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Home My WebLink About03-0632 PETITION FOR PROBATE and GRANT OF LETTERS also known as To: Register of Wills for the ., Deceased. County of Cumberland in the Social Security i179- 30- 5906 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut ~- named in the last wilt of the above decedent, dated November 16, 19~2t , and codicil(s) dated (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in C umbo~ r 1 a n d County, Pennsylvania, with h er last family or principal residence at 630 ~_uploy Rd: W~rml oy~burg: PA 17011 (list street, number and muncipality) Decendent, then __fi4 __ years of age, died Juna 25 , __Z0_0_3_, Except as follows, decedent d~d not marry, was not d~vorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ 75: 000.00 (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $100. 000.00 situated as follows:630 Rup!ey Ra_: Wormleysburg, PA WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters test=_ment=_ry (testamentary; administration c.t.a.; administration d.h.n.c.t.a.) theron. '~Z bt -~ ~~----~ Wachovia Bank NA) ~& Lancastcr, PA 1750d OATH OF' PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well an~ trUly administer the estate accOrding to law. Sworn to or affirmed and subscribed before ~l~e this [.49Fi. day of [ I Estate Of ~ ~n~t~-~-,,~ ~q ~_a ~t~, , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW '~L~ot.w-'~x R-, ~;:~o..~_-, in consideration of the petition,on the reverse side hereo~f, ~atisfactory proof having be, eh presented before me, IT IS DECREED that the instrument(s) dated [X,J~~~. ~ L,., t ~ ~ q/ described therein be admitted to probate and filed of record as the last will of and Letters '------[~.,,-~-I% rn~r~-'r~ ~.~ are hereby granted to ~3~)1~ t ~% "~, INI.~q FEES Probate, Letters, Etc .......... $~ Smith B. Ge, phart XD ~06864 · O N '.Y ' C.I.D. Short Certificates( ) .......... $ b~'tgO Kill~r ~ ~t~g No.) -$) Em. q..c?~ 218 Pine st Harrisburg PA 17101 ~en)un~c ation ................ $ · , ,.~R $ tO.t:~ .~,r~ss TOTAL .. $~ (717) 232-1851 Filed .~. ~ ~ It,.. o~..~C~.. ~: .............. PHONE 'Ul~is is to ceftin, that the intbrmation here given is correctly copied from an original certificate of death duly filed with me as Local R~:gistrar. The original certificate will be forwarded to the State Vital Records Office for permanent ~ling. WARNING: It is illegal to duplicate this copy by photostat or photograph. ~ ! Local Registrar P 9 3 31114 %~,,~ /2-,~_ ~ ~ ~ No. '~ ~ Date ~lu~ ~43 a,~. 2~a? COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF HEALTH · VITAL RECORDS ........ ~ CERTIFICATE OF DEATH I I I I~~°~-~~- . ,, x -- 'MEDIAL EXAMIN~C~ONER ~ ~ ~ ~2.{.~ ~1 2~:Z~ ~-OgV OF CHRISTINE M. SCAFIDI I, CHRISTINE M. SCAFIDI, declare this to be my Last Will and Testament and hereby revoke all prior wills and codicils made by me. FIRST: My Executor shall pay from the residue of my estate all my debts, funeral expenses, administration expenses, and all estate, inheritance, succession, and transfer taxes imposed by the United States or any state, territory, or possession which shall become payable by reason of my death. It shall not be necessary to file any claims therefor, nor to have them allowed by any court. SECOND: I bequeath all of my tangible personal property and insurance thereon, which I own, not including cash and securities, as is set forth in a separate, unsigned letter of instruction, which I shall place with my Will, to the persons therein designated. If I have not prepared a letter of instruction or for those items of my estate not distributed under this letter, I give and devise such tangible personal property to my children in equal shares as they may select. I direct my Executor to sell any such property not specifically allocated in such separate, unsigned letter of instruction and to add the net proceeds thereof to the residue of my estate. LAST WILL AND TESTAMENT OF CHRISTINE M. SCAFIDI THIRD: I give, devise and bequeath all of the rest, residue and remainder of my estate to HAMILTON BANK, Harrisburg, Pennsylvania, Trustee, to be added to and administered as a part of a trust estate created by a certain Trust Agreement between myself as Settlor and the said HAMILTON BANK, Harrisburg, Pennsylvania, as Trustee, dated ~/P~~J~ /~ /~ , said Agreement having been executed before this Last Will and Testament. FOURTH: I nominate, constitute and appoint HAMILTON BANK, Harrisburg, Pennsylvania Executor of this my Last Will and Testament, to serve without bond or security, and I hereby authorize, empower and direct it to sell and convey, by good and sufficient deed, in fee simple estate, any and all of my real estate, at public or private sale, for such price or prices, upon such terms and conditions, as in its judgment is best for my estate, and to that end to sign, seal, execute, acknowledge and deliver all deeds to other instruments necessary therefor, as effectively as I could do if I were personally present. IN WITNESS WHEREOF, I, CHRISTINE M. SCAFIDI, the TESTATRIX, have to this my Last Will and Testament -2- LAST WILL AND TESTAMENT OF CHRISTINE M. SCAFIDI set my hand and seal this /~ ~ day of ~/~~, 198~: CHRISTINE M. SCAFIDi Signed, sealed, published and declared by the above named TESTATRIX, as and for her Last Will and Testament, in the presence of us, who have hereunto subscribed our names at her request, as witnesses hereto, in the presence of the said TESTATRIX, and of each other. This document consists of this and two other consecutively numbered typewritten pages. '-~ ~ . residing at /~~ ~/Zz~-~ t -3- ACKNOWLEDGMENT AND AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) ) SS.: COUNTY OF DAUPHIN ) The Testatrix and the witnesses whose names are sub- scribed to the foregoing instrument, being first duly sworn and qualified according to law, do hereby acknowledge and declare to the undersigned authority that the Testatrix signed and executed the instrument as her last Will in the presence of the witnesses, that she signed willingly or willingly directed another to sign for her, that she executed it as her free and voluntary act for the purposes therein expressed, that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witnesses, and that to the best of their knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Testatrix / Witness Sworn to, subscribed and acknowledged before me by the above named Testatrix and witnesses this ~[~/~day of-~/.?,~j, 1984. /Notary Public JUDITH A. NORDSTI~OM, NOTARY PUBLIC HARRISBURG, DAUPH!N COU,",UY MY COMMISSIOH EXPIRES S£P/. 21, 1985 Member, Pennsyl~,ania Association oi' I'~otaries THE LAW FIRM OF KILLIAN & GEPHART :~18 PINE STREET BOX 886 HARRISBURG, PENNSYLVANIA 17108 CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: Christine M. Scafidi Date of Death: June 25, 2003 Will No.: 2003-00632 Admin. No.: To the Register: I certify that Notice of Beneficial Interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on September 3, 2003. Name: Address: Maria S. Gregg 304 11th Street New Cumberland, PA 17070 John M. Scafidi 6501~ 4th NW Seattle, WA 98117 Notice has now been given to all persons entitled thereto under Rule 5.6(a) . September 10, 2003 .~;.F.~' ~ ~-~- Signature Name: Smith B. Gephart, Esq. Address: Killian & Gephart 218 Pine Street Harrisburg, PA 17108 Telephone: (717)232-1851 Capacity: __Personal Representative X Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE REV-1162 EX(11-96) BUREAU OF INDIVIDUAL TAXES DEPT. 28O601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 003736 WACHOVIA BANK NA 100 NORTH QUEEN ST LANCASTER, PA 17604 ACN ASSESSMENT AMOUNT CONTROL NUMBER ........ fold ;::~.:~ 101 $43,511.96 ESTATE INFORMATION: SSN: 179-30-5906 FILE NUMBER: 2103-0632 DECEDENT NAME: SCAFIDI CHRISTINE M DATE OF PAYMENT: 03/29/2004 POSTMARK DATE: 03~25~2004 'COUNTY: CUM BERLAND DATE OF DEATH: 06/25/2003 ~... TOTAL AMOUNT PAID: 843,511.96 .REMARKS: WACHOVlA BANK CHECK//48486505 INITIALS: VZ SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH ~-' REGISTER OF WILLS TAXPAYER PHI LADELPH I A, PA 19110 MAR 25,' 04 Wachovia Bank, National Association C~ ,-~ · AMOUNT Estate Tax Division Re , < ~, -~., ,., - ~ Post office Box 7558, PA1308 ~'~::!~'-; : '~ '? ~~ SB gO Philadelphia, PA19101-7558 ~00~ 3~O BOOB 3q~q ~3~ "~ ooo4A~-°~ 0000 ~7013 '~ MAR29 P4:01 Register of Wills of Cumberland County 1 Courthouse Square Carlisle, PA 17013 RE¥-15O0 E~ (6-00) Ot=FIC~q. USE ONLY COMMONWEALTH OF . REV-1500 DEPARTMENT OF REVENUE DEPT. 280~01 INHEF~TANCE TAX RETURN H^..~ssu.c. P^ ~?~2s-o~ol RESIDENT ~CEDENT 21 -- 2~0~ ~632_____ ~ ~ Y~ ~ER ~S ~ (~ST. RRST. AND MI~E INfflAL) ~L ~ ~MBER Scafi~ ~=is[ine M , 179-30-5906 ~~ (M M-~Y~R) ~ ~ BlaH (M~R) ~S R~ M~T BE FIL~ IN ~ ~ 06/25/2003 J 07/17/1938 REG~TER OF WI~ LS {IF~I~ ~NI~ ~S ~ME (~ST, FIRST. AND MI~E IN~L) ~ ~ ~ M~R ~1~4' L"~" E~e ~ 4a. Fmu--I~ ~p~--(d~e ~ d., ~ 12.,2~2, ~ 5- F"~I E~,e T~ RMum R, uir, I ' - . . ~)< / ~ ~IL~ A~E~ F~ S. Ba~n, ~st. Vi~ Presi~nt ~M~AM~(~A~) ~ 123 S. Broad Strut - PA1308 Wa~ovia ~, N.A. ~la~lphia, PA 19!~9 (215) 670-6394 ~ ~ 0 1. ~E~ ~u~A) (1) 130,900.00 2. ~a~ ~s(~u~B) (2) 25,411.60 ~ ~. 3. Q~ly Held ~. P~ ~~ip O) 0.00 '~ ~) ~ ~' ~.~ 4. Mo~ S ~ R~ (~ D) (4) 0.00 ;:9 ~"~ ?i 5. ~. ~k ~ & M~ P~I P~ (~u~ ~ (5) 100 ~ 144.71 s- ~ ~.~(~u~ (s) 5,835.50 ~ ~e Bilang ~u~ 7. lnter-Vi~ T~ & M~ ~ p~ ~) 767,043.69 (~G~L) 8. Te~l G~ ~ (~ U,~ 1-D (8) 1,029,335.50 9. Fune~ ~ & Adm~ ~ (~u~ H) (9) 60,327.11 10. ~mof~ M~~ & ~s(~a~) (10) 2,076.02 11. 7~1 ~_~ (~ta Li.~ 9 & 10) (11) 62,403.13 12. ~t Val~ ~ (Line 8 min~ Li~ 11) (12) 966 ~ 932.37 13. ~ ~d ~mmental B~ 9113 T~ ~ ~ ~ ~ ~ ~ ~ ~ ~ m~ (~ J) (~3) 0.00 14. ~t vai~ ~ ~ Tax (Line 12 mi~s L~e 13) (14) 966,932.37 15. Am~nt ~Line 14 ~b~~l~, ~e, ort~u~. 9116(a)(1.2) 0.00 x.00 (15) 0 00 - 16. Am~nt ~ Une 14 ~ ~ ~ ~e 966,932.37 x.04~ (16) 43,5[[.96 17. Am~nt ~ Line 14 ~ aa~g ~ 0.00 x.~2 (~7) 0.00 18. Am~nt ~ Line 14 ~ble ~ ~1 ~e 0. O0 x .15 (18) 0.00 19, Tax~e (19) 2w4845 1.0~0 Decedent's Complete Address: I~A~ JZIP PA 17011-1271 Tax Payments and Credits: 1. Tax Due (Page I Li~ 19) (1) 43,511.9~ 2. Credi~Paymen~ A. Spousal Pove~ Cmd~ 0.00 B. P~r Paymen~ 0.00 C. Dis~u~ 0. O0 To~l Cred~ (A + B + C) (2) 0.00 3. Intere~Penal~ E applicable D. In~re~ 0.00 E. Pena~ 0.00 To~l InteresUPe~ (D + E) (3) 0,00 4. If Line 2 is greater ~n Line I + Line 3, en~r ~e d~m~. ~ ~ ~ OVERPAYMENT. Check box on Page 1 Line 20 to r~ue~ a m~ (4) 5. If Line 1 + Line 3 is greater ~an Line 2, enter ~e d~m~. ~ ~ ~ T~ DU~ (5) 43 ~ 511.96 A. En~r ~e interest on ~e ~x d~. (5A) 0.00 B. En~r ~e ~1 of Line 5 + 5~ ~b ~ ~ BA~E DUI (5B) 43 ~ 511.96 :~=~,...~,~.,..~?~.~..~,~...~,.~ ,..~ ~k Pay~.~ to: ~OF~AG~ - ' PL~SE ANSWER THE FOLLOWING QUES~NS BY ~Q~ ~ ~ ~ THE AP~~ BL~KS 1. Did de.dent make a ~n~er and: Y~ No a. retain the use or in.me ~ ~e ~o~ ~e~ ....................... ~ ~ b. re. in the right to designate ~o shall use ~e pr~ ~n~e~ or b i~; ......... ~ ~ c. retain a re~rs~na~ i~re~; or ................................ ~ ~ d. recede the promise for lee of e~er ~, ~f~ or ~re? ................. ~ ~ 2. If death occurred a~er Decem~r 12, 1982. d~ de~ent ~ansfer ~o~ ~in ~e ~r of ~a~ ~out re~Mng ade~ate ~m~? ............................ ~ ~ 3. Did de.dent o~ an "~ ~ust for' or ~ble u~n ~ath ~nk ~ or ~ at h~ or h~ de~? ~ ~ 4. Did de.dent own an IndNidual Retirement A~u~, annu~, or o~er non-~o~e ~o~ ~ ~nalns a ~.efic~ ~a~n? ................................ ~ ~ IF THE ANSWER TO ~Y OF THE ~O~ QUEST~ ~ ~S, Y~ M~T ~E SCHEME G ~D FILE ff ~ P~ ~ THE ~TU~ ~ ~ P~ ~1~ ~ ~ ~ ~TE P~la~lp~ia, PA 19109 For dat~ of death on ~ ~er July 1, 1994 and he.re Janua~ 1, 1 ~2 P.S. ~ 9916 (a) (1.1) (~]. For dat~ of death on ~ ~er Janua~ 1, 1995, the ~ ~ im~ ~ ~e ~ ~e ~ ~ ~ ~ ~ ~ u~ ~ ~e ~ng ~ ~ 0% ~2 P.S. ~ 9116 (a) (1.1) (iO] The ~t~e d~ n~ ~empt a ~ns~r to a ~ng sp~ the su~ing ~ ~ ~e ~ ~. F~ d~ ~ d~th on m ~ JuN 1, The ~ rote impo~ on the net ~lue or a stepper ~e ~iM b 0% ~2 P.S. ~ 9116(a)(1.2)]. The ~ rote lm p~ on ~e n~ ~lue ~ ~ ~ m ~ ~e u~ ~ d~ an~ ~ ~ 4.5%. ~t ~ ~ ~ 72 P.S. ~ 9116(1.2) ~2 P.S. ~9116(a)(1 )]. The t~ rote Imp~ ~ ~e n~ ~ Ind~dua ~o h~ ~ ~ ~e ~ ~ ~m~ ~ ~ ~ ~ ~ ~ ~ ~,. ~4~461.~ REV- 1502EX + (I-97) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA RF_J~ ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT · , ESTATE OF FILE NUMBER Scafidi, Christine M 21-2003-0632 · JI real prc.,~-~, owned solely o~ as a tenant in c~mmon must be repo~ad at fair market ~mlue. Fair marke~ value is defined ~s the price at which prope~/would be exchanged betv,~.:~.~l a willing I:~yer and a willing sell~, nei~er being comp~led to buy or sell, bo~ having reasonal~le klx~ledge Of the relevant facts. Real prope~y which Is jointly-owned vviltt right o1' s~rvivorship must be disclosed off Schedule F. ITEM NUMBER [~E. SCRI~ VALUE AT DATE OF DEATH 1. p~..i ses: 130,900.00 630 Ruple¥ Road C~ HAll, PA 17011-1271 Sold @ (Copy of Real Estate Settl~me_nt Sheet enclosed) TOTAL. (Al~o enter m line 1, I~,.,~?, ,~,~m) $ 130;900.00 2w4~s~ zooo (If mom space is ~4ed, inmart adcibxt~ she~ of the ~me e~e) REV-1503 EX + (1-g~ SCHEDULE B COMM~DNWEALTN OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Scafidi, Christine M 21-2003-0632 All property jointly-owned with right of survivorship must be disoiosed on Schedule F. ITEM VALUE AT DATE NUMBER EESCRII:n3ON I 2,020 S~s. O~&c.l.e Co:~3. 25,411.60 TOT.~ (Nso enter on line 2, RecW, aulalim) $ 25,411.60 :wv4~e~ 3.oo0 (If mote e4xtce i needed, insert Ekittm~d slmets c4, ttm santo ei~B) REV-1508 EX + (I-97) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN ' RES~t)ENT DECEDENT PERSONAL PROPERTY ESTATE OF FILE NUMBER Scafidi, Christine M 21-2003-0632 Include the ~roceed s of litigat~on and the date the proceeds were received by the estate. All propel~y jointly-owned with the right of sun,'tvorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PA State ~m~loyees Credit Union 33,887.68 Savings Account - S1 Interest accrued to 06/25/2003 23.21 2 PA State ~m~ loyees Credit Union 2,750.93 Vacation Savings Account - S2 Interest accrued to 06/25/2003 1.81 3 PA State ~m?Loyees Credit Union 19,009.84 Checking Account - S4 Interest accrued to 06/25/2003 7.50 4 PA State ~w?loyees Credit Union 5,079.61 12 Month Certificate of Deposit - S51 Interest accrued to 06/25/2003 8.42 5 PA State Employees Credit Union 5,283.32 12 Month Certificate of Deposit - S57 Interest accrued to 06/25/2003 7.92 6 PA State ~lo~ees Cred/t Union - S58 5,310.06 12 Month Certificate of Deposit Interest accrued to 06/25/2003 9.32 7 PA State ~m~ lo~ees Credit Union 5,151.33 12 Month Certificate of Deposit - S59 Interest accrued to 06/25/2003 6.70 8 Wac~ovia Bank, N.A. 1,768.91 . Checking Account # 1000590335734 (No accrued interest) Total f~ ~o~tinuation pages .... 21,838.15 TOTAL (Ads0 ~r ~ line 5, P___--~ e:--=~.<~) $ 100,144.71 2VV4~AO 2.0O0 (If mo~e space is needed, inae~t ad~-.~ sheet~ ef the same ~ze) Page 2 Estate of: Scafidi, Christine M 21-2003-0632 Schedule E -- Cash, Bank Deposits & Miso. Personal Property Item Value at No. Description Date of Death 9 Merrill Lynch, Pierce, Fenner & Smith 6,290.86 Investor Account # SBA 38S74 Cash balance as of 06/25/2003 Interest accrued to 06/25/2003 3.51 10 Connor-Rich Associates - Reimbursement of medical payments 114.40 covered by medical insurance for appoin~nts on 4/1/03, 4/25/03 a 5/15/03 11 Green Tree Perpetual Assurance Co. - Refund of unearned 2,862.00 portion of homeowners insurance premium 12 The Patriot-News - Refund of unused~ortion of magazine 79.38 subscription 13 Miscellaneous Personal Property 1,188.00 Sold @ 14 Automobile - 2001 Honda Accord 11,300.00 TOTAL. (Carry forward to main schedule) ...... 21,838.15 '' PSEC the finen¢i~l I/nt(T~ August 13, 2003 Account # 0179305906 KIM GARRETT - ESTATE CONSULTANT C/O WACHC)VIA BANK NA PC) BC)X 3959 - PA6907 LANCASTER, PA 17604 Dear MS GARRETF: The following is the status of CHRISTINE M SCAFIDI's account with PSECU as of the date of death. Joint Owner's Name NONE Date Established I 0.14.1981 Date of Death 06.25.2003 Date of Birth 07.17.1938 Share(s) Balance Accrued Dividend Rate Maturity Date Regular Shares (S1) $33,887.68 $ 23.21 0.75% V~¢afion Shaz~ (S2) 2,750.93 1.81 0.75% Cliecking Shares (S4)' '-:::- ' ',- 19,009.84 7.50 0.25% 60 MOnth IRA Certificate-4 (S50) 36,880.09 118.58 4.89% 12 Month Certificate (S51) 5,079.61 8.42 2.52% 10.15.2003 12 Month Certificate (S57) 5,283.32 7.92 2.28% 01.10.2004 12 Month Certificate (S58) 5,310.06 9.32 2.67% 07.10.2004 07.10.2003 Renewed at !.88% 12 Month Certificate (S59~, -5,151.33 6.70 1.98% 04.04.2004 48 Month IRA Certificate (S60) 8,302.93 25.38 4.65% Loan(s) Balance Accrued Interest Personal Service Loan (L1) $ 0.00 $ 0.00 The lRAdividend earned f~om Sanuary 1, 2003 through the date of death was $1,038.97; the Non-IRA dividend earned was $513.03. We do not have safe deposit boxes for our members. If you have any questions, please call 234-8484 in Harrisburg or our toll-flree number, (800) 237-7328. At the menu prompt, enter 6 and then extension 2227. Sincerely, Member Service Representative ·. Finance Support Unit . :,. PENNSYLVANIA STATE EMPLOYEES CREDIT UNION Main Address: I Credit Union Place. Harrisburg, PA 17110-29g0 . (717)234-8484 · (800)237-7328 Mailing Address: P.O. Box 67013, Harrisburg. PA 17106-7013 · (717) 777-2100 (TDD) · (800) 472-1967 (TDD) Web Address: www. psecu.com $~-~,~a f~,~,&~&;ly Inaurad up to $1n0,000 by tha National Crecllt Union Admlniatratlon. WACHOVIA Reference ID: 678826 Wachovia Bank N.A. Balance Confirmation Services P O Box 40028 Roanoke, VA 24022-7313 August 15, 2003 PA 6907 ATTN: KIM E GARRETT SUBJECT: Verification / Confirmation of Account and Balance Information provided for: Customer: CHRISTINE M SCAFIDI (SSN# 179-30-5906) Date of Death: June 25, 2003 Deposit Account Information Account Account Date of Death Average Date Maturity Interest_ Accrued YTD Date Type Number Balance Balance* Opened r~t~ Rate Int~t b~i~z~t Paid CHECKING 1000590335734 $1,768.91 11/27/1991 NA LEGAL TITLE: CHRISTINE SCAFIDI * Due to system limitations, we can only provide a twelve month average balance on depository accounts. Revolvin~ Credit Information Account Account Date of Death Credit Date Date Times Legal Title Type Number Balance Limit Opened VISA 426429836225224 ; MBNA - Revolving credit accounts are no longer serviced by Wachovia Bank. Please contact MBNA at 800-44 !-7048. Other Account Information Account Account Date of Balance Date Date Ledger Collected Type Number Opened ~osed TRUST 1519163680 9/4/1998 LEGAL TFFL£: CHRISTIN£ SCAFIDI TRUST WACHOVLA BANK NA TRUSTEE UNDER AGREEMENT DATED ! 1/16/1984 PLEASE CALL OUR TRUST DEP/~RTMENT (~} 888-216-2308 FOR TRUST AI)MINISTPu~TOR INFORIVlATION. REV-1509 EX + (1-97) SCHEDULE F ODMMONWEALTH OF PENNSY~.VANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN ESTATE OF FILE NUMBER Scafidi, Christine M 21-2003-0632 If an asset was made joint v~thin one year of the decedefl~s date of death, ~ must be reported off $chedu~ G. SU~VW~G ~INT ~ZNANT(S) NAME ~URESS ~ONS~P TO ~NT A. Gregg, Maria T (Date of Birth: 1/5/65) Daughter 304 Eleventh Street New C~-~erland, PA 17070 JOIN'n.Y~ ED PROi~RTY: NUMBER ~ JOINT :similar kler~f~ing humid. Ntae~ amd for ,_ _ _~ha~l m~ --~,- VALUE OF A..~ET ~ ~1~ 1. A 05/01/1998 ~e at~ list of O~ 11,671.00 50.00 5,835.50 S~s Sa~ngs ~n~ ~ held jointly ~~ ~e ~ia T. G~g ~ia T. S~i~). .... T~ (~ ~r ~ li.e 6. ~=~=~) ~ 5,835.50 ~z~ (~m~~ ~~~~) Savings Bond Calculator Page I of 2 Savinc [06/2009 t u ,aat 'l Series Denomination Serial Number Issue Date lEE Bonds $15oo # Bonds Total Price Total Interest Total Value YTD Iw 31 $6,750.00 $4,921.00 $11,671.00 $249. Issue Interest Next Final Serial Number Issue Date Series Denom Price Interest Value Rate Accrual Maturit2 D48477909EE 05/1998 EE $500 $250.00 $64.60 $314.60 2.66% 07/2003 05/202~ D48475144EE 01/1998 EE 500 250.00 72.00 322.00 3.25% 07/2003 01/202~ D48472138EE 08/1997 EE 500 250.00 80.60 330.60 3.25% 07/2003 08/202~ D43917262EE 03/1997 EE 500 250.00 74.00 324.00 3.07% 09/2003 03/202~ D43914150EE 11/1996 EE 500 250.00 79.00 329.00 2.51% 11/2003 11/202( D42767010EE 06/1996 EE 500 250.00 86.60 336.60 2.51% 12/2003 06/202¢ D42763781EE 02/1996 EE 500 250.00 89.40 339.40 3.07% 08/2003 02/202( D42760337EE 09/1995 EE 500 250.00 98.60 348.60 3.07% 09/2003 09/'202.' D42757119EE 04/1995 EE 500 250.00 119.40 369.40 3.08% 10/2003 04/202.'. D42753768EE 12/1994 EE 500 250.00 125.20 375.20 2.50% 12/2003 12/202z D40494422EE 07/1994 EE 500 250.00 128.00 378.00 3.13% 07/2003 07/202z D40491348EE 03/1994 EE 500 250.00 136.20 386.20 3.00% 09/2003 03/202z D40488200EE 10/1993 EE 500 250.00 145.40 395.40 3.09% 10/2003 10/202.- D27147575EE 05/1993 iEE 500 250.00 151.40 401.40 2.49% 11/2003 05/202: D27144656EE 01/1993 EE 500 250.00 201.60 451.60 6.00% 07/2003 01/202.'- D27141797EE 08/1992 EE 500 250.00 215.20 465.20 6.00% 08/2003 08/202; D27255783EE 04/1992 EE 500 250.00 229.20 479.20 6.00% 10/2003 04/202~ D27253477EE tl/1991 EE 500 250.00 243.40 493.40 6.00% 11/2003 11/202] D27155151EE 06/1991 EE 500 250.00 258.20 508.20 4.00% 12/2003 06/2021 D26982194EE 02/1991 EE 500 250.00 258.20 508.20 4.00% 08/2003 02/202] ~D26616134EE 09/1990 EE 500 250.00 268.40 518.40 4.00% 09/2003 09/202( D25848630EE 05/1990 EE 500 250.00 278.80 528.80 4.00% 11/2003 05/202( D23724646EE 12/1989 EE 500 250.00 289.40 539.40 4.00% 12/2003 12/201~. D20107916EE 07/1989 EE 500 250.00 289.40 539.40 4.00% 07/2003 07/201.~ D20106194EE 02/1989 EE 500 250.00 300.20 550.20 4.00% 08/2003 02/201.~ D20104411EE 10/1988 EE 500 250.00 311.20 561.20 4.00% 10/2003 10/201~ C164760036EE 05/1988 EE 100 50.00 64.48 114.48 4.00% 11/2003 05/201~ C161420846EE 03/1988 EE 100 50.00 64.48 114.48 4.00% 09/2003 03/201~ Savings Bond Calculator Page 2 of 2 C1614~2470EE 01/1988 EE 100 50.00 64.48 114.48 4.00% 07/2003 01/201~ C154118889EE 11/1987 EE 100 50.00 66.76 116.76 4.00% 11/2003 11/201~ C154099337EE 09/1987 EE 100 50.00 67.20 117.20 4.00% 09/2003 09/201~ {Vie~ 10 [I Viewing Bonds 1-31 Note Description NI Not Issued NE Not Eligible for Payment P5 Includes 3-month interest penalty ME Matured (Exchangeable for HH) MN Matured (Not Exchangeable for I-IH) Please rate this service. (Please print and/or save this page before submitting your survey) Service Excellent Good Fair Poor Savings Bond Calculator C © C C S~_41EDUM~ G CO~O~VEAC~H ~ ~S~V~ IN~-~OS ~SFERS & I~lm~m~ R~RN MI~. NON~ROBA~ PROPER~ ~ ~T ESTATE ~ FI~ ~R Scafi~ ~ ~ristine M 21-2003-0632 ~is ~hedule must ~ ~m~e~d and fi~ if ~e ~r ~ any of ~ns I ~r~h 40n ~e re~ ~ of ~ R~-I~ ~R SHEET is ~. ~~OF~Y NUMBEF ~~ ~m ~ T~FE~ a~ A ~ ~ ~ ~ ~ O~ DECKS ~CLUS~ T~E VALUE ~D ~ ~ ESTmE V~UE OF ~ Ih ~ ~EST (F 1. ~ris~ne M. Scafi~ ~eat~ a 0.00 100.00 0.00 0.00 ~voc~le ~~nt of T~st wi~ ~m~ lton B~, N/K/A Wa~ia B~, N.A. , ~st~, ~ted N~r 16, 1984. (Accost ~ 1519163680) ~e assets ~at c~ris~ ~s ~st as of ~is~ne Sc~i~'s ~ of ~a~ ha~ ~en ~v~u~ as of 06/25/03, ~r it~ ~2 ~ugh i~ %11, as follows. (C~y of T~st ~~nt ~os~) 2 20,625.617 S~s. ~~ PA 243,382.28 100.00 0.00 243,382.28 ~~ ~n~ ~ Cl I (Fd ~216) Inco~ a~ to 06/25/2003 732.61 100.00 0.00 732.61 3 1,565.041 S~s. ~~ Co~ 82,712.42 100.00 0.00 82,712.42 E~ ~a C1 I (Fd ~457) Inc~ aoc~ to 06/25/2003 43.43 100.00 0.00 43.43 4 1,963.01 Shs. ~~n 37,513.12 100.00 0.00 37,513.12 S~ategic Value ~d Cl I (Fd ~4S0) Inc~ aoc~ to 06/25/2003 40.73 100.00 0.00 40.73 5 3,153.054 Shs. ~~ ~e 36,796.14 100.00 0.00 36,796.14 Cap ~ ~d C1 I (Fd 9716) 6 Prin~p~ Cash b~ of ~e 11,856.73 100.00 0.00 11,856.73 ~istine S~fi~ T~st as of 06/25/2003 To~a! f~ ~ntinua~on ~s .... 353,966.23 TOT~ (~ e~er on I~e 7. R~~) 767,043.69 2w~ z~ (~ m~ ~ ~ ~' ~ ~ ~ ~e Page 2 Estate of: Scafidi, Christine M 21-2003-0632 ' 'Schedule G -- Inter-vivos Transfers & Misc. Non-probate Property £tem Date of death % of Decd's Exclusion No. Description Value of asset Interest (If applicable) Taxable Value 7 Income Cash balance of the 11,932.15 100.00 0.00 11,932.15 Christine Scafidi Trust as of 06/25/2003 8 Interest accrued to 06/25/2003 14.94 100.00 0.00 14.94 on the Principal & Income Cash balances of the Christine Scafidi Trust 9 Investment Advisory fee 106.88 100.00 0.00 106.88 adjustment on Evergreenfunds from 06/01/03 - 06/25/03 10 Wachovia Bank, N.A. - Monthly (288.01) 100.00 0.00 (288.01) fiduciary's fee for the Christine Scafidi Trust, accrued through 06/25/03 11 Wachovia Bank - Death of (4,250.00) 100.00 0.00 (4,250.00) grantor estate settl~nt fee 12 PA State ~-~.loyees Credit 36,880.09 100.00 0.00 36,880.09 Union ; 60 Month IRA Certificate of Deposit-4 (S50) Beneficiaries: Maria T. Gregg (50%) & John M. Scafidi (50%) Interest accrued to 06/25/2003 118.58 100.00 0.00 118.58 13 PA State Employees Credit 8,302.93 100.00 0.00 8,302.93 Union 48 Month IRA Certificate of Deopsit (S60) Beneficiaries: Maria T. Gregg (50%) & John M. Scafid~ (50%) Interest accrued to 06/25/2003 25.38 100.00 0.00 25.38 Page 3 Estate of: Scafidi, Christine M 21-2003-0632 · ' 'Schedule G -- Inter-vivos Transfers & Misc. Non-probate Property £tem Date of death % of Decd's Exclusion No. Description Value of asset Interest (If applicable) Taxable Value 14 Commonwealth of Pennsylvania 178,684.45 100.00 0.00 178,684.45 Deferred Compensation Program Account ~ 01111142 ( 179-30-SBNJ) (Valued as of 06/30/2003) Beneficiaries: Maria T. Gregg (50%) & John M. Scafidi (50%) 15 Fidelity Inves~nts 12,276.00 100.00 0.00 12,276.00 ~Fidelity Fund Traditional IRA Account ~ 2AJ-797847 - Comprised of only the following asset: 140. 105 Shs. Fidelity Magellan Beneficiaries: Maria T. Gregg (50%) & John M. Sca~idi (50%) (Copy of account confirmation letter enclosed) 16 For Informational Purposes 0.00 100.00 0.00 0.00 Only At time of death the deoec~ent had an interest in the following annuity: Com~o~__nwealth of PA, State ~m~loyees' Retir~nt System, Option I Annuity Beneficiaries: Maria T. Gregg (50%) & John M. Scafidi (50%) (Value as of date of death was $528,719.88, per attached copy of doc~,~m~ntation) T~is ~n-_uity is not subject to PA Inheritan~e Tax, and thus, is being disclosed for informational ~ses only. Page 4 Estate of: Scafidi, Christine M 21-2003-0632 ' 'Schedule G -- Inter-vivos Transfers & Misc. Non-probate Property £tem Date of death % of Decd's Exclusion No. Description Value of asset Interest (If applicable) Taxable Value 17 The decedent made the 3,500.00 100.00 3,000.00 500.00 following gifts to a College 529 Plan, for the benefit of her granddaughter, Olivia B. Gregg, within one year of death, as follows: 09/19/2002 - $1,000.00 12/03/2002 - 750.00 (2002 gifts fully 02/11/2003 - $ 500.00 04/18/2003 - 3,000.00 18 The decedent made the 4,100.00 100.00 3,000.00 1,100.00 following gifts to a College 529 Plan, for the benefit of her granddaughter, W. Gregg, within one year of death, as follows: 09/19/2002 - $1,000.00 12/03/2002 - 750.00 (2002 gifts fully 02/11/2003 - $ 600.00 04/18/2003 - 3,000.00 19 Masland & Barrick AdvisoL-f, 72,178.36 100.00 0.00 72,178.36 Inc. Metlife Bank, Trustee Rollover IRA Account # 5W8-881646 (Com~rise~ of 3 mutual funds & · cash - Copy of documentation attached) Beneficiaries: Maria T. Gregg (50%) & John M. Sca~ic~ 20 Masland & Barrick Advisory, 36,384.48 100.00 0.00 36,384.48 Inc. Hartford Life Contract ~ 711106662 (Con~rise~ of 2 funds - of documentation attached) Beneficiaries: MA~ia T. ~regg Page 5 Estate of: Scafidi, Christine M 21-2003-0632 Schedule G -- Inter-vivos Transfers & Misc. Non-probate Property £tem Date of death % of Decd's Exclusion Taxable Value No. Description Value of asset Interest (If applicable) TOTAL. (Carry forward to main schedule) ...... 353,966.23 Deferred , ~,~1' P[mnssl',.'ania Compensation Program SECUREadminisrered, enrolledYOUR FUTURE. TO-flAY. . ............. ~2a0l~a ..................... Olllll4l I,,,lll,,,llh,,,,,Ih,,Ih,,Ih,hlh,,h,,Ih,ll,il,,,,Ih,l Rer~ 0t8839 ~375~3 1-800-422-1327 CHRiST[NE H SCAF]D[ 63~ RUPLEY RD CAHP H~LL PA 17~11-~271 PAGE 1 OF INCEPTION TO DATE SUltRY INVESTHENI FUND ** TOTAL TRANSFER DISTRIBUTION5 TOTAL DESIGNATION NUHBER CONTRIBUTION GAIN/(LOSS) BALANCE CPA GROUP FUNDS AGGREGATE BOND INDEX 0185 53,475.79 2,194.20 .00 37,192.97 92,862.96 SHORT-TERM MONEY MARKET 0186 3,980.61 (4,388.40) .00 407.79 .00 STOCK INDEX FUND 0187 45,531.53 2,194.20 .00 38,095.76 85,821.49 PLAN TOTALS lOZ,y~/.93 .00 .00 /5,bD§.SZ 1/~,§~4.45 .*~ ..PLEASENOTE YOUR FOUR DIGIT FUND NUMBER FOR USE WITH THE CZTISTREET AUTOMATED INFOR~TION SYSTEM. CALL PERIOD $UI~4ARY ( 4/81/83 - 6/39/03) INVESTMENT 84/01 TOTAL PERZOD TRANSFER DISTRIBUTION5 PERIOD 86/36 DESIGNATION BALANCE CONTRZBUTZON GAIN/(LOS$) BALANCE CPA GROUP FUNDS AGGREGATE BOND INDEX 90,676.39 .O0 .00 .00 2,186.57 92,862.96 STOCK INDEX FUND 74,408.46 .00 .00 .00 11,413.03 85,821.49 DETAILED TRANSACTIONS ( 4101193 - 6138/03) INVESTMENT TRANSACTION FUND DOLLAR UNIT/SHARE UNIT5/ DATE DESCRIPTION NANE ANOUNT VALUE SHARES : 04/25/03 ASSET CHARGE AGGREGATE BOND INDEX 15.55 173.4755 .0896 04/25/03 ASSET CHARGE STOCK INDEX FUND 13.67 12.2600 1.1150 05/23/03 ASSET CHARGE AGGREGATE BOND INDEX 15.89 177.2153 .0896 05/23/03 ASSET CHARGE STOCK INDEX FUND 14.00 12.7500 1.0980 ....... 06/27/03 .... ASSET CHARGE AGGREGATE BOND INDEX 15 85 176 5441 .0897 PAYROLL CONTRIBUTIONS NOT YET POSTED BY THE APPROPRIATE ISSUERS TOTALED $ .00 ( PLEASE SEE NEXT PAGE ) Fideli~ Investments, WACHOVIA BANK, NA ATTN: KIM E GARRETT PO BOX 3959-PA6907 LANCASTER PA 17604 Dear Ms. Garrett: We are responding to your request for information about Christine M. Scafidi's account with Fidelity. The table below lists the account holdings and values as of 06/25/2003. Fidelity account 2AJ-797847: CHRISTINE SCAFIDI-TRADITIONAL IRA Security Description CUSIP Quantity Unit Value Market Value FIDELITY MAGELLAN 316184100 140.105 $87.62 $12,276.00 Total Value $12,276.00 We hope this information is helpful. For questions concerning account holdings or instructions on how to transfer the ownership of the accounts, please call our Inheritor Services Group at 800-544-0003 between 9:00 A.M. and 5:30 P.M. Eastern time Monday through Friday or visit our website at www.fidelity, com. Sincerely, Fidelity Investments Our file: W018273-06OCT03 Brokerage Services provided by Fidelity Brokerage Services LLC, Member NYSE, SIPC Clearing, custody, and settlement services by National Financial Services LLC, Member NYSE, SIPC P.O. Box 770001. Cincinnati, OH 45277-0034 ~'--I~--Bd. ~99:48 ESTATE SETTLEMENT ID=717 295 3815 ~U. :::~'; ' ' C~MO~/~ ~ ~LV~A 30 ~ THIRD ~R~ - P-O. ~X 1147 Fe. bruary 1~. FAXED AND ESTATE SE~I~.~ENT CONSULTANT ASSOCIAT~ WACH0~rfA BANK N~ LEGACY ~/~NT ADVISO~ 100 N QUF~EN STREET LANC~-~T~R PA 17603 Re: Christine M. Scafidi, deceased SS~ 179-30-5S06 Dear ~L~. G~rrett: T~is is ~ Scafi~ wi~ Ce~ifica=e ~ ~r ~tate. ~e tot~ dea~ b~it $528,719.88, an4 is parle to ~e ~d b~fi~es of her reti~t accost. ~ere ~ ~ b~fit ~ her Estate from our Retir~t assist~ce, plebe ~ntact ~ office at (~17) 787-6293. Sincerely, ~i~e ~. S~ti~ B~efiu Dete~=i~ Di~sion TO: Klm Garrett - Wachovia Bank FROM: Robin Rowe - Masland & Barrick Advisory, Inc. RE: Christine Scafidi date-of-death values DATE: 8/27/2003 Rollover IRA account # 5W8-881646 Money market $19.18 Eaton Vance Gov't Obligation C1 B $12,820.72 Eaton Vance Floating Rate CI C $15,404.46 Van Kampen Equity & Income C1 B $43,934.00 Hartford \;ariable Annuity contract # 71 ] 10662 Capital Appreciation sub-account $18,962.33 Growth & Income sub-account $17,422.15 Alliance College Bound Fund 529 Plans Fbo Samantha Gregg $9,733.28 Fbo Olivia Gregg $8,907.18 F-bo Henry Gregg $8,021.92 REV-1511 EX + (1-97) ' SCHEDULE H COM~LTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERIT~,NCE TAX RETURN AD MINISTRATIVE COSTS ESTATE OF FILE NUMBER Sca--=icli, Ch=ist£ne M 21-2003-0632 Debts of decedent must be reported on Schedule L FrEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Neill ~'h~aeral Ho~e, Tn=. - Drofessiona[ serv";_ces 3,413.73 2 Dininni Foods - Food from cate=er for funera_l. =teal 1,000.00 3 G.lean t~.~lle='s ~ee= & Soct~ Waz~ehouse - Beverages fo= 82.26 funeral meal 4 OfficeMax - Fee for waste cans and waste removal 78.19 it~m~ for funeral meal B~ ADMINISTRATIVE COSTS: 1. Personal Representstive% Commissions 20,956.34 Name of Personal Represefltative(s) Wac.hcrvia Bank, N.A. Social Security Number(s) I EIN Number of Personal Relxesentati~s) 22-1147033 Street Address 123 S. Broad Street - PA1308 City Philadelphia ~a~ PA Zip 19109 Year(s) Commission Paid: 2. AttorneyFeasName: Killian & Gel~hart, LLP 20,000.00 3. Family Exemption: (If ddcedenrs address is not ~%e same as da~nan~s, attach ex~ana~) 0.00 Claimant Street Address Ci~/ S~ Zip Re~fionship of Claimant tu 0ecedent 4. ~0~ee Fees 0.00 5. Accountants Fees 0.00 6. Tax Retum ~epare~s Fees 0.00 7. Ol~namic Appraisals, Inc. - Fee for appraisal of real 300.00 estate 8 Killian & Gel~hart, LLP - Re~s~-~nt for palm.hr of 365.12 probate ~osts (272.), estate advertising expense (75.) and miscellaneous ex[0~nses (18.12) 9 ~ses re: Maintainence and upkeep of real estate 1,972.45 prior to sale, per schedule attached To_~_ ~_ £zo~- continuation ~ages .... 12,159.02 TOTAl. (Also --.-.~r on line 9, P+--~-'-':~- ::~ $ 60,327.11 2w4e~32.00o (If i~,o~e space is needed, insalt adcilional sheets of same size) Page 2 Estate of: Scafidi, Christine M 21-2003-0632 Schecb~le H, Part A -- Funeral Expenses Item No. Description Amount 5 U.S. Postal Service - St~m~.s for thank you cards 37.00 6 Circuit City Stores, Inc. - Expense for aud/o cables 52.96 (2 @ 19.99 & 2 @ 4.99 + tax) for music hook up at the fn~ral meal 7 Party 'N' More - Cost of plates, cups, napkins and 93.46 utensils for the funeral meal 8 FYE Store, Capital City ~all - Con~act discs 73.09 purchased for providing nmsi¢ during the funeral meal TOTAL. (Carry fo~ to~a/n schedule) ...... 256.51 Estate of Christine M. Scafidi Schedule "H", Part "B", Item # 9 Expenses re: Maintenance and upkeep of Real Estate prior to sale, as follows: 1. Zimmerman's Landscaping - Lawn maintenance services 700.00 2. Montour Oil Service Co. - Fuel oil delivery services 424.69 3. PP&L - Electric services 134.75 4. Verizon Telephone services - 106.28 5. PA-American Water Co. - Water services 124.48 6. Borough of Wormleysburg - Sewage and refuse services 112.00 7. Willlis Corroon Ins. Co. - Property liability insurance 313.00 8. Comcast Cable - Cable television services 5.29 9. Natural Lawn of A~erica - Early Fall lawn treatment 51.96 Total 1,972.45 Page 2 Estate of: ~cafidi, Christine M 21-2003-0632 Schedule H, Part B -- ~nistrative Costs Item No. Description Amount 10 Expenses re: Brokerage co-~ssions and closing costs 3,692.11 in the sale of real estate, per copy of Settle~nt Sheet enclosed (Sale price of $130,900. less net proceeds received of $127,207.89) 11 Wachovia Bank, N.A. - Fee for services rendered for 7,854.00 and on behalf of the real estate from date of death up through, and including, the sale of the real estate ($130,900. X 6%) 12 Fa=merville Auction - Auction c~-~, ssLons and 356.40 :i expenses in the sale of miscellaneous personal property :i TOTAL. (Carr~ forward to m{ n schedule) ...... 11,902.51 ' R~-~2 ~x + 0-97) SCHEDULE I COII,tMONVVF_A~]I-I OF PENNSY[.VANIA DEBTS OF DECEDENT, IM-ERFTANCE TAX RETURN ~OENT~CEm~rr MORTGAGE LIABILITIES, & LIENS ESTATE OF · FILE NUMBER Scafidi, Christine M 21-2003-0632 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1. AT&T Wireless - Balance due for cell phone serv£ces 28.36 2 pp&T. - Balance due for electric services 85.59 3 Zi~rman's Landscaping - Balance due for lawn mowing services 200.00 4 Verizon - Balance due for telephone services 69.60 5 American Water Company - Balance due for water utility services 41.15 6 AT&T - Balance due for long distance telephone services 90.65 7 MBNA America, LL Bean - Balance due for crectit card charges 65.00 8 Bankcard Services - Balance due for Wachovia o~<iit oard 33.90 charges 9 Connor-Rich Associates - Balance due for medical services 275.00 )rovided on 3/28/03, 4/1/03, 5/15/03 & 5/22/03 10 )iscover Card - Balance due for credit card charges 349.86 11 Fulton Bank Mastercard - Balance due for credit card charges 407.00 12 Montour Oil Service Co. - Balance due for fuel oil delivery 125.84 services 13 PA State ~loyees C~t Union, Checking Account (Sha~e 04) - 304.07 Seven separate checks, representing payments of various bills, were written prior to death and presented for payment subsequent thereto TOTAL (Also ~-¢~e,- on line 10, P-~-~:;--~.'--~) $ 2,0 7 6.02 2W48AH 2.0<30 (If ~ space is needed, il~ adi~k~ sh~ 0Ir Ihe I~/le liize) R~,~'~513 EX+ (9-00) SCHEDULE J COMM(~VVEALTH ~)F PENNSYLVANIA BENEFICIARIES INHERITANaE TAX RE'rURN ESTATE OF FILE NUMBER Scafi ., Christine M 21-2003-0632 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distdb~inns, and transfers under Sec. 9116 (a) (1.2)] 1. Gregg, Maria T Daughter 485,583.93 (Date of Birth: 1/5/65) 304 Eleventh Street New C~m~erland, PA 17070 2 Scafidi, John M Son 479,748.44 (Date of Birth: 5/7/67) 2403 NW 60th St. - Apt. 202 Seattle, WA 98107 3 Gregg, Samantha W Granddaughter 1,100.00 304 Eleventh Street New C~m~erland, PA 17070 4 Gregg, Olivia B Granddaughter 500.00 304 Eleventh Street New Cumberland, PA 17070 ENTER DOLLAR AMOUNTS I=CR DISTRIBUTIONS SHOWN ABOVE ON UNES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHE. E.~ IL NON-TAXABLE DISTRIBUTIONS: A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR VVHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXA~?_ DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SH~-~- I $ 0.00 2w4~ ~.ax) (If mom s~,~,.~ is needed, ~,~,~ ~1 s~ee~s of the same si=a) OF CHRISTINE M. SCAFIDI I, CHRISTINE M. SCAFIDI, declare this to be my Last Will and Testament and hereby revoke all prior wills and codicils made by me. FIRST: My Executor shall pay from the residue of my estate all my debts, funeral expenses, administration expenses, and all estate, inheritance, succession, and transfer taxes imposed by the United States or any state, territory, or possession which shall become payable by reason of my death. It shall not be necessary to file any claims therefor, nor to have them allowed by any court. SECOND: I bequeath all of my tangible personal property and insurance thereon, which I own, not including cash and securities, as is set forth in a separate, unsigned letter of instruction, which I shall place with my Will, to the persons therein designated. If I have not prepared a letter of instruction or for those items of my estate not distributed under this letter, I give and devise such tangible personal property to my children in equal shares as they may select. I direct my Executor to sell any such property not specifically allocated in such separate, unsigned letter of instruction and to add the net proceeds thereof to the residue of my estate. LAST WILL AND TESTAMENT OF CHRISTINE M. SCAFIDI THIRD: I give, devise and bequeath all of the rest, residue and remainder of my estate to HAMILTON BANK, Harrisburg, Pennsylvania, Trustee, to be added to and administered as a part of a trust estate created by a certain Trust Agreement between myself as Settlor and the said HAMILTON BANK, Harrisburg, Pennsylvania, as Trustee, dated /~/~~J~ f6..f~ , said Agreement having been executed before this Last Will and Testament. FOURTH: I nominate, constitute and appoint HAMILTON BANK, Harrisburg, Pennsylvania Executor of this my Last Will and Testament, to serve without bond or security, and I hereby authorize, empower and direct it to sell and convey, by good and sufficient deed, in fee simple estate, any and all of my real estate, at public or private sale, for such price or prices, upon such terms and conditions, as in its judgment is best for my estate, and to that end to sign, seal, execute, acknowledge and deliver all deeds to other instruments necessary therefor, as effectively as I could do if I were personally present. IN WITNESS WHEREOF, I, CHRISTINE M. SCAFIDI, the TESTATRIX, have to this my Last Will and Testament -2- LAST WILL AND TESTAMENT OF CHRISTINE M. SCAFIDI set my hand and seal this /~ ~ day of CHRISTINE M. SCAFID~' Signed, sealed, published and declared by the above named TESTATRIX, as and for her Last Will and Test~ent, in the presence of us, who have hereunto s~scribed our names at her request, as witnesses hereto, in ~e presence of the said TESTATRIX, and of each other. This doc~ent consists of this and two other consecutively numbered typewritten pages. ~ _ . ,~ /~ residing -3- ACKNOWLEDGMENT AND AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) ) ss · COUNTY OF DAUPHIN ) The Testatrix and the witnesses whose names are sub- scribed to the foregoing instrument, being first duly sworn and qualified according to law, do hereby acknowledge and declare to the undersigned authority that the Testatrix signed and executed the instrument as her last Will in the presence of the witnesses, that she signed willingly or willingly directed another to sign for her, that she executed it as her free and voluntary act for the purposes therein expressed, that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witnesses, and that to the best of their knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Testatrix / Wit ss ' Witness Sworn to, subscribed and acknowledged before me by the above named Testatrix and witnesses this /~/day o~~&~j, 1984. CZ .~ Notary Public JUDITH A. NORDSTROm, NOTARY PUBLIC MY COM,MISSION EXPIRES SE~F. 21, 19~5 Mem~r, Pennsylvania As~ciction AGREEMENT OF TRUST This TRUST AGREEMENT is made and executed thfs of ~/~ , 1984, by an~ between CHRISTINE M. SCAF!DI, of Cumberland County, Pennsylvania, hereinafter called Settlor, and HA/~.~L.ON BANK, Harrisburg, Pennsylvania, hereinafter called Trustee. 1. The Settlor does hereby assign, transfer and deliver to the Trustee the property described in Schedule A autached hereto, all. of which'shall be subject to'the reservaticns made by the Settlor in this instrument. As further evidence of such assignment, the Settlor has executed or will execute or cause to be executed such other instruments as may be required for the purposes of completing the assignment or transfer of title to such prcperty to the Trustee. The Trustee accepts such transfer and assignment to itself as Trustee, and undertakes to hold, manage, invest and reinvest the assets of this Trust, subject to the approval of the Settlor during her lifetime, and distribute the income and principal of the trust in ascordance with the=_~ovJsions. of this Agreement. 2. During the lifeuime of the Settlor, the net income and the principal of t]~e trust shall be administered by the Trustee, subject to the fol!o%,ing terms and conditions: A. The hen income of the trust shall be paid to the Settlor in quarter-annual installments, or shall be distributed to her and her issue in such manner as she may from time to time specify in written or other directions delivered to the Trustee. B. The Settlor may withdraw part or all of the trust principal at any one time or from time to time, by written request signed by her and delivered in her lifetime to the Trustee. C. In the event of the disability of the Settlor for any reason, as much of the income and principal as the Trustee may deem proper for the welfare, maintenance and support of the Settlor or her issue shall be paid to or applied directly for her or their benefit, providing the Trustee takes into consideration her or their other income and other readily available assets. 3. In addition to the rights to receive net income and withdraw principal, as specified in paragraph 2 hereof, the Settlor reserves to herself the right at any time to transfer during her lifetime, or at her death by testamentary disposition, additional proper~y to the Trustee hereunder and to alter, amend or revoke in whole or in part the trust at any time. 4. Upon the death of the Settlor, the Trustee shall divide the corpus of this trust and any accumulated or --2-- undistributed income into as many shares as Settlor has then-living children and children then-deceased survived by then-living issue. The share of any deceased child shall be distributed to the issue of that child, per stirpes. ?he share of Settlor's then-living children shall be held in further separate trust and shall be administered, as follows: A. Trustee to accumulate income or pay on behalf of such child, so much of the income and principal as Trustee, in its sole and absolute discretion, deems advisable .for the health, maintenance, support and education (including vocational and colleqe education, both graduate and undergraduate) of such child, or during 'illness or emergency. B. When such child attains age twenty-one (21), he or she may request and receive up to one-half (1/2) of the net income of such child's separate trust. C. As each child attains age twenty-five (25), Trustee shall distribute absolutely to each child all. of the net income of such child's separate trust. D. When such child attains age twenty-five (25) he ~r she may request and receive up to on~-third (I/3), 'cumulatively, of the initial principal of such child's separate trust in the sole discretion of my Trustee for ~he --3-- purposes of investing in a business, purchasing a house cr any other reasonable purpose. E. When such child attalns age t%¢enty-eight (28), he or she may request and receive up to one-half (1/2) of the then-remaining principal of such child's separate trust. F. As each child attains age thirty-one (31), Trustee shall distribute absolutely the then-remaining principal of such child's separate trust. G. Should such child fail to survive to age thirty-one (31), the then-remaining principal and accumulated income of such child's trust shall be distributed to such child's surviving issue, if any, in equal shares; if no issue survive such child, the then-remaining principal and accumulated income shall be distributed in equal shares to Settlor's surviving child or children, including the issue of any deceased child, per stirpes. In the event there are none cf the Setttor's issue then-surviving, the Trust shall be terminated and the proceeds shall be distributed, as follows: (1) Twenty-five (25%) percent to the Settlor's brother, MICHAEL WINSLOW, and sister-in-law, GEORGEANN WINSLOW, or their then-living issue, per stirpes; (2) Twenty-five (25%) percent to the Settlor's brother, STANLEY WINSLOW, or his then-living issue, per stirpes; (3) Twenty-five (25%} percen~ to the Setttor's parents, JOHN D. WINSLOW and VERNA WINSLOW, as joint tenants with right of survivorship, or to their issue, per stirpes; and (4) Twenty-five (25%) percent in equal shares to the following named family members of my deceased husband, Samuel Scafidi, who are living at the time of distribution of this share of my trust: LEO $CAFIDI, JOHN SCAFIDI, JENNY LIPCHOCK and MARY VIANALE. The distribution in paragraph 4 (G) (4) is to be construed as a gift to a class of individuals who must survive as provided herein. 5. Subject to the provisions of this Agreement relating to the powers reserved by the Settlor, the Trustee shall have and exercise exclusive management and control of the trust, and shall be vested with the following specific powers and discretion, in addition to the powers as may be generally conferred from time to time upon trustees by law: A. To invest any funds at any time held in trust in any stocks, bonds, notes or other securities or property, real or personal, including the Common Trust Funds and stock of the Trustee, in accordance with the Prudent Man Rule and the laws of the Commonwealth of Pennsylvania. B. To sell or otherwise dispose of any property, real or personal, at any time held hereunder, for cash or upon credit, in such manner and on such terms and conditions as it may deem best, and no person dealing with it shall be bound to see to the application of any moneys paid. C. TO borrow or loan money for ans, purpose in connection with the administration of this nrust upon such terms and with such security as it may determine. D. To make any distribution hereunder in cash, in kind, or partly in cash and partly in kind. E. To maintain all property held in trust hereunder in a single fund, and to maintain such records as may be necessary to properly administer said fund and the trust created herein. F. To make any distribution hereunder for the benefit of minor beneficiaries directly to the beneficiary thereof, to the natural guardian cf such beneficiary, To his legal guardian, or to the person who has custody of such beneficiary, or to apply any such distribution directly to the benefit of any such beneficiary. Trustee shall not in any way be liable to see to the proper use or application of any amount paid by it whether directly to a beneficiary or otherwise. G. To receive such other property, including policies of insurance, or the proceeds thereof, upon the life of the Settlor, as may from time to time be deposited with it by the Settlor or any other person and to administer such property or policies and the proceeds thereof in accordance with the terms of this Agreement. --6-- H. To dispose of all income producing property upon whatever terms or conditions Trustee, in its sole discretion, deems advisable. I. In general, to exercis{~ all po%~ers in the management of this trust which any individual could exercise in nhe management cf s~ilar property owned in his own right, upon such terms and conditions as to it may seem best, and to execute and deliver all instruments and to do all acts which it may deem necessary or proper to carry out the purposes of this trust. J. To make such expenditures out of this trust as it, in its sole discretion, may consider desirable in order to facilitate the settlement of Settlor's estate. In e>:ercising such power, Trustee may pay, in whole or in part, any or all of the followlng items: the expenses of Settlor's last illness and burial, including the cost of a gravemarker; debts; income taxes; the death, inheritance and estate taxes on any and all property included in the gross estate for tax purposes; and all other items in connectio~ with the settlement of said estate. Any such items may be paid directly by Trustee or the funds for their payment may be transferred by Trustee to Settlor's executor or administrator; and neither such executor or administrator nor any beneficiary of Settlor's estate shall be required to reimburse Trustee for any funds so paid or transferred. All such death taxes on present or future interests shall be paid at such time or times as Trustee deems proper, regardless of whether such taxes are then due, provided that any postponed taxes on future lnnerests shall be charged against the particular share with respect to which the taxes are imposed. 6. Settlor hereby nominates, constitutes and appoints HAMILTON BANK, Harrisburg, Pennsylvania, Trustee of any trusts herein created to exercise all of the powers conferred upon trustees by law, and all of the discretionary powers granted herein. The Trustee and any successor ~rustee shall be entitled to compensation for its services based on its regular schedule of fees for such services in effect from time to time during the period which its services are performed. 7. No interest of any beneficiary of Settlor's estate or of the trust created herein, either in income or principal, shall be subject to anticipation or to pledge, assignment, sale or transfer in any manner, nor shall any such interest be liable on account of the debts, contracts, torts, or other engagements of any beneficiary. 8. The Trustee may reszgn at any time upon written notice given to the Settlor if she is living, or in the event of her death, upon written notice to nhe current income beneficiary or beneficiaries hereunder. A successor trustee may be appointed by the Settlor during her lifetime, or, after her death, by any court having jurisdiction over the trust. Any successor trustee thus appointed, or, if the Trustee shall merge with or be consolidated with another corporate fiduciary, then such corporate fiduciary, shall succeed to all the duties and to all the powers, including discretionary powers, herein granted to the Trustee. 9. If at any time the Trustee, in its absolute discretion should determine that this Trust, or any share hereunder, is impracticable to administer, the Trustee may, in full discharge of its duties, without fore, al court accounting, make distribution of the principal thereof to the person then entitled to the income. Should any such person be a minor, or, in the opinion of the Trustee, be mentally or physically incapacitated, the Trustee may pay the share to the parent or guardian of the beneficiary, or to any person taking care of the beneficiary, or, in the case of a minor may deposit the share in a savings account, made payable to the minor upcn attaining majority, which Settlor defines as twenty-one (21) years of age. -9- IN WITNESS WHEREOF, the Settlor and Trustee have hereunto set their hands and seals this /~T~day of Witness: Attest: HAMILTON BANK -10- O F" ~' NUMBER' [] [] INS. J .... 7 LOAN NUMBER SEYTLEMENT STATEMENT j RECH j ' : ~. ~0--'"~: This form is furnished to give you a statement of actual settlement costs. Amounts paid to an~ by the settlement agent are shown~ Items marked "[POC]" were paid outside the closing' ~hey are s~own here for informational purposes and are not included in the totals. ~ 1.0 3~8 {RECH.PFD/RECH/11 ) NAME AND ~S OF BUYER: E. NAME AND ADDRESS~LLER: F. NAME AND ADDRESS OF~ EDWARD L. RECH WACHOVIABANK, N.A., EXECUTOR /~/ ~7~/~ of the Estate of Christine M. S~fidi G. PROPER~ LOCATION: H. SE~L~MENT AGENT: 23-2402316 630 RUPLEY ROAD I. SE~LEMENT DATE: CAMP HILL, PA 17011 PURI~ ABSTRACT COMPANY CUMBER~ND Count, Pennsylvania P~CE OF SE~LEMENT December 5, 2003 3329 Market S~eet Camp Hill, PA 17011 DUE FROM~ . O A :LL: A A 400. GROSS AMOUNT DUE TO SELLER: ce ~rope~ 130 ce 130,900~ arges to Buyer (Line ~ Prope~, 12/05/~"~ to 01/01/0-'~----'---~, ~ Ao/ustments ~s Pald ~ance -- ax to 12/05/0"~' to 01/01/~' 27.05 to -- ax 1210~ , 556.97 ~ax 12/05-~'0~ to 07/~ 556.~ 10.86 22.01 10.8E 120. GROSS AMOUNT DUE FROM BUYER 137,393.39 420. GROSS AMOUNT DUE TO SELLER 131.516.89 dD BY OR IN BEHALF OF 500. REDUCTIONS IN AMOUNT DUE TO SELLER: )st money ~f New Loan(s) ~posi[ (See instructions} subject to arges to Seller (Line 1400) 1,309.00 g ~oan(s) taken su~)ect to odgage - of secono Mortgage retained b, 3,000.00 A~ustments For Items Unpai~ By Seller to Adjustmems ~or Items Unpaid By Sefier ax to s to to ax to ax to PAID BY/FOR BUYER -- 300. : 3,000.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 4,309.00 301. ross&mount ue From Buyer (Line l?r~ ......... : i I( 4,309.00 303, CASH( X FROM)( TO)BUYER 134,393.39 603. CASH( X TO)( FROM)SELLER I 127,207.89 The undersigned hereby acknowledge receipt of a completed copy of pages I&2 of this statement & any attachments referred to herein. Buyer ~ ~k,~l~c,,,,t% ) ' Se,er by Sharon Burnside i~ .. : ~ .... ~' ..... ~ L. SETTLEMENT CHARGES 700. iOTAL COMMISSION Based on Price $ 130,900.00 @ 3.0000 % ; ..... 3,927.00 [ 'PAID F~'OM '"'T''';~ ~ ?? `ii' ~ 0 , . ~ SETTLEMENT EC ON 1. oan ngmarion ee o to 802. Loan iscount % to · en e s nsDec on ee '~' "~r{~'~'~-~Eee to '~7'-G~'~t~'ee 0 - - · ocumen rep ee · 900. ITEMS REQUIRED BY LENDER TO BE PAiD IN ADVANCE 901. Interest From to @ $ /day ( days %) · o gage nsurance remlum or mon--"~"E~o 9 3. Hazard Insurance rem~um or years to 1000. RE~ 1001· Hazarcl Insurance (~ $ "--'-'--"-' per 10~. Mortgage Insuranc~ ~ ~ per 1004. ity Tax ~ per 1005. chool ax ~ per ~ ~ per 1007~ .-'~E~'-~ ~ per 1008. A R AT W ADJ. per 1100. TITLE ~ per 1101. E-Mail Document Retrieval to ~earcJ3 to ~ Examination to -- 1104. Insured losing Letter to ~rst American ~tJe Insurance o. ~eparalJon to ~ 1106. Notary ees to _ 1107. urchaser~sA~omey's ees to MI~ ~~umDer$: 1108. die Insurance to U I AR A MPANY ')" ~age ~ · wners overage 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed $ 40.50; Mortgage $ ; Releases $ 402 · ~ oun a mps: e ~lamps: ~'~"~ta m p s ~age REC~ 1301. Survey to 1302. est Inspec~on to 1400. TOTAL SETTLEMENT CHARGES (Enter on Lines 103, Section J and ~mnes acxnow~eage recap! of a ~ of page ;' of ~is Certified to be a true copy. ~lement Agent ANY-' . COPY 706, United States... __.Estate (and Generation-Skipping · ransTer Tax Return I (Rev. August 2003) - . Es..t.ate..of a.citiz.en or r.esident of the United States (see separate instructions). Department of the Treasury /O De fi~eu ~or ueceoents eying after December 3'1, 2002, and before January 1, 2004. Internal Revenue Sen4ce For Paperwork Reduction Act Notice, see the separate instructions. la Decedent's first name and middle initial (and maiden name, if any) I b Decedent's last name 2 Decedent's Social Security No. Christine M Scafidi 179-30-5906 3a Legal residence (domicile) at time of death (county, state, and 3b Year domicile established 4 Date of birth 5 Date of death ZIP code. or foreign country) Cumberland County, PA 1938 07/17/1938 06/25/2003 6a Name of executor (see page 3 of the instructions) 6b Executor's address (number and street including apartment or suite no. or rural route; city. town, or post office; state; and ZIP code) Wachovia Bank, N.A. 123 S. ~road Street - PA1308 6c Executor's social security number (see page 3 ofthe instructions) Philadell:)hia, PA 19109 22 -1147033 7a Name and location of court where will was probated or estate administered 7b Case number Reg. of Wills, Cumberland Co., i Courthouse Square, Carlisle, PA 17013 21-2003-0632 8 If decedent died testate, check here ll~J X and attach a certified copy of the will. I 9 If Form 4768 is attached, check here · 0 If Schedule R-1 is attached~ check here · 1 Total gross estate less exclusion (from Part 5, Recapitulation, page 3, item 12) ................ 1,563,090.88 2 Total allowable deductions (from Part 5, Recapitulation, page 3, item 23) ................... 62, &03.13 3 Taxable estate (subtract line 2 from line 1) .................................. I, 5 0 0,6 8 ?. ? 5 4 Adjusted taxable gifts (total taxable gifts (within the meaning of section 2503) made by the decedent after December 31, 1976, other than gifts that are includible in decedent's gross estate (section 2001(b)))... 0 o 0 0 5 Add lines 3 and 4 ............................................. 3., 500· 687. ?5 6 Tentative tax on the amount on line 5 from Table A on page 4 of the instructions ............... 5 5 6 7 Total gift tax payable with respect to gifts made by the decedent after December 31. 1976. Include gift taxes by the decedent's spouse for such spouse's share of split gifts (section 2513) only if the decedent was the donor of these gifts and they are includible in the decedent's gross estate (see instructions) ...... 0 o 0 0 8 Gross estate tax (subtract line 7 from line 6) ................................. 556,109. 9 Maximum unified credit (applicable credit amount) against estate tax ...... 190 3~5,800.00 ~ 0 Adjustment to unified credit (applicable credit amount). (This adjustment may not exceed $6,000. See page 5 of the instructions.) ............. 0. 11 Allowable unified credit (applicable credit amount) (subtract line 10 from line 9) ............... 3~5,800 o 00 12 Subtract line 11 from line 8 (but do not enter less than zero) 210 3 0 9 9 13 Credit for state death taxes (cannot exceed line 12). Attach credit evidence (see instructions). Figure the credit by using the amount on line 3 less $60.000. See Table B in the instructions. Enter the amount here from Table B I~ __ x.50 ................. ~ 32,222.01 14 Subtract line 13 from line 12 178,087.48 15 Credit for Federal gift taxes on pre-1977 gifts (section 2012) (attach computation) ................................. 15 O.OO 6 Credit for foreign death taxes (from Schedule(s) P). (Attach Form(s) 706-CE.) ................................ 16 0.0 0 7 Credit for tax on prior transfers (from Schedule Q) ................ 0.0 0 8 Total (add lines 15, 16. and 17) ....................................... 0.00 9 Net estate tax (subtract line 18from line 14) ................................ 178~ 087.~8 :0 Generation-skipping transfer taxes (from Schedule R, Part 2, line 10) ..................... 0 o 0 0 21 Total transfer taxes (add lines 19 and 20) .................................. 17 8,0 8 ?. & 8 22 Prior payments. Explain in an attached statement ................ 22 0.00 23 United States Treasury bonds redeemed in payment of estate tax ........ 23 0 o 0 0 24 Total (add lines 22 and 23) ......................................... 0.00 25 Balance due (or overpayment) (subtract line 24 from line 21 ) ......................... 3.7 8,0 8 ?. ~ 8 Under penalties of perjury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, true, correct, and complete. Declaration of preparer other than the executor is based on all information of which preparer has any knowledge. S~gnature(s)' '~ of executor(s) ' / '' - Dai~ ~ · Signature of preparer other than executor Address (and ZIP code) Date 1000 Form 706 (Rev. 8-2003) Estate of: ChriStine M Scafidi 179-30-5906 Part 3 - Elections by the Executor Please check the "Yes" or "No' box for each question. (See instructions be~innin~ on page 6.) Yes No I Do you elect alternate valuation? ................................................ 1 X 2 Do you elect special use valuation? ............................................... Z If "Yes," you must complete and attach Schedule A-1. 2 ~ 3 Do you elect to pay the taxes in installments as described in section 61667 ........................... Z If "Yes," you must attach the additional information described on pa,ge 9 of the instructions. 3 4 Do you elect to postpone the part of the taxes attributable to a reversionary or remainder interest as described in section 61637 .... ~ .................................................... 4 X Part 4- General Information (Note: Please attach the necessary supplemental documents. You must attach the death certificate.) (See instructions on page 10.) Authorization to receive confidential tax information under Regs. sec. 601.504(b)(2)(i); to act as the estate's representative before the IRS; and to make wdtten or oral presentations on behalf of the estate if retum prepared by an attorney, accountant, or enrolled agent for the executor: Name of representative (print or type) State Address (number, street, and room or suite no., city, state, and ZIP code) I declare that lam the I I attorney! L_.J certified public accountant/ J enro ed agent (you must check the applicable box)for the executor and prepared this return for the executor. I am not under suspension or disbarment from practice before the Intemal Revenue Service and am qualified to practice in the state shown above. Signature I CAF number Date I Telephone number I I 1 Death certificate number and issuing authority (attach a copy of the death certificate to this return). No. P 9331112 - Commonwealth of PA, Department of Health, Vital Records 2 Decedent's business or occupation. If retired, check here ,JX~ and state decedent's former business or occupation. System Analyst 3 Marital status of the decedent at time of death: Married Widow orwidower- Name, SSN, and date of death of deceased spouse l~_S__am_uel J Scafidi 176-18-7264 06/07/1984 Single Legally separated Divorced - Date divorce decree became final ~' 4a Surviving spouse's name I 4b Social security number 4c Amount received (see page 10 of the instructions) I 0,00 5 Individuals (other than the surviving spouse), trusts, or other estates who receive benefits from the estate (do not include charitable beneficiaries shown in Schedule O) (see instructions). For Privacy Act Notice (applicable to individual beneficiaries only), see the Instructions for Form 1040. Name of individual, trust, or estate receiving $5,000 or more Identifying number Relationship to decedent Amount (see instructions) Maria T Gregg 182-40-8823 Daughter 651,024.63 John M Scafidi 207-54-5353 Son 639,353.63 All unascertainable beneficiaries and those who receive less than $5,000 ......................... I~ 0 o 0 0 Total 1,290,378.26 Please check the "Yes" or "No" box for each question. Yes N o 6 Does the gross estate contain any section 2044 property (qualified terminable interest property (QTIP) from a prior gift or estate) (see pa,qe 10 of the instructions)? X (continued on next page) Page 2 JSA 3R8001 2 000 Form 7~6 (Rev. 8-2003) Part 4 ~ General Information (continued) 179-3o-s906 Pfease check the "Yes' or 'No " box for each question. Yes No 7a Have Federal gift tax returns ever been filed? If "Yes," please attach copies of the returns, if available, and furnish the following information: 7b Period(s) covered 7c Internal Revenue office(s) where filed If you answer 'Yes" to any of questions 8-15, you must attach additional information as described in the instructions. 8a Was there any insurance on the decedent's lifo that is not included on the return as part of the gross estate? ............. X b Did the decedent own any insurance on the life of another that is not included in the gross estate? .................. X 0 Did the decedent at the time of death own any property as a joint tenant with right of survivorship in which {a) one or more of the other joint tenants was someone other than the decedent's spouse, and {b) loss than the full value of the property is included on the return as part of the gross estate? If "Yes," you must complete and attach Schedule fi ................. X 10 Did the decedent, at the time of death, own any interest in a partnership or unincorporated business or any stock in an inactive or closely held corporation? X 11 Did the decedent make any transfer described in section 2035, 2036, 2037, or 2038 (see the instructions for Schedule G beginning on page 13 of the separate instructions)? If "Yes," you must complete and attach Schedule G ................ X 12 Were there in existence at the time of the decedent's death: a Any trusts created by the decedent during his or her lifetime? b Any trusts not created by the decedent under which the decedent possessed any power, beneficial interest, or trusteeship? X 13 Did the decedent ever I:X3s.sess, exemise, or release any general power of appointment? If "Yes," you must complete and attach Schedule H X 14 Was the marital deduction computed under the transitional rule of Public Law 97-34. section 403(e)(3) (Economic Recovery Tax Act of 1981)? X If '"Yes," attach a separate computation of the marital deduction, enter the amount on item 20 of the Recapitulation, and note on item 20 "computation attached." 15 Was the decedent, immediately before death, receiving an annuity described in the "General" paragraph of the instructions for Schedule I? If "Yes," you must complete and attach Schedule I 16 Was the decedent ever the beneficiary of a trust for which a deduction was claimed by the estate of a pre-deceased spouse under section 2056(b)(7) and which is not reported on this return? If "Yes," attach an explanation ................... X Part 5 - Recapitulation Item number Gross estate Alternate value Value at date of death I Schedule A- Real Estate ............................. I 130,900.00 2 Schedule B - Stocks and Bonds 2 2 5,41 1 o 6 0 3 Schedule C - Mortgages, Notes, and Cash ..................... 3 8 '7,6 56..71 4 Schedule D - Insurance on the Decedent's Life (attach Form(s) 712) ........ 4 8 00 o 0 0 5 Schedule E - Jointly Owned Property (attach Form(s) 712 for life insurance) ...... 5 11,6'71.0 0 6 Schedule F - Other Miscellaneous Property (attach Form(s) 712 for life insurance).. 6 '12,4 8 8 o 0 0 7 Schedule G - Transfers During Decedent's Life (att. Form(s) 712 for life insurance).. 7 6 56,8 80.8 5 8 Schedule H - Powers of Appointment ....................... 8 0.0 0 9 Schedule I - Annuities 9 63.7,282..72 10 Total gross estate (add items I through 9) ..................... 10 I, 563,0 9 0.8 8 11 Schedule U - Qualified Conservation Easement Exclusion 11 0 o 0 0 12 Total gross estate less exclusion (subtract item 11 from item 10). Enter here and on line 1 of Part 2 - Tax Computation ....................... 12 1,563,090.88 Item number Deductions Amount 13 Schedule J - Funeral Expenses and Expenses Incurred in Administering Property Subject to Claims ...... 13 6 0,3 2'7 o 11 14 Schedule K - Debts of the Decedent .................................... 14 2,0'76.02 15 Schedule K - Mortgages and Liens ..................................... 15 0 o 0 0 16 Total of items 13 through 15 16 62,403 13 17 Allowable amount of deductions from item 16 (see the instructions for item 17 of the Recapitulation) ..... 17 62,403.13 18 Schedule L - Net Losses During Administration 18 0.0 0 19 Schedule L - Expenses Incurred in Administering Property Not Subject to Claims ............... 19 0.0 0 20 Schedule M - Bequests. etc., to Surviving Spouse 0.0 0 21 Schedule O - Charitable, Public, and Similar Gifts and Bequests ....................... 21 0.00 22 Schedule T - Qualified Family-Owned Business Interest Deduction ...................... 22 0.0 0 23 Total allowable deductions (add items 17 through 22). Enter here and on line 2 of the Tax Computation .... 23 62,4 03 o 13 Page 3 JSA 3R8002 1 000 Form 706 (Rev. 8-2003~ Estate of: Christine M Scafidi 179-30-5906 SCHEDULE A - Real Estate · For jointly owned property that must be disclosed on Schedule E, see the instructions on the reverse side of Schedule E. · Real estate that is part ora sole proprietorship should be shown on Schedule F. · Real estate that is included in the gross estate under section 2035, 2036, 2037, or 2038 should be shown on Schedule G. · Real estate that is included in the gross estate undersection 2041 should be shown on Schedule H. · If you elect section 2032A valuation, you must complete Schedule A and Schedule A-1. Item Alternate number Description valuation date Alternate value Value at date of death i Premises.- 130,900.00 630 Rupley Road Cam~ Hill, PA 17011-1271 Sold @ (Copy of Real Estate Settlement Sheet enclosed) Total from continuation schedules or additional sheets attached to this schedule . 0.00 TOTAL. (Also enter on Part 5, Recapitulation, page 3, at item 1 .) .......... 130,900.00 (If more space is needed, attach the continuation schedule from the end of this packa! e or additional sheets of the same size.) (See the instructions on the reverse side.) JSA 3M8OO3 ~ ooo Schedule A - Page 4 I~orrn 706 (l~ev. 8-2003) Estate of: Christi~ze M Scafidi 179-30-5906 SCHEDULE B - Stocks and Bonds (For jointly owned property that must be disclosed on Schedule E, see the instructions for Schedule E. Item Description including face amount of bonds or number of shares and par Unit value Alternate Alternate value Value at date of death number value where needed for identification. Give 9~igit CUSIP number, valuation date CUSIP number See Schedule attached Total from continuation schedules (or additional sheets) attached to this schedule.. 25,411.60 TOTAL. (Also enter on Part 5, Recapitulation, page 3, at item 2.) ........... 25, ~,11.60 (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.) (The instructions to Schedule B are in the separate instructions.) Schedule B - Page 12 JSA 3M8008 1000 Page 2 Estate of= Christine M Scafidi 179-30-5906 Schedule B -- Stocks and Bonds Item Unit Val. Alternate Alternate Value at No. Description CUSIP Val. Date Value Date of Death i 2,020 Shs. Oracle Corp. 12.58 25,411.60 68389X105 TOTAL. (Carry forward to main schedule) ...... 25,411.60 Form 706 (Rev. 8-2003I Estate of: Chrfstlne M Scafldi 179-30-5906 SCHEDULE C - Mo~gages, Notes, and Cash (For joint~ owned prope~y ~at must be disclosed on Schedule E, see the ~struc~ns ~r Schedule E.) Item Alternate number Description Alternate value Value at date of death valuation date i PA State Employees Credit Union 33,887.68 Savings Account - S1 Interest accrued to 06/25/2003 23.21 2 PA State Employees Credit Union 2,750.93 Vacation Savings Account S2 Interest accrued to 06/25/2003 1.81 3 PA State Employees Credit Union 19,009.84 .Checking Account - S4 Interest accrued to 06/25/2003 7.50 4 PA State Employees Credit Union 5,079.61 12 Month Certificate of Deposit - S51 Interest accrued to 06/25/2003 8.42 5 PA State Employees Credit Union 5,283.32 12 Month Certificate of Deposit - S57 Interest accrued to 06/25/2003 7.92 6 PA State Employees Credit Union - S58 5,310.06 =12 Month Certificate of Deposit Interest accrued to 06/25/2003 9.32 7 PA State Employees Credit Union 5,151.33 12 Month Certificate of Deposit - S59 Interest accrued to 06/25/2003 6.70 8 Wachovia Bank, N.A. 1,768.91 Checking Account # 1000590335734 (No accrued interest) 9 Merrill Lynch, Pierce, Fenner & Smith 6,290.86 :Investor Account # SBA 38S74 Cash balance as of 06/25/2003 Interest accrued to 06/25/2003 3.51 Total from continuation schedules (or additional sheets) attached to this schedule.. 3,055.78 TOTAL. (Also enter on Pad 5, Recapitulation, pa~e 3, at item 3.) ........... 87,656.71 (If more space cs needed, attach the continuation schedule from the end of this package or additional sheets of the same size.) (See the instructions on the reverse side.) J~ 3M80091.000 Schedule C-Page13 Page 2 E~tate ~f: Christine M Scafidi 179-30-5906 Schedule C -- Mortgages, Notes, and Cash Item Alternate Alternate Value at No. Description Val. Date Value Date of Death 10 Connor-Rich Associates - Reimbursement of 114.40 medical payments covered by medical insurance for appointments on 4/1/03, 4/25/03 & 5/15/03 11 Green Tree Perpetual Assurance Co. - 2,862.00 Refund of unearned portion of homeowners insurance premium 12 The Patriot-News - Refund of unused 79.38 portion of magazine subscription TOTAL. (Carry forward to main schedule) ...... 3,055.78 · PSEC the financial IinkT~ August 13, 2003 Account # 0179305906 KIM GARRETT - ESTATE CONSULTANT C/O WACHOVIA BANK NA PO BOX 3959 - PA6907 LANCASTER, PA 17604 Dear MS GARRETT: The following is the status of CHRISTINE M SCAFIDI's account with PSECU as of the date of death. Joint Owner's Name NONE Date Established I 0.14.1981 Date of Death 06.25.2003 Date of Birth 07.17.1938 Share(s) Balance Accrued Dividend Rate Maturity Date Regular Shares (SI) $33,887.68 $ 23.21 0.75% Vacation Shares (S2) 2,750.93 1.81 0.75% Checking Shares (S4) 19,009.84 7.50 0.25% 60 Month IRA Certificate4 (S50) 36,880.09 118.58 4,89% 12 Month Certificate (S51) 5,079.61 8.42 2.52% 10.15.2003 12 Month Certificate (S57) 5,283.32 7.92 2.28% 01.10.2004 12 Month Certificate (S58) 5,310.06 9.32 2.67% 07.10.2004 07.10.2003 Renewed at 1.88% 12 Month Certificate (S59) 4,151.33 6.70 1.98% 04.04.2004 48 Month IRA Certificate (S60) 8,302.93 25.38 4.65% Loan(s) Balance Accrued Interest Personal Service Loan(L1) $ 0.00 $ 0.00 The IRAdividend earned from January 1, 2003 through the date of death was $1,038.97; the Non-IRA dividend earned was $513.03. We do not have safe deposit boxes for our members. If you have any questions, please call 234-8484 m Harrisburg or our toil-free number, (800) 237-7328. At the menu prompt, enter 6 and then extension 2227. Sincerely, Member Service Representative Finance Support Unit PENNSYLVANIA STATE EMPLOYEES CREDIT UNION Main Address: 1 Credit Union Place. Harrisburg, PA 17110-2990 · (717) 234-8484 · (800) 237-7328 Mailing Address: P.O. Box 67013, Hamsburg, PA 17106-7013 · (717) 777-2100 (TDD) · (800) 472-1967 (TDD) Web Address: www.psecu.com Savings federally insured up to $100.000 by the National Credit Union Administration. WACH©',VIA Raferene~ ID: 67~26 Wachovia Bank N.Af Balance Confirmation Services P O Box 40028 Roanoke, VA 24022-7313 August 15, 2003 PA 6907 ATTN: Ir-dM E GARRETT SUBJECT: Verification / Confn-rnation of Account and Balance Information provided for: Customer: CHRISTINE M SCAFIDI ($SN# 179-30-5906) Date of Death: June 25, 2003 Deposit Account Information Act' )unt Account Date of Death Average Date Maturity Interest Accrued Y'rD Date ~ T~, pe Number Balance Balance* Opened Date Rate Interest Interest Paid Closed CHECKING 1000590335734 $1,768.91 I 1/27/1991 NA LEGAL TITLE. CttRISTINE SCAFIDI * Due to system limitations, we can only provide a twelve month average balance on dq~ository account~. Revoivinv Credit Information Acc: unt Account Date o£ Death Credit Date Date Time~ L~gai Title T):~e Number Balance Limit Opened Clo~ed Late VISA 426429836225224 MBNA - Revolving credit accounts are no longer seN'iced by Wachovia Bank. Please contact MBNA at 800...441-7048. Other Account Information Accc mt Account Date of Balance Date Date Ledger Collected Ty]: e Num her ~ _,..,_. Opted Closed TRUST 1519163680 9/4/1998 LEGAL TITLE: ('tlRISTINE SCAFIDI TRUST WACItOVIA BA ',IK NA TRUSTEE UNDIR AGREEMENT DATED 11/16/1984 PLEASE CALL (~UR TRUST DEPARTMENT ~ 888-216-2308 FOR TRUST ADMINISTRATOR INFORMATION. Form 706 (Rev. 8-2003) Estate of: " ' Christine M Scafidi 179-30-5906 SCHEDULE O - Insurance on the Oecedent's Life You must list all policies on the life of the decedent and attach a Form 712 for each policy. Item Alternate number Description Alternate value Value at date of death valuation date i John Hancock Life Insurance Co. 800.00 McCall Settlement Death Benefit Policy No. PN0#7360170 Beneficiaries= Maria S. Gregg (50%) & John M. Scafidi (50%) Total from continuation schedules (or additional sheets) attached to this schedule.. 0.00 TOTAL. (Also enter on Part 5, Recapitulation, page 3, at item 4.) ........... 800.00 (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of thr same size.) (See the instructions on the reverse side.) Schedule D - Page 15 JSA 3M8010 1 000 Form 706 (Rev. 8-2003) Estate of: Christine M Scafidi 179-30-5906 SCHEDULE E -Jointly Owned Property (If you elect section 2032A valuation, you must complete Schedule E and Schedule A-I.) PART 1. - Qualified Joint Interests - Interests Held by the Decedent and His or Her Spouse as the Only Joint Tenants (Section 2040(b)(2)) Item Description Alternate number For securities, give CUSIP number, valuation date Alternate value Value at date of death Total from continuation schedules (or additional sheets) attached to this schedule . 0.00 la Totals I la 0.00 lb Amounts included in gross estate (one-halfof line la) ..............I lb 0.00 PART 2. - All Other Joint Interests 2a State the name and address of each surviving co-tenant. If there are more than three surviving co-tenants, list the additional co-tenants on an attached sheet. Name Address (number and street, city, state, and ZIP code) 304 Eleventh Street A. Maria T Gregg New Cumberland, PA 17070 B. Item Enter Description number letter for (including alternate valuation date if any) For Percentage Includible Includible value at co-tenant securities, give CUSIP number, includible alternate value date of death See Schedule attached Total from continuation schedules (or additional sheets) attached to this schedule . 11,671.00 2b Total other joint interests 2b 11,671.00 3 Total includible joint interests (add lines 1 b and 2b). Also enter on Part 5, Recapitulation, page 3, at item 5 ......................... 11,671.00 (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of th, same size.) (See the instructions on the reverse side.) Schedule E - Page 17 JSA 3M8011 1000 Page 2 Estate of= Christine M Scafidi 179-30-5906 Schedule E, Part 2 -- All Other Joint Interests Item Cot. Unit Val. Percent Alternate Value at No. Let. Description CUSIP Includible Value Date of Death I A The attached list of United 100.0000% 11,671.00 States Savings Bonds were held jointly between the decedent and her daughter, Maria T. Gregg (formerly Maria T. Scafidi). TOTAL. (Carry forward to main schedule) ...... 11,671.00 ~awngs ~ona c'alculator Page 1 of 2 Savinc 106/2003 -u p }i a-t H lp- -! Series Denomination Serial Number Issue Date lEE Bonds _~ $1600 # Bonds Total Price Total Interest Total Value YTD In' 31 $6,750.00 $4,921.00 S 11,671.00 $249. Issue Interest Next Final Serial Number Issue Date Series Dehorn Price Interest Value Rate Accrual Maturit,~ D48477909EE 05/1998 EE $500 $250.00 $64.60 $314.60 2.66% 07/2003 05/202~ D48475144EE 01/1998 EE 500 250.00 72.00 322.00 3.25% 07/2003 01/202~ D48472138EE 08/1997 EE 500 250.00 80.60 330.60 3.25% 07/2003 08/202~ D43917262EE 03/1997 EE 500 250.00 74.00 324.00 3.07% 09/2003 03/202~ D43914150EE 11/1996 EE 500 250.00 79.00 329.00 2.51% 11/2003 11/202( D42767010EE 06/1996 EE 500 250.00 86.60 336.60 2.51% 12/2003 06/202( D42763781EE 02/1996 EE 500 250.00 89.40 339.40 3.07% 08/2003 02/202( D42760337EE 09/1995 EE 500 250.00 98.60 348.60 3.07% 09/2003 09/202: D42757119EE 04/1995 EE 500 250.00 119.40 369.40 3.08% 10/2003 04/202.' D42753768EE 12/1994 EE 500 250.00 125.20 375.20 2.50% 12/2003 12/202~ D40494422EE 07/1994 EE 500 250.00 128.00 378.00 3.13% 07/2003 07/202~ D40491348EE 03/1994 EE 500 250.00 136.20 386.20 3.00% 09/2003 03/202~ D40488200EE 10/1993 EE 500 250.00 145.40 395.40 3.09% 10/2003 10/2022 D27147575EE 05/1993 EE 500 250.00 151.40 401.40 2.49% 11/2003 05/202] D27144656EE 01/1993 EE 500 250.00 201.60 451.60 6.00% 07/2003 01/202." D27141797EE 08/1992 EE 500 250.00 215.20 465.20 6.00% 08/2003 08/202; D27255783EE 04/1992 EE 500 250.00 229.20 479.20 6.00% 10/2003 04/202; D27253477EE 11/1991 EE 500 250.00 243.40 493.40 6.00% 11/2003 11/2021 D27155151EE 06/1991 EE 500 250.C0 258.20 508.20 4.00% 12/2003 06/2021 D26982194EE 02/1991 EE 500 250.00 258.20 508.20 4.00% 08/2003 02/202] D26616134EE 09/1990 EE 500 250.00 268.40 518.40 4.00% 09/2003 09/202( D25848630EE 05/1990 EE 500 250.00 278.80 528.80 4.00% 11/2003 05/202( D23724646EE 12/1989 EE 500 250.00 289.40 539.40 4.00% 12/2003 12/201~ D20107916EE 07/1989 EE 500 250.00 289.40 539.40 4.00% 07/2003 07/201~ D20106194EE 02/1989 EE 500 250.00 300.20 550.20 4.00% 08/2003 02/201~ D20104411EE 10/1988 EE 500 250.00 311.20 561.20 4.00% 10/2003 10/201~ C164760036EE 05/1988 EE 100 50.00 64.48 114.48 4.00% 11/2003 05/201~ C161420846EE 03/1988 EE 100 50.00 64.48 114.48 4.00% 09/2003 03/201~ http:/;wwws.publicdebt.treas.gov/BC/"SBCPrice 2/7/04 ~awngs t~ona t_,mcutator .... : ..... :? ...... ::" ' Page 2 of 2 C161402:470EE 01/1988 EE 100 50.00 64.48 114.48 4.00% 07/2003 01/201~ C154118889EE 11/1987 EE 100 50.00 66.76 116.76 4.00% 11/2003 11/201~ C154099337EE 09/1987 EE I00 50.00 67.20 117.20 4.00% 09/2003 09/201'~ ~W ii~-~ [ Viewing Bonds 1-31 Note Description NI Not Issued NE Not Eligible for Payment P5 Includes 3-month interest penalty ME Matured (Exchangeable for HH) MN Matured (Not Exchangeable for HH) Please rate this service. (Please print and/or save this page before submitting your survey) Service Excellent Good Fair Poor Savings Bond Calculator C' (" ~ ~ Submit Su r~/'f!~'.~l :~ http:, ,'wwws.publicdebt.treas.gov/BC/SBCPrice 2/7/04 Form 706 (Rev. 8-2003) Estate0f: Christine M Scafidi 179-30-5906 SCHEDULE F - Other Miscellaneous Property Not Reportable Under Any Other Schedule (For jointly owned property that must be disclosed on Schedule E, see the instructions for Schedule E.) (If you elect section 2032A valuation, you must complete Schedule F and Schedule A-I.) I Did the decedent at the time of death own any articles of artistic or collectible value in excess of $3,000 or any ~'es No collections whose artistic or collectible value combined at date of death exceeded $10,0007 X If "Yes," submit full details on this schedule and attach appraisals. ' ............... 2 Has the decedent's estate, spouse, or any other person, received (or will receive) any bonus or award as a result of the decedent's employment or death? Z If "Yes," submit full details on this schedule. 3 Did the decedent at the time of death have, or have access to, a safe deposit box?. ...................... X If "Yes," state location, and if held in joint names of decedent and another, state name and relationship of joint depositor. If any of the contents of the safe deposit box are omitted from the schedules in this return, explain fully why omitted. Item Description Alternate numbel For securities, give CUSIP number, valuation date Alternate value Value at date of death 1 Miscellaneous Personal Property 1,188.00 Sold ~ 2 Automobile - 2001 Honda Accord 11,300.00 Total from continuation schedules (or additional sheets) attached to this schedule.. 0.00 TOTAL. (Also enter on Part 5, Recapitulation, page 3, at item 6.) ........... 12,488.00 (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.) (See the instructions on the reverse side.) JSA Schedule F - Page 19 3M8012 1 000 Form 706 (Rev. 8-2003) Estate of~ Christine M Scafidi 179-30-5906 SCHEDULE G -Transfers During Decedent's Life (if you elect section 2032A valuation, you must complete Schedule G and Schedule A-I.I Item Description Alternate Alternate value Value at date of death number For securities, .qive CUSIP number, valuation date A. Gift tax paid by the decedent or the estate for all gifts made by the decedent or his or her spouse within 3 years before the decedent's death (section 2035(b)) ............... X X X × × 0.0£ B. Transfers includible under section 2035(a), 2036, 2037, or 2038: See Schedule attached Total from continuation schedules (or additional sheets) attached to this schedule.. 656,880. TOTAL. (Also enter on Part 5, Recapitulation, pacje 3, at item 7.) ........... 656,880.8~ SCHEDULE H - Powers of Appointment (Include "5 and 5 lapsing" powers (section 2041(b)(2)) held by the decedent.) (If you elect section 2032A valuation, you must complete Schedule H and Schedule A-I./ Item Description Alternate Alternate value Value at date of death number valuation date Total from continuation schedules (or additional sheets) attached to this schedule.. 0 o 00 TOTAL. (Also enter on Part 5, Recapitulation, parle 3, at item 8.) ........... 0.00 (If more space ~s needed, attach the continuation schedule from the end of this package or additional sheets of th~ same size.) (The instructions to Schedules G and H are in the separate instructions.) JSA 3M80t31000 Schedules G and H - Page 21 Page 2 E~tate'of= Christine M Scafidi 179-30-5906 Schedule G -- Transfers During Decedent's Life Item Unit Val. Alternate Alternate Value at No. Description CUSIP Val. Date Value Date of Death i Christine M. Scafidi created a 0.00 Revocable Agreement of Trust with Hamilton Bank, N/K/A Wachovia Bank, N.A., trustee, dated November 16, 1984. (Account # 1519163680) The assets that comprised this trust as of Christine Scafidi's date of death have been revalued as of 06/25/03, per item #2 through item #11, as follows. (Copy of Trust Agreement enclosed) 2 20,625.617 Shs. Evergreen PA 11.8 243,382.28 Municipal Bond Fund Cl I (Fd #216) 300326402 Income accrued to 06/25/2003 732.61 3 1,565.041 Shs. Evergreen Core 52.85 82,712.42 Equity Fund Cl I (Fd #457) 299909101 Income accrued to 06/25/2003 43.43 4 1,963.01 Shs. Evergreen Strategic 19.11 37,513.12 Value Fund C1 I (Fd #450) 299909507 Income accrued to 06/25/2003 40.73 5 3,153.054 Shs. Evergreen Large Cap 11.67 36,796.14 Equity Fund C1 I (Fd #716) 30023C657 6 Principal Cash balance of the 11,856.73 Christine Scafidi Trust as of 06/25/2003 7 Income Cash balance of the 11,932.15 Christine Scafidi Trust as of 06/25/2003 8 Interest accrued to 06/25/2003 on 14.94 the Principal & Income Cash balances of the Christine Scafidi Trust 9 Investment Advisory fee adjustment 106.88 on Evergreen funds from 06/01/03 06/25/03 10 Wachovia Bank, N.A. - Monthly (288.01) fiduciary's fee for the Christine Scafidi Trust, accrued through 06/25/03 11 Wachovia Bank - Death of grantor (4,250.00) estate settlement fee TOTAL. (Carry forward to main schedule) ...... 420,593.42 Page 3 E~t~te'of: Christine M Scafidi 179-30-5906 Schedule G -- Transfers During Decedent's Life Item Unit Val. Alternate Alternate Value at No. Description CUSIP Val. Date Value Date of Death 12 PA State Employees Credit Union 36,880.09 60 Month IRA Certificate of Deposit-4 (S50) Beneficiaries: Maria T. Gregg (50%) & John M. Scafidi (50%) Interest accrued to 06/25/2003 118.58 13 PA State Employees Credit Union 8,302.93 48 Month IRA Certificate of Deopsit (S60) Beneficiaries: Maria T. Gregg (50%) & John M. Scafidi (50%) Interest accrued to 06/25/2003 25.38 14 Commonwealth of Pennsylvania 178,684.45 Deferred Compensation Program Account # 01111142 (179-30-SBNJ) (Valued as of 06/30/2003) Beneficiaries: Maria T. Gregg (50%) & John M. Scafidi (50%) 15 Fidelity Investments 87.62 12,276.00 Fidelity Fund Traditional IRA 316184100 Account # 2AJ-797847 - Comprised of only the following asset: 140.105 Shs. Fidelity Magellan Beneficiaries: Maria T. Gregg (50%) a John M. Scafidi (50%) (Copy of account confirmation letter enclosed) TOTAL. (Carry forward to main schedule) ...... 236,287.43 ':"""' ..... Deferred of PClIllS% I~..lnill Compensation Program SECURE YOL'R FUTURE. T6~Y. CHRISTINE M SCAFIDI 1-800-422-1327 630 RUPLEY RD CAMP HILL PA 17~11-1271 PAGE I OF 2 INCEPTION TO DATE SUHHARY INVESTMENI FUND ** TOTAL TRANSFER DISTRIBUTIONS GAIN/(LOSS) BALANCE DESIGNATION NUMBER CONTRIBUTION TOTAL 06/30 CPA GROUP FUNDS AGGREGATE BOND INDEX 0185 53,475.79 2,194.20 .00 37,192.97 92,862.96 SHORT-TERM MONEY MARKET 0186 3,980.61 (4,388.40) .00 407.79 .00 STOCK INDEX FUND 0187 45,531.53 2,194.20 .00 38,095.76 85,821.49 PLAN TOTALS. 102,98/.93 .00 .00 /b,bgb.bZ 1/8,6~4.45 ** PLEASE NOTE YOUR FOUR DIGIT FUND NUMBER FOR USE WITH THE CITISTREET AUTOMATED INFORMATION SYSTEM, CALL THE HELPLINE FOR MORE: DETAILS ** PERIOD SUHH4RY ( 4/01/03 - 6/30/03 ) ~'NVESTMENT 04/0! TOTAL PERIOD TRANSFER DISTRIBUTIONS GAIN/(LOSS} BALANCE DESIGNATION BALANCE CONTRIBUTION PERIOD 86/30 CPA GROUP FUNDS AGGREGATE BOND INDEX 90,676.39 .00 .00 .00 2,186.57 92,862.96 STOCK INDEX FUND 74,408.46 .00 .00 .00 11,413.03 85,821.49 ii!!i?i!]i):i:i:i.PERIOD TOTALs/iii!i :~ .00 .00 .00 OETAILEO TRANSACTIONS ( 4/01/05 - 6/$0/05 ) iNVESTMENT TRANSACTION FUND DOLLAR UNIT/SHARE UNITS/ DATE DESCRIPTION NAME AMOUNT VALUE SHARES 04/25/03 ASSET CHARGE AGGREGATE BOND INDEX 15.55 173.4755 .0896 04/25/03 ASSET CHARGE STOCK INDEX FUND 13.67 12.2600 1.1150 05/23/03 ASSET CHARGE AGGREGATE BOND INDEX 15.89 177.2153 .0896 05/23/03 ASSET CHARGE STOCK INDEX FUND 14.00 12.7500 1.0980 06/27/03 ASSET CHARGE AGGREGATE BOND INDEX 15.85 . 176.5441 . .0897 ii:i!!ii:06/27/03 ASSETCHARGE ]: STOCK INDEX FUND t4.83 PAYROLL CONTRIBUTIONS NOT YET POSTED BY THE APPROPRIATE ISSUERS TOTALED $ .00 ( PLEASE SEE NEXT PAGE ) 'Fi#elity ~ Investments. O~tober 10, 2003 WACHOVIA BANK, NA ATTN: KlM E GARRETT PO BOX 3959-PA6907 LANCASTER PA 17604 Dear Ms. Garrett: We are responding to your request for information about Christine M. Scafidi's account with Fidelity. The table below lists the account holdings and values as of 06/25/2003. FideliB, account 2AJ-797847: CHRISTINE SCAFIDI-TRADITIONAL IRA Security. Description CUSIP Quantity Unit Value Market Value FIDELITY MAGELLAN 316184100 140.105 $87.62 $12,276.00 Total Value $12,276.00 We hope this information is helpful. For questions concerning account holdings or instructions on how to transfer the ownership of the accounts, please call our Inheritor Services Group at 800-544-0003 between 9:00 A.M. and 5:30 P.M. Eastern time Monday through Friday or visit our website at www.fidelity, com. Sincerely, Fidelity Investments Our file: W018273-06OCT03 ~ro~er?oe $ervices prov,deO by Fidelity Brokerage Services LLC, Member NYSE, sIPC Z: .... c :~stca',' ,~na sett:ement serwces by National Financial Services LLC, Member NYSE, SIPC D© Box 770001, Cincinnati, OH 45277-0034 Form 706 (Rev. 8-2003) Estateof:' Christine M Scafidi 179-30-5906 SCHEDULE I - Annuities Note: Generally, no exclusion is a/lowed for thu esta[oo of du~.~u~,,La uy,~t ~zur uecemuer .~-~, 7~u,~ (see page 1~ ot the instructions . A Are you excluding from the decedent's gross estate the value of a lump-sum distribution described in section 2039(f)(2) Yes No (as in effect before its repeal by the Deficit Reduction Act of 1984)? ............................. X If "Yes," you must attach the information required by the instructions. Item Description Alternate Includible Includible value number Show the entire value of the annuity before any exclusions, valuation date alternate value at date of death i Masland & Barrick Advisory, Inc. 72,178.3~ Metlife Bank, Trustee Rollover IRA Account # 5W8-881646 (Comprised of 3 mutual funds & cash - Copy of documentation attached) Beneficiaries.- Maria T. Gregg (50%) John M. Scafidi (50%) 2 Masland & Barrick Advisory, Inc. 36,384.4~ Hartford Life Contract # 711106662 (Comprised of 2 funds - Copy of ,4ocumentation attached) Beneficiaries.- Maria T. Gregg (50%) a John M. Sc&fid/ (50%) 3 Commonwealth of Pennsylvania 528,719.88 State Employees' Retirement System Option I Annuity Beneficiaries.- Maria T. ~regg (50%) & John M. Scafidi (50%) (Copy of letter from the Commonwealth of PA attached) Total from continuation schedules (or additional sheets) attached to this schedule.. 0.0 ri TOTAL. (Also enter on Part 5, Recapitulation, pa,qe 3, at item 9.) ........... 637,282.7~ nu schedule from the end of this package or additional sheets of the same size.) Schedule I - Page 22 (The instructions to Schedule I are in the separate instructions.) JSA 0'9/02..'" 200:3 11: 45 7177617524 BAR TO: Kim Garrett - Wachovia Bank FROM: Robin Rowe - ~asl~nd ~ B~rrieE Ad~i~. I~. RE: Christine Se~fidi ~te-of-d~ wlu~s DATE: 8127~200~ Rollover I~ account ~ 5W8-881~6 Money market $19.18 Eaton Vance Gov't Obligation CI B $12,820.72 'Eaton Vance Floating Rate CI C $15,~.46 Van Kampen Equi~, & Income C1 B ~3,934.~ Hartfi:>rd Variable Annuity con~act g 71110662 Capital Appreciation sub-accost $18,962.33 Growth & Income sub-account $17,422.15 Alliance College Bound Fund 529 Plans Fbo Sam~tha Gregg $9,733.28 ~o Hen~' Gregg $8,021.92 ,.-_--.,,.,~,./,~....o... .... .~ ......OnilL~..~g~l ID=?i7 295 3815 ?L"..: :: '- '," , · ' COMMONWEALTH OF PEN~YLVAN/A STATE. EMPLOYEES' RETIREMENT SYSTEM 30 I~OE'TH THIRD ~'REET - RO. ROX 1147 HARRISBURG, PE~N&~'LVAI~A 1~'10~-1147 TOLU=REF.: Febl'~)m~-y 13. 2004 F~D ~ KIM ~. GARR~TT ESTATE SETTL~ CONSULTANT ASSOCIATE WACHOVIA BANK NA LEGACY H~/TAG3DU~Tr ADVISORS 100 N QUEEN STREET LA~O_~.u T~R PA 17603 Re: christine M. Scafidi, deceased SS~ 179-3~-5906 Dear MS. Garrett: T~is is in resp~se to ~ e~i! to ~. Ted Lewis oE ou~ of Eice re~es~g ~e dea~ BeneEit ~lue in =he accost of ~istlnu M. Scafidi with o~ ~. We ~e ~ ~ceip~ of ~e f~ad Sho~ Cer=ificate o= her ~tate. ~e total death b~it ~ of Mrs. E~fidi's accost is $528,719.88, ~ is pay~le to ~e ~d benefici~ies of her retir~t accost. ~re is ~ b~efit due her Estate from our assist~ce, plebe contact ~ office at ~717) 787-62~3. Sincerely, B~efic De=e~=i~ Division sW--13-84 89:43 TO:ESTATE SETTLEMENT FROM:?I? 767 5666 R0~m ~06 (Rev. 8-2003) Estateof: Christine M Scafidl 179-30-5906 SCHEDULE J - Funeral Expenses and Expenses Incurred in Administering Property Subject to Claims Note: Do not list on this schedule expenses of administering property not subject to claims. For those expenses, see the instructions for Schedule L. If executors' commissions, attorney fees, etc., are claimed and allowed as a deduction for estate tax purposes, they are not allowable as a deduction in computing the taxable income of the estate for Federal income tax purposes. The 'are allowable as an income tax deduction on Form 1041 if a waiver is filed to waive the deduction on Form 706 (see the Form ,041 instructions~. Item number Description Expense amount Total amount A. Funeral expenses: 1 Neill Funeral Home, Inc. - Professional services 3,413.73 2 Dininni Foods Food from caterer for funeral meal 1,000.00 Total funeral expenses ............................ · _ 4,830.69 B. Administration expenses: 1 Executors' commissions - amount estimated/az,;ccd upc.'Vp__Jd. (Strike out the words that do not apply.) _ 20,956.34 2 Attorney fees - amount estimated/c, grc. cdu~,v,.,/"~'~,. .... (Strike out the words that do not apply.)... 20,000.00 3 Accountant fees - amount estimated/agr-ee4-uCe~/-~. (Strike out the words that do not apply.) . 0.00 4 Miscellaneous expenses: Expense amount 4 Dynamic Appraisals, Inc. Fee for appraisal of real 300.00 estate 5 Killian & Gephart, LLP - Rei~ursement for payment 365.12 of probate costs (272.), estate advertising exl0ense (75.) and miscellaneous expenses (18.12) 6 Expenses re: Maintainence and upkeep of real estate 1,972.45 prior to sale, per schedule attached 7 Expenses re: Brokerage commissions and closing costs 3,692.11 in the sale of real estate, per copy of Settlement Sheet enclosed (Sale price of $130,900. less net proceeds received of $127,207.89) 8 Wachovia Bank, N.A. - Fee for services rendered for 7,854.00 and on behalf of the real estate from date of death up through, and including, the sale of the real estate ($130,900. X 6%) 9 Farmerville Auction - Auction conanissions and 356.40 expenses in the sale of miscellaneous personal property Total miscellaneous expenses from continuation schedules (or additional sheets) attached to this schedule ............................... 0. O0 Total miscellaneous ex~enses ...................................... · 14,540 o 08 TOTAL. (Also enter on Part 5, Recapitulation, page 3, at item 13.) ...................... · 60,327.11 space ~s , attach the continuation schedule from the end of this package or additional sheets of the same size.) (See the instructions on the reverse side.) Schedule J - Page 23 JSA 3M8015 1000 . ,, · Page 2 Estate of~ Christine M Scafidi 179-30-5906 · Schedule J, Part A -- Funeral Expenses Item No. Description Amount 3 Glenn Miller's Beer & Soda Warehouse - Beverages for 82.26 funeral meal 4 OfficeMax - Fee for waste cans and waste removal 78.19 items for funeral meal 5 U.S. Postal Service - Stamps for thank you cards 37.00 6 Circuit City Stores, Inc. - Expense for audio cables 52.96 (2 @ 19.99 & 2 @ 4.99 + tax) for music hook up at the funeral meal 7 Party 'N' More - Cost of plates, cups, napkins and 93.46 utensils for the funeral meal 8 FYE Store, Capital City Mall - Compact discs 73.09 purchased for providing music during the funeral meal TOTAL. (Carry forward to main schedule) ...... 416.96 Estate of Christine M. Scafidi Schedule "J", Item # 6 Expenses re: Maintenance and upkeep of Real Estate prior to sale, as follows: 1. Zimmerman's Landscaping - Lawn maintenance services 700.00 2. Montour Oil Service Co. - Fuel oil delivery services 424.69 3. PP&L - Electric services 134.75 4. Verizon - Telephone services 106.28 5. PA-American Water Co. - Water services 124.48 6. Borough of Wormleysburg - Sewage and refuse services 112.00 7. Willlis Corroon Ins. Co. - Property liability insurance 313.00 8. ComCast Cable- Cable television services 5.29 9. Natural Lawn of America - Early Fall lawn treatment 51.96 Total 1,972.45 Form 706 (Rev. §-2003) Estate of:' Christine M Scafidi 179-30-5906 SCHEDULE K - Debts of the Decedent, and Mo~gages and Liens Item Debts of the Decedent - Creditor and nature of claim, and Amount unpaid to date Amount in contest Amount claimed as number allowable death taxes a deduction 1 AT&T Wireless - Balance due for cell 0.00 0.00 28.36 )hone services 2 'P&L - Balance due for electric 0.00 0.00 85.59 services 3 Zim~erman's Landscaping - Balance due 0.00 0.00 200.00 for lawn mowing services 4 Verizon - Balance due for telephone 0.00 0.00 69.60 services 5 American Water Company - Balance due 0.00 0.00 41.15 for water utility services 6 AT&T - Balance due for long distance 0.00 0.00 90.65 telephone services 7 MBNA America, LL Bean - Balance due 0.00 0.00 65.00 for credit card charges Total from continuation schedules (or additional sheets} attached to this schedule ............... 1,4 9 5.67 TOTAL. (Also enter on Part 5, Recapitulation, page 3, at item 14.) ........................ 2,076.02 Item Mortgages and Liens - Description Amount number Total from continuation schedules (or additional sheets) attached to this schedule ............... 0.0 0 TOTAL. (Also enter on Part 5, Recapitulation, page 3, at item 15.) ........................ 0.00 (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.) (The instructions to Schedule K are in the separate instructions.) Schedule K o Page 25 JSA 3M8010 1.000 Page 2 ~s6'a~J' of= Christine M Scafidi 179-30-5906 · Schedule K, Part 1 -- Debts of the Decedent Item Amount unpaid Amount Deduction No. Description to date in contest amount 8 Bankcard Services - Balance due for 0.00 0.00 33.90 Wachovia credit card charges 9 Connor-Rich Associates Balance due 0.00 0.00 275.00 for medical services provided on 3/2e/03, 4/1/03, 5/15/03 a 5/22/03 10 Discover Card - Balance due for 0.00 0.00 349.86 credit card charges 11 Fulton Bank Mastercard - Balance due 0.00 0.00 407.00 for credit card charges 12 Montour Oil Service Co. Balance due 0.00 0.00 125.84 for fuel oil delivery services 13 PA State Employees Credit Union, 0.00 0.00 304.07 Checking Account (Share 04) Seven separate checks, representing payments of various bills, were written prior to death and presented for payment subsequent thereto TOTAL. (Carry forward to main schedule) ...... 1,495.67 Wachovia Bank, N.A. Estate Tax Division PA1308 Post Office Box 7558 Philadelphia, PA 19101-7558 Fax 215 670-6422 WACHOVIAWEALTH MANAGEMENT March 24, 2004 Register of Wills of Cumberland County 1 Courthouse Square Carlisle, PA 17013 RE: Estate of Christine M. Scafidi Date of Death: 06-25-2003 File Number: 21-2003-0632 Social Security Number: 179-30-5906 Dear Sir or Madam: Enclosed, for filing with your office, is the PA Inheritance Tax Return in duplicato..for the abOve estate, together with the following: ': Copy of Will of Christine M. Scafidi, dated 11/16/84 Copy of Revocable Agreement of Trust of Christine M. Scafidi, dated 11/lt~/84 Copy of Real Estate Settlement Sheet Copy of the decedent's Federal Estate Tax Return Our check in the amount of $43,511.96, representing the amount of PA Inheritance Tax due Please date-stamp the enclosed copy of this letter and return it to us using the prepaid envelope provided. Please send us your usual receipt covering this payment of tax. Very truly yours, Fred S. Bachman Assistant Vice President cc: Smith B. Gephart, Esquire Susan E. Lederer, Esquire Patricia A. Jackson, Vice President Certified Mail -Receipt # 7003 3110 0000 3494 6636 '.COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE REV-1162 EX(11-96) BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 003736 WACHOVIA BANK NA 100 NORTH QUEEN ST LANCASTER, PA 17604 ACN ASSESSMENT AMOUNT CONTROL NUMBER ........ fold ,"; 101 $43,511.96 ESTATE INFORMATION: SSN.. 179-30-5906 'FILE NUMBER: 2103-0632 DECEDENT NAME: SCAFIDI CHRISTINE M DATE OF PAYMENT: 03/29/2004 POSTMARK DATE: 0312512004 COUNTY: CUMBERLAND DATE OF DEATH: 06/25/2003 i!' TOTAL AMOUNT PAID: $43,511.96 R;EMARKS: WACHOVIA BANK '~ CHECK//48486505 .~; INITIALS: VZ SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS Wachovia Bank. N.A. Legacy Management Advisors PA690? Post Office Box 3959 1_00 North Queen Street Lancaster, PA 17604 Fax 717 295-3815 March 24, 2004 ~'~CH OV~A ~'EALTH ]~IANA(~.E ME N T Register of Wills of Cumberland County 1 Courthouse Square Carlisle, PA 17013 RE: Christine M. Scafidi Estate File: 21-03-0632 Dear Sir or Madam: Wachovia Bank, NA has been appointed executor of the Estate of Christine M. Scafidi. At this time we have two requests: 1. Please file the enclosed Inventory and time stamp the extra-enclosed copies. 2. Two Short Certificates - enclosed is a check for $6.00 for the certificates. Please return the time stamped Inventory copies and the Short Certificates in the reusable UPS envelope with the enclosed UPS Label. If you have any questions, please feel free to contact our office at 717-291-3431. Sincerely, Kim E. Garrett Estate Settlement Consultant Associate Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of Christine M. Scafidi No. 21-03-0632 also known as ' Date of Death June 25, 2003 ,Deceased Social Security No. 179-30-5906 Personal Representative(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 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 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 made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities. Name of Attorney: Smith B. Gephart Personal Representative: I.D. No.: 06864 Wacho~vi/a/Bank, NA Ez,.ecutoF Address: Killian & Gephart, LLP .By: ~;~ ._: ~/~ ~.~ 218 Pine Street Klm E Garrett, Trust Officer Harrisburg, PA 17108 Telephone: 717-232-1851 Description ~ Value See Attached Schedule I'otal: $ 256,456.31 (Attach Additional Sheets if necessary) Note: The Memorandum of real estate outside the Commonwealth of Pennsylvania ma ~, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. Sworn to and subscribed before me this 24 day of March A.D. 2004 ,-r , Notary Public Notarial Seal J Yvonne M. Rutter, Notary Public ' ' City of Lancaster, Lancaster County My Commission Expires Aug 2 i, 2005 Member, Pennsylvania Association of Notaries FILE NUMBER: 21-03-0632 INVENTORY FOR THE ESTATE OF CHRISTINE M. SCAFIDI Who Died on 6/25/03 Real Estate 630 Rupley Road Camp Hill, PA 17011 130,900.00 _Stocks 2020 Shares Oracle Corporation at $12.38 25,411.60 _Certificates of Deposit_ Pennsylvania State Employees Credit Union 12 Month Certificate Maturity Date 10/15/2003 Rate 2.52% Accrued Dividend til 6/25/03 5,079.61 8.42 Pennsylvania State Employees Credit Union 12 Month Certificate Maturity Date 1/10/2004 Rate 2.28% Accrued Dividend til 6/25/03 5,283.32 7.92 Pennsylvania State Employees Credit Union 12 Month Certificate Maturity Date 7/10/2003 Rate 1.88% Accrued Dividend til 6/25/03 5,310.06 9.32 Pennsylvania State Employees Credit Union 12 Month Certificate Maturity Date 04/04/2004 Rate 1.98% Accrued Dividend til 6/25/03 5,151.33 6.70 _Cash Wachovia Bank, NA Checking Account No. 1000590335734 1,768.91 Pennsylvania State Employees Credit Union Regular Share Account No. 0179305906 Accrued Dividend til 6/25/03 33,887.68 23.21 FILE NUMBER: 21-03-0632 INVENTORY FOR THE ESTATE OF CHRISTINE M. SCAFIDI Who Died on 6/25/03 Pennsylvania State Employees Credit Union Vacation Share Account No. 0179305906 2,750.93 Accrued Dividend til 6/25/03 1.81 Pennsylvania State Employees Credit Union Checking Share Account No. 0179305906 19,009.84 Accrued Dividend til 6/25/03 7.50 Merill Lynch Ready Asset Money Market Account No. 8BA38S74 6,290.86 Accrued Dividend til 6/25/03 3.51 Personal Property Personal Property Sold at Auction 1,188.00 2001 Honda Accord 11,300.00 Miscellaneous Refund from The Patriot-News Subscription 79.38 Refund Green Tree Perpetual Assurance Co - Policy#26401 2,862.00 Connor-Rich Assoc. - reimbursement for medical payments 114.40 Total $ 256,456.31 2 COMMONNEALTH OF PENNSYLVANZA BUREAU OF TNDZVIDUAL TAXES DEPARTMENT OF REVENUE /NHER/TANCE TAX DI¥ISION DEPT. HARRZSBURG, PA 17128-0601 NOTZCE OF INHERITANCE TAX APPRAISEHENT, ALLO#ANCE OR DISALLO#ANCE OF DEDUCT/ONS AND ASSESSHENT OF TAX RE¥-15~TEXAFP(01-O$) DATE 07-05-2004 ESTATE OF SCAFIDI CHRISTINE H DATE OF DEATH 06-25-2005 FZLE NUHBER 21 05-0652 FRED S BACHMAN '~'; di.;~ -=' : 'Ii~ COUNTY CUMBERLAND "= ACN 101 NACHOVIA BANK I Amoun~ 125 S BROAD ST I PHI LA PA ~. t~! 09 MAKE CHECK PAYABLE AND REMZT PAYMENT TO: REGISTER OF HILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THZS L/NE ~ RETAZN LONER PORTZON FOR YOUR RECORDS REV-15q7 EX AFP ~01-03) NOTICE OF INHERZTANCE TAX APPRAISEMENT~ ALLONANCE OR D/SALLONANCE OF DEDUCTZONS AND ASSESSMENT OF TAX ESTATE OF SCAFIDI CHRISTINE M FZLE NO. 21 05-0652 ACN 101 DATE 07-05-2004 TAX RETURN NAS: (X) ACCEPTED AS FZLED ( ) CHANGED RESERVATZON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es*a~a (Schedule A) (1) 1~0~900.00 NOTE: To insure proper E. S*ocks and Bonds (Schedule B) (2) 25;411.60 cradi~ ~o your account, $. Closely Held S~ock/Par~narship Zn*aras~ (Schedule C) ($) O0 sub. i~ ~ha upper par*ion ~. Hor~gagas/No~as Receivable (Schedule D) (~) O0 of *his fore ~i~h your S. Cash/Bank Daposi~s/Hisc. Personal Proper~y (Schedule E) ($) 1001144.7! ~ax payment. 6. Jointly O~nad Propar~y (Schedule F) (6) 5;8~5.50 7. Transfers (Schedule G) (7) 767; 045.69 8. To'al Assa~s (B) 1,029,335.50 APPROVED DEDUCTZONS AND EXEMPTZONS: 60,$27.11 9. Funeral Expansas/Adm. Cos~s/Hisc. Expenses (Schedule H) (9) 10. Dab*s/Hor~gege Liabilities/Liens (Schedule l) (10) Z,O76.0Z 11. To,al Deductions (11) 12. Na~ Value of Tax Ra~urn (12) 966,952.$7 15. Charitable/Governmental Bequests; Non-elac~ad 9113 Trusts (Schedule J) (15) .00 lq. Na~ Value of Es~a~e Subjec~ ~o Tax (1~) 966,95Z.~7 NOTE: If an assessment ~as issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 ~ill reflect flgures that lnclude the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Aaoun~ of Line lq a~ Spousal ra~e (15) .00 X O0 = .00 16. Amoun~ of Line 1~ ~axabla a~ Lineal/Class A ra~a (16) 966,95Z.$7 x 045 = 45,511.96 17. Amoun~ of Line 1~ a~ Sibling ra~a (17) .00 X 1~ = .00 18. Amoun~ of Line 1~ ~axabla a~ Collateral/Class B ra~a (18) .00 X 15 = .00 19. Principal Tax Due (19)= 43,511.96 TAX CRED/TS: PAYHENT RECEZPT : DISCOUNT (+~ AHOUNT PATD DATE NUNBER TNTEREST/PEN PATD (-) 0~-25-2004 CD005756 .00 45,511.96 TOTAL TAX CREDZT 43,511.96 BALANCE OF TAX DUEI .00 TNTEREST AND PEN. . O0 TOTAL DUE . O0 ZF PA/D AFTER DATE TNDTCATED~ SEE REVERSE ( TF TOTAL DUE TS LESS THAN $1, NO PAYNENT TS REGUTRED. FOR CALCULATTON OF ADDTTZONAL ZNTEREST. TF TOTAL DUE TS REFLECTED AS A 'CREDTT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SI:DE OF THTS FORH FOR :]:"STRUCT:]:ONS.) i~.~-' RESERVATION: Estates of decadents dying on or before December 1Z, 198Z -- if any futura interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the laaful Class S (collateral) rate on any such futura interest. PURPOSE OF NOTICE: To fulfill the requirements af Section ZI~O of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (72 P.S. Sect[on 91q0). PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: REGISTER OF NILES, AGENT REFUND (CR): A refund of a tax credit, ehich was not requested on the Tax Return, may ba requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax'* (REV-iSIS). Applications are available at the Office of the Register of Hills, any of the Z5 Revenue District Offices, or by calling the special Z~-hour answering service for fores ordering: 1-800-$SZ-ZO50; services for taxpayers with special hearing and / or speaking needs: 1-800-~7-$0Z0 (TT only). OBJECTIONS: Any party in interest nat satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount ar interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBlOZ1, Harrisburg, PA 17128-lOZl, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADNIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-iS01) far an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three (5) calendar months after the decedant's death, a five percent (Si) discount of the tax paid is allowed. PENALTY: The 15Z tax amnesty nan-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same tiaa period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January l, 1982 bear interest at the rate of six (Si) percent per annum calculated at a daily rate of .O00lSq. Al1 taxes which became delinquent on and after January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through 200~ are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rata Factor Year Rate Factor 1~ ZOZ .0005q8 1988-1991 ZZZ .000501 ~ 9Z .O00Z~7 1985 16Z .000~38 1992 9Z .000Z47 ZOOZ &Z .000164 1984 11Z .000301 1995-1994 7Z .000192 2005 5Z .000157 1985 15X .000556 1995-1998 9Z .O00Z~7 ZOOq ~Z .000110 1986 IOZ .000Z74 1999 7X .O0019Z 1987 10Z .O00ZT~ ZOO0 7Z .00019Z --Interest is calculated as follows: iNTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will re~lect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. COHNONNEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION PEP;. Z8,60~ NOTICE OF DETERMINATION AND HARRISDURG, PA I?IZS-060! ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN DATE 09-ZO-200q ESTATE OF SCAFID! CHRISTINE N DATE OF DEATH 05-25-2005 F/LE NUHBER 21 05-0652 COUNTY CUHBERLAND FRED S BACHMAN ACN ZO1 NACHOVIA BANK I Amoun~ Remi~ed 125 S BROAD ST PHILA PA 19109 HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF HILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credi~ ~o your account, submi~ ~he upper portion of ~his form wi*h your ~ex payment. CUT ALONG THIS LINE ~-- RETA'rN LONER PORTION FOR YOUR FILES ~ REV-483 EX AFP (01-03) ~ NOTICE OF DETERMINATION AND ASSESSHENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN ~ ESTATE OF SCAFIDI CHRISTINE M FILE N0.21 05-0632 ACN 201 DATE 09-20-200q ESTATE TAX DETERblZNATZON 1. Credit For State Death Taxes as Verified $Zz222.01 Z. Pennsylvania Inheritance Tax Assessed ~$z511.96 (Excluding Discount and/or Interest) $. Inheritance Tax Assessed by Other States .00 or Territories of the United States (Excluding Discount end/or Interest) ~ q. Total Inheritance Tax Assessed '~ !.ii... ~$,511.96 5. Pennsylvania Estate Tax Due ! -~ , TAX CREDITS: ~ PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID ~ DATE NUMBER INTEREST/PEN PAID (-) '4' TOTAL TAX CREDIT .00 BALANCE OF TAX DUEI .00 INTEREST AND PEN. .00 TOTAL DUE . O0 ~ZF pATD AFTER THIS DATE, SEE REVERSE SIDE (TF TOTAL DUE ZS LESS THAN $1~ NO PAYMENT ZS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THTS FORM FOR INSTRUCTIONS.) ~.~'~ PURPOSE OF NOTICE: To fulfill the requirements of Section 2140 (b) of the Inheritance and Estate Tax Act, Act 23 of ZOO0. (72 P.S. Section 9140). PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Mills printed on the reverse side. -- Hake check or money order payable to: REGISTER OF HILLS, AGENT. REFUND (CR): A refund of a tax credit may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Hills, any of the Z3 Revenue District Offices or from the Department's Z4-hour ansmering service for forms ordering: 1-800-36Z-ZO50~ services for taxpayers with specie! hearing and / or speaking needs: 1-800-447-30Z0 (TT only). OBJECTIONS: Any party in interest not satisfied with the assessment of tax as shown an this notice may object aithin sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --electing to have the matter determined at audit of the personal representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTM: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601, Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) far an explanation of administratively correctable errors. PENALTY: The 15Z tax amnesty non-participation penalty is caaputed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: For dates of death on or after 10-3-91, Pennsylvania Estate Tax based on the Federal Estate Tax return becomes delinquent at the expiration of nine (09) months from the date of death. For dates of death prior to 10-3-91, Pennsylvania Estate Tax based on the Federal Estate Tax return becomes delinquent at the expiration of eighteen (18) months from the date of death. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (67.) percent per annum calculated at a daily rata of .000164. All taxes which became delinquent on or after January 1, 198Z ail1 bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2004 ars: Interest Daily Interest Daily Interest DaiIy Yaa~ Rate Factor Year Rate Factor Year Rate Factor 1982 207. .0005r+6 1988-1991 112 .000301 ZOOl 92 .000247 1983 162 .000438 1992 92 .000247 2002 62 .000164 1984 llZ .000301 1993-1994 77. .000192 2003 52 .000137 1985 132 .000356 1995-1998 92 .000247 2004 4Z .000110 1986 102 .000274 1999 7Z .000192 1986 lOZ .000274 2000 82 .000219 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELTNQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. CONHONNEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHER/TANCE TAX DIVISION DEPT. 280601 HARRZSBURG, PAZ7128-0601 NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER DATE 09-27-200~ ESTATE OF SCAFIDI CHRISTINE M DATE OF DEATH 06-Z5-ZO05 FILE NUMBER 21 03-0632 COUNTY CUMBERLAND FRED S BACHMAN ACN 202 NACHOVIA BANK Amoun~ Remi~ed 123 S BROAD ST PHZLA PA 19109 HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF NZLLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credi~ ~o your account, submi~ ~he upper portion of ~hJs form wJ~h your ~ax payment. CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR FILES REV-736 EX AFP (01-02) x# NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER ESTATE OF SCAFID! CHRISTINE M FILE NO.ZZ 03-0632 ACN ZOZ DATE 09-27-2004 ESTATE TAX DETERHZNATZON 1. Credit For State Death Taxes as Verified 32,333.01 Z. Pennsylvania Inheritance Tax Assessed ~,3,511.96 (Excluding Discount and/or Interest) 3. Inheritance Tax Assessed by Other States .00 or Territories o~ ~he United S~a~es (Excluding Discount and/or ~n~eres~) ~. To~al Inheritance Tax Assessed ~511.96 = ~ ~ ~ ~*'*" .00 5. Pennsylvania Es~a~e Tax Due ~ :-~ ~ , 6. Amoun~ of Pennsylvania Estate Tax P~eviously Assessed ~ eased on Federal Es~a~e Tax Re~urn :,:L rq ~ .00 7. Additional Pennsylvania Estate Tax Due ' .00 TAX CREDITS: , ' ~ ~.~: PAYHENT RECEIPT DISCOUNT (+) '~ : ~ DATE NUHBER INTEREST/PEN PAID (-) AHOUNT PAID ~ TOTAL TAX CREDIT .00 BALANCE OF TAX DUEI .00 INTEREST AND PEN. .00 TOTAL DUE .00 ~ZF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REQUIRED ~ FOR CALCULATION OF ADDZT/ONAL /NTEREST. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.) PURPOSE OF NOT%CE: To fulfill the requirements of Section 1140 of the Inheritance and Estate Tax Act) Act Z$ of ZOO0. (71 P.S. Section 916`0). PAYMENT: Detach the top portion of this Notice and submit mith your payment to the Register of Hills printed on the reverse side. -- Hake check or money order payable to: REGISTER OF NILLS, AGENT. REFUND (CR): A refund of a tax credit may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices or from the Department's Z6`-hour ansmaring service for forms ordering: 1-800-361-Z050; services for taxpayers with special hearing and/or speaking needs: 1-800-6`6`7-3010 (TT only). OBJECTIONS: Any party in interest not satisfied with the assessment of tax as shown on this notice may object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue) Board of Appeals) Dept. 281021) Harrisburg) PA 17118-1011, OR --electing to have the matter detarained at audit of the personal representative) OR --appeal to the Orphans' Court ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 180601, Harrisburg) PA 17128-0601) Phone (717) 787-650S. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. PENALTY: The 157. tax amnesty non-participation penalty is computed on the total of the tax and interest assessed) and not paid before January 18, 1996) the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Additional Pennsylvania Estate Tax assessed as a result of a change on the Federal Estate Tax closing letter becomes delinquent at the expiration of one (1) month from the date the final notice of the increase in Federal Estate Tax is received. Taxes which became delinquent before January 1) 1981 bear interest at the rate of six (67.) percent per annum calculated at a daily rate of .000166`. All taxes which became delinquent on or after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through 2006` are: Interest Daily Interest Daily Interest Daily Yea__.r Rate Factor Yej_r Rate Factor Yea~ Rate Factor 1982 ZOZ .00056`8 1988-1991 IIZ .000301 Z001 9Z .O002q? 198:5 16Z .0006`38 1991 9Z .00016`7 ZOOZ 61 · 00016r+ 1986` llZ .000301 1993-1996, 77. .000192 2003 57. .000137 1985 137. .000356 1995-1998 97. .00016`7 Z006` 6`7. .000110 1986 IOZ .000176` 1999 7Z .000192 1987 92 .00026`7 ZOO0 8X .000219 --Interest is calculated as folXows: INTEREST = BALANCE OF TAX UNPA/D X NUHBER OF DAYS DELINQUENT X DA/LY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen {15) days beyond the data of the assessment. If payment is made after the interest computation date shown on the Notice) additional interest must be calculated. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Christine M. Scafidi Date of Death: June 25, 2003 Will No. : 2003 - 00632 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No__ 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes__ No 7, . b. The separate Orphans' Court No. (if any) for the personal representative's account is: NA c. Did the personal representative state an account informally to the parties in interest? Yes X No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: I//o/cPZ-.,j .~z_.r~-[5~ signature / Smith B. Gephart, Esquire CD <.,:> CD , L~.~ --! ~ ,- ~:: Name (Please type or print) t.%:' rillian & Gephart < :~ c~r~: 218 Pine Street C~'> < ::7 CD ~ Cf: '2.: ' ,::..~ ~.-- ~L~ ~. ~_:: Harrisburg, PA 17101 ¢.D c: ~ u_ ,-~-~ Address (717) 232-1851 Tel. No. Capacity: Personal Representative X Counsel for Personal Representative