwartz, Cynthia L. Bell, Douglas M. Zugay and Thomas J. Zugay - Annuity No. 905486; see date of death value letter attached 2 M& T IRA (Certificate of Deposit) Account No. 27,404.83 27,404.83 0174203667; beneficiaries all five of her children; - See date of death value letter attached 3 Old Mutual Financial Network; beneficiaries all 60,250.91 60,250.91 five of her children; - Annuity No. 03047685; see date of death value letter attached 4 Real estate located at 251 Cumberland Road, 127,000.00 127,000.00 Camp Hill, PA; - Owned by the Zugay Family Trust; and sold 6/30/06 5 Cash gift to daughter, Cynthia L. Bell - March, 4,000.00 3,000.00 1,000.00 2006 TOTAL (Also enter on Line 7, Recapitulation) 348,946.55 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA.1500 Schedule G (Rev. 6-98) . 100 DELANEY DRIVE / PITTSBURGH, PENNSYLVANIA 15235-5416 EDWARD W. PAZO National Secretary/Treasurer 412/843-0380 FAJ<:412/823-1594 June 28, 2006 L-13 Marshall Parker & Associates 49 East Fourth Street, Suite 200 Williamsport, PA 17701 RE: Vilma E. Zugay Cert. #905486 Dear Ms. Drawbaugh: In answer to your inquiry concerning the date of death value of the above-captioned certificate, please know the amount was $133,290.81. Hopefully, this satisfies this inquiry, but should you have further questions, please advise my office. with my best wishes, I remain ::~~ National secretartJTreasurer EWP/dms @) S~~ C- '-b~ :::.:.: J. V J1.UL.& . 11~1~~!~I:lllh~::I~~~~~l!lr.{~~m~~~*l ~j1i1~1~~~~~~~rI'~I~i1~H:IT::!:1 174-20-3667 0174203667 INDIVIDUAL RETIREMENT' ACCOUNT M&T BANK AS TRUSTEE FOR i,1lli::~~~~1IT:fim~~~~lt~~~~f,~~~~~~~~:I!:~~1:1~~:~;; ij~~~4~~~~tt:~I:~ 01-01-06 to 04-17-07 1 M&T TELEPHONE BANKING CTR PO BOX 767 BUFFALO, NY 14240 800-829-1924 CSW337021l VILMA f: ZUGAY 557 FISHING CREEK RC LEWISBERRY PA 173399509 IWf;"~\N.~.Qi.1l"~_I''''': 16-0538020 ..~....l.:"""___'.'IM~, 1~~J.~~ii__~~~lIl 0 1- 29- 2 7 ACCOUNT NO 35-004201329594 ACCOUNT TYPE 60-72 MONT~S RATE 2.970 MATURING 02-28-08 REGULAR IRA 01-01-06 BEGINNING BALANCE 27,913.58 o - S 06-22-06 INTEREST 06-22-06 TRANSFER OUT TO BENEFICIARY . 56.16 27,660.33- , . 27,660.33 .00 BEGIN PLAN BAL PLUS DEPOSITS NET INTEREST LESS DEDUCTIONS PLAN 27,913.58 .00 464.46 28,378.04 SUMMARY DISBURSEMENTS FED TAX WITHHELD ST TAX WITHHELD TOTAL PLAN VALUE 717.71 .00 .00 .00 2006 IRA CONTRIBUTION INFORMATION THE FOLLOWING IS YOUR FORM 5498 TOTALS. BECAUSE THE AMOUNTS ARE ZERO, NO REPORTING TO THE I.R.S HAS OCCURRED BOX 1 - IRA CONTRIBUTIONS IN 2006 OR 2007 FOR 2006 BOX 2 - 2006 ROLLOVER CONTRIBUTIONS BOX 5 - FAIR MARKET VALUE OF PLAN AT END OF 2006 0.00 0.00 0.00 L007 (11,00) '~C;-\4J>k~ :>- . "".,., .(..UUU U-J. UU f.1.fU...J.L..JL..J..J I HL-LJU I #/ r ... . OLD MUTUAL J Ffll/.U.lCIAL NnWORK i FIlEUTY3GUARANfVIFf DI4II Mutllt! "It~l.l N.twelk , I'1lllll.ll'YlllI.IAIWm'J,nllFNlWVQftK P,O. BOlt Il2ll68 I ~t"-'lIC~UPI!.~ Linc;g\n. m 685D, i "~I ? .MII, ru:C.tl'l'l- I ~ ) t - C q I ~ 3dv qq A-M :4itf\ Jeffrey Fratz S KactyCt Sww 101 Mechanicrburg P A 17055 May 1, 2006 Polioy~ Owner: Annu.itant; 0304768:5 Vilma Zupy Vilmil Zupy - Dear Mr. Fratz: We hive been notified of the death of the poliqr owner. We msh to convey OUT sinoere sympathy to the famUy in their tWent loss. Our records indicate that Cynthia Bell. daughter, Michele Schwartz, daughter, Douglas Zugsy, BO.1'l, Robert ZugaY. son, and Thomas Zugay. son,. an! the beneficiaries of this policy. The approximate benefit amount is $60,393. The benefit atnOUOt 0,", 4/11106 wu $60,250.91. The bendiGiaries may choose only "me ofthe following 2 settlement options; J. LumD SlIm l.a~t - the beneficiary will receive s lingle lump awn paymcmt of the policy ,P1'oceeds throuih an F&G Life Asset Account. The personal AsBet AccOtlnt is an interest bearing checking account es.tablis"d in. the beneficiary's name. The tccOUn.t oun'cntly earns i1:lterest at a rate "f 2.5%. We will :mail tbe beneficiary a personalized Chtckbook. To acctSs the fimds~ the beneficiary simply writes a check. We will also send the b~Gci8.t'Y .nloD.th1y sta:teln&nt$ for the DOOount, just like a bank. It'~.. ,-' convenient way to keep track of tbe :fiu1ds. ~ftft~tHHls will IlUtomtltktdl.F be patti hi (J btmp sum "nk~ yqlf. cumplete the election forms dnoribetl btlbw. . 2. ~):"yr Ueferral ... the beneficiaty must fully amender and ~e wtlotdbl,(l.ion or ~b~ prooeec:ts wltht'Q. 5 ycm of the poltey owner's cleati,l (5 years from December 31 of the calendar year in which the policy owner died for tmr qUI1H.fied p1an~)_ If e1eoting 'tb.is option, plell~ complete and mum the enelosed. S-Year Deferral Form. The bencfi.ctiaries will a1$O J.\ee4 to eomplcrte and/or provide the following: www.omfn.com ~~ C ~/'I. '3 /24/2006 09:00 7176913299 TALBOT - . . 2~9~M12X~M ; CHef Mulu.1 r....MI.' ~Jk I p.o. 11m: Qll&Il I.fncol1'l, NUt501 ! PH UM.102.Z"" I FIlm.Ir'i' . ew.rwny l.FI! I'IllI!I.lTY & lfUAlWlT'f ~ llf' .....'f0ltK ^ItfiCCMLI'li&A~ 1. Claimant's Statement, having the beneficiary's signa.ture wrJ'NESSED. 2. ~ed Death Certificate (a photocopy i3 NOT acceptable) 3. QrisWal Policy (if the oriainal policy ill lost or has been misplaced, ple~ make a note oftbie on your olaim fcmn) 4. IRS W-4P Form A44i1i0Dal periodic pa:ym.ent BettlemeAt options d~bed in the policy may aleo be available to the beneficiBries. Please contact OW' office if you are interested in more information about tb.ose lIett1ement ~ti012A. Some policies apply :mrrender charges to lump sum distributions or distributions made under tho ~.yvar deferral option. PleUe refer to the policy for more infol'lDatlon, A self.. ~ return en"clope is enclosed for your convcmence. If you should have any q'Ue5tiozw, feel free: to QDl\*=t out offic$ at 1.866-102-2194., e.1d:f!ddOlk J4128. SinCloly, April Dam=! C1alq &mnim:r Fidelity & Oaanzlty Life Insurano. Company www.a...fn.1II0m t-'AI.:lt. t:J,j/t:J.:l ,w'" ....r. II B. TYPE OF LOAN 1. 2. FMHA 3. CONY. UNINS. 4. 0 VA 5. 0 CONY. INS. 6. ESCROW FILE NUMBER: 7. LOAN NUMBER: 00063159-001 RRH 11629607 U,S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SIiTTLEMENT STATEMENT Aftiliated Settlement Sevices Group, LLC 3912 Market Street Camp Hill, PA 17011 (717) 975-7839 FINAL 6. MORTGAGE INSURANCE CASE NUMBER: :. NOTE: This form is fumished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(P. O. C.)" _Ill paid outside the closing; they alll shown helll for informational purposas and are not included in the totals. I. NAME OF BORROWER: ADDRESS OF BORROWER: Joseph M. Punch 4338 Winfield Street Harrisburg, PA 17109 Roger W. Zugay and Cynthia L. Bell 251 Cumberland Road Camp Hill, PA 17011 M & T MortQaQe Corp. P.O. Box 1288 Buffalo, NY 14203 251 Cumberland Road Camp Hill, PA 17011 Cumberland County 13-24-0797-031 Parcel # 13-24-0797-031 Affiliated Settlement Sevices Group, LLC 3912 Market Street, Camp Hill, PA 17011 6130/2006 PRORATION DATE: NAME OF SELLER: ADDRESS OF SELLER: NAME OF LENDER: ADDRESS OF LENDER: PROPERTY LOCATION: I. SETTLEMENT AGENT: PLACE OF SETTLEMENT: SETTLEM ENT DATE: SUMMARY OF BORROWER'S TRANSACTION K. 6130/2006 DISBURSEMENT DATE: SUMMARY OF SELLER'S TRANSACTION 6/3012006 01. Contract Sales Price 02. Personal Property 03. Settlement charges to Borrower (line 1400) 04. 05. 127,000,00 401. Contract Sales Price 402. Personal Property 4,798.04 403. 404. 405. ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE: 406. Ci fTown Taxes 227.30 407. County Taxes 06130/06 to 12/31/06 408. Assessments 409. 410. 411. 412. 413. 414. 415. 132,025.34 420. GROSS AMOUNT DUE TO SELLER: 127,000.00 ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE: 06. C' fTown Taxes 07. Count Taxes 06130/06 10 12/31/06 06. Assessments J9. 10. 11. 12. 13. 14. 15. 20. GROSS AMOUNT DUE FROM BORROWER: 227.30 127,227.30 ~. ~ :J.jhl~"llr:.1"i il" _:\u I~J; '11~11~1~~f~t:I-I.::Jr-I~S!~~~\(I..~~1 - .[111; I^Iful~lc 1l.S~1.clr'JI Jl~H~lf'i1 l!~J;~~li2IJill~~~ -. _ ~ . ~ ~ i l1. DeposU or eamest money l2. Principal amount of new loan(s) l3. Exisling loan(s) taken subject to )4. l5. lB. l7. l6. 19. ADJUSTMENTS FOR ITEMS UNPAID BY SELLER: 10. CnyfTown Taxes 11. County Taxes 12. Assessments 13. 14. 15. 16. 17. 16. 19. 20. TOTAL PAID BYIFOR BORROWER: 5,000.00 501. 27,000.00 502. 503. 504. 505. 506. 507. 506. 509. ADJUSTMENTS FOR ITEMS UNPAID BY SELLER: 510. Cit fTown Taxes 511. County Taxes 512. Assessments 513. 514. 515. 516. 517. 516. 519. Excess deposit (see instructions) Settlement charges to Seller (line 1400) Existing loan(s) taken subject to Payoff of first mortgage loan Payoff of second mortgage loan 9,516.00 32,000.00 520. TOTAL REDUCTIONS IN AMOUNT DUE SELLER: 9,516.00 rl f!1,B1Jn~11$H~~~tl'j~~l&'lr.J_CJLillii.l;Jj)j,1;l\~ ~~ 1];~~I_"\\il$1f.~ll:~flJ,~}I~~)~;~ _ - - ~ -- ~__~ 1 )1. Gross amount due from Borrower ( line 120) )2. Less amount paid bylfor Borrower ( line 220) 13. CASH ( IRJ FROM) ( 0 TO) BORROWER: 132,025.34 32,000.00 100,025.34 601. Gross amount due to Seller Cline 420\ 602. Less reduction in amount due Seller Cline 520\ 603. CASH (0 FROM) (IX! TO) SELLER: 127,227.30 9,516.00 117,709.30 ::5c~ G ~ ~ ETTLEMt:N I l;HAK .t:::; " . sf' S BASl!OD ON PRICE$ 127,000.00 @ DIVISION OF COMMISSION (LINE 700) AS FOLLOWS: 701. $ 3.635.00 to ERA-NRT. INC. 702. $ 3.765.00 to John Glise. Inc. Realtor 703. Commission paid at settlement 704. Transaction Fee to Glise/ERA NRT 6.000%= $7,620.00 , K PAID FROM BORROWER'S FUNDS AT SETTLEMENT PAID FROM SELLER'S FUNOSAT SETTLEMENT 125.00 7,620.00 125.00 'i)); !J@,mj';^\v1,:lli!'_~L~~=1i,TiJg)~a{[I~I1\?l,JII . -- - J;lm&=. =~ -.~ - -- :. - -:-- ; 601. Loan Origination Fee 602. Loan Discount Fee % to M & T Mortgage Corp. 603. Appraisal Fee 604. Credit Report B05. Lenders Inspection Fee 806. Mortgage Insurance Application Fee B07. Assumption Fee BOB. Tax Service Fee to First American RETS B09. Flood Cert Fee to First American FDS Bl0. Application Fee to M & T Mortgage Corp. Bl1. -See attached for breakdown 135.00 "1 InJ.;!&l.,::l'1<;,ll!J;!;:[oJ"\" i:J.'lrJj; ""Aft; r;~lli.1II1 '.',1'. :11'1" . . '. ",,' . . .' .' .' . i 76.00 6.00 100.00 747.50 901. Interest From 06130106 to 07101/06 @ $5.0B56/day 902. Mortgage Insurance Premium for Month(s) to 903. Hazard Insurance Premium for Years(s) to 904. 905. % ( days) 5.09 !LII 1;!..~;1;~jI.:l",'~J2J~:.~0~ij_~} ~jq.~li.!l~llliE~i - ~ - - _ ~ - - - - _ - I J01. Hazard Insurance J02. Mortgage Insurance J03. City Property Taxes J04. County Property Taxes J05. Annual Assessments J06. J07. J06. monlhs 0 $ monlhs @ $ monlhs @ $ monlhs @ $ monlhs @ $ manllls @ $ monlhs @ $ manllls @ $ per month per month per month 37.56 per month per month per month per month per month ('TI11lJl~~t~~LJ~{;l~ -- ~- ~ - ~ - - ~ - - ~~2~-- - ~_ "--~-~=--~-=~---~--; 101. Settlement or closing fee 102. Abstract or title search 103. Title examination 104. Title insurance binder 105. Document preparation 106. Notery fees to SettlemenVClericaVNotary 107. Attomey's Fees (includes aboYe nems numbers: lOB. Tille Insurance to Affiliated Settlement Services Group,LLP (includes aboYe noms numbers: 109. Lenders coverage $ 27,000.00 110. Owne(s coverege $ 127,000.00 111. Endrs. (100, 300, B.l) to Affiliated Settlement Services Group,LLP 112. Insured Closln Letter to GT&T 113. Ovemiaht Fees to Affiliated Settlement Services Grouo,LLP 30.00 22.00 B94.38 150.00 35.00 30.00 !O1. 3B.50 Mortgage $ 86.50 Release $ 102. Deed $ 1,270.00 Mort a e $ !O3. Deed $ 1,270.00 Mort a e $ 104. '05 105.00 1,270.00 1,270.00 27.00 ~ffir :~J~j""J"jJ~1 ~i ~;"'1hl~-I~.'nr'~J~I,;;F!:fu!:J ~- - - I. <o,f" _ -~ - ~ _~ -- 1 101. Survey 102. Pest Inspection 103. Document Trans/Wire Fee to Affiliated Settlement Services GrouP,LLP 40.00 lO4. 2006/07 School Tax to Bonnie K. Miller 961.57 l05. Tax Cert. Reimb. to Affiliated Settlement Services Group,LLP 10.00 106. Sewer & Trash 7/1 to 9130 to Lower Allen Twp Sewer Authority 65.50 107. Home Warranty to AON Home Warranty Services, Inc. 429.00 100. TOTAl SETTLEMENT CHARGES (Enter on Ine 103.SectionJ - 8Ild- Hno 502, Section K) 4,79B.04 9,518.00 1\'8 C8l8fully revle"",d the HUD-1 SetUement Statement and to the best of my knowledge and belief. It is a true and accurate statement of all receipts and disburaements made on my :aunt or by me in this transaction. I further certify that I have received 8 copy of the HUD-1 SetUement Statement ;'~'J// ~ Roger W. Zugay 80rrowers CY~~ Z ./J ~ Sel~rs m...,ftCh I have prepared Is 8 true and accurate ac:count of thiatransaction r have caused <<wlB cause the funds to be disbursed nl accordance WIth thiS ~ Settlement Agent ~/<;o /CJ6 Dale men Sevlces Group. LLC I listed Se ~RNING: It is . crine to knowingly make fajse statements to the United States on this or any simlar form. Penalties upon conviction clln include 8 fine and imprisonment For datals see; .18 U.S. Code Section 1001 and Secllon 1010. ;.row Nl;lmber. 00063159-001 RRH UD 811 DETAILED BREAKDOWN OF ITEMS PAYABLE IN CONNECTION WITH LOAN Total as shown on HUD page 2 Line #811 Buyer Amount 195.00 50.00 67.50 400.00 35.00 747.50 Description 12. Processing Fee to M & T Mortgage Corp. 13. Property Valuation Fee to M & T Mortgage Corp. 14. Escrow Waiver fee to M & T Mortgage Corp. 15. Doc/Prep Fee to M & T Mortgage Corp. 16. Clerical Closing to M & T Mortgage Corp. UD 1200 DETAILED BREAKDOWN OF GOVERNMENT RECORDING AND TRANSFER FEES Buyer Seller Amount Amount ~02. City & County Tax/Stamps City TaxlStamps: Deed $1,270.00 Total as shown on HUD page 2 Line #1202 1,270.00 Buyer Seller Amount Amount !03. State Tax/Stamps Slate TaxlStamps: Deed $1,270.00 Total as shown on HUD page 2 Line #1203 1,270.00 OREV_1151 EX+ (12-99) *' SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Zugay, Vilma E. Debts of decedent must be reported on Schedule I. FILE NUMBER 21-06-0380 ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 5,467.24 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City State Zip - Year(s) Commission paid 2. Attorney's Fees 3,902.03 See continuation scheduJe(s) attached 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 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 10,878.01 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 20,247.28 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) . Rev-1602 EX+ (6-98) . SCHEDULE H.A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Zugay, Vilma E. FILE NUMBER 21-06-0380 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Defense Distribution Depot Susquehanna - Funeral luncheon 637.50 2 Weis Markets - Food for gathering after the funeral 99.14 3 Wiedeman Funeral Home - Funeral services 4.730.60 Subtotal 5.467.24 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) . Rev-1602 EX+ (6-98) *' SCHEDULE H.B2 ATTORNEY'S FEES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Zugay, Vilma E. IFILE NUMBER 21-06-0380 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Marshall, Parker & Associates - Attorney's Fee per Contract 3.500.00 2 Marshall, Parker & Associates - Costs advanced reimbursed; Cumberland County ROW, probate fee $140.00; The Sentinel, legal advertising $137.03; Cumberland County Law Journal, legal advertising $75.00; toll calls, photocopies, faxes and postage $50.00; 402.03 Subtotal 3.902.03 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B2 (Rev. 6-98) . Rev-1602 EX+ (6-98) . ESTATE OF . SCHEDULE H.B7 OTHER ADMINISTRATIVE COSTS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Zugay, Vilma E. FILE NUMBER 21-06-0380 ITEM NUMBER AMOUNT DESCRIPTION 1 Certified mail to Croatian FU - Claim forms 6.56 2 Certified Mail to F&G Life Insurance - claim forms 6.08 3 Closing costs associated with sale of real estate at 251 Cumberland Road, Camp Hill, PA; - See settlement statement attached 9.476.00 4 Comcast - Cable 47.81 5 Cumberland County ROW - Filing Inheritance tax return and Inventory 30.00 6 Cumberland County ROW - Filing fee for Family Settlement Agreement 20.00 7 Harrisburg Pharmacy - Co-pay prescriptions 38.20 8 Health South - Patient pay obligation 33.14 9 Jay R. Gerber - Fee for prepration of 2006 tax return 35.00 10 PA American Water - Final water bill 112.22 11 Postage - For acknowledgements 15.60 12 PPL - Final electric bill 49.43 13 Reimburse Rob Zugay for out of pocket - Repair items for house 487.65 14 Reimburse Tom Zugay for out of pocket - Repair items for house 256.76 15 UGI - Final gas bill 96.01 16 Verizon - Final phone bill 167.55 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) B TYPE OF LOAN 1. 2. FMHA CONV. UNINS. 4. 0 VA 5. 0 CONV. INS. 6. ESCROW FILE NUMBER: 7. LOAN NUMBER: 00063159-001 RRH 11629607 U.6. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SIiTTLEMENT STATEMENT Affiliated Settlement Sevices Group, LLC 39"12 Market Street Camp Hill, PA 17011 (717) 975-7839 FINAL S. MORTGAGE INSURANCE CASE NUMBER: :. NOTE: This folT11 is furnished to give you a statement 01 actual settlement costs. Amounts paid to and by the settlement agent are shown. Iiams marked "(Po O. c.)" WB'" paid ou/side the closing; thay a'" shown he", for infolT11a6onal purposes and ara not included in the totals. ). NAME OF BORROWER: NAME OF SELLER: Joseph M. Punch 4338 Winfield Street Harrisburg, PA 17109 Roger W. Zugay and Cynthia L. Bell 251 Cumberland Road Camp Hill, PA 17011 M & T MortQaQe Com. P.O. Box 1288 Buffalo, NY 14203 251 Cumberland Road Camp Hill, PA 17011 Cumberland County 13-24-0797-031 Parcel # 13-24-0797-031 Affiliated Settlement Sevices Group, LLC 3912 Market Street, Camp Hill, PA 17011 6/3012006 PRORATION DATE: 6/3012006 DISBURSEMENT DATE: 6/3012006 ADDRESS OF BORROWER: ADDRESS OF SELLER: . NAME OF LENDER: ADDRESS OF LENDER: PROPERTY LOCATION: I. SETTLEMENT AGENT: PLACE OF SETTLEMENT: SETTLEMENT DATE: SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 01. Contract Sales Price 02. Personal Property 03. Settlement charges to Borrower (line 1400) 04. 05. 127,000.00 401. Contract Sales Price 402. Personal Property 4,798.04 403. 404. 405. 127,000.00 ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE: 06. CltyfTown Taxes 07. Coun Taxes 06130106 to 12/31106 08. Assessments 09. 10. 1L 12. 13. 14. 15. 20. GROSS AMOUNT DUE FROM BORROWER: ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE: 406. Cit fT own Taxes 227.30 407. County Taxes 06130106 to 12131106 408. Assessments 409. 410. 411. 412. 413. 414. 415. 132,025.34 420. GROSS AMOUNT DUE TO SELLER: 227.30 127,227.30 J) i"b2J:)J]I;~I.; JJ.l! ~i]( ~; 1~l1j.:1, r jJrlSll8:1;~~{q\J.'l?~~ ~ - l..ii.UJ ,a3}1illclI1LSi~JCW~lifollJ/~[-lnI:; %,~~~ - ~ ~~ ~ --~ 1 J1. Deposit or eamest money J2. Principal amount of new loan(s) J3. Existing loan(s) taken subject to J4. )5. J6. J7. J8. J9. ADJUSTMENTS FOR ITEMS UNPAID 8Y SELLER: 10. CltyfTown Taxes 11. County Taxes 12. Assessments 13. 14. 15. 16. 17. 18. 19. 10. TOTAL PAlO BYIFOR BORROWER: 5,000.00 501. 27,000.00 502. 503. 504. 505. 506. 507. 508. 509. ADJUSTMENTS FOR ITEMS UNPAID BY SELLER: 510. Clt fTown Taxes 511. County Taxes 512. Assessments 513. 514. 515. 516. 517. 518. 519. Excess deposit (see instructions) Settlement charges to Seller (line 1400) Existin9 loan(s) taken subject to Payoff of first mortgage loan Payoff 01 second mort9age loan 9,51 B.OO 32,000.00 520. TOTAL REDUCTIONS IN AMOUNT DUE SELLER: 9,518.00 .!J, ','.c'0;'~\]'~I'I~,'MI'~:l,.';~ln0)82.*ljj'!;3:1 - ~U 0t~'iiJ;Jt "0i'fiiilili)Zili.F'" iii!r1ili.!IJ.fj;[;~,L - - _ - -. . _"~ J )1. Gross amount due Irom Borrower ( line 120) )2. Less amount paid byllor Borrower ( line 220) )3. CASH ( K1FROM) ( 0 TO) BORROWER: 132,025.34 32,000.00 100,025.34 601. Gross amount due to Seller !line 420) 602. Less reduction in amount due Seller !line 520\ 603. CASH (0 FROM) (lliI TO) SELLER: 127,227.30 9,518.00 117,709.30 5c~ 1-\ '{Pi ~3 1~.~~1J::~J' '-'. . .. -- . :.- ~ ~.. =.'::: -..~,~-:~-:~~:" ~::~~"~'-~-=-._~n: -~:':.J 6.000%= $7,620.00 PAID FROM BORROWER'S FUNDS AT SETTLEMENT PAID FROM SELLER'S FUNDS AT SETTLEM ENT BASED ON PRICE$ 127,000.00 @ DIVISION OF COMMISSION (LINE 700) AS FOLLOWS: 701. $ 3,835.00 to ERA-NRT, INC. 702. $ 3.785.00 to John Glise, Inc, Realtor 703. Commission paid at settlement 704. Transaction Fee to Glise/ERA NRT 125.00 7,620,00 125.00 ''..' i1Ji!JZ.0r;j';;il{i,fu.ltItI,/[~i'Jlil,0il\l1i~])~ili . " _ .. T;jill~_ _ _' ~__ ..:. - __:--,:' _ - , 801. Loan Origination Fee 802. Loan Discount Fee % to M & T Mortgage Corp. 803. Appraisal Fee 804. Credit Report 805. Lenders Inspection Fee 806. Mortgage Insurance Application Fee 807. Assumption Fee 808. Tax Service Fee to First American RETS 809. Flood Cert Fee to FirslAmerican FDS 810, Application Fee to M & T Mortgage Corp. 811 . -See attached for breakdown 135.00 76.00 8.00 100.00 747.50 IIJ InJ$L1:~J;:J~!!J~lt::~1 ~:~J;!0".d;fFI.2't;j:~;:;,:ID.i!J~I"~l~ t~~l:t . _ I i':LCjl ( -_ ~- .- -- ] 901. Interest From 06130/06 to 07/01106 @ $5.08561dey 902. Mortgage Insurance Premium for Month(s) to 903. Hazard Insurance Premium for Years(s) to 904. 905. % ( days) 5.09 III l;,:;illl~~-'0~;l.,<;(:j('8~,\~11il~;111I~WPI3;l -" , - ~ - .. = ._ ; 001. Hazard Insurance 002. Mortgage Insurance 003. City Property Taxes 004. County Property Taxes 005. Annual Assessments 006. 007. OOB. months @ S months @ $ months @ S months @ $ months @ $ months @ $ months @ $ months@$ per month per month per month 37.58 per month per month per month per month per month .i '1 l~~L,sisfJ".l~,i~;::~ -~-- - - -_- --- --- -- 1;&*; - - ~- ~-~~--- ~-~- _ ; 101. Settlement or closing fee 1 02. Abstract or tllle seerch 103. Title examination 104. Title insurence binder 105. Document preparation 106. Notary fees to SattlemenllClericaVNotary 107. Attorney's Fees (includes above Items numbers: 108. Tille Insurance to Affiliated Settlement Services Group,LLP (includes above Items numbers: 109. Lenders coverage $ 27,000.00 110. Owne~s coverage $ 127,000.00 111. Endrs. (100, 300, 8,1) to Affiliated Settlement Services Group,LLP 112. Insured Closin Letter to GT&T 113. OverniQht Fees to Affiliated Settlement Services GrouD.LLP 30.00 22.00 894.38 15.00 150.00 35.00 30.00 201. 38.50 Mortgage $ 66.50 Release $ 202. Deed $ 1,270.00 Mort a e $ 203. Deed $ 1,270.00 Mort a e $ 204. 205 105.00 1,270.00 1,270.00 27.00 {lr~ j ,!2Jr,l~! ~]):I~~! 8Il-nJ~I~~h'J1f!Ej~t.F{Et~i - - - - -~ f;: ~/((~ - _ - - - - - ~ J 301. Survey 302. Pest Inspection 303. Document TranslWire Fee to Affiliated Settlement Services Group,LLP 40,00 304. 2006/07 School Tax to Bonnie K. Miller 961.57 305. Tax Cert. Reimb. to Affiliated Settlement Services Group,LLP 10.00 306. Sewer & Trash 71110 9/30 to Lower Allen Twp Sewer Authority 85.50 307. Home Warranty to AON Home Warranty Services, Inc. 429.00 400. TOTAL SETTLEMENT CHARGES (Enter on line 103 ,Section J - and - ino 502, Section K) 4,798.04 9,518.00 ave carefuly rev;evwtd the HUD-1 Settlement Statement and to the best of my knowtedge and belief. It is 8 true and accurate statement of sI receipts and disbursements made on my :Gun' or by me In this transaction. I further certify that I have received 8 copy of the HUD-1 SetUement Statement ;'~'7ff. ~ Roger W. Zugay Borrowers cy~~.;;Z fi ~ S~~rs ",.c:e propored Is a true and accurate accounl of this llansedion I ha"" caused", win caua. the funds to be dlabu...d " accord.nee ..111 thIS / SettlemenlAgent ~/~O /fJ6 Date en SeYlces Group, LLC I iliated Se ~RNING: It is . crime 10 knoY04nglymake hllse statements to the United States on this or 8ny simler form. Pendies upon conviction can i1cJude 8 fine and imprisonment For cletals see: Ie 18 U,S. Code Section 1001 and Section 1010. iCrow N~mDer: UUUt;;l1 o~-UUl KKH IUD 811 DE1AILED BREAKDOWN OF ITEMS PAYABLE IN CONNECTION WITH LOAN Total as shown on HUe page 2 Line #811 Buyer Amount 195.00 50.00 67.50 400.00 35.00 747.50 "Description 112. Processing Fee to M & T Mortgage Corp. 113. Property Valuation Fee to M & T Mortgage Corp. 114. Escrow Waiver fee to M & T Mortgage Corp. 115. Doc/Prep Fee to M & T Mortgage Corp. :16. Clerical Closing to M & T Mortgage Corp. IUD 1200 DETAILED BREAKDOWN OF GOVERNMENT RECORDING AND TRANSFER FEES Buyer Seller Amount Amount 202. City & County Tax/Stamps City Tax/Stamps: Deed $1,270.00 Total as shown on HUe page 2 Line #1202 1,270.00 Buyer Seller Amount Amount l03. State Tax/Stamps State Tax/Stamps: Deed $1,270.00 Total as shown on HUD page 2 Line #1203 1,270.00 Rev-1512 EX+ (5-98) ." *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Zugay, Vilma E. FILE NUMBER 21-06-0380 Include unrelmbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Marshall, Parker & Associates - Fee for meeting re planning VALUE AT DATE OF DEATH 250.00 TOTAL (Also enter on Line 10, Recapitulation) 250.00 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV-1613 EX+ (9-00) . SCHEDULE .. BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT NUMBER Zugay, Vilma E. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal Clistributions.l. and transfers under Sec. l1116(a)(1.2)] RELATIONSHIP TO DECEDENT Do Not L1et Truetee/e) FILE NUMBER 21-06-0380 SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) ESTATE OF I. Cynthia L. Bell 557 Fishing Creek Road Lewisberry, PA 17339 Michele M. Schwartz 914 Cedars Road Lewisberry, PA 17339 Daughter One-fifth of residuary estate Daughter One-fifth of residuary estate Douglas M. Zugay 362 Old Fort Road King Of Prussia, PA 19406 Son One-fifth of residuary estate Robert W. Zugay 8277 Sugarwood Drive Mechanicsville, VA 23116 Son One-fifth of residuary estate Thomas J. Zugay 27 Sussex Road Camp Hill, PA 17011 Son One-fifth of residuary estate Total Enter dollar amounts for distributions shown above on lines 5 through 18, as appropriate, on Rev 1500 cover sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) LAST WILL AND TESTAMENT OF VILMA E. ZUGAY LAW OFFICES MARSHALL & ASSOCIATES 303 ALLEGHENY STREET JERSEY SHORE, PENNSYLVANIA 17740 570-398-7603 @(Q)~" LAST WILL AND TESTAMENT OF VILMA E. ZUGAY I, VILMA E. ZUGAY, currently residing at 2395 Old Trail Road, York Haven, York County, Pennsylvania, 17370, declare that this is my Will and I revoke all other Wills and Codicils which I have made. ARTICLE 1 FAMll Y 1.01. IDENTIFICATION OF MY FAMilY. I declare that I am unmarried and that I have five children: ROBERT W. ZUGA Y, CYNTHIA L. BEll, DOUGLAS M. ZUGA Y, THOMAS J. ZUGA Y, MICHELE M. SCHWARTZ. 1.02. DEFINITION OF FAMILY TERMS. As used in this Will, the term "my children" refers only to the above-referenced children set forth in Paragraph 1.01. The term "my children" excludes all other persons. For purposes of inheritance from me, the "children" of an individual shall be interpreted to include persons who have been legally adopted by the individual but shall exclude stepchildren who have not been legally adopted. ARTICLE 2 PAYMENT OF DEBTS AND TAXES 2.01. PAYMENT OF DEBTS. I direct my Executor to pay all of my debts that my Executor in my Executor's sole discretion may allow as claims against my estate. 2.02. PAYMENT OF TAXES. I direct my Executor to payout of the principal of my residuary estate all inheritance, transfer, estate, and similar taxes (including interest and penalties), assessed or payable by reason of my death, on any property or interest in property which is included in my estate for the purpose of computing such taxes. My Executor shall not require any recipient of such property or interest in such property to reimburse my estate for taxes paid under this paragraph. ARTICLE 3 DISTRIBUTION OF ESTATE TO BENEFICIARIES 3.01. DISPOSITION OF PERSONAL EFFECTS. I may leave a separate memorandum, addressed to my Executor, which gives directions to my Executor as to the disposition of certain items of my personal effects. I desire that my Executor distribute those certain items of my personal effects in conformity with that separate memorandum. That separate memorandum shall not have the effect of modifying or revoking this Will. All of my personal effects which are not specified in the separate memorandum, and in the event that I do not leave such a separate memorandum, all of my personal effects I give to my children, to be divided among them in substantially equal shares as they shall agree. If no such agreement is reached within ninety (90) days after my death, then such personal effects shall be divided or sold in such manner as my Executor shall direct. The decision of my Executor in this regard shall be conclusive and binding on all persons interested in my estate. My Executor is authorized to represent minor beneficiaries in regard to any division of my personal effects in accordance with this paragraph. 3.02. DISPOSITION OF RESIDUARY ESTATE. I give all of the rest, residue, and remainder of the property that I own at the time of my death, both real and personal, of every kind and description, wherever situated, to which I may be legally or equitably entitled at the time of my death (my "residuary estate"), in equal shares to my children. In the event that my son, ROBERT W. ZUGAY, my daughter, CYNTHIA L. BELL, my son, DOUGLAS M. ZUGAY, or my son, THOMAS J. ZUGAY should fail to survive me, I direct that his or her share of my estate shall be paid as an addition to the shares of other beneficiaries of my residuary estate in proportion to their interests in my residuary estate. In the event that my daughter, MICHELE M. SCHWARTZ, should fail to survive me, then her share shall be paid to those of her children who survive me. If my daughter, MICHELE M. SCHWARTZ, should fail to survive me and leave no children who so survive me, then I direct that her share shall be paid as an addition to the shares of other beneficiaries of my residuary estate in proportion to their interests in my residuary estate. 3.03. TRUST FOR BENEFICIARIES WHO ARE UNDER THE AGE OF TWENTY-TWO (22). Any share of my estate which would otherwise pass to any beneficiary who is under the age of twenty-two (22) years of age, shall be held, by my Trustee, hereinafter named, IN TRUST, in accordance with the trust terms hereinafter set forth. The Trustee shall hold the trust assets in separate shares for each of my beneficiaries who are under the age of twenty-two (22) years and administer and distribute each said share as follows: a. Until the beneficiary attains the age of twenty-two (22) years, the Trustee shall pay to or apply for the beneficiary's benefit in quarterly or other convenient installments so much of the net income and, if the net income is insufficient, so much of the principal, up to whole thereof, of the beneficiary's share of the trust estate as the Trustee in the Trustee's sole discretion deems advisable for the beneficiary's proper care, support, maintenance, and education. The Trustee shall accumulate and add to the principal of the beneficiary's share of the trust estate the undistributed portion of any net income of the share at the end of the year. b. When the beneficiary attains the age of twenty-two (22) years, the Trustee shall be required to distribute to such beneficiary all of the balance of his or her share of the trust estate. c. If the beneficiary should die prior to attaining the age of twenty-two (22) years, then on the death of such beneficiary the Trustee shall distribute all of the undistributed balance of the beneficiary's share of the trust estate in accordance with the beneficiary's Will if the beneficiary dies testate or to the heirs-at-Iaw of the beneficiary if the beneficiary dies intestate. 2 ARTICLE 4 FIDUCIARIES 4.01. EXECUTOR. I appoint my daughter, CYNTHIA L. BELL, to be Executor of my estate. In the event that my daughter, CYNTHIA L. BELL, is unable or unwilling to act or continue as Executor, for any reason whatsoever, then I appoint my son, ROBERT W. ZUGA V, to be Executor of my estate. 4.02. TRUSTEE. I appoint my daughter, CYNTHIA L. BELL, as Trustee of any trust created pursuant to this Will. In the event that my daughter, CYNTHIA L. BELL, is unable or unwilling to act or continue as such, for any reason whatsoever, I appoint my son, ROBERT W. ZUGA Y, as Trustee of any trust created pursuant to this Will. 4.03. GUARDIAN OF THE ESTATES OF MINORS. I appoint my daughter, CYNTHIA L. BELL, to be Guardian of the Estate for any minor beneficiaries of my estate. In the event that my daughter, CYNTHIA L. BELL,is unable or unwilling to act or continue as such, for any reason whatsoever, I appoint my son, ROBERTW. ZUGAY, to be Guardian. Appointment as a Guardian of the Estate of a minor under this Will shall include guardianship of the proceeds of any life insurance on my life payable to such minors and any other property, rights, or claims which passes to a minor, either under this Will or otherwise, with respect to which I am authorized to appoint a Guardian and have not otherwise specifically done so. The Guardian shall have the power to use principal as well as income from time to time for the minor's support and education (including college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support and education, or to make payment for these purposes, without further responsibility, to the minor or to the minor's parents or to any person taking care of the minor. 4.04. WAIVER OF BOND. None of the Executors, Guardians, or other Fiduciaries named in this Will shall be required to furnish bond for the faithful performance of his or her duties. ARTICLE 5 POWERS OF FIDUCIARIES 5.01. POWERS OF FIDUCIARIES. My Executors, Trustees, Guardians and their successors (hereafter sometimes jointly referred to in the singular as the "Fiduciary"), shall have the following powers in addition to those vested in them by law and by other provisions of my Will, applicable to all property, whether principal or income, including property held for minors, exercisable without court approval, and effective until actual distribution of all property: a. To retain and continue to hold any or all of the assets of my estate, real or personal, including any shares of stock or other securities I may own without restrictions to investments authorized for Fiduciaries, as they deem proper, without regard to any principle of diversification or risk. b. To invest in all forms of real and personal property (including, without limitation, stock, option, or other securities, common trust funds, and mortgage investment funds), without 3 restriction to investments authorized for Fiduciaries, as the Fiduciary shall deem proper, without regard to any principle of diversification or risk. c. To sell at public or private sale, to exchange, or to lease for any period of time, any real or personal property and to give options for sales, exchanges or leases, with such prices and upon such terms or conditions as the Fiduciary deems proper. d. To allocate receipts and expenses to principal or income or partly to each as the Fiduciary from time to time thinks proper. e. To borrow from, or to sell to, any of my Fiduciaries even though the Fiduciary is my Trustee, Executor, or Guardian. f. To exercise any law-given option to treat administrative expenses either as income or as estate tax deductions, without regard to whether the expenses were paid from principal or income. g. To exercise, respecting securities held by my estate or any trust or guardianship estate, all the rights, powers, and privileges of an owner, including, without limitation, the power to vote, give proxies, and to pay assessments and other sums deemed by the Fiduciary to be necessary for the protection of the estate. h. To continue and operate, to sell or to liquidate, as the Fiduciary deems advisable, at the risk of the estate, any business or partnership interests received by my estate or any trust or guardianship estate. i. To sell for cash or on deferred payments at public or private sale, to exchange, and to convey any property of the estate. j. On any division of an estate into separate shares or trusts, to apportion and allocate the assets of the estate in cash or in kind, or partly in cash and partly in kind, or in undivided interests in the manner deemed advisable in the discretion of the Fiduciary; after any division of the estate, the Fiduciary may make joint investments with funds from some or all of the several other shares or trusts, but the Fiduciary shall keep separate accounts for each share or trust. k. To abandon any asset or interest therein in the discretion of the Fiduciary. I. To lease any real or personal property of an estate for any purpose for terms within or extending beyond the duration of the estate. m. To manage, control, improve, and repair real and personal property belonging to any estate. n. To employ attorneys, investment advisers, accountants, brokers, tax specialists, and any other agents deemed appropriate in the discretion of the Fiduciary, including persons associated 4 with or employed by any Fiduciary, and to pay from the estate reasonable compensation for all services performed by any of them. o. To procure and carry at the expense of the estate or trust insurance of the kinds, forms, and amounts deemed advisable by the Executor or the Trustee against any hazard. p. To compromise, submit to arbitration, release with or without consideration, or otherwise adjust claims in favor of or against any estate; to commence or defend litigation affecting the estate or any property thereof as deemed advisable by the Fiduciary. q. To pay all taxes, assessments, compensation of the Fiduciary, and all other expenses incurred in the collection, care, administration, and protection of the estate. r. To do all the acts, to take all the proceedings, and to exercise all the rights, powers. and privileges which an absolute owner or the property would have, subject always to the discharge of Fiduciary obligations; the enumeration of certain powers in this Will shall not limit the general or implied powers of the Fiduciary and the Fiduciary shall have all additional powers that may now or hereafter be conferred by law or that may be necessary to enable the Fiduciary to administer the estate in accordance with the provisions of this Will, subject to any limitations specified in this Will. ARTICLE 6 MISCELLANEOUS PROVISIONS 6.01. MISCELLANEOUS PROVISIONS. a. As long as any income or principal to which any beneficiary under my Will may be entitled remains in the possession of my Fiduciaries and is not actually distributed to the beneficiary, such income or principal shall not be subject to anticipation or alienation by the beneficiary, by assignment, or by any other means (except as specifically authorized herein), and it shall be free and clear of the beneficiary's debts and obligations and shall not be taken, seized, or attached by any process whatsoever. b. No person dealing with my Fiduciaries shall be bound to see to the application of any purchase money or other consideration or to inquire into the validity, necessity, or propriety of any transaction to which my Fiduciaries may be a party. c. Whenever appropriate in this Will, the singular shall be deemed to include the plural and vice versa; and the masculine shall be deemed to include the feminine, and vice versa, and each of them to include the neuter, and vice versa. d. For all purposes hereunder, the word "property" shall be deemed to include real and personal property and any interest of any kind in any real or personal property; the word "estate" shall be taken to include probate, trust, and guardianship estates and any of them, and the word "give" shall be taken to include the words "devise" and "bequeath" wherever appropriate in order to effectuate the testamentary transfer of real or personal property. 5 e. For all purposes hereunder, the terms "Executors," "Trustees," "Guardians," and "Fiduciaries," and the singulars thereof, shall apply, respectively, to those who are then entitled and qualified to act as such, whether originally appointed, remaining, substituted, or succeeding. 6.02. FORM OF DISTRIBUTIONS. If my Executor or other Fiduciary is at any time required to make any distribution to a beneficiary who is a minor, or is an incapacitated person, or is a person whom the Fiduciary in his or her or their sole discretion deems unable to handle funds properly or wisely if paid directly to the beneficiary, the Executor or other Fiduciary in his or her or their sole discretion may make payments in anyone or more of the following ways: a. Directly to the beneficiary, or to the duly appointment agent under power of attorney for the beneficiary; b. To the natural Guardian or legally appointed Guardian of the Person or Estate of the beneficiary; c. By making expenditures directly for the care, support, maintenance, or education of the beneficiary; d. To any person or organization furnishing care, support, maintenance, or education for the beneficiary; e. To any custodial parent of a minor beneficiary; f. Directly to creditors in payment of the debts and expenses of the beneficiary; g. To a custodian for the beneficiary under any law related to gifts or transfers to minors, including to my Executor in that capacity. The Executor or other Fiduciary shall not be required to see to the application of any funds paid or applied in any of the aforementioned ways and the receipt of the payee shall be full acquittance. The decision of the Executor or other Fiduciary with regard to the selection of which of the aforementioned methods should be used in making payments shall be conclusive and binding on all parties concerned. The Executor or other Fiduciary is hereby authorized to retain and hold and manage assets for such reasonable period of time as may be required to facilitate distributions to or for the benefit of a beneficiary pursuant to this Article of my Will. Provided, however, the Executor or other Fiduciary shall not exercise the powers granted in this Article of my Will in any manner which would result in disallowance of a marital deduction for inheritance or federal estate tax purposes with regard to any share of my estate to be distributed to my spouse. 6.03. TERMINATION WHEN CONTINUATION UNECONOMIC. Should the principal of any trust created herein become so small, in the Trustee's sole discretion, as to make continuance of the trust uneconomic or inadvisable, the Trustee may make immediate distribution of the then remaining principal and any accumulated or undistributed income outright to the person or persons and in the proportions 6 then entitled to income. Upon such termination, the rights of all persons who might otherwise have an interest as succeeding income beneficiary or in remainder shall cease. If any person entitled to receive distribution is a minor, or is under the age of 21 years, or is incapacitated, the Trustee may, at the Trustee's option and in the Trustee's sole discretion, pay the fund to the parent or Guardian of the beneficiary, or, with respect to a minor, the Trustee may deposit the funds in a savings fund account in the minor's name payable to the minor at majority, or, with respect to a person under the age of 21 years, the Trustee may make a transfer to a custodian for the beneficiary acting pursuant to the Pennsylvania Uniform Transfers to Minors Act (Title 20 Pennsylvania Consolidated Statutes, Chapter 53) or the similar law of another state to be held by the custodian for the beneficiary pursuant to the terms of said Act. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 11 th day of February, 2002. ";?!1) cfl C) - 'VICMA~UGAY d ~? Signed, sealed, published, and declared by the above-named, VILMA E. ZUGAY (the "Testator"), as and for the Testator's Last Will in the presence of us and each of us, who, at the Testator's request and in the Testator's presence and in the presence of each other, have hereunto subscribed our names as witnesses thereto the day and year last above written. residing at 1537 Oakmont Drive Williamsport. PA 17701 S.lMi~~ at ~ residing at 2104 Royal Avenue Williamsport, PA 17701 7 COMMONWEALTH OF PENNSYLVANIA : SS COUNTY OF L YCOMING I, VILMA E. ZUGAY, Testator whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. 4.J!-14^ , 6' '? / '~ VILMA E. ZUGJW - d )- Sworn to and subscribed before me by VILMA E. ZUGAY, the Testator, this 11th day of February, 2002. Q m ~(iAA VU-A . Notary Public NOTARIAL SEAL PATTI Jo TURNEH, NOTAflY PUBLIC JERSEY SHollE BORo, lYCOM/NG co.. PA MY COMMISSION EXPIRES MAY 13, 200i COMMONWEALTH OF PENNSYLVANIA : SS COUNTY OF L YCOMING We, JEFFREY A. MARSHALL and SUSAN A. HAGEMEYER, the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testator sign and execute the instrument as the Testator's Last Will; that the Testator signed willingly and executed it as the Testator's free and voluntary act for the purpose therein expressed; that each of us in the hearing and sightofthe Testator signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more years of age; of sound mind and under no constraint or undue influence. Sworn to and subscribed before me by JEFFREY A. MARSHALL and SUSAN A. HAGEMEYER, witnesses, this 11th day of February, 2002. ~Q)jAl ~A A vuA Notary Public NOT AHlAl SEAL PATTI Jo lURNEH, NOlAHY PUBLIC JERSEY SHORE BORo, LYCoMING W. PA. MY COMMISSION EXPIRES MAY 13. ?Oll? 8 . ' IRREVOCABLE TRUST AGREEMENT ZUGAY FAMILY TRUST VILMA E. ZUGAY S ETTLO R AND ROBERT W. ZUGAY AND CYNTHIA L. BELL, CO- TRUSTEES LAW OFFICES MARSHALL & ASSOCIATES 303 ALLEGHENY STREET JERSEY SHORE, PENNSYLVANIA 17740-1405 570-398-7603 IRREVOCABLE TRUST AGREEMENT This Trust Agreement entered into this 21st day of March, 2002, by VILMA E. ZUGAY, who currently resides at 2395 Old Trail Road, York Haven, York County, Pennsylvania, 17370, hereafter referred to as "Settlor," A N D ROBERTW. ZUGAY, who currently resides at 8277 Sugarwood Drive, Mechanicsville, Virginia, 23116 and CYNTHIA L. BELL, who currently resides at 557 Fishing Creek Road, Lewisberry, Pennsylvania, 17339, as co-Trustees of the Trust. The co-Trustees are hereafter sometimes referred to in the singular as the "Trustee." ARTICLE 1 CREATION OF TRUST ESTATE 1.01. NAME OF TRUST. The name of the Trust will be the ZUGAY FAMILY TRUST. 1.02. TRANSFER IN TRUST. The Settlor hereby transfers the property listed in Schedule A of this Trust Agreement to the Trustee and acceptance of this property is hereby acknowledged by the Trustee. The Settlor may transfer additional property to the Trust. Said property and all other property transferred to and received by the Trustee to be held pursuant to this Trust shall constitute the "Trust Estate" and shall be held, administered, and distributed by the Trustee as hereinafter provided. 1.03. ADDITIONS TO THE TRUST ESTATE. The Settlor, either during life or by Will, or any other person shall have the right at any time to add property acceptable to the Trustee to this Trust. Such property, when received by the Trustee, shall become part of the Trust Estate. 1.04. MANAGEMENT OF TRUST INVESTMENTS. The person or persons serving in the capacity of Trustee may in writing designate one of said persons or a third person of his or their choosing to act as the authorized agent of the Trustee for purposes of performing investment and other property management decision making and services and exercising the Fiduciary powers specified in this Trust Agreement. ARTICLE 2 IRREVOCABILITY OF TRUST 2.01. IRREVOCABILITY OF TRUST. The Settlor hereby expressly acknowledges that the Settlor shall not have any right or power, either alone or in conjunction with others, or in any capacity whatsoever, to alter, amend, modify, revoke, or terminate this Trust or any of the terms of this Trust .. Agreement in whole or in part, or otherwise to cause any of the principal of the Trust to revert to the Settlor or to the Settlor's estate or to the creditors of the Settlor or the creditors of the Settlor's estate. ARTICLE 3 DISTRIBUTIONS BV THE TRUSTEE WHILE SETTLOR IS LIVING 3.01. NET INCOME TO SETTLOR. While Settlor is living, the Trustee shall pay to or apply for the benefit of the Settlor, in quarterly or such other convenient and reasonable installments as the Settlor shall require, all of the net income from the Trust Estate, unless otherwise directed by the Settlor. Capital gains are to be deemed principal and not income for purposes of distribution from this Trust and are not distributable to Settlor and must be retained by the Trust and added to principal. 3.02. INVASION OF TRUST FOR THE CHILDREN OF THE SETTLOR. While the Settlor is living, the Trustee, if so directed by the Distribution Committee as specified in Article 7.01 hereinafter, shall make such distributions of such amounts from the Trust Estate, up to the whole thereof, as the Distribution Committee in its sole discretion may from time to time determine and direct; provided, however, that any such distributions may be made only to ROBERT W. ZUGA V, CVNTHIA L. BELL, DOUGLAS M. ZUGAV, THOMAS J. ZUGAV, and MICHELE M. SCHWARTZ, who are the children of the Settlor, and to no other persons. The Distribution Committee may authorize the Trustee to make distributions to one or more of the said children of the Settlor in unequal amounts and to exclude one or more of the others of them from such distributions. In no event may any distributions of trust principal be made to or for the benefit of either the Settlor or to the Settlor's estate or to the creditors of the Settlor or the creditors of the Settlor's estate, nor to or for the benefit of any spouse of the Settlor. ARTICLE 4 MANAGEMENT OF TRUST UPON DEATH OF SETTLOR 4.01. DISPOSITION OF TRUST ESTATE UPON THE DEATH OF THE SETTLOR. Upon the death of the Settlor, the Trustee shall pay all debts and expenses aoolicable to the Trust estate including state and federal death taxes applicable to the Trust's assets, Trustee and attorney's fees, and all appropriate Trust administration expenses. The Trustee is not authorized and shall not pay any of the Settlor's debts, and specifically shall not make payment or repayment to any person or entity or government body in regard to any debt or claim arising from Medicaid, Medical Assistance, SSI, or in regard to any other public or governmental benefits paid to or on behalf of Settlor. After payment of the trust expenses allowed under this Article, and subject to the provisions of Article 4.02 of this Agreement, the Trustee shall thereupon distribute all ofthe remaining principal and accumulated income of the Trust in equal shares to the Settlor's children, ROBERT W. ZUGA V, CVNTHIA L. BELL, DOUGLAS M. ZUGA V, THOMAS J. ZUGA V, and MICHELE M. SCHWARTZ (the "remainder beneficiaries" of the Trust estate). 2 , A. In the event that any of the following of the Settlor's children, ROBERT W. ZUGA Y, CYNTHIA L. BELL, DOUGLAS M. ZUGAY, or THOMAS J. ZUGAY, should be deceased at the time of distribution his or her share of the Trust estate shall be paid as an addition to the shares of the other then living remainder beneficiaries of the Trust estate, in proportion to their interests in the Trust estate. B. In the event that the Settlor's daughter, MICHELE M. SCHWARTZ, should be deceased at the time of distribution, her share of the Trust estate shall be paid to those of her children who are then living. 4.02. SPECIAL POWER OF APPOINTMENT. The provisions of Article 4.01 hereinabove notwithstanding, the Settlor reserves the power, exercisable at any time or from time to time, by written instrument delivered to the Trustee during the Settlor's lifetime or by a provision in the Settlor's Will or any Codicil thereto making express reference to this power, to appoint any part or all of the principal or income of the Trust fund, outright or upon trusts, conditions or limitations among the foHowing persons: ROBERT W. ZUGA Y, CYNTHIA L. BELL, DOUGLAS M. ZUGA Y, THOMAS J. ZUGA Y, and MICHELE M. SCHWARTZ, the children of the Settlor, and the children of the aforesaid children of the Settlor; provided, however, that the power specified in this Article 4.02 shall not for any reason be used to the benefit of the Settlor, the Settlor's creditors, the Settlor's estate, or the creditors of the Settlor's estate, nor for the benefit of any spouse of the Settlor. Unless within thirty (30) days after the death of the Settlor, the Trustee has actual notice of the existence of a Will or other writing wherein this special power of appointment was exercised, it shall be deemed for all purposes hereunder that such power of appointment was not exercised. ARTICLE 5 GENERAL ADMINISTRATIVE DIRECTIONS 5.01. PAYMENTS FOR THE BENEFIT OF A BENEFICIARY. If at any time any beneficiary entitled to receive income or principal from the Trust Estate is a minor or an incompetent or a person whom the Trustee in the Trustee's discretion deems unable to handle funds properly or wisely if paid directly to the beneficiary, the Trustee in the Trustee's sole discretion may make payments in anyone or more of the following ways: a. Directly to the beneficiary; b. the beneficiary; To the natural Guardian or legally appointed Guardian of the Person or Estate of c. By making expenditures directly for the care, support, maintenance, or education of the beneficiary; or d. To any person or organization furnishing care, support, maintenance, or education for the beneficiary; 3 e. To a duly appointed Agent of the beneficiary authorized to receive such payments pursuant to a Durable Power of Attorney. The Trustee shall not be required to see to the application of any funds paid or applied in any of the aforementioned ways and the receipt of the payee shall be full acquittance of the Trustee. The decision of the Trustee with regard to the selection of which of the aforementioned methods should be used in making payments shall be conclusive and binding on all parties concerned. 5.02. CONFLICTING CLAIMS. Whenever there are conflicting claims as to the person entitled to any payment or distribution from the Trust Estate, the Trustee may in the Trustee's discretion withhold, without the payment of interest, all or any part of any disputed payment or distribution until the matter has been adjudicated and final judgment entered by an appropriate court. 5.03. SPENDTHRIFT PROVISIONS. No beneficiary or remainderman of any interest in any trust created by this instrument shall have any right to alienate, encumber, or hypothecate his or her interest in the principal or income of the Trust in any manner, nor shall any interest of any beneficiary or remainderman be subject to claims of his or her creditors or liable to attachment, execution, or other process of law. This article shall not restrict the exercise of any power of appointment specified in this Trust Agreement. 5.04. PHOTOCOPIES. Photocopies of this Trust Agreement shall have the same force and effect as the original and shall be accepted by any party as being of the same force and effect as the original. ARTICLE 6 POWERS OF FIDUCIARIES 6.01. POWERS OF FIDUCIARIES. The Trustee, and any successor Trustee, shall have the following powers in addition to those vested in them by law and by other provisions of this Trust Agreement, applicable to all property whether principal or income, including property held for minors or incompetents, which powers shall be exercisable without court approval, and shall be effective until actual distribution of all property: a. To invest in all forms of real and personal property (including, without limitation, stock, option, or other securities, common trust funds, and mortgage investment funds), without restriction to investments authorized for Fiduciaries, as the Trustee shall deem proper, without regard to any principle of diversification or risk. b. To pay all taxes, assessments, compensation of the Trustee, and all other expenses incurred in the collection, care, administration, and protection of any Trust Estate. 4 \ c. To sell at public or private sale, to exchange, or to lease for any period of time, any real or personal property and to give options for sales, exchanges or leases, with such prices and upon such terms or conditions as the Trustee deems proper. d. To allocate receipts and expenses to principal or income or partly to each as the Trustee from time to time thinks proper. e. To borrow from, orto sell to, any Fiduciary even though the Fiduciary is the Trustee, Agent, Guardian, or Executor. f. To hold property in the Trustee's name without designation of any Fiduciary capacity or in the name of a nominee or unregistered. g. To enter into transactions with other Fiduciaries including the Trustees or Executors of other trusts and estates in which any beneficiary under this instrument has any interest, and including themselves as Fiduciaries for other estates and trusts, and in such transactions to purchase property, or make loans or notes secured by property, even though similar property constitutes a large portion of the Trust property, and to retain any such property or notes as if they had been an original part of the estate or trust. h. To exercise, respecting securities held by the Trust Estate, all the rights, powers, and privileges of an owner, including, without limitation, the power to vote, give proxies, and to pay assessments and other sums deemed by the Trustee to be necessary for the protection of the Trust Estate. i. To continue and operate, to sell or to liquidate, as the Trustee deems advisable, at the risk of the Trust Estate, any business or partnership interests received by the Trust Estate. j. To sell for cash or on deferred payments at public or private sale, to exchange "and to convey any property of the Trust Estate. k. On any division of the Trust Estate into separate shares or trusts, to apportion and allocate the assets of the Trust Estate in cash or in kind, or partly in cash and partly in kind, or in undivided interests in the manner deemed advisable in the discretion of the Trustee. After any division of the Trust Estate, the Trustee may make joint investments with funds from some or all of the several shares or Trusts, but the Trustee shall keep separate accounts for each share or trust. I. To abandon any Trust asset or interest therein in the discretion of the Trustee. m. To grant an option involving disposition of a Trust asset and to take an option for the acquisition of any asset by the Trust Estate. 5 . , n. To lease any real or personal property of the Trust for any purpose for terms within or extending beyond the duration of the Trust. o. To manage, control, improve, and repair real and personal property belonging to the Trust Estate. p. To employ attorneys, investment advisers, accountants, brokers, tax specialists, and any other Agent deemed appropriate in the discretion of the Trustee, including persons associated with or employed by any Trustee, and to pay from the Trust Estate reasonable compensation for all services performed by any of them. q. To borrow money for any Trust purpose from any person, firm, or corporation, including one acting as a Trustee hereunder, on the terms and conditions deemed appropriate by the Trustee and to obligate Trust assets for repayment; to encumber the Trust or any property thereof by mortgage, deed oftrust or otherwise, using whatever procedures to consummate the transaction deemed advisable by the Trustee; and to replace, renew, and extend any encumbrance and to pay any loans or other obligations of the Trust deemed advisable by the Trustee. r. To procure and carry at the expense of the Trust insurance of the kinds, forms, and amounts deemed advisable by the Trustee against any hazard. s. To compromise, submit to arbitration, release with or without consideration, or otherwise adjust claims in favor of or against trust; to commence or defend litigation affecting the Trust or any property thereof as deemed advisable by the Trustee. t. To do all the acts, to take all the proceedings, and to exercise all the rights, powers and privileges which an absolute owner or the property would have, subject always to the discharge of Fiduciary obligations; the enumeration of certain powers in this Trust Agreement shall not limit the general or implied powers of the Trustee. The Trustee shall have all additional powers that may now or hereafter be conferred on the Trustee by law or that may be necessary to enable the Trustee to administer the Trust in accordance with the provisions of this Trust Agreement, subject to any limitations specified in this Trust Agreement. u. To pay all taxes, assessments, compensation ofthe Trustee, and all other expenses incurred in the collection, care, administration, and protection of any Trust Estate. v. To make loans from the corpus of the trust on such reasonable terms and conditions as the Trustee determines. w. To retain in the Trust for such time as the Trustee may deem advisable any property, including shares of the Trustee's own stock, notes, accounts, certificates, or other investments in which the Trustee has an interest, received by the Trustee from the Settlor, whether or not such property is of the character permitted by law for the investment of Trust funds, and to operate at the risk of the Trust Estate any business or property received by the Trustee from the Settlor. 6 " t.. ARTICLE 7 DISTRIBUTION COMMITTEE 7.01. DISTRIBUTIONS OF PRINCIPAL DURING LIFETIME OF SETTLOR BY DISTRIBUTION COMMITTEE. Settlor hereby nominates, constitutes, and appoints the following individual and/or individuals as a "Committee", (sometimes hereafter referred to as lithe Distribution Committee" or "the Committee"), with the powers and authorities hereinafter set forth: a. The initial members of the Committee shall be ROBERT W. ZUGA Y, the son of the Settlor, and CYNTHIA L. BELL, the daughter of the Settlor. b. Whenever in the sole judgment of a majority of the members of the Distribution Committee it is determined to be appropriate to make a distribution from the Trust Estate to one or more of the following persons: ROBERT W. ZUGA Y, CYNTHIA L. BELL, DOUGLAS M. ZUGA Y, THOMAS J. ZUGA Y, and MICHELE M. SCHWARTZ, the children of the Settlor, and the children of the aforesaid children of the Settlor (i.e. the grandchildren of the Settlor), the Committee is authorized to require the Trustee to make such distributions to anyone or more of the said persons as the Distribution Committee shall direct. Distributions from the Trust may not be made to or for the benefit of any persons other than those listed in this paragraph. Distributions need not be equal among the persons listed as potential distributees, and one or more of potential distributees may receive more or less in distributions than other potential distributees, as the Distribution Committee shall determine. 7.02. ADDITIONAL PROVISIONS RELATED TO THE DISTRIBUTION COMMITTEE. a. Any member of the Committee may resign in the manner provided hereinafter. b. There shall be two (2) members of the Committee at all times. If at any time a member of the Committee becomes incapacitated or resigns, or fails or ceases to act or continue as member of the Committee for any reason whatsoever, then the remaining member of the Committee shall by an instrument in writing name a successor member of the committee. Such instrument in writing shall be delivered to the Trustee or the successor Trustee provided that the failure to file or deliver such instrument shall not make it ineffective. The successor member of the Committee shall be MICHELE M. SCHWARTZ, the Settlor's daughter. Thereafter, in the event that, at any time, there are not two members of the Committee, the then living children of the Settlor (ROBERT W. ZUGAY, CYNTHIA L. BELL, DOUGLAS M. ZUGAY,THOMAS J. ZUGAY, and MICHELE M. SCHWARTZ), by majority vote, shall appoint such additional members of the Committee as may be required, provided that any successor member of the Committee shall be a person who is a child or other issue of the Settlor. c. A resignation of a member of the Committee or appointment of a member to the Committee shall be by instrument in writing and such instrument shall be delivered to the Trustee or the successor Trustee provided that the failure to file or deliver such instrument shall not make it ineffective. 7 . . ~ d. The incapacity, failure to act, resignation, or cessation of action of any person named herein as a member of the Committee shall be conclusively presumed by all persons upon presentation of a written statement executed by anyone of the following persons, ROBERTW. ZUGAY and CYNTHIA L. BEll and MICHELE M. SCHWARTZ, which certifies the said incapacity, resignation, failure, or cessation of action by the member. All persons shall rely upon such a certification and are hereby released from any and all liability of any nature in regard to the Trust Estate and the beneficiaries of the Trust resulting from the reliance on said certification. ARTICLE 8 MISCEllANEOUS PROVISIONS 8.01. MISCEllANEOUS PROVISIONS. a. Neither the Trustee nor any other person acting hereunder shall be required to give bond for the faithful performance of his duties in any jurisdiction. b. No person dealing with the Trustee, or the Trustee's successors or survivors, shall be bound to see to the application of any purchase money or other consideration or to inquire into the validity, necessity, or propriety of any transaction to which such Fiduciaries may be parties. c. Any Trustee shall be entitled at any time to seek a judicial settlement of accounts in any court of competent jurisdiction selected by my Trustee. As an alternative, the Trustee may at any time settle the account of the Trust or Trust share hereunder by agreement with the income beneficiary or beneficiaries of that Trust or Trust share who are not under any legal disability; and such agreement shall bind all persons whether or not then in being or sui juris, or then or thereafter entitled to any portion of the Trust or Trust share, and shall effectively release and discharge the Trustee for the acts and proceedings so accounted for. d. The Trustee shall be entitled to receive reasonable compensation. Any Trustee shall be entitled to be reimbursed for reasonable expenses it incurs which are necessary to carry out its duties as Trustee hereunder. e. Whenever appropriate in this Trust Agreement, the singular shall be deemed to include the plural and vice versa; and the masculine shall be deemed to include the feminine, and vice versa, and each of them to include the neuter, and vice versa. f. For all purposes hereunder, the word "property" shall be deemed to include real and personal property and any interest of any kind in any real or personal property; and the word "give" shall be taken to include the words "devise" and "bequeath" wherever appropriate in order to effectuate the transfer of real or personal property. g. For all purposes hereunder, the terms "Personal Representatives," "Committee Members," "Executors," "Trustees," "Guardians," "Agents," and "Fiduciaries," and the singulars thereof, 8 . shall apply, respectively, to those who are then entitled and qualified to act as such, whether originally appointed, remaining, substituted, or succeeding. The term "corporate Trustee," if used herein, shall mean a corporation which is in the business of acting as a Fiduciary and is duly authorized under the law of the situs of the Trust to serve as Trustee. h. The Trustee shall have the power, in the Trustee's discretion, to select assets to be sold by the Trust Estate for the payment of debts, and taxes in a manner that will minimize the recognition of gain for federal income tax purposes. The Trustee shall have the right to exercise any options and elections under the tax laws applicable to the Trust Estate as the Trustee determines should be made. No compensation adjustments between income and principal shall be made even though the elections may affect the interests of the beneficiaries. The action of the Trustee with respect to options and elections made shall be conclusive and binding upon all beneficiaries. i. There shall be no duty on the Trustee to payor see to the payment of any premiums on any policies of life insurance or to take any steps to keep them in force, until such time as the Trustee holds title to any insurance policies hereunder as a part of the corpus of any Trust Estate. The Trustee furthermore assumes no responsibility with respect to the validity or enforceability of said policies. However, as soon as practicable after receiving notice of the death of the insured under any of such policies, the Trustee shall proceed to collect all amounts payable thereunder. The Trustee shall have full and complete authority to collect and receive any and all such amounts and its receipt therefor shall be a full and complete acquittance to any insurer or payor, who shall be under no obligation to see to the proper application thereof by the Trustee. ARTICLE 9 ALTERNATE FIDUCIARIES 9.01. SUCCESSOR TRUSTEES. If either ROBERT W. ZUGA Y or CYNTHIA L. BELL should be unable or unwilling to act or continue as Trustee for any reason whatsoever, MICHELE M. SCHWARTZ shall become co-Trustee with full power and authority as specified herein. Thereafter, in the event that, at any time, there are not two persons serving as co-Trustees, the then living children of the Settlor (ROBERT W. ZUGA Y, CYNTHIA L. BEll, DOUGLAS M. ZUGA Y, THOMAS J. ZUGA Y, and MICHELE M. SCHWARTZ), by majority vote, shall appoint such persons to serve as co-Trustee as may be required. 9.02. DETERMINATION OF INCAPACITY, RESIGNATION, OR OTHER INABILITY OR UNWilLINGNESS TO ACT BY PERSON SERVING AS TRUSTEE. The inability or unwillingness of any person to act or continue as Trustee or co-Trustee shall be conclusively presumed for all purposes upon execution by anyone of the following persons of a written statement certifying the existence of said incapacity or unwillingness: ROBERT W. ZUGA Y, CYNTHIA L. BELL, and MICHELE M. SCHWARTZ. All persons shall rely upon such a certification and are hereby released from any and all liability of any nature in regard to the Trust Estate and the beneficiaries of the Trust resulting from the reliance on said certification. In the alternative, the inability of any person to act or continue as Trustee shall be 9 . . ~ conclusively presumed by all persons if a physician, duly licensed to practice in the Commonwealth or Pennsylvania or another of the United States, shall by written statement declare that in the physician's opinion the person is unable to serve as Trustee due to ill health, disability, incapacity, death, or for any other reason. All persons shall rely upon such a statement by said physician and the Settlor hereby releases all persons acting in reliance thereupon and any said physician from any and all liability of any nature in regard to the making or relying upon such a statement. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 21st day of March, 2002. tfJJ~ cfm VILMA E. ZUGA y ttl COMMONWEALTH OF PENNSYLVANIA : SS COUNTY OF L YCOMING ON THIS, the 21st day of March, 2002, before me a Notary Public for the Commonwealth of Pennsylvania, the undersigned officer, personally appeared VILMA E. ZUGAY, known to me to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same as the act of herself and the Principal for the purpose therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal. ?a.rT~ ~ ;j~ Notary Public NOT ARIAL SEAL 1 PATTI JO TURNER. NOTARY PUBLIC JERSEY SHORE BORO., lYCOM/NG CO MY COMMISSION EXPIRES MAY 13. 2002 My Commission Expires 10 . . ~ . SCHEDULE A ZUGAY FAMILY TRUST The following assets have been conveyed to the Trust this 21 st day of March, 2002. 1. Ten Dollars ($10.00). !~E.zut,~r:;77 By executing this Schedule A of the ZUGA Y FAMILY TRUST AGREEMENT, each of the persons named below agrees to accept the position of Trustee and further accepts the Trust assets hereby conveyed. ACCEPTED BY: ?~,b lk~ . ROBERT W. ZUG , c - ~ CY~L~~ 11 Register of Wills, Cumberland County, Pennsylvania INVENTORY Estate of Vilma E. Zugay No. 21-06-0380 . Deceased Date of Death 04111/2006 Social Security No. 174-20-3667 also known as Cynthia L. Bell The Pe-Iional Representatfve(S) of the above Estate, deceased, verify that the items appearing In the following Inventory Include all of the personal assets wherever situate and all of the real estate located In the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each Item of said Inventory represents Its fair value as of the date of the Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears In a memorandum at the end of this Inventory. I/We verify that the statements made In this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Firm: Personal Re resentative --7 A ~, Signature: L::~~ ~ --- Cjhihi8CBeiI - ~ ~ t 0 = ____~_______________~ Igna ure: C::o -.I : ,"--. :0 C-. H,J.-o c: lIO I . --~~93 I'J c{'J ;;;:;: 0"\ 00 ~~) Q --rl ~ Address: 557 Fishing Creek Road _J'::o _ Lewisberry, PA 17339}2 ~ .. Telephone: Matthew J. Parker, Esq. --_.._,~----_.__. ..-......-"..--.--- Attorney: Signature: _:_-' , J; (-..:--) -~-) ~'~-:J ",.J :-J o ,- C) :~q ( ) III I.D. No.: Marshall. Parker & Associates Address: 49 East Fourth Street, Suite 200 __Willia!"sp()_':l,_P ~~'7'701 570-321-9008 N Telephone: Dated: Personal ProDertv Cash............................................................................................... Personal Property.............................. ........... ..... ..... ........... ..... ...... Stocks/Listed................................................................................. Stocks/Closely Held...................................................................... Bonds.......... .,........... ...................... .... ..... ............ ... ..... ...... ..... ........ Partnerships and Sole Proprietorships ..................................... Mortgages and Notes Receivable............................................... All Other Property.................... ..... ........... .......... ..... ........... ..... ...... 3,508.58 4,163.25 5,583.38 19,000.00 Total Personal Property......................................... 32,255.21 Total Real Property................................................ Total Personal and Real Property......................... Total Out-of-State Real Property.......................... COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2B0601 HARRISBURG. PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT BELL CYNTHIA L 557 FISHING CREEK RD LEWISBERRY, PA 17339 ___~___w fold ESTATE INFORMATION: SSN: 174-20-3667 FILE NUMBER: 2106-0380 DECEDENT NAME: ZUGAY VILMA E DA TE OF PAYMENT: 07/26/2007 POSTMARK DATE: 07/25/2007 COUNTY: CUMBERLAND DATE OF DEATH: 04/11/2006 NO. CD 008456 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $7,056.92 I .f- I I I I I I I TOTAL AMOUNT PAID: REMARKS: CYNTHIA L BELL CHECK# 1018 SEAL INITIALS: DM RECEIVED BY: REGISTER OF WILLS $7,056.92 ... GLENDA FARNER STRASBAUGH REGISTER OF WILLS 49 East Fourth Street, Suite 200 Williamsport, PA 17701 570-321-9008 1-800-401-4552 www.paelderlaw.com MarshalJ, Parker ~,oc Williamsport, PA +JerseyShore, PA + Wi1lces-Barre, PA + Clarks Summi~ PA July 24, 2007 Register of Wills of Cumberland County Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 '" = = ~ c- c: r- N 0'" () So '0:" ::0 .JlJ .J:cO " ~ F;=; ~::D .....:-,.j ;;, .'(")0 Q11 '- . ::0 :-0-1 )> - .. Re: Vilma E. Zugay Estate " ::n:: Dear Sir/Madam: N Enclosed please find the following for recording at your office: 1. Original and two copies of the Pennsylvania Inheritance Tax return; 3. Original and one copy of the Inventory; 4. Filing fee of $30.00; 5. Tax due in the amount of $7,056.92; and 6. Self-addressed stamped envelope for your convenience in returning the recorded documents (marked "return") to our office. Please contact the undersigned if any additional information is needed. Very truly yours, MARSHALL, PARKER & ASSOCIATES, by: calhC~augh' Paralegal '.-1 r':.~'1 ':- -) '-~ ,i~ --;--1 , <:J C) .:::r"l -'I c.='S in