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HomeMy WebLinkAbout06-06-08 (3)15056051047 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue (;ounty Code Year File Number Bureau of Individual Taxes ~ INHERITANCE TAX RETURN ~ ~ - PO BOX 280601 Harrisburg PA 17128-0601 RESIDENT DECEDENT ~ ~ ~~} `S 'jJ ~' ENTER DECEDENT INFORMATION BELOW Social Security Numher Date of Death Date of Birth /~~ ~ 033dado 8 ©~~ ~~ 9 / ~ Dr~elent~ Last Name Suffix Decedent's First Name MI S~ YG a ~ ~ U~ ~c ~ K (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Secur+ty Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) ® 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust Q 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number }~ ~ ~ rt ~ ~ ~ S P A ~ ~ ~ ~ S o ~ 7 I `7 ;~ 3 ~' ~,,~ 7 ~f Firm Name (If Applicable) First line of address I i I ~ ~ ~ ~ d Second line of address City or Post Office I-~ {~ t- t~ I s 6 u ~ G- 5 i ~eei State ZIP Code ~ ~R +7~~a E ILLS USE`ONLY - • ~ C ~ _ > _ ..f~ _, 7 r~ I-C) I - '„ 1 o ~„ = ~~~ ~ - N DATE FILED ...~ Correspondent's a-mail address: ~ S~ I EACH ~ ~ ® ~14 ~-00, t?~ Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SI~p~G~G~~ ON fj~SP9~IBL FILING R TURN ~ _ DATE ADDRESS/~ ,~ / y ~~ ~~ ~~ ~ ~ `V ~.~~ Q /~/. G ~ V SIGNATURE OF PREPARER OTHER THAN REPRESEI~1ifFfIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 15056051047 15056051047 \~ J 15056052048 REV-150/0 EnX /I~, ~/ `/ Decedent's RE(:APITULATION 1. Real estate (Schedule A). 1 2. Stocks and Bonds (Schedule B) ....................................... 2. ~ ~ 7 / 7 ~ • ~ 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages & Notes Receivable (Schedule D) ............................. 4. • 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ........ 5. !~ '~ ~' ~ ~ • ~~ 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6. • 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested........ 7. 8. Total Gross Assets (total Lines 1-7) .................................... 8. ill 3~~(o•~t' 9. Funeral Expenses & Administrative Costs (Schedule H) ................... .. 9. / ~ ~ 1 ~ . -`~ r!G' 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............. .. 10, / ~ ~ `~ - ~) d 11. Total Deductions (total Lines 9 & 10) ................................. .. 11. ~ f p ~ l ~> 12:. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. '~ U / (~" ~ U • ~ (O 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ...................... .. 13. • 1~I. Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14. ~ U ~ (l~ `'7 v • 3 cp T~4X COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 1 `.i. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 1G. Amount of Line 14 taxable at lineal rate X .0 ~- ~ ~ Q ~ `f ' ~ • ~ ~ 16. ~ {~ O O Q ~ ` 17. Amount of Line 14 taxable 17 at sibling rate X .12 . ~ 18. Amount of Line 14 taxable / ~ U d 18. ~ ~~ O at collateral rate X .15 19 ~ ~~ ~•~ ~~ 19. ..................................................... TAX DUE. . ... / 2'0. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O ~~~ \„a ~ ~ ~\ ~~ ~~ ~~ ~ ~~,~ ~~ ~~ ~ ~ Side 2 15056052048 15056052048 REV-1500 EX Page 3 File Number ~ ~ ., v ~_ v ~ ~~ Decedent's Complete Address: UtGtUtN I'S NAMt /' STREET ADDRESS CITY l,, ( _ _ _ _ - _ ESC Y 1 l~ 1~1 1^~° sYJ v ~ ~j~- STATE ~j ZIP Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments - C. Discount 9~ ~ ~"L 3. Interest/Penalty if applicable D. Interest E. Penalty _ __ _ - Total Credits (A + B + C) (2) ~~ ~~ ~ Total Interest/Penalty (D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. 5. It 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. (3) (4) (5A) (5B) ~ 7i ~( 7/ . C~ Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.................................................................................... ...... ^ b, retain the right to designate who shall use the property transferred or its income : ...................................... ...... ^ []~ c. retain a reversionary interest; or .................................................................................................................... ...... ^ d. receive the promise for life of either payments, benefits or care? ................................................................ ...... ^ [~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ........................................................................................................ ...... ^ ~-,/ 1~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ........ ...... ^ , ~/ L~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which ,.~,/ contains a beneficiary designation? .................................................................................................................. ...... ^ L IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)J. For dates of deathh on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a;l (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling 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-150,3 E}:+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER ~~. R C L. ~ r4 ~ ~r ~ y ~ ~ ~ ylr -4 ~.-. ~ 1 - ~~ - v" ~v All property jointly-owned with right of survivorship must be disclosed on Schedule F. (If more space is needed, insert additional sheets of the same size) -P N N O O 00 n33o C ~ ° ^ z '~ d ~ N ^G ~ 3 a v. ~ N fi d 41 r* ~ d 3 ~ L' ~ ~ N . -r ~ ~ O - ' W r r °~~° ~ ~ c R r* ~ ~ 0~ 3 ~~ N 0 O ~ ~ ~S7 i3f ~ (Tp ~' d ~ ~ O H ~ ~ ~ ~ ~ N O fi~ ~ ~O C n O ( O ~ r ~ p a<aD N n N 7 O ~' O ~ ~ ~H .*pa~, 7 N ~ d ~ 3 ~ ~ ~ a m ~~ ~~N~ H ^ ~ o QI ~ Q1 ~ ~ m Q ~ ri -+ ~ro m'o ~ 1 O n ~ < O1 n m o~ 2 n~o - ~ ~ 6 3 --I ~ ~ ~ p rF3 ~ ~ N (!1 ~ O O rt v'Y+ ~ 3 N ~ ro N ~ N ro ~ m ° °~' °- c ~ ~, ~ H ff "M1 A 'D d n r m ~_ Z 0 rt n ~ = ~ ~ to ~ N 3 ,~ ~ 3 ~~ N r •a ~ ~ < Yi 6 v, ~ rt -* m 3 C Q n ~ r'1' O ro ~ + coy N °* p 3 .t ~~ ~- c ~~ o ~ a n ° ° ~ ~ ~ r ' i n ~ as io ~ Q~ ~ ^ ' n '~ ~ o ~ ~ ~ N ~ ~ "~ ~. 3 i ~ ~ a o ~ i • ~ t9 p N tD QD ' ~ A ~ ~= W r o ~ x ~ ~p N ~ W ~ O p O ~ O ~ ~ GO ~ ~ ~. O C . ~ ~ lD '~ Page z Wachovia Securities Account 7585-1872 WY38 Gracie K. Seygal Datc~ of Death: March 30, 2008 Quantity Security Price Value Common Stocks 2,250 Allied Irish Banks 43.56/42.03 42.47/41.62 42.42 95445.00 28o Dominion Resources Inc. 41.02/40.27 41.38/40.39 40.765 11,414.zo 40o PPL Corporation 46.09/45.51 47.04/45.74 46.095 18,438.00 60o UGI Corporation (New) 25.00/24.62 24.94/24.69 24.8125 14,887.50 Preferr ed Stocks 40o ASBC 7.b25% TOPRS Cap I 24.93/24.90 24.99/24.50 24.83 9932.00 40o Baltimore G & E 6.20% Pfd 22.go/22.64 22.92/22.58 22.76 g, 104.00 40o Bank of America 6.00% Tr 21.18/21.13 21.25/21.14 21.175 8,470.00 40o Bank New York 5.95% Pfd 21.85/21.40 21.75/21.48 21.62 8,648.00 40o CitiGroup Cap IX 6.00% Pfd 19.74/19.52 19.74/19.55 19.6425 7857.00 40o KeyCorp Cap 6.125% VI Pfd ig.78/19.42 ig.86/ig.59 ig.6625 7,865.00 20o FPC Cap Trust 7.10% Pfd 24.69/24.49 23.95/23.70 24.5625 4912.50 4oa FPL Grp Cap Tr 5.875% Pfd 23.99/23.65 23.95/23.70 23.8225 9529.00 20o ING Grp N.V. 6.125% Pfd 21.33/21.00 21.34/20.87 21.135 4227.00 40o PNC 6.125% Cap Tr D Pfd 21.84/21.56 21.92/21.68 21.75 8,700.00 40o Public Storage 6.60% Pfd 21.48/21.10 21.52/21.33 21.3575 8543.00 40o Public Storage 6.45% Pfd 20.68/20.55 20.87/20.34 20.61 8,244.00 40o SL Green Rlty 7.875% Pfd 2z.74/2z.52 23.08/22.53 22.7175 9087.00 40o Wells Fargo VIII 5.625 Pfd 22.1g/21.75 22.00/21.80 21.935 8774.00 Mutual Funds: Open-End 7,690.824 Franklin Income Fund - Class A 2.41 / 2.41 2.41 18534.89 799.677 Income Fund of America - Class A 17.88 / 17.86 17.87 14,290.23 2949.297 Lord Abbett Bond Debentu re - Cl A 7.57 / 7.57 7.57 22,326.18 682.430 Dryden High Yield Fund - Class A 5.25 / 5.27 5.26 3589.58 1,855729 Putnam High Yield Fund - Class A 7.35 / 7.36 7.355 13648.89 Mutual Funds: Closed-End z5a Eaton Vance Tax-Managed 16.10/15.85 15.94/15.70 15.8975 3974.38 1,000 Nuveen Qual Pfd Inc Fund 10.37/10.00 10.09/g.g8 loa i lo,i 10.00 PagE~ 3 Wachovia Securities Account 7585-1872 WY38 Gracie K. Seygal Date of Death: March 30, 2008 Quantity Security Price Value Corporate Bonds /Notes 10,000 Ford Motor Credit Corp 62.045 / 62.125 62.085 6,208.50 6.000% due 11/20/2014 (acc int} 218.33 10,000 General Motors Acceptance Corp 61.623 i 61.703 61.663 6,166.30 6.875% due x8/15/2016 (acc int} 87.85 10,000 General Motors Acceptance Corp 62.400 i 58.718 60.559 6,055.90 7.250% due 08/15/2018 (acc int) 32.22 10,000 Hartford Life Global Funding Notes g6.7o4 / 86.815 96.7595 9675.95 5.100% due o1/15/2015 (acc int) 107.67 10,000 LaSalle Funding LLC Notes 97.547 / 97•b6b 97.bo65 8,760.65 5.000% due 07/15/2015 (acc int) 105.56 Unit Investment Trusts 1,ooa Claymore C/E Preferred & Income 7.72 / 7.77 7.745 7745.00 Money Market Funds 18,953.03 Bank Deposit Sweep l.oo / l.oo l.o0 18,953.03 Total $ 405,668.3 i "This report has been prepared solely for informational purposes and does not supersede the proper use of your Wachovia Securities client statement, which is considered to be the only official and accurate record of your account. If there are any discrepancies between this and your Wachovia Securities client statement, please call your local branch manager." REV-~~<x , ~~-y» ~~, SCHEDULE E COMiMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. iNNERITANCE TAX RETURN PERSONAL PROPERTY nr_rnn[niT n[rrn[nir _ ESTATE OF' FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. VALUE AT DATE ITEM OF DEATH NUMBER DESCRIPTION ,. S o v ~ 2 e >• ~~'~CC. v<~ cK . r~~ r. ~ 3 3 ~ o ~ t~ 7~ I ~ ~1~ ~ ~ ~, 7d~ (,l9esfi S ~-~ PI,~Z r~ ~wtoy~e, ?P~ t~o~3 ~ . (.,t~ C~~-~fl a v ~ c~. J e c u ;~ , ~l e S +'Yl p rl~ ~~ ~G~ t~ ~~ ~ 4• 'fix ~ 7,; d~~~ - ~d'7Z l,~y3~ /~; x/33. v3 L ~v~n ~ ~ ioo . c2~ . ~ 3~a.c~ P~ ~, ~,~.~, s ~. c~ ~~~. ~- ~ S ^ ~?o o - ~ fQ Io .. ~~1 ~. I~ VYI t u m~'e~v vC~ ~1~ 0l d'3 1 OU 3 4'~~ _ - ~~ ~ ~ ~~ ~ ta`~es /~~ ~~ ri~ C ~~ 6 7~ ,~ ~ Ord . n /''' r~~Cr a i. ~ v V ~1~t Z oil /Pe ~ nc~1 C~ 7~ 7 73'7 ~~ ~i ~ ~ t~ 3 0~ v~ ~'iS. ,~e~u,~c~' ~~;71,n ~~ (oooc~~o7yd'~l~l, ZO icy. l~y~~~21~ 5 TOTAL (Also enter online 5, Recapitulation) I $ p? ~ ~~ C~. Cs~ ({f more space is needed, insert additional sheets of the same size) Sovereign Bank STATEMENT OF ACCOUNTS ~ Statement Period 03/27/08 TO 04/27/08 1-877-SOV-BANK (1-877-768-2265) www.sovereignbank.com SOVEREIGN FREE INTEREST CHECKING GRACE K SEYGAL Account # 2331046751 Balances Beginning Balance $2,968.78. Curcent Balance $775.17 Deposits/Credits + $769.17 Average Daily Balance $1,901.03 Withdrawals/Debits - $2,962.78 Interest Paid this Period " $ 0.17 Annual Percentage Yield Eamed 0.10% Eanned this Period $ 0.17 Paid Last Year $2.01 Paid Year-To-Date $ 0.57 'The interest earned and the interest paid may differ depending on when interest is credited to your account. Account Activity Dates Description Additions Subtractions Balance 03-27 Beginning Balance $2,968.78 04-~D3 US TREASURY 303 $769.00 $3,737.78 SOC SEC 040308 D SSA _ 04-07 HARP HEALTH CARE _ $21.00 $3,716.78 PREMIUM 0183100391 04-'10 WTHDRWL $2,941.78 $775.00 04-;?5 INTEREST CREDIT $0.17 $775.17 04-:>7 Ending Balance $775.17 page3 of3 233/Q4675/ Page 3 Wachovia Securities Account 7585'1872 WY38 Grace K. Seygal Date of Death: March 30, 2008 Quantity Security Price Value Corporate Bonds /Notes 10,000 Ford Motor Credit Corp 6z.o45 / 62.125 62.085 6,208.50 6.000% due 11/20/2014 (acc int) 218.33 10,000 General Motors Acceptance Corp 61.623 / 61.703 61.663 6,166.30 6.875% due 08/15/2016 (acc int) 87.85 10,000 General Motors Acceptance Corp 62.400 / 58.718 60.559 6055.90 7.250% due 08/15/2018 (acc int) 32.22 10,000 Hartford Life Global Funding Notes 96.704 / 96.815 96.7595 9675.95 5.100% due o1/15/2015 (acc int) 107.67 10,000 LaSalle Funding LLC Notes 97.547 / 97.666 97.6065 9,760.65 5.000% due 07/15/2015 (acc int) 105.56 Unit l[nvestment Trusts 1,000 Claymore C/E Preferred & Income 7.72 / 7.77 7.745 7745.00 Money Market Funds 18,95.3.03 Bank Deposit Sweep 1.00 / 1.00 1.00 18,953.03 Total s 405,668.31 "This :report has been prepared solely for informational purposes and does not supersede the proper use of your Wachovia Securities client statement, which is considered to be the only official and accurate record of your account. If there are any discrepancies between this and your Wachovia Securities client statement, please call your local branch manager." REV-1511 EX+ (10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF ~ FILE NUMBER ~-~2r~ce ~r~~YZ.yrv ~~y~~J-- 0?1- 08 -03~ Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~. J~+~iL.~ rv~~~C'~J ,Jet2L) tCES ~ y'1~Et"~(~t~avt,c~ 1ST 7~ ~~~. C~ ~~~~ C~t~,~fi~.r~Y ~- yo~tns~s ~ , a~~ . ©o -f~ ~8. ~~ ~ ~f43. iZ G ~ ~ Tt~ez~~.f L YI e~s~,~pe~~ B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) _ _ _ _ _ _ _ - _ _ _ _ Street Adtlress -. _ _ __ _ _ __ _ _ _ _ _. Gity State Zip _ _ _ _ - Year(s) Commission Paid: __ _ _- - 2. Attorney Fees 3. Family Exemption: (lf decedent's address is not the same as claimant's, attach explanation) -'~ Claimant - -- _ _ _ __ _- _ _ _ _ _ _ -- _ - Street Address _ _- - -- -- - - - - - - City State Zip _ Relationship of Claimant to Decedent _ - _ _ - -- - 4. I Probate Fees 5. I Accountant's Fees --- 6. Tax Return Preparer's Fees ~- (` . ~ vl~~ ~Ufi~ C ~S ^7`~~. ~a ~ ~~ TOTAL (Also enter on line 9, Recapitulation) f $ /d y / 1 Z . ~ ~o (If more space is needed, insert additional sheets of the same size) April 07, 2008 Page 1 of 2 7411 -Neill Funeral Home, Inc. 3401 Market Street Camp Hill, PA 170114428 (717) 737-8726 Statement Date: Accounit Number: Director Name: April 07, 2008 741100200101 Daniel C Huff Jr. Gai! Seygai 317 Price Ave Narberth, PA 19072 The following is a detailed bill for the professional services and/or merchandise arranged for: Grace K. Seygal Date of Service: April 03, 2008 Funeral Dir & Staff Srvc E3asic Professional Service Fee $2,480.00 Total Funeral Dir & Staff Srvc $2,480.00 Care & Prep of Remains Dressing and Casketing of Deceased $395.00 Embalming $795.00 Total' Care & Prep of Remains $1,190.00 Facilities & Related Srvc Chapel Funeral Ceremony $495.00 Total Facilities & Related Srvc $495.00 Transportation Funeral Vehicle/Hearse $395.00 Service Vehicle $395.00 Transferring Remains io Funeral Home $495.00 Total Transportation $1,285.00 Other Goods & Srvc Memorial Booklet $25.00 Service Folders $60.00 Total Other Goods & Srvc $85.00 Merchandise Concrete Grave Liner $995.00 RevereSilvrlChrchillBlue!Roman/MistyRoseietc ; $1,095.00 Total Merchandise $2,090.00 April 07, 2008 Statement Date: Account Number: Director Name: 7411 -Neill Funeral Home, Inc. 3401 Market Street Camp Hill, PA 170114428 (717)737-8726 April 07, 2008 741100200101 Daniel C Huff Jr. Gail Seygal 317 Price Ave Narberth, PA 19072 The following is a detailed bill for the professional services and/or merchandise arranged for: Grace K. Seygal Date of Service: April 03, 2008 Cash Advance Cemetery $1,295.00 Certified Copies $48.00 Newspaper Notice $493.12 Total Cash Advance $1,836.12 Total Service, Merchandise and Cash Advance Charges $9,461.12 Cash Received $0.00 Page 2 of 2 Unpaid Balance Due $9,461.12 The Patriot-News Co. 812 Market St. Harrisburg, PA 17101 Inquiries - 717-255-8292 PATTERSON 1118 N. 2ND STREET HARRISBURG PA 17102 ~e~latriot Neu~s NoW you knOW THE PATRIOT NEWS THE SUNDAY PATRIOT NEWS Proof of Publication Under Act No. 587, Approved May 16, 1929 Commonwealth of Pennsylvania, County of Dauphin} ss JosE~ph A. Dennison, being duly sworn according to law, deposes and says: Tha~~t he is the Assistant Controller of The Patriot News Co., a corporation organized and existing under the laws of the Commonwealth of Pennsylvania, with its principal office and place of business at 812 to 818 Market Street, in the City of Harrisburg, County of Dauphin, State of Pennsylvania, owner and publisher of The Patriot-News and The Sunday Patriot-News newspapers of general circulation, printed and published at 812 to 818 Market Street, in the City, County and State aforesaid; that The Patriot-News and The Sunday Patriot-News were established March 4th, 1854, and September 18th, 1949, respectively, and all have been continuously published ever since; That the printed notice or publication which is securely attached hereto is exactly as printed and published in their regular daily and/or Sundayl Metro editions which appeared on the date(s) indicated below. That neither he nor said Company is interested in the subject matter of said printed notice or advertising, and that all of the allegations of this statement as to the time, place and character of publication are true; and That he has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolution unanimously passed and adopted severally by the stockholders and board of directors of the said Company and subsequently duly recorded in the office for the Recording of Deeds in and for said County of Dauphin in Miscellaneous Book "M", Volume 14, Page 317. PUBLICATION COPY This ad # 0001841729 ran on the dates shown below: April 23, 2008 Apri130, 2008 May 07, 2008 ,.. The Patriot-News Co. 812 Market St. Harrisburg, PA 17101 Inquiries - 717-255-8292 PATTERSON 1118 N. 2ND STREET HARRISBURG ~e~llahiot News Now you know PA 17102 THE PATRIOT NEWS THE SUNDAY PATRIOT NEWS Proof of Publication Under Act No. 587, Approved May 16, 1929 Commonwealth of Pennsylvania, County of Dauphin} ss Joseph A. Dennison, being duly sworn according to law, deposes and says: That he is the Assistant Controller of The Patriot News Co., a corporation organized and existing under the laws of the Commonwealth of Pennsylvania, with its principal office and place of business at 812 to 818 Market Street, in the City of Harrisburg, County of Dauphin, State of Pennsylvania, owner and publisher of The Patriot-News and The Sunday Patriot-News newspapers of general circulation, printed and published at 812 to 818 Market Street, in the City, County and State aforesaid; that The Patriot-News and The Sunday Patriot-News were established March 4th, 1854, and September 18th, 1949, respectively, and all have been continuously published ever since; That the printed notice or publication which is securely attached hereto is exactly as printed and published in their regular daily and/or ~~unday/ Metro editions which appeared on the date(s) indicated below. That neither he nor said Company is interested in i:he subject matter of said printed notice or advertising, and that all of the allegations of this statement as to the time, place and character of publication are true; and That he has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolution unanimously passed and adopted severally by the stockholders and board of directors of the said Company and subsequently duly recorded in the office for the Recording of Deeds in and for saki County of Dauphin in Miscellaneous Book "M", Volume 14, Page 317. PUBLICATION COPY tNhrs of rrr - SEYOMLPATTiRSON atrwr . Pw ~nd~ This ad # 0001841729 ran on the dates shown below: April 23, 2008 April 30, 2008 May 07, 2008 ,~' n to~d sub cribed before met is 07 ay ay 408 A. D. 1' ~~, Notary Public COMMONWEALT!~ c.?F ?~NPVSYLVANlA slot~rai SSai Sh®rr:~ i,. t(rsn~t, i:~?atsy Public City C7f ~t~r" beit~, r?a±~phin County My Commissarn c,,pir~a Mov. 26, 2x11 Member, Pennsyl~~~ania Association of Notarise The Patriot-News Co. ' 812 Market St. e a ~lo ~ e~~ Harrisburg, PA 17101 Now you know Inquiries - 717-255-8292 PATTERSON 1118 N. 2ND STREET HARRISBURG PA 17102 t NVOIC E ALL CHARGES ARE NET ACCT # NAME AD ORDER # DATE EDITION ADDTL. INFO. TYPE OF CHARGE AMOUNT 182438 PATTERSON 182438 PATTERSON 182438 PATTERSON 182438 PATTERSON 0001841729 04/23/08 REGULAR 0001841729 04/23/08 REGULAR 0001841729 04/30/08 REGULAR 0001841729 05/07/08 REGULAR TOTAL: REMITTANCE ADDRESS The Patriot-News Co. 23794 Network PL Chicago, IL 60673-1237 Please include the Account # or Ad Order # (above) with your remittance--Thank You BOLD TEXT CHARGE $4.00 BASIC AD CHARGE $66.48 BASIC AD CHARGE $66.48 BASIC AD CHARGE $66.48 AFFIDAVIT CHARGE $5.00 $208.44 NOTE: This Invoice replaces the Order Confirmation which we previously sent with Proofs of Publication RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Receipt Date: 4/04/2008 CumY~erland County - Register Of Wills Receipt Time: 11:26:14 One Courthouse S uare Receipt No.: 1052172 Carlisle, PA 1713 SEYGAL GRACE KATHRYN Estate File No.: 2008-00385 Paid, By Remarks: KATHRYN S PATTERSON AJW ------------------------ Receipt Distrib ution ------ ------- ------- ---- Fee/Tax Description Payment Amount Payee Name PETITION LTRS TEST 360.00 CUMBERLAND COUNTY GENERAL FUN WILL 15.00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 48.00 CUMBERLAND COUNTY GENERAL FUN RENU[~CIATION 5.00 CUMBERLAND COUNTY GENERAL FUN JCP :FEE 10.00 BUREAU OF RECEIPTS & CNTR M.D AUTOMATION FEE 5.00 CUMBERLAND COUNTY GENERAL FUN Chec]k# 1414 ---------------- $443.00 Tot a.1 Received......... $443.00 REV-1512 EX+ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF f? ~ ~C~ ~ ~~ ~ Y ~ ~~ ~~ ~ ~ FILE NUMBER (~' o~I - Od' -D~BU Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. (It more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) , COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE IMF FILE NUMBER NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. ,/~ ~~ y~4 t' ~ E S I~ U S~ C` cl- 9 1 IGC ~~ VC> t?S~ r^ `.~O U ~ i Jl~ ~ ~ v O ©. ~/t} ~,. ~c~ 1 ~ 7v ~lYl ~~ I le p ` ~ 1 7U i~ ~l.~U~~~/I ~ ~, rn es ~,U t ~~ ~ f ~ ~ i ,c~~oc~ ~' -1" j2 ~ e tv U ,. ~ U o . CI1) . 1 v u ~ a ~ vi ~ (9 ~ d f }~-~rr~sbV~~, ~'~ -~~+o 3 ~ ~}~ t`.~,v ~ey~~4 ~ ~c~~`i e~6or~ v -~ h ~,~ ~ ~~eT- Cc. er ~~, ~ yo. ~~ ~I^r~~sb~~, `~~ »~©z ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THR OUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET ~ $ (If more space is needed, insert additional sheets of the same size) REGISTER OF WILLS CUMBERLAND COUNTY PENNSYLVANIA CERTIFICATE OF GRANT OF LETTERS No . 2008- 00385 PA No . 21- 08- 0385 Estate Of : GRACE KATHRYN SEYGAL (First, Middle, Last) Late Of : HAMPDEN TOWNSH/P CUMBERLAND COUNTY Deceased Social Security No: 193-36-4320 WHEREAS, an the 4th day of April 2008 an instrument dated August 8th 2001 was admitted to probate as the last will of GRACE KATHRYN SEYGAL (First, Middle, Lastl 1 a t e of HAMPDEN TOWNSHIP, CUMBERLAND County, who died on the 3rd day of March 2008 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: KATHRYN SEYGAL PATTERSON who has duly qualified as EXECUTOR(R/Xl and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HDUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of ray office on the 4th day of April 2008. **NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) •J ~-~ ~: O c=am -_ 1 \~I~ PLC N{i~~ ~l' \~.1~ ~.l ~.~ - r-~ ~`J TM ' ~ '7 _ ^ ~.~ l l ..'~ _ _ . _ _ . ~ 1 ~ ~ ~~1 ~ .~) _ .../ ~ .~ i LAST ~`~ILL AND TESTA~[ENT =,~~~T =~ ~ _~ ; ; ~ , O F T rv - N GR_aCE K. SEYGAL I. GR_aCE h. SE~'CAL. of Camp Hill, Cumberland County. Pennsylvania, bein~~ of sound and dispusin~~ mind. memory and understanding, do hereby make, publish and declare this my Last ~~'ill and Testament. hereb~~ reyokinQ any and all prior `4'ills and Codicils thereto by me at anytime heretofore made. y l.. IDENTIFICATION OF FAiVIILY. I declare that I have t~~~o children whose names are: GAIL E. SEYG AL and I:.ATHRY~i S. PATTERSON . As used in this Will, the term `'mv children" refers to all m~ natural children and adopted children. As used in this `Fill. the term "issue'" refers to all lineal descendants of the indicated person of all generations, with the relationship of parent and child at each generation determined by the definition of "children" set forth in this paragraph. 2. PAYi\[ENT OF BURIAL EXPENSES AND DEBTS. I authorize my executor to pay all the expenses of (1) a funeral or memorial service; (?) the internment of my remains, includin~~ the costs of a __ravesite. if necessary; and (3) the installation and inscription of a suitable marker at. and perpetual care of, the `~rayesitz. t further direct my executor to pay all of m~ debts that my e~.cutor in his or her soli discretion ma~• alloy as claims a\_ainst my csta[e. y 3. tiPEC[F[C BEQt; ESTS. I hereby devise and bequeath the follo~yin<~ items of personal property to: A. To my dau4Thter. GAIL E. SEYGAL 1 give my wedding band and solitare rin~~. B. To my daughter KATHRYN S. PATTERSON I give m~• ruby cocktail ring and my square diamond ring. C. To CH.-ARLES BUSER AND tifARTf-L-~ BUSER, his «-ife, of ~lechaniesburg, Pennsylvania, I give One Thousand Dollars ($1,000.00). uGz ~~. 1 GRACE K. SEYGAL `.lay ;i._iq~l "- D. To J;\~fES ~~~ILE~' of Harrisburg. Pennsylvania (~,ive Fizz Hundred Dollars ~. D(SPOSITIO` OF TA\GIBLE PERSONAL PROPERTY. -L l Disposition. I dive all of m_v tangible personal property of every kind and description. including. but not limited to, books. pictures, clothing. articles of household or personal use or adornment, household furnishings and effects. and automotive ~•ehicles and their accessories, but excluding any money, evidences of indebtedness, documents of title, and securities and property used in connection with the operation of atly trade or business, equally to my children. 5. DISPOSITION OF RESIDUARY ESTATE. ~. l Disposition. All of the rest, residue and remainder of the property that I own at the time of my death. both real and personal, and of every kind and description, wherever situated. to which I may be legally or equitably entitled at the time of my death (my "residuar~~ estate"l. I give outright and absolutely in equal shares to my daughters, GAIL E. SEYG AL and KATHRYN S. PATTERSON, if they survive me. PROVIDED TH.~T. if any of my children shall predecease me then I leave the share ~~f that deceased child to the survivor of them. G. I'O~~'ERS OF AD~1I\ISTRATiON. c~.l Grant of Po~~ers. iViy executor, in the administration of m``~ estate. (my "tiduclanes")shall hive the po``yers and authorities set forth in this Article ~. These po~vyers and authorities may be exercised by my executor and trustee in their sole and Absolute discretion. without the permission or order of any court. These powers shall bz supplementan,~ to those conferred by law, including, but not limited to, those set forth in Title 20. Chapter 33, of the Pennsylvania Consolidated Statutes. 6? Retention of Assets. My fiduciaries shall have the power to retain any or all propert}~ of my estate. ho~yever received and acquired, for so long as they dezm appropriate. This power may be exercised even thou~~h the property may not be of the type authorized by law for investment, and even though the retention may leave a disproportionately large amount of the value of my estate invested in one type of property. ~~~ ~ . ~ GRACE (;. SEYGAL shC ctr ~~ iI15~~Sc~ _af l\ ill 6.3 Transfer of .assets. qty fiduciaries shall have the poti~er to sell, transfer, and com•ey am~ property. of «hateyer nature, including real properr<•, and wherever situated, that I may o«n at the time of my death. or that may come into my estate or after my death. The sale. transfer, or conveyance may be by public or private sale, at such time, on such terms and conditions, including selling price and credit, in such manner. and for any reason that my fiduciaries deem appropriate, including. but not limited to, the purpose of obtaining net proceeds to be distributed to my residuary beneficiaries. 6.-1 Investment. `t~~ fiduciaries shall have the power to im•est and reim•est any propert}' in my estate in preferred and common stocks, bonds, notes, common trust funds (including anv managed by any corporate fiduciary), interests in investments, trusts, mutual funds, leases, mortgages on property wherever located, and, generally, in any property and in proportions of property as my fiduciaries deem advisable, even thott~~h the in~-estments are not of the character or proportions authorized by applicable iaw for the investment of the funds. 6.~ Po~~~er to I3orro~~. Viy fiduciaries shall have the power to borrow money for any purpose, for any periods of time, and on any terms and conditions as they deem advisable (including the power to borrow from any corporate fiduciary). and to pledge, mort`age. or otherwise encumber any property in my estate to secure repayment of an~~ loan, as well as the power to renew existing loans either as maker or endorser. 6.6 Po~~er to F{old Property in Nominee Form. ~iy fiduciaries shall have the po«•er to hold any property in the name of a nominee or in bearer form. 6.7 Distribution in Cash or in Kind. h'[y fiduciaries shall have the po«-er to make distributions in cash or in kind, or partly in cash, in divided or undivided interests, as amended, or other applicable law, and to determine which assets shall be sold and which shall be distributed in kind, without notice to or consent by any beneficiary. 6.8 Distribution to Minors and Persons Under Disability. ~tv fiduciaries shall have the power to make distributions or payments to or for the benefit of any beneticiary ~~ho is a minor, an incompetent, or who in the fiduciaries' jud~`ment is incapacitated. The distributions or payments shall be made in am~ one or more of the following «~a~•s: (1) directly to the beneticiary•; (3) directly to the creditor in payment of the debts or expenses of the beneficiary; (~) to the guardian of the person or estate of the beneticiary; !-1) to any custodial parent of a minor beneficiary; (~) to a custodian for uc~ C ~ GRACE K. SEYGAL ~hc ~tr~~ill> Sc<<~al ll ~,I{ ~~lac ~I. 'uui - the btneticiar<~ under an~~ lacy related to Rifts to minors. including to m~~ fiduciaries in that capacity: or (6) to any other person vvho shall have the care and custody of the person of the beneficiary. There shall be no duty to see to the application of funds so paid. provided due care vvas exercised in the selection of the person to whom the funds wire paid. and the receipt of the person shall be full acquittance of the fiduciaries. b.9 Continuation or Liquidation of Business. iVly fiduciaries shall have the power to continue or to perniit the continuation of any business. incorporated or unincorporated. in which I may have any interest at the time of my death for any period of time, or to liquidate the business on any terms as they deem appropriate. This power includes, but is not limited to (1) the power to invest additional sums in any business. even to the extent that my estate may be invested largely or entirely in the business, without liability for any loss resulting from lack of diversification; (2j the power to act as or to select other personsyto act as directors, officers, or employees of am~ business, to be compensated without regard to being a fiduciary under this Vl•'ill: and (3) the power to make any other arranvements in regard to any business as m~~ fiduciaries shall deem proper. y y 6.10 Em~lo~~ment of agents. 41y fiduciaries shall have the power to employ and pay the compensation of any and all attorneys, agents, custodians, attorneys-in-fact, experts, investment counsel. accountants, boola:eepers, or other agents or providers of services as m~ fiduciaries deem advisable in the administration of [m' estate. ti.l 1 Commissions. ~(y fiduciaries shall have the power to take reasonable commissions on account at any time during the administration of my estate without the approval of any beneficiary or or the court, but subject to allowance or disallowance on the settlement of the final accounts of my fiduciaries. 6.12 Third Party Reliance. No person or corporation dealing with my executor shall be required to see to the application of any property paid or delivered to my executor, or to inquire into either the authority of my executor to enter into any transaction or the expediency or propriety of any transaction entered into by m~ executor. 6.13 Charitable Donations. In the event that any of my tangible personal property is donated to a charitable organization(s) then my fiduciary is instructed to use the value of said donations} as an inheritance tax deduction for any inheritance tax return which mav~ be required to be tiled as a consequence of my death. GIGS ~~ ~ -4 GRACE K. SEYG~L ihC .IC «ills',Se~sal ll ;il ?.1a~ _ ,. _~qll -- "r'. PAYti1FNT OF DEATH T-~~CES. 7.1 Pa~•ment of Estate Taxes. I direct that all federal and Pennsylvania estate taxes payable as a result of taxes assessed on property passim under this Wiil shall be paid from my residuary- estate as a part of the expenses of the administration of the estate. 7.? Inheritance Tax. I direct that the Pennsylvania inheritance takes payable as a result of my death, limited to taxes assessed on property passing under this Will. shall be paid out of my residuary estate and shall not be deducted or collected from any beneficiary under this `Vill or other transferee. 8. EXECUTOR. 8.1 APPointment. I name, constitute, and appoint my daughters GAIL E. SE~~GAL and tiATHRYN S. PATTER5ON, or the survivor of them, as Co- executrices (,executor hereinl of my estate. S? Bond Not Required. None of the individuals named in Section 8.1 shall be required to furnish a bond for the faithful performance of their duties as executor. 9. PRESt'~iPTION IN CASE OF SIMULTANEOUS DEATH. For the purposes of this `'ill, in determining whether a person has survived me or another person, a person shall not be deemed to have survi~-ed me or another person if he or she dies within sixty (60) days of ntv death or of the death of the other person. 10. LIAB[LIT~' OF EXECtTOR. My executor shall not at any time be liable for mistake of law or of fact, or both lacy and fact, or errors of judgment, nor for any loss coming to any benetician~ under this `~~ill, or to any other persons, except through actual fraud or «illful misconduct on the part of the executor or trustee. My executor may, from time to time, consult ~yith counsel with respect to the meaning, construction, and operation of this «'ill, particularly with respect to the appointments, allocations, and disbursements, and may- act on the ad~+ice of counsel in all matters without incurring liability on account of his or her aCt1ol15. Gt,~~ 1 ~ GR CE K. SEYGAL ~ the ~tr~~ills`S«eal ltiill 11. INTERPRETAT[O\. 11.1 Successors of Fiduciaries. All pronouns referring to an executor and the term "executor" shall be construed to mean any person acting as my executor, co-executor, personal representative, or administrator, as the case may be. 1 l .`? ~; umber and Gender. If required by the contest of this Will, singular lanauaQe shall be construed as plural, plural language shall be construed as singular, and the Qender of personal pronouns shall be construed as either masculine, feminine, or neuter. 11.3 Headings. All headings used in this Will to describe the contents of each article, paragraph, or other division are provided for convenience only and shall not be construed to be a part of this Will. 1 l.~ Governing La~~~. This Will shall be construed in conformity with the law of the Commonwealth of Pennsylvania. Ill ~VIT:~ESS ~VHER.EOF, I have hereunto set m~- hand and seal to this, my Last `'ill and Testament, consisting of six (6) t}~pewritten panes, the first tine (~) of which bear my signature in tl•le Illar~gin for the purpose of identitication. this ~ day of X001. GRACE K. SEYGAL Si~~ned. sealed. publishzd and declared by the above-named Testatrix, GRACE K. SE1'G AL, as and for her Last t~'ill and Testament, in the sight and presence of us, who. at her request. in her si~,ht and presence and in the sight and presence of each other, have hereunto subscrib ur names with ~es. _ Address ~~/ / ~ l ~~~~~ J r l ~~ .,,JCL ~~ t. _ Address - . ~ `' i ,'';':~' ~- ~~, .~ .^, i / 6 tiht qtr ~~ill:`ti~~~~~1 ~.l;il ?.t.t~ . I ._n~t I - - CO~tMON~~'EALTH OF PENNSI"LVANI.-~ COUNTY OF SS. [, GRACE K. SEYGAL, THE TESTATRIX, WHOSE NAME IS SIGNED TO THE FOREGOING INSTRUi~tENT. HAVING BEEN DULY' QUALIFIED ACCORDING TO LAW, DO HEREBY ACKNOWLEDGE THAT I SIGNED AND EXECUTED THE INSTRUMENT AS MY LAST WILL AND TEST.-~~tENT; THAT I SIGNED IT WILLINGLY; AND THAT I SIGNED IT AS NIY FREE AND VOLUNTARY ACT FOR THE PURPOSES THEREIN EXPRESSED. SWORN OR AFFIRMED TO AND AC NOWLED~vED BEFORE i~1E BY GRACE K. SEYGAL, THE TESTATRIX THIS ~l~ DAY OF ~ 7r , 2001. NpTARIAL SEAL CASSANDRA T ROSENBAUM. Notary Public Harrisburg. Daupnm County ti~Y Commission Expires December 4.2004 Ct L~ CE K. SEYGAL ~~{ ---- OTARY PUBLIC CO~I~tON~4'EALTH OF PENNSYLVANIA ) SS. COUNTY OF 1 //~ \ W E. ~I?yj' L ~ ~~/lCGG AN D 1) ~ C li . / ~.F . "l~f{E ~~~ITNESSES WHOSE NAMES ARE SIGNED TO THE FOREGOING INSTRUMENT, BEING DRILY ~~UALIF[ED ACCORDING TO LA~~". DEPOSE AND SAY THAT EVE WERE PRESENT AND S,'~~~' Tf-{E AFORESAID TESTATRIX SIGN AND EXECUTE THE INSTRUMENT AS H[S LAST ~~~(LL AND TESTAMENT; THAT SHE SIGNED ~~'ILLINGLY AND THAT SHE EXECUTED IT AS HER FREE AND VOLUNTARY ACT FOR THE PURPOSES THEREIN EXPRESSED; THAT EACH OF US [N THE HEARING AND SIGHT OF THE TESTATRIX SIGNED THE ~~"[LL AS WITNESSES; AND THAT TO THE BEST OF OL'R KNOWLEDGE THE TESTATRIX WAS AT THE TIME EIGHTEEN (18) OR MORE YEARS OF AGE. OF SOUND Ni[ND AND UNDER NO CONSTRAINT OR UNDUE INFLUENCE. ~; SWORN OR AFFIRtitED TO AND SUBSCRIB TO BEFORE (V~THIS ~+~' DAB' OF l~-~~. ~ 001. - - G~ %~~ W[ 1 ESS C.. ~ ~~--~ E_ L ~ WITNESS NpTARIAL SEAL CASSANDRA T ROSENBAUM. Notary Public `~~ ~- - ~ f~~ L-~u,~~~_ Harrisburg. Dauphin County ti1y Comm~sson Expues December a. 2004 NOTARY PUBLIC IN RE: : IN THE COURT OF CQMMON PLEAS ESTATE OF GRACE K. SEYGAL :CUMBERLAND COUNTY, PENNSYLVANIA DECEASED :ORPHANS' COURT DIVISION : N0.2108-385 DISCLAIMER OF INTEREST IN ACCORDANCE WITH 20 PA C.S.A. § 6201, et se°. KNOW ALL MEN BY THESE PRESENTS, THAT: Grace K. Seygal (the "Decedent") died on March 30, 2008, leaving a Last Will and Testament tha# was admitted to probate by the Register of Wilts of Cumberland County, Pennsylvania (the "Will"). 2. Gait E. Seygal (the "Disclaimant") pursuant to Section 6201 et seq. of the Probate, Estates and Fiduciaries Code, Pa. C.S.A. §6201-6207, and the Gammon law of the Commonwealth of Pennsylvania, irrevocably disclaims and renounces her entit~ement in the residue of the estate, as set forth in Paragraph 5.1 of the Decedent's Will. She has not received any distribution from the residue. 3. This Disclaimer shall be filed with the Clerk of the Orphans' Court of Cumberland County, Pennsylvania, and a copy delivered to Kathryn S. Patterson, the Executrix of the Decedents Estate in accordance with 20 PA C.S.A. §6204. 4. The Disclaimant has not received, and will not receive, any consideration in money or money's worth for such renunciation and disctaimer from any person or persons whose interest is to be accelerated or increased, or from any other person or persons. IN WITNESS WHEREOF, and intending to be legally bound hereby, the Disclaimant has Executed this Disclaimer this ~, day of May, 2008. J GAIL E. SEYG { A 1151996:1 } COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF `~ , On this z-`~ day of May, 2008, before me, a Notary Public, in and for said Commonwealth and County, personally appeared Gail E. Seygal, personally known to me to be the person whose name is subscribed in the within instrument and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, t hereunto set my hand and official seal. Public (SEAL) My Commission Expires: ~ l z9 /z~ !v COMMONWEALTH OF PENNSYLVANIA Notarial Seal Jeanette M. Foelster, Notary Public Narberth Boro, Montgomery County My Commission E~ires June 29, 2010 Member, Pennsylvania Association of Notaries {A1151996:1 }