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Home My WebLink About03-0495INRE ESTATE OF MARY G. LUCAS DECEASED :IN THE COURT OF COMMON PLEAS :OF CUMBERLAND COUNTY,PENNSYLVANIA :ORPHANS' COURT DIVISION RECEIPT, RELEASE, APPROVAL OF ACCOUNT AND INDEMNITY AGREEMENT This Receipt, Release, Approval of Account and Indemnity Agreement (hereinafter called the "Release") is given this ~O ~ day of ~e,~o~4~ ~ r-, 2004, by Hershey Trust Company, Trustee under Trust Agreement dated 3/23/99. For the purpose of inducing the Company to make the distribution described herein and intending to be legally bound, the Executor/Trustee hereby represents, warrants, covenants and agrees as follows: 1. Background. Mary G. Lucas executed a Trust Agreement on March 23, 1999. At the death of Mary G. Lucas, June 7, 2003 the trust continued, in separate trust, for the benefit of her daughter, Mary Ellen Frame, her son, John J. Lucas, Jr., in equal shares. The residue of the Estate of Mary G. Lucas was distributed to the trust established under Trust Agreement dated March 23, 1999. After transfer of the residue from the Estate to the Trust, the balance of the Mary G. Lucas Trust was transferred to a separate trust for each of the children. 2. Acknowledgment of Receipt and Release of Trust Company. The Trustee acknowledges that the amount indicated on the First and Final Account for the Estate of Mary G. Lucas, deceased has been transferred to the Mary G. Lucas T/U/A dated March 23, 1999, in full payment and satisfaction of said distribution. The Truste~alTso ack~.owledges that the amount indicated on the First & Final Account of Mary G. Lucas T/U/A ~ed March 23, 1999 has been transferred to the Mary Ellen Frame T/U/A and JOhn J. Lucas T/U/A. In consideration of the foregoing distributions being made at this time, The TruCe releases absolutely and discharges the Trust Company and its officers, directors, emplo~r,e.~s, agents, representatives, successors and assigns from any liability whatsoever in connecti~)n with the distribution and the administration generally of the Trust, to which this distributi.'on relates. 3. Indemnity Agreement. The Executor agrees to indemnify the Trust C,b'mpany and hold it harmless, to the extent of any funds or assets received by the Beneficihi'y from the Trust Company hereunder, from and against the Beneficiary's pro rata share of any and all liability (including attorneys' fees and other costs or expenses of defense) to which the Trust Company may be subjected by reason of its administration of the trust. In connection with this Agreement, the Beneficiary agrees to refund or return, promptly upon the Trust Company's written demand, any funds or assets distributed by the Trust Company to the Beneficiary, if the distribution thereof is determined at any time to have been an erroneous or negligent distribution to the Beneficiary, whether such error or negligence was or was claimed to have been premised upon a mistake of law or of fact. 4. Approval of Accounting. The Beneficiary has examined the attached account of the Trust Company and accepts and approves it as being true, correct and complete in all particulars, and approves a waiver of an income accounting. 5. Miscellaneous. The construction, effect, validity and performance of this Release shall be governed in all respects by the internal substantive law of the Commonwealth of Pennsylvania. The provisions of this Release shall be deemed severable in the event that any one or more thereof shall be deemed invalid or unenforceable, with the effect that the remaining provisions shall persist as if such invalid or unenforceable provision had never been a part hereof. This Release shall bind the Beneficiary and his/her heirs, representatives, successors and assigns. IN WITNESS WHEREOF, the Beneficiary has executed and sealed this Release on the date first above inscribed in the presence of at least two (2) witnesses. Witnesses: H~ey Trust~ Vi},e~resid~nt & Trust Officer COMMONWEALTH OF PENNSYLVANIA ) · SS ' COUNTY OF ~ ~ ) On the ~¢6-~ day of~~2004, before me, a Notary Public in and for the Commonwealth and County aforesaid, personally appeared Raymond T. Cameron, who acknowledged himself to be the Vice President & Trust Officer of Hershey Trust Company, being authorized to do so, executed the foregoing instrument for the purposes therein contained by signing the name of the corporation by himself as Vice President. Witness my hand and notarial seal the day and year aforesaid. ~qot~j Public ~ Nota~l Seal Lisa L. Pierga~ni, Notary Public Deny Twp., Daupt~in County My Commission Ex~ires May 5, 2007 Member, pennsylvania Associa~on Of Notaries COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA ORPHANS' COURT DIVISION FIRST AND FINAL ACCOUNT For the Inter Vivos Trust Agreement of Mary G. Lucas, deceased dated March 23, 1999 Stated by HERSHEY TRUST COMPANY, Trustee Date of Death of Settlor: Date of Trustees' first receipt of funds Account Stated for the Period: June 7,2003 February 20, 2001 February 20, 2001 to June 3, 2004 Purpose of Account: Raymond T. Cameron, Vice President and Trust Officer, Hershey Trust Company, offers this account to acquaint interested parties with the transactions that have occurred during their administration. It is important that the account be carefully examined. Requests for additional information or questions or objections can be discussed with: Raymond T. Cameron Vice President and Trust Officer Hershey Trust Company P.O. Box 445 Hershey, PA 17033 (717) 520-1130 Proposed Distributions to Beneficiaries Principal Receipts Net Gain (or Loss) on Sales or C)ther Dispositions Less Disbursements: General Disbursements Fees Balance before Distributions Distributions to Beneficiaries Transfers to Income Principal Balance on Hand For Information: Investments Made Changes in Investment Holdings Income Receipts Less Disbursements Balance Before Distributions Distributions to Beneficiaries Income Balance on Hand Combined Balance on Hand SUMMARY OF ACCOUNT Current Page Value 18 $2,700.37 2- 4 $1,807,297.25 5- 9 39,606.57 10 193,896.25 10 0.00 10-12 12 13 13 14 15-16 16 17 17 Fiduciary Acquisition Value $2,700.37 1,846,903.82 193,896.25 $1,653,007.57 1,582,778.86 67,790.37 2,438.34 $25,633.56 21,797.99 3,835.57 3,573.54 262.03 $2,700.37 RECEIPTS OF PRINCIPAL 0212012001 0212112001 03/08/2001 03/13/2001 O3/13/2001 03/13/2001 03/13/2001 03/13/2001 03/13/2001 03/13/2001 03/13/2001 03/13/2001 03/13/2001 03/13/2001 03/13/2001 03/13/2001 03/13/2001 03/26/2001 03/26/2001 04/12/2001 04/12/2001 05/02/2001 05/02/2001 05/02/2001 05/02/2001 05/02/2001 05/03/2001 06/05/2001 07/11/2001 07/11/2001 0'7111/2001 0'7119/2001 09/10/2001 11/16/2001 11/28/2001 0'1/02/2002 0'1/18/2002 0'1/25/2002 02~26~2002 0:],10112OO2 0:],1O612OO2 05~08~2002 06/13/2002 RECEIPTS FROM SETTLOR Cash - PNC checking account Cash - Hershey Trust Co IRA required minimum distribution for 2001 Cash - Patriot-News refund 697 shs Allied Irish Banks -Spons ADR 2,249 shs American Electric Power Co 1,580 shs Citigroup Inc 300 shs Cytec Industries 871 shs General Motors 100 shs General Motors CI H 105 shs Electronic Data Systems Corp 1,354 shs Lucent Technologies Inc 165 shs NCR Corporation 673 shs Pall Corp 712 shs PPL Corporation 5,053 shs Public Service Enterprise Group Inc 246 shs PNC Financial Services Group 7,217 shs SBC Communications Inc 3,442 shs BellSouth Corp 1,076 shs Hershey Foods Corp 2,468 shs AT&T Corporation Cash - cancellation of American Spectator LLC subscription 580 shs Visteon Corporation 7,057 shs Ford Motor Company 1,725 shs Qwest Communications International Inc 2,983 shs Verizon Communications 112 shs Avaya Inc 1,713 shs Vodafone Airtouch PLC Cash - Prudential Financial contract # 07 347 284 518 shs General Motors Corp Class H 640 shs Delphi Automotive Systems Corporation 157 shs Pall Corporation 112 shs Raytheon Company Cash - balance of Merrill Lynch account Cash - refund from American Golf Corporation Cash - proceeds from sale of EDS fractional share Cash - PA Blue Shield medical insurance reimburse- ment Cash - proceeds from the sale of vehicle Cash - PA Blue Shield medical insurance reimburse- ment Cash - refund from PPL Electric Cash - PNC Bank checking account withdrawal Cash - Penn National Insurance refund US Treasury - individual income tax refund for 2001 Cash - Hershey Trust Co IRA required minimum distribution for 2002 $50,000.00 4,841.73 85.70 6,755.64 66,132.92 18,975.50 1,570.81 26,673.46 687.86 947.89 7,304.50 910.98 4,410.12 15,349.38 121,021.08 6,288.71 58,601.50 34,884.72 11,382.67 31,135.16 14.58 2,176.52 57,138.97 20,025.19 5O,347.25 418.31 5,496.06 27.56 3,563.14 5,144.98 1,022.72 2,660.91 1,040.47 125.00 0.94 69.00 10,000.00 2,353.33 33.69 40,OO0.0O 358.00 5,063.00 4,66O.0O 2 '10~08~2002 10/10~2002 111/20/2002 12/10~2002 12/24/2002 01/23/2003 02/07/2003 02/10/2003 02/24/2003 02/25/2003 04/15/2003 Cash - balance in petty cash fund at Frey Village Cash - refund from Comcast Cable Cash - reimbursement from Express Scripts for prescription drugs Cash - refund from Tressler Lutheran Services for Frey Village Cash - proceeds of sale of 724 Linden Road Hershey PA Cash - refund from Hershey Settlement Services Inc of balance of escrow funds Cash - refund from Waste Management Inc Cash - proceeds of sale of household items from Ziegler Auctions Cash - withdrawal from PNC Bank checking account Cash - refund from Penn National Insurance Cash - Hershey Trust Co IRA required minimum distribution for 2003 84.92 49.65 551.88 469.24 254,353.21 8.28 5.61 8,453.95 35,000.00 20.00 4,687.78 $983,384.47 06/30/2003 09/24/2003 0~24/2003 05/04/2004 06/03/2004 Miscellaneous Receipts Semi Annual transfer of income John J Lucas Trust per Family Agreement Mary G Lucas IRA per Family Agreement Mary G Lucas Estate - advance distribution Mary G Lucas Estate - residue Adjustments on following securities to reflect date of death (6-7-2003) value: 49,4 shs AT& T Corp Book Value $9,665.11 9,054.26 4,047.78 238,793.36 63,59O.58 2,275.84 2,438.34 610.85 311,145.90 610.85 3,442 shs BellSouth Corp Book Value $93,234.31 34,884.72 58,349.59 58,349.59 1,;_~00 shs Citigroup Inc Book Value $51,99O.00 13,493.74 38,496.26 38,496.26 798 shs Comcast Corp Class A Book Value $25,005.33 15,128.86 9,876.47 9,876.47 300 shs Cytec Industries Inc Book Value $10,455.75 1,570.81 8,884.94 8,884.94 6,40 shs Delphi Automotive Systems Corp Book Value $6,139.20 5,144.98 994.22 994.22 105 shs Electronic Data Systems Corp Book Value $2,311.81 947.89 1,363.92 1,363.92 6'18 shs General Motors Corp Class H Book Value $7,806.73 4,251.00 3,555.73 3,555.73 1,076 shs Hershey Foods Corporation Book Value $76,350.27 11,382.67 64,967.60 64,967.60 830 shs Pall Corporation Book Value $19,874.35 5,432.84 14,441.51 14,441.51 246 shs PNC Financial Group Inc Book Value $12,001.11 6,288.71 5,712.40 5,712.40 712 shs PPL Corporation Book Value $29,952.06 15,349.38 14,602.68 14,602.68 5,053 sgs Public Service Enterprise Group Inc Book Value $219,717.07 121,021.08 98,695.99 98,695.99 6,800 shs SBC Communications Inc Book Value $180,608.00 55,215.49 125,392.51 125,392.51 52 shs Travelers Property Casualty Group A Book Value $83O.44 287.79 542.65 542.65 107 shs T~velers P~perty Casualty Group B Book Value $1,708.26 640.83 1,067.43 1,067.43 2,900 shs Verizon Communicationslnc Book Value $114,158.50 48,946.37 65,212.13 65,212.13 Total Receipts $1,807,297.25 GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS 2~05~2001 557 shs Ford Motor Company Net Proceeds Fiduciary Acquisition Value Gain $10,354.28 4,509.91 $5,844.37 Loss 12/05/2001 117 shs SBC Communications Inc Net Proceeds Fiduciary Acquisition Value 4,388.52 950.03 3,438.49 12/05/2001 83 shs Verizon Communications Inc Net Proceeds Fiduciary Acquisition Value 3,926.59 1,400.88 2,525.71 0110912002 300 shs SBC Communications Inc Net Proceeds Fiduciary Acquisition Value 12,212.81 2,435.98 9,776.83 01/18/2002 112 shs Avaya Inc Net Proceeds Fiduciary Acquisition Value 1,083.02 418.31 664.71 01/18/2002 100 shs NCR Corporation Net Proceeds Fiduciary Acquisition Value 4,232.93 910.98 3,321.95 01/18/20O2 112 shs Raytheon Company Net Proceeds Fiduciary Acquisition Value 3,544.74 2,660.91 883.83 02/01/2002 725 shs Qwest Communications International Inc Net Proceeds Fiduciary Acquisition Value 8,380.87 8,416.38 (35.51) 02/11/2002 197 shs Allied Irish Banks - Spons ADR Net Proceeds Fiduciary Acquisition Value 3,678.48 1,909.41 1,769.07 02/13/2002 500 shs Qwest Communications International Inc Net Proceeds Fiduciary Acquisition Value 4,604.93 5,804.41 (1,199.48) 5 02/19~2002 500 shs Qwest Communications International Inc Net Proceeds Fiduciary Acquisition Value 4,239.93 5,804.40 (1,564.47) 0310612002 795 shs AT&T Wireless Services Inc Net Proceeds Fiduciary Acquisition Value 6,778.87 6,968.80 (189.93) 03/22/2002 354 shs Lucent Technologies Inc Net Proceeds Fiduciary Acquisition Value 1,539.87 1,909.74 (369.87) 04/16/2002 1,713 shs Vodafone Group PLC Net Proceeds Fiduciary Acquisition Value 27,364.34 5,496.O6 21,868.28 06/07/2002 180 shs Citigroup Inc Net Proceeds Fiduciary Acquisition Value 7,557.97 2,161.77 5,396.20 06/12~2002 1,000 shs Lucent Technologies Inc Net Proceeds Fiduciary Acquisition Value 2,759.91 4,409.92 (1,650.01) 0,6/21/2002 200 shs Citigroup Inc Net Proceeds Fiduciary Acquisition Value 8,604.94 2,401.96 6,202.98 06/21/2002 0.392 shs Agere Systems Inc CL A Net Proceeds Fiduciary Acquisition Value 1.21 1.37 (0.16) 07~09~2002 11 shs Agere Systems Inc CL A Net Proceeds Fiduciary Acquisition Value 15.40 38.57 (23.17) 0'7/09/2002 265 shs Agere Systems Inc CL B Net Proceeds Fiduciary Acquisition Value 376.29 947.37 (571 .O8) 6 [)7125/2002 500 shs Allied Irish Banks - Spons ADR Net Proceeds Fiduciary Acquisition Value 12,154.63 4,846.23 7,308.40 11 O/O2/2002 533 shs American Electric Power Co Inc Net Proceeds Fiduciary Acquisition Value 15,344.60 15,673.12 (328.52) 10/15/2002 2,500 shs Ford Motor Company Net Proceeds Fiduciary Acquisition Value 17,449.47 20,241.95 (2,792.48) 12/12/2002 0.398 shs Comcast Corp Class A Net Proceeds Fiduciary Acquisition Value 9.26 7.55 1.71 02111/2003 1,716 shs American Electric Power Co Inc Net Proceeds Fiduciary Acquisition Value 37,819.49 50,459.8O (12,640.31) 0,2/27/2003 4,000 shs Ford Motor Company Net Proceeds Fiduciary Acquisition Value 32,879.00 32,387.11 491.89 03/06/2003 871 shs General Motors Corporation Net Proceeds Fiduciary Acquisition Value 28,898.90 26,673.46 2,225.44 03/07/2003 580 shs Visteon Corporation Net Proceeds Fiduciary Acquisition Value 3,282.70 2,176.52 1,106.18 06/12/2003 494 shs AT&T Corporation Net Proceeds Fiduciary Acquisition Value 9,579.15 9,665.11 (85.96) 06/12/2003 3,442 shs BellSouth Corporation Net Proceeds Fiduciary Acquisition Value 91,890.21 93,234.31 (1,344.10) 7 06/12~2003 798 shs Comcast Corporation Class A Net Proceeds Fiduciary Acquisition Value 24,735.72 25,005.33 (269.61 ) 06/12/2003 300 shs Cytec Industries Inc Net Proceeds Fiduciary Acquisition Value 10,298.51 10,455.75 (157.24) 06/12/2003 640 shs Delphi Automotive Systems Corp Net Proceeds Fiduciary Acquisition Value 5,932.52 6,139.20 (206.68) 06/12/2003 105 shs Electronic Data Systems Corp Net Proceeds Fiduciary Acquisition Value 2,225.89 2,311.81 (85.92) 06/12/2003 618 shs General Motors Corp Class H Net Proceeds Fiduciary Acquisition Value 7,684.46 7,8O6.73 (122.27) 06/12/2OO3 1,076 shs Hershey Foods Corporation Net Proceeds Fiduciary Acquisition Value 76,274.06 76,350.27 (76.21) 06/12/2003 246 shs PNC Financial Services Group Net Proceeds Fiduciary Acquisition Value 11,797.60 12,001.11 (203.51) 06/12/2003 712 shs PPL Corporation Net Proceeds Fiduciary Acquisition Value 29,610.69 29,952.06 (341.37) 06/12/2003 830 shs Pall Corporation Net Proceeds Fiduciary Acquisition Value 19,719.87 19,874.35 (154.48) O6/12/2OO3 1,953 shs Public Service Enterprise Group Inc Net Proceeds Fiduciary Acquisition Value 82,979.O8 84,921.32 (1,942.24) 06/12~2OO3 52 shs Travelers Property Casualty Corp - A Net Proceeds Fiduciary Acquisition Value 828.32 830.44 (2.12) 06/12/20O3 107 shs Travelers Property Casualty Corp - B Net Proceeds Fiduciary Acquisition Value 1,704.43 1,708.25 (3.82) 06/12/2003 2,900 shs Verizon Communications Inc Net Proceeds Fiduciary Acquisition Value 112,800.65 114,158.50 (1,357.85) 06/13/2003 1,200 shs Citigroup Inc Net Proceeds Fiduciary Acquisition Value 51,045.60 51,990.00 (944.40) 06/13/2003 3,100 shs Public Service Enterprise Group Inc Net Proceeds Fiduciary Acquisition Value 132,431.99 134,795.75 (2,363.76) 06/13/2003 6,800 shs SBC Communications Inc Net Proceeds Fiduciary Acquisition Value 173,262.67 180,608.00 (7,345.33) 01/15/2004 1,076 shs Hershey Foods Corporation Net Proceeds Fiduciary Acquisition Value 81,137.36 75,984.97 5,152.39 Total Gains and Losses Less Losses Net Gain $77,978.43 (38,371.86) $39,606.57 ($38,371.86) 9 DISBURSEMENTS OF PRINCIPAL 01/17/2003 136113~2OO3 06/17/2003 06/18/2003 09/02/2003 03/01/2004 General Disbursements Hershey Trust Company - real estate transfer fee for sale of 724 Linden Ave Hershey, PA Messiah Village - nursing home room and board for May 2003 Register of Wills Cumberland County - probate fee Mary Lucas Estate - distribution for payment of estate expenses Mary Lucas Estate - distribution for payment of estate expenses Mary Lucas Estate - distribution for payment of estate expenses Fees Hershey Trust Company, quaderly principal fees Total Principal Disbursements $7,680.00 5,917.25 99.00 5,000.00 42,2OO.0O 133,000.00 $193,896.25 0.00 $193,896.25 0212212001 02126120O1 0212612001 03/09/2001 03/09/2001 03/09/2001 0,8/21/2001 08/21/2001 09/25/2001 10/29/2001 12/11/2001 12/24/2001 01/11/2002 DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES Mary Lucas - per request payment of Verizon statement dated 2/10/01 Mary Lucas - per request payment of The GM Card account # 5437 0001 0171 Mary Lucas - per request payment of Comcast Cable per statement dated 2/7/01 Mary Lucas - per request payment to Medi-Claim for services provided Mary Lucas - per request payment to Country Club of Hershey per statement dated 2/25/01 Mary Lucas - per request payment to MSHMC Physicians Group per statement dated 3/2/01 Mary Lucas - gift to Dr John Lucas per request of settlor Mary Lucas - gift to Mary Ellen Frame per request of settlor Mary Lucas - per request payment to Frey Village for room and board expenses for September and October 2001 Mary Lucas - per request payment to Frey Village for room and board expenses for October 2001 Mary Lucas - per request payment to Frey Village for room and board expenses for November 2001 Mary Lucas - per request payment to Frey Village for room and board expenses for December 2001 Mary Lucas - per request payment to Hershey Entertainment and $66.69 95.94 33.47 140.00 232.87 100.00 10,000.00 10,000.00 9,356.9O 4,831.27 4,622.69 4,982.OO 365.05 10 01/16~2002 01/17~2002 01123120O2 0112512002 0112512OO2 0112512OO2 01 ~25~2002 01 ~25~2002 0112512002 0,1/29/2002 01/31/2002 02~20~2002 0212812002 02~28~2002 03/18~2002 0,4/23/2002 0,4/25/2002 0,4/30/2002 05/15~2O02 06/11/2002 06/13/2002 06/19~2O02 09/17~2O02 1012312002 1 '1/01/2002 1111412002 11/25/2002 Resorts per statement dated 12/27/01 Mary Lucas - per request payment of Comcast Cable for period 1/7/02 through 2/6/02 Mary Lucas - per request payment to Continuing Care Rx for prescription drugs for period 12/3/01 - 12/31/01 Mary Lucas - per request payment to Frey Village for room and board expenses for January 2002 Mary Lucas - per request payment of Waste Management of Central PA expenses Mary Lucas - per request payment of Verizon expenses Mary Lucas - per request payment to Pinnacle Health Hospitals for services provided 12/17/01 Mary Lucas - per request payment to Pinnacle Health Hospitals for services provided 11/24/01 Mary Lucas - per request payment to Philhaven for professional services Mary Lucas - per request payment to Physicians of Rehabilitation per statement dated 1/21/02 Mary Lucas - per request payment to Lower Swatara EMS Inc for services provided 1/15/02 Mary Lucas - per request payment to NCAS Pennsylvania for medical insurance premium Mary Lucas - per request payment to Frey Village for room and board expenses for February 2002 Mary Lucas - gift to Dr John Lucas per request of settlor Mary Lucas - gift to Mary Ellen Frame per request of settlor Mary Lucas - per request payment to Frey Village for room and board expenses for March 2002 Mary Lucas - per request payment toElite Staffing Services Inc for private duty caregiver Mary Lucas - per request payment to Continuing Care Rx for prescription drugs Mary Lucas - per request payment toElite Staffing Services Inc for private duty caregiver Mary Lucas - per request payment to Continuing Care Rx for prescription drugs per statement dated 4/30/02 Mary Lucas - per request payment to Healthdrive Podiatry Group PA per statement dated 6/5/02 Mary Lucas - per request payment to Frey Village for room and board expenses for June 2002 Mary Lucas - per request payment of Verizon expenses Mary Lucas - per request payment to Frey Village for room and board expenses for September 2002 Mary Lucas - per request payment toAlert Pharmacy Services Inc for prescription drugs for period 9/26/02 through 10/17/02 Mary Lucas - per request payment to Lisa Clark for private duty caregiver Mary Lucas - per request payment to Messiah Village for room and board for October 2002 Mary Lucas - per request payment to Hershey Nursery per invoices dates 10/25/02 and 11/19/02 37.31 680.96 5,186.15 30.81 34.72 108. O0 38.00 19.42 77.51 65.00 245.22 5,165.04 11,000.00 11,000.00 5,604.70 536.00 733.05 448.00 668.91 46.00 5,462.25 61.65 5,333.05 635.79 560.00 5,987.25 279.39 11 11/26/2002 12~03~2002 12/17~2002 01/02/2003 01/02/2003 01/03/2003 01/10/2003 02/12/2003 03/11/2003 04/11/2003 09/25/2003 0912512003 05/04/2004 0,5/04/2004 Mary Lucas - per request payment to Lisa Clark for private duty caregiver Mary Lucas - per request payment to Conservative Enviromental Services Inc Mary Lucas - per request payment to Messiah Village for room and board for November 2002 Mary Lucas - gift to Dr John Lucas per request of settlor Mary Lucas - gift to Mary Ellen Frame per request of settlor Mary Lucas - per request payment to Cassel Plumbing, Heating, and Air Conditioning for repairs at 724 Linden Ave Hershey Mary Lucas - per request payment to Messiah Village for room and board for December 2002 Mary Lucas - per request payment to Messiah Village for room and board for January 2003 Mary Lucas - per request payment to Messiah Village for room and board for February 2003 Mary Lucas - per request payment to Messiah Village for room and board for February 2003 Mary Lucas Trust for benefit of Mary Ellen Frame 30 units Common Trust Fund - Fixed Income 190 units Common Trust Fund - Value Equity Cash Mary Lucas Trust for benefit of John J Lucas Jr 30 units Common Trust Fund - Fixed Income 190 units Common Trust Fund - Value Equity Cash Mary Lucas Trust for benefit of Mary Ellen Frame Cash Mary Lucas Trust for benefit of John J Lucas Jr Cash 560.00 3,047.50 5,752.00 11,000.00 11,000.00 124.49 5,898.00 6,036.39 5,384.14 5,956.50 31,642.67 51,331.26 575,000.00 31,642.67 51,331.25 575,00O.00 53,600.46 53,6OO.47 $1,582,778.86 0.4/03/2001 0.4/10/2001 0'9/11/2001 09/28/2001 12/20/2001 03/28/2002 05/14/2002 06/11/2002 07117/2002 08/21/2002 12/23/2002 03/28/2003 06/27/2003 Principal Principal Principal Principal Principal Principal Principal Principal Principal Principal Principal Principal Principal to ~ncome transfer to ~ncome transfer to income transfer to ~ncome transfer to ~ncome transfer to ~ncome transfer to ~ncome transfer to ~ncome transfer to ~ncome transfer to ~ncome transfer to ~ncome transfer to ~ncome transfer to ~ncome transfer TRANSFER TO INCOME $2,000.00 12,000.00 3,000.00 1,567.55 5,000.00 10,000.00 5,000.00 5,000.00 6,000.00 10,000.00 3,000.00 5,000.00 222.82 $67,790.37 12 PRINCIPAL BALANCE ON HAND Current Value As of 6/3/2004 Fiduciary Acquisition Value Cash and temporary investments $2,438.34 $2,438.34 0'7/19~2001 06/19/2002 0612112002 09/13~20O2 09/13/2002 12105120O2 06/16~2003 0(.)/10~20O3 0(.)/10~2003 INFORMATION SCHEDULE - PRINCIPAL Investments Made Units of Temporary Investment Fund were purchased or redeemed as funds were available or required. 0.798 shs AT&T Wireless Services Inc purchased @ 16.541353 0.437 shs Agere Systems Inc CL B purchased @ 2.35 0.613 shs Agere Systems CL A purchased @ 2.35 0.155 shs Travelers Property Casualty Corp - A purchased @ 15.731544 0.481 shs Travelers Property Casualty Corp - B purchased @ 16.951131 0.4 shs AT&T Corp purchased @ 27.7535 1,076 shs Hershey Foods Corporation purchased @ 70.578 with commissions of $43.04 60 units Common Trust Fund - Fixed Income purchased @ 1054.7556 380 units Common Trust Fund - Value Equity purchased @ 270.1645 $13.20 1.03 1.44 2.44 8.15 11.10 75,984.97 63,285.34 102,662.51 13 04/12~2001 06/22/2001 0612212O01 11/27/2002 11/27/2002 11/27/2002 11/27/2002 Changes in Investment Holdings A T& T Corporation 2,468 shs AT&T Corporation received from settlor 794.202 shs AT& T Wireless Services Inc received in distribution for AT&T 2,468 shs AT&T Corporation held at: 798.393 shs Comcast Corp - Class A received in stock distribution from AT&T Corporation 2,468 shs AT&T Corporation held at: 493.6 shs AT&T Corporation received in exchange for 2,468 shs of AT&T Corp 493.6 shs AT&T Corporation held at: 31,135.16 (6,955.60) 24,179.56 (15,136.41) 9,043.15 9,043.15 03/13/2001 O6/07/2OO2 06/07/2002 06/21/2002 06/21/2002 08/27/2002 08/27/2002 08/27/2002 08/27/2002 Citigroup /nc 1,580 shs Citigroup Inc received from settlor 180 shs Citigroup Inc sold 1,400 shs Citigroup Inc held at: 200 shs Citigroup Inc sold 1,200 shs Citigroup Inc held at: 51.845 shs Travelers Property Casualty Corp - A received in stock distribution from Citigroup Inc 1,200 shs Citigroup Inc held at: 106.519 shs Travelers Property Casualty Corp - B received in stock distribution from Citigroup Inc 1,200 shs Citigroup Inc held at: 18,975.5O (2,161.77) 16,813.73 (2,401.96) 14,411.77 (285.35) 14,126.42 (632.68) 13,493.74 03/13/2001 03/22/2002 03/22/2002 06/11/2002 O6/11/2002 06/11/2002 06/11 ~2002 06112~2002 Lucent Technologies Inc 1,354 shs Lucent Technologies Inc received from settlor 354 shs Lucent Technologies sold 1,000 shs Lucent Technologies Inc held at: 10.779 shs Agere CL A received in .010779 per share Lucent in stock spin-off 1,000 shs Lucent Technologies Inc held at: 264.563 shs Agere CL B received in .264563 per share Lucent in stock spin-off 1,000 shs Lucent Technologies held at: 1,000 shs Lucent Technologies sold 7,304.50 (1,909.74) 5,394.76 (38.50) 5,356.26 (946.34) 4,4O9.92 (4,409.92) 14 RECEIPTS OF INCOME Waiver of Income Accounting An income accounting having been waived for the period February 20, 2001 to March 31, 2003 a limited schedule of receipts of income follows: Balance per last income statement rendered $4,878.44 Dividends 04/01/2003 04/02/2003 (:)4/25/2OO3 05/02/2003 05/02/2003 05/O2/20O3 05/O2/2003 05/06/2003 05/19/2003 05/27/2003 06/02/2003 0,6/02/2003 06/11/2003 06/16/2003 07/01/2003 07/02/2003 09/16/2OO3 12/16/2003 Public Service Enterprise Group Inc - quarterly dividend PPL Corporation - quarterly dividend PNC Financial Services Corp - quarterly dividend BellSouth Corp - quarterly dividend SBC Communications Inc - quarterly dividend Verizon Communications Inc - quarterly dividend AT&T Corp - quarterly dividend Delphii Automotive Systems Corp - quarterly dividend Pall Corporation - quarterly dividend Citigroup Inc - quarterly dividend Travelers Property Casualty Corp - A - quarterly dividend Travelers Property Casualty Corp - B - quarterly dividend Electronic Data Systems Inc - quarterly dividend Hershey Foods Corp - quarterly dividend Public Service Enterprise Group Inc - quarterly dividend PPL Corporation - quarterly dividend Hershey Foods Corp - quarterly dividend Hershey Foods Corp - quarterly dividend 2,728.62 274.12 118.08 722.82 2,261.00 1,116.50 92.62 44.80 74.70 240.00 3.12 6.42 15.75 352.39 2,728.62 274.12 425.02 425.02 11,903.72 Interest from temporary investment funds 2003 March April May June July August September October November December 2004 January February March April May 456.42 431.64 438.97 831.95 988.42 955.21 669.54 123.55 120.91 126.53 162.20 176.01 82.60 80.00 8.14 5,652.09 15 Miscellanous Receipts 04115~2003 06/03/2003 0612712003 09/2412003 10/02/2003 '10/03/2003 06/03/2004 US Treasury - federal individual income tax refund Prudential Financial - dividend on contract Principal to income transfer John J Lucas Trust per Family Agreement John J Lucas Trust per Family Agreement Mary Lucas IRA - final distribution of income Mary Lucas Estate - residue Total Income Receipts 2,341.00 22.73 222.82 427.89 136.63 36.26 11.98 3,199.31 $25,633.56 (:)410112003 (:)410412003 (:)410912003 04111/2003 0412112003 0412312O03 04125120O3 0412912OO3 05102120O3 0510512003 0510812003 0510912003 05/13~2003 05/14~2003 05/16~2003 0512312003 0,5~27~2OO3 05~28~2003 0512912003 0513012003 06~06~2003 0610912003 06/27/2003 07/30/2003 08~28~2003 0912912003 1,013012003 11/2512003 1213012003 01/29/2004 02126120O4 03/30/2004 0412912004 01512712004 DISBURSEMENTS OF INCOME PDAIS - insurance premium for May 2003 Lisa Clark - private duty caregiver PA Department of Revenue - estimated tax payment Lisa Clark - private duty caregiver Lisa Clark - private duty caregiver Alert Pharmacy Services Inc - prescription drugs 3/27/03 - 4/17/03 Lisa Clark - private duty caregiver Hershey Trust Company - market value fee Lisa Clark - private duty caregiver PDAIS - insurance premium for June 2003 Hershey Trust Company - tax preparation fee Lisa Clark - private duty caregiver Messiah Village - room, board and miscellaneous charges Messiah Village Employee Christmas Fund - contribution Lisa Clark - private duty caregiver Alert Pharmacy Services Inc - prescription drugs 4/22/03 - 5/20/03 Lisa Clark - private duty caregiver PDAIS - insurance premium for July 2003 Hershey Trust Company - market value fee Lisa Clark - private duty caregiver Lisa Clark - private duty caregiver PA Department of Revenue - estimated tax payment Hershey Trust Company - market value fee Hershey Trust Hershey Trust Hershey Trust Hershey Trust Hershey Trust Hershey Trust Hershey Trust Hershey Trust Hershey Trust Company - Hershey Trust Company - Hershey Trust Company - Company - market value fee Company - market value fee Company - market value fee Company - market value fee Company - market value fee Company - market value fee Company - market value fee Company - market value fee market value fee market value fee market value fee 252.15 560.00 600.00 560.00 560.00 242.70 560.00 938.75 448.00 252.15 350.00 560.00 5,751.50 50.00 560.00 231.12 448.00 252.15 984.63 504.O0 560.00 600.00 1,017.80 1,017.15 1,021.39 1,019.16 375.00 375.00 375.00 200.01 198.53 198.50 87.65 87.65 $21,797.99 16 0912512003 1:)9/25/2003 DISTRIBUTIONS OF INCOME TO BENEFICIARIES Mary Lucas Trust for benefit of Mary Ellen Frame Mary Lucas Trust for benefit of John Lucas Jr 1,786.77 1,786.77 3,573.54 BALANCE OF INCOME ON HAND Current Value As of 6/3/2004 Cash and temporary investments $262.03 Fiduciary Acquisition Value $262.03 17 PROPOSED DISTRIBUTIONS TO BENEFICIARIES Per Item II of the Inter Vivos Trust Agreement of Mary G. Lucas (deceased) dated March 23, 1999 PRINCIPAL: Current Value As of 6/3/2004 Fiduciary Acquisition Value TO: Mary G. Lucas Trust for the benefit of Mary Ellen Frame Cash $1,219.17 $1,219.17 TO: Mary G. Lucas Trust for the benefit of John J. Lucas, Jr Cash 1,219.17 1,219.17 Total Principal $2,438.34 $2,438.34 INCOME: TO: Mary G. Lucas Trust for the benefit of Mary Ellen Frame Cash $131.01 $131.01 TO: Mary G. Lucas Trust for the benefit of John J. Lucas, Jr Cash 131.02 131 .O2 Total Income $262.03 $262.03 Combined Total $2,700.37 $2,7O0.37 18 RAYMOND T. CAMERON, Vice President and Trust Officer, Hershey Trust Company, Trustee under the Inter Vivos Trust Agreement of Mary G. Lucas, deceased, hereby declares under oath that said Trustee has fully and faithfully discharged the duties of his office; that the foregoing First and Final Account is true and correct, and fully discloses all significant transactions occurring during the accounting period; that all known claims against the trust have been paid in full; that, to his knowledge, there are no claims now outstanding against the trust; and that all taxes presently due from the trust have been paid. HERSHEY TRUST COMPANY, Trustee vice P~it[den;~-an~l'Tr~st Officer Subscribed and sworn to by RAYMOND T CAMERON before m,e this .~c-¢z-. day of x,~~o,.~ ,2004. Notary Public 1,3m L. Ptecgaani, Notary Public COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA ORPHANS' COURT DIVISION First And Final Account FIRST AND FINAL ACCOUNT OF Hershey Trust Company, Executor For ESTATE of Mary G. Lucas, Deceased File Number: 2003-0495 Stated by HERSHEY TRUST COMPANY, Executor Date of Death: Date of Executor's Appointment: Advertisement of the Grant of Letters: Accounting for the Period: June 7,2003 June 18,2003 June 25,2001 June 18,2003 to June 3, 2004 Purpose of Account: Raymond T. Cameron, Vice President and Trust Officer, Hershey Trust Company, offers this account to acquaint interested parties with the transactions that have occurred during their administration. The account also indicates the proposed distribution of the estate. It is important that the account be carefully examined. Requests for additional information or questions or objections can be discussed with: Raymond T. Cameron Vice President and Trust Officer Hershey Trust Company P.O. Box 445 Hershey, PA 17033 (717) 520-1130 Proposed Distributions to Beneficiaries Principal Receipts Net Gain (or Loss) on Sales or Other Dispositions Less Disbursements: Debts of Decedent Funeral Expenses Family Exemption Administration Expenses Federal and State Taxes Fees and Commissions Balance before Distributions Distributions to Beneficiaries Principal Balance on Hand For Information: Investments Made Changes in Investment Holdings SUMMARY OF ACCOUNT Page Current Value 6 $2,450.32 2 3 3 3 3 3 3 $2,434.60 6,281.30 0.00 1,138.00 187,580.48 2,500.00 4 4 Fiduciary Acquisition Value $204,786.49 362.07 205,148.56 199,934.38 $5,214.18 2,775.84 $2,438.34 Income Receipts Less Disbursements Balance Before Distributions Distributions to Beneficiaries Income Balance on Hand Combined Balance on Hand 5 6 $114.62 5.73 $108.89 96.91 11.98 $2,45O.32 RECEIPTS OF PRINCIPAL Assets Listed in Inventory, per copy attached Fiduciary Acquisition Value $23,049.49 06/18/2003 08/22/2003 0910212003 03/01/2004 O4~20~20O4 05/11/2004 Receipts Subsequent to Inventory: Mary Lucas TUA - transfer for payment of estate expenses Hershey Entertainment & Resorts - refund of over- charge of funeral reception Mary Lucas TUA - transfer for payment of estate taxes Mary Lucas TUA - transfer for payment of estate taxes US Treasury - federal individual income tax refund PA Department of Revenue - state individual income tax refund 5,000.00 265.00 42,200.00 133,000.00 521.00 751.00 Total Receipts of Principal 181,737.00 $204,786.49 05/18/2004 GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS 40 shs Prudential Financial Inc Net Proceeds Fiduciary Acquisition Value $1,688.57 1,326.50 Gain $362.07 Loss Total Gains and Losses Less Losses Net Gain $362.07 0.00 $362.07 $0.00 O6/23/2OO3 07/15/2003 11/12/2003 O6/20/2OO3 07/14/2003 06/18~2003 08/12~2003 01114~2004 0310512004 03/23/2004 05/04/2004 09/02/2003 03/03/2004 03/03/2004 DISBURSEMENTS OF PRINCIPAL Debts of Decedent MSHMC Physicians Group - balance due per state- ment dated 6/14/03 Messiah Village - balance due on nursing home for period 6/1 - 6/30/03 US Treasury - balance due on 2001 federal individual income tax return Funeral Expenses Hershey Golf Club - funeral reception Hoover Funeral Home & Crematory Inc - professional services provided Family Exemption Administration Expenses Cumberland County Law Journal - estate advertising Ledger Newspapers - estate advertising Register of Wills, Cumberland County - additional short certificates Register of Wills, Cumberland County - filing fee for PA Inheritance Tax return Register of Wills, Cumberland County - additional short certificate A Mark Winter, Esquire - legal services provided estate Federal and State Taxes Register of Wills, Cumberland County, Agent - PA Inheritance Tax prepayment Register of Wills, Cumberland County, Agent - PA Inheritance Tax balance due on return US Treasury - balance due on Federal Estate Tax return $102.22 1,147.50 1,184.88 651.30 5,630.00 75.00 39.00 6.00 15.00 3.00 1,000.00 55,000.00 4,642.65 127,937.83 $2,434.60 6,281.30 0.00 1,138.00 187,580.48 112/09/2003 Hershey Trust Company, Executor's Fee Total Principal Disbursements 2,500.00 2,500.00 $199,934.38 06/25/2003 05/04/2004 DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES Lisa P Clark - distribution per request of Mary Ellen Frame and John Lucas Mary G Lucas TUA - transfer of funds for advance distribution to trusts per trust agreement $500.00 2,275.84 $2,775.84 PRINCIPAL BALANCE ON HAND Current Value As of 6-3-2004 Fiduciary Acquisition Value Cash and temporary investments $2,438.34 $2,438.34 INFORMATION SCHEDULES - PRINCIPAL Investments Made Units of Temporary Investment Fund were purchased or redeemed as funds were available or required. Changes in Investment Holdings 4 RECEIPTS OF INCOME Dividends 112/18/2003 05/18/2004 Prudential Financial Inc- dividend payable 12/18/03 Prudential Financial Inc - dividend payable 5/13/04 20.00 16.00 36.00 Interest (;)612312004 0210912OO4 PNC Bank Checking Acct #5002896800 Prudential Financial Ins Policy #07 247 284 - interest from date of death $1.94 22.89 24.83 Interest from temporary investment funds 2003 June July August September October November December 2004 January February March April May $4.66 13.94 11.97 3.57 3.19 2.78 1.35 0.90 1.29 7.66 2.00 0.48 53.79 Total Income Receipts $114.62 DISBURSEMENTS OF INCOME Hershey Trust Company, income commission $5.73 5.73 96.91 96.91 0510412004 DISTRIBUTIONS OF INCOME TO BENEFICIARIES Mary G Lucas TUA - transfer of funds for advance distribution to trusts per trust agreement BALANCE OF INCOME ON HAND Current Value As of 6-3-2004 Fiduciary Acquisition Value Cash and temporary investments $11.98 $11.98 5 INFORMATION SCHEDULE - INCOME Units of Temporary Investment Fund were purchased or redeemed as funds were available or required. PROPOSED DISTRIBUTIONS TO BENEFICIARIES Per Item Four of the Last Will and Testament of Mary G. Lucas, deceased, dated March 23, 1999 PRINCIPAL: TO: Current Fiduciary Value Acquisition As of 6-3-2004 Value Inter Vivos Trust Agreement of Mary G Lucas, deceased, dated March 23, 1999 Cash $2,438.34 $2,438.34 INCOME: TO: Cash $2,438.34 $11.98 $2,438.34 $11.98 $11.98 $11.98 Total Distribution $2,450.32 $2,450.32 6 RAYMOND T. CAMERON, Vice President and Trust Officer, Hershey Trust Company, Executor under the Last Will and Testament of Mary G. Lucas, deceased, hereby declares under oath that said Executor has fully and faithfully discharged the duties of his office; that the foregoing First and Final Account is true and correct, and fully discloses all significant transactions occurring during the accounting period; that all known claims against the estate have been paid in full; that, to his knowledge, there are no claims now outstanding against the estate; and that all taxes presently due from the estate have been paid. HERSHEY TRUST COMPANY, EXECUTOR Viceye'~;ident and Trust Office Subscribed and sworn to by RAYMOND T CAMERON before , this .._3~-~'~-'. day of ~ ~-J}G.~,~, ~ .... 2004. Lisa L. Piefgallini, Notary Public Demj Twp., Dauphin County My Commission Expires May 5, 2007 Member, PennsCvania Assodation Of Notades Inventory of the real and personal estate of M~ry Go Lucas deceased PNC Bank Checking Account # 5002896800 Accrued Interest to Date of Death P£~IS - Premium Refund 40 shs. Prudential Financial Inc. Prudential Insurance Ccmpany of America policy #07 347 284 Post Mortem Dividends 20,466 3 252 1,326 1,000 Total 23,049 49 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND Raymo_nd.~Vice President & T~fficer, Hershey Trust Comoany being duly according to law, deposes and says that he __ F,x~l~t~r of the Estate of M~ry C~. L~ , Cumberland County, Pa., deceased and that the late of within is an inventory made by ~hey ~q C~ny _ ., the said Executor of the entire estate of said decedent, consisting of all the personal property and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. and subscribed before me, 19 Executor - Administrator Addrass Date of Death 7th gume 2003 Day Month Year INSTRUCTIONS I. An inventory must be filed withln three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. , = PETITION FOR PROBATE and GRANT OF LETTERS Estate of Mary G. Lucas No. also known as To: Register of Wills for the County of Cumberl and Commonwealth of Pennsylvania Deceased. Social Security No. 4 6 ? - 32 ~- 6 ? 81 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age orolder an Lllg exe. cut nr in the last will of the above decedent, dated M ar c h z,3, 19 9 9- and codicil(s) dated in the named ,19.__ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in C umber l and _la~tfamilyorpri~c. ipaJ residence at 100 Mt. Allen an~csburg, va -17055 (list street, number and muncipality) Decendent, then 87 years of age, died June 7,2003 at County, Pennsylvania, with Dr. Upper Allen Twp. , 19 , Except as follows, decedent did not marry, was not divorced 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 $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: 17,000 WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and-the grant of letters Irs t amen t ar y theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) Hershey Trust Company 100 Mansion Rd-East Hershey_ PA 170.33 By: Vice President & Trust Officer OATH OF' PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberl and 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~a~ tru~ ~[Ix~ster,~l~$6tate according to law. Sworn to or affirmed and subscribed ~_ .~&¢~ b~fore me this 1~ day of [ ~ ~ '~~~gister ~ ~ ~ ' Estate Of Mary G. Lucas , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW ,~c~e.. IA ~ 2003 . ,1~ ., in consideration of the petition..on the .reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated March 23,1999 described therein be admitted to probate and filed of record as the last will of I~ ~ r ]/ G, L u c a s and Letters Testamentary are hereby granted to H e r s hey Trust Company FEES Probate, Letters, Etc .......... $. 59.00 Short CertifiCates( 1)0 .......... Renunciation ................ $ JCP $ 10.00 TOTAL $ 99.00 Filed . Lo.~ .1~.-.0.~. ...... I~- t'~- o.~ A. Mark Winter, Esq. # 23178 A~ORNEY (Sup. Ct. I.D. No.) 310 W. Chocolate ADDRESS (717) 533-4868 PHONE Ave.Hershey,PA his is to certiI~ ti~at the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent fiiing. WARNING: it is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 9389016 No. (~cal Registrar Date TYP~PmNT PERMANENT BL.ACKLNK NAME C~DECEDENT(F~.MK~e. La,tq COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH ,, VITAL RECORDS CERTIFICATE OF DEATH , 87 v,..] : I ~ ..Cumberland [~. Upper Allen T~.L ~5~ lli~[~o~ J:~,~.=~.=~c--. ~'s~'white ~c~_~'?us~t~u~. I mo~.os,.~s~.~sT.~ ' ~SOEC~O~.T~.~ ,' v ~c~r~ I'i ...... I,o. .,. Housewife 11,,. Home makin~ I.. I 2430 Opal Road York, PA 17404 ~s.~,~, ~ '' Andrew Girman ~r~. e~ Cumberland ~n~.~? m.~,~ ~ L, Indianto~ Gap Nat. Cem. LdAnnville, PA 17003 Mary Ellen Frame June 12, 2003 ]a,=Mnnv.r F H & Cr~mmtnry. p O Box 475.Hershey.~ 170 1 JUN 17 /~11:21 LAST WILL AND TESTAMENT OF MARY G. LUCAS I, MARY G. LUCAS, having my legal residence at 724 Linden Road, Hershey, Dauphin County, Commonwealth of Permsylvania, do hereby declare this to be my Last Will and Testament, revoking all other W'flls and codicils heretofore made by me. My children, John J. Lucas, Jr. and Mary Ellen Frame, are living at the date of the execution of this, my Last W'fll and Testament. ITEM ONE: I direct that the expenses of my last illness and funeral be paid fi.om my estate as soon as practicable a~er my death. ITEM TWO: I give and bequeath any personal clothing or jewelry, formerly belonging to my husband, John J. Lucas, that I may own at the date of his death, to my son, John $. Lucas, Jr., and all of my personal clothing or jewelry to my daughter, Mary Ellen Frame, provided my children, John $. Lucas, Jr. and Mary Ellen Frame, survive my death by thirty (30) calendar days. ITEM THREE: I give and bequeath all shares of Hershey Foods Corporation, in my dividend reinvestment account and shares held in certificate form, to my grandchildren, John J. Lucas, Ill and Katherine R. Lucas, per stirpes. If a grandchild is under twenty-one (21) years of age, the Hershey Foods Corporation stock is to be transferred to their dividend reinvestment plan, which is currently in existence. If a grandchild should predecease me and without issue, then his or her share shall be distributed to the surviving grandchild. Page -1- ITEM FOUR: The residue of my estate, of whatever nature and wherever situate, shall be distributed to the Hershey Trust Company of Hershey, Pennsylvania, or its corporate successor, as Trustee under an Inter Vivos Trust Agreement which was created on the ~ ~t9 day of //~t:~/~ ,1999, to be administered in accordance with the terms of that Trust Agreement and ail amendments thereto. ITEM FIVE: I am granted a special power of appointment under Item II (B) (2) of the Inter Vivos Trust Agreement of John J. Lucas, dated July 15, 1992, of the residual benefits of the John J. Lucas Family Trust. I hereby exercise that power of appointment and direct that at my death, the residue of the John J. Lucas Family Trust shall be distributed, accumulated income and principal, to the Inter Vivos Trust Agreement of Mary G. Lucas, dated July 15, 1992, as amended. ITEM SIX: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid fi.om my residuary estate as part of the expense of administration of my estate, subject to the discretion which I have invested in Hershey Trust Company of Hershey, Pennsylvania, or it corporate successor, as Trustee under the aforesaid Inter Vivos Trust Agreement. ITEM SEVEN: I appoint the Hershey Trust Company, or its corporate successor the Executor of this Will and direct that they be permitted to serve without bond and without any intervention of any court except as required by law. I authorize my Executor to sell, encumber, mortgage, invest, distribute in kind, or retain any items of property of my estate in such manner as they shall deem proper, limited only by their own discretion. "-DI ~ .:~. Page -2- IN WITNESS WHEREOF, I have hereunto set my hand this ,~_ ~ r"~ ~ ,1999. .~ 3.,~/day Of Page -3- The preceding instrument, consisting of this and two other type-written pages, each identified by the signature of the Testatrix, Mary G. Lucas, was on the date thereof signed, published and declared by Mary G. Lucas, the Testatrix therein named, as and for her Last Will and Testament, in the presence of us, who, at her request, in her presence and in the presence of each other have subscribed our names as Witnesses hereto. ~t~.v-~ /~/J - ~.~l.kq'l.g>"-"~ Residence '~"~,J. ,/./~.~.d ~_:~.. Residence Page -4- AC~O~EDGE~ COMMONWEALTH OF PENNSYLV~ : :SS: COUNTY OF DAUPHIN : I, MARY G. LUCAS, the Testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I have signed and executed the instrument as my Last W'fll and Testament; and that I signed it willingly and as my flee and voluntary act for the purposes therein expressed. Sworn to, or affirmed and acknowledge before me by Mary G. Lucas, the Testatrix, this aq$~o day of /ff'ff~ ~ , 1999. Mary G. Lucks Notary Pul~li¢ ~ Seal ~N~._.nCy _L ~, ~ Pubic ~, ~inC~nly ~ ~ ~ms Ju~ 30, 2~ Member, Pem3sylva~a A~,sociation o~ Notaries Page -5- AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN: 'SS: and the witnesses whose names are subscribed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testatrix sign and execute the instrument as her Last Will; that she signed it willingly and that she executed it as her flee and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the W'dl and witness; and that to the best of our knowledge, the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. SWORN and subscribed to before me, this c~7cYx*D day Notary Pul~lic ' ~~ N. an~'t.. Slx~_. ~o~ar~ ~ emmsou~g, uau~fin L;ounty M!~ GOmltll~ion E~oims June 80, 2001 Member', I~o~yl~tar~ Assoc2ation of Notaries WITNESS LAST [dILL & TEMT~2~"T OF I~ARY G. ~ LAW OFFICES A. MARK WINTER- 310 WEST CHOCOLATE AVENUE P. o. BOX 41~ HEILBHEY, PENNSYLVANI^ 17033 HERSHEY TRUST COMPA~ '. RAYMOND T. CAMERON VICE PRESIDENT AND TRUST OFFICER '03 ~J{JN (717) 520-1130 rcameron@hersheytrust.com CERTIFICATION OF NOTICE UNnE [:tt S.6 Name of Decedent: Mary G. Lucas Date of Death: June 7, 2003 Estate No. 2003-00495 State File No. 21-03-0495 To the Register: I certify that notice of beneficial interest required by Rule 5.6 (a) of the Orphans' Rules was served on or mailed to the following beneficiaries of the above-captioned estate on June 23, 2003. Name Address Mary_ Ellen Frame, 2430 Opal Road, York, PA 17404 John J. Lucas, 140 Riverside Drive, Apt. 15D, New York, NY 10024 Notice has now been given to all persons entitled thereto under Rule 5.6 (a) except 100 MANSION ROAD EAST · P. O. BOX 445 · HERSHEY, PENNSYLVANIA 17033-0445 ° (717) 534-3225 ° FAX (717) 520-1111 ° www.hersheytrust.com Date a ond Z C m r on Name (Please type or print) Address: 100 Mansion Road East P.O. Box 445 Hershey, Pa. 17033 Telephone No. (717) 520-1130 Capacity:. X Personal Representative Counsel for personal Representative HERSHEY TRUST COMPANY BRYAN S. BREIDIGAM TRUST TAX MANAGER (717) 520-1105 · FAX (717) 520-1111 September 3, 2003 C 'umber!and County Register of Wills Office 1 Courthouse Square Carlisle, PA 17013 RE: Estate of Mary G. Lucas FILE: 00495-2003 Social Security Number: 467-32-6781 Gentlemen: Enclosed is a check representing the pre-payment of Pennsylvania Inheritance Tax for the above estate. Please credit the payment against the estate's pending tax liability. We are requesting that the receipt for the tax payment be mailed to our attention. If you have any queSti°hs regarding the payment, please contact me at 520-1105. Sincerely, 100 MANSION ROAD EAST * p. O. BOX445 · HERSHEY, PENNSYLVANIA 17033-0445 · (717) 534-3225 · FAX (717) 520-1111 HERSHEY TRUST COS~[PANY 100 MANSION ROAD EAST · P.O. BOX 445 HERSHEY, PENNSYLVANIA 17033-0445 MAILED FROM ZiP Cumberland County Courthouse Register of Wills Office 1 Courthouse Square Carlisle, PA 17013 ':-_00'2. IqlERSHE'Y TRUST COMPAN'Y' HERSHEY, PENNSYLVANIA 17033 4187 Mary G. Lucas Estate Pennsylvania Inheritance Tax Prepayment of PA Inheritance Tax for Mary G. Lucas SSN: 467-32- 6781 Paid For: Register of Wills, Cumberland County Credit: Mary G. Lucas Estate Term No: #2003-00495 14150785 09/02/03 $55,000.00* q COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11~96) CD 002977 HERSHEY TRUST COMPANY 100 MANSION ROAD EAST P O BOX 445 HERSHEY, PA 17033-0445 ........ fold ESTATE INFORMATION: SSN: 467-32-6781 FILE NUMBER: 2103-0495 DECEDENT NAME: LUCAS MARY G DATE OF PAYMENT: 09/04/2003 POSTMARK DATE: 09/03/2003 COUNTY: CUMBERLAND DATE OF DEATH: 06/07/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $55,000.00 REMARKS: TOTAL AMOUNT PAID: HERSHEY TRUST COMPANY $55,000.00 SEAL CHECK# 062330 INITIALS: SK RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS HERSHEY TRUST COMPANY BRYAN S. BREIDIGAM TRUST TAX MANAGER (717) 520-1105 * F~X (717) 520-1111 March 3, 2004 Cumberland County Courthouse Register of Wills 1 Court House Square Carlisle, PA 17013 RE: Mary G. Lucas File Number: 21-00495-2003 Gentlemen: Enclosed are the PA Inheritance Tax Returns for Mary G. Lucas, deceased. A copy of the return is provided for filing with the Commonwealth of Pennsylvania. Additionally, a copy of the Form 706, Federal Estate Tax Return filed for the decedent is provided. A check in the amount of $4,642.65 representing the payment on the balance of Pennsylvania Inheritance Tax due is enclosed. If you have any questions, please contact me at 717-520-1105. Sincerely, Trust Tax Manager 100 MANSION ROAD EAST · P. O. Box 445 · HERSHEY, PENNSYLVANIA 17033-0445 · (717) 534-3225 · FAX (717) 520-1111 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003638 HERSHEY TRUST COMPANY 100 MANSION RD-EAST HERSHEY, PA 17033-0445 ........ foid ESTATE INFORMATION: SSN: 467-32-6781 FILE NUMBER: 2103-0495 DECEDENT NAME: LUCAS MARY G DATE OF PAYMENT: 03/04/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 06/07/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 84,642.65 REMARKS: ..... SEAL HERSHEY TRUST CHECK# 65696 TOTAL AMOUNT PAID: 84,642.65 INITIALS: AC RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ~ 6 ~ 0 o.s. pos~,~ 66 ~ ~ s OB, 00° Cumberland Co. Courthouse Register of Wills 1 Court House Square Carlisle, PA 17013 REV-1500 EX (6-OO) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 OFFICLN. USE ONLY REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 COUNTY CODE -- 2003 00495 I-- LU UJ DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Luca. s, Ma. rT' G DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 06/07/2003 6/25/15 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 467-32-6781 THIS ~ MUST BE FILED IN [~JPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ~ ~ 1. Original Retum ~ 2. Supplemental Return ~ 3. Remainder Ratum (date of death prior to 12-13-82) ~ ~:e3 Ir--'-I [~ 4a. Futura Interast Compromise (date of death after 12-12-82) [~ 5. Federal Estate Tax Return Required O ~v~, I I I 4. Limited Estate 6. Decedent Died Testate (Attach copy of Will) ~ 7. Decedent Maintained a Living Trust (Attach copy of Trust) 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) J-~ 1 1. Election to tax under Sec. 9113(A)(^ttachSch O) TO=. iii NAME Hershey Trust Company FIRM NAME (If Applicable) TELEPHONE NUMBER 717-520-1105 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) COMPLETE MAILING ADDRESS PO Box 445 100 Mansion Road East Hershey, PA 17033 (1) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 6. JR Orated Property (Schedule F) (6) I___J Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Prabate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Sd~edule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estata (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) Amount of Line 14 taxable at lineal rate Amount of Line 14 taxable at sibling rate Amount of Line 14 taxable at collateral rate. 0.00 1,326.50~ 0.00c 0.00i:' 20,722.28 0.00' (8) 15,516.54 9,369.65 (11) (12) (13) 15. 16. 17. 18. 19. 120. (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 0o00 1,389,717.45 0.00 0.00 Tax Due OFFICIAL USE ONLY ! 1,414,603.64 24,886.19 1,389,717.45 0.00 1,389,717.45 x .oo__ (15) 0.00 62,537.29 x .045 (16) x.12 (17) 0.00 x .15 (18) 0 · 00 62,537.29 (19) 2W4645 1.000 Decedent's Complete Address: tS'~P, EET ADDRESS __2430 Opal Road CITY STATE ZIP /York PA 17404 Tax Payments and Credits: 1. Tax Due (Page I Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty 0.00 55,000.00 2,894,64 0.00 0.00 (,1) Total Credits (A + B + C) (2) Total Interest/Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (4) (5) (5A) (5B) 62,537.29 57,894.64 0.00 4,642.65 0.00 4,642.65 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ....................... ~-~ b. retain the right to designate who shall use the property transferred or its income; ......... I~1 c. retain a reversionary interest; or ................................ ~] d. receive the promise for life of either payments, benefits or care? ................. ~ ~--~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................ F~ 3. Did decedent own an "in trust for" or payable upon death bank account or secudty at his or her death? r-~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................ ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST ~PLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. DATE Hershey, PA-'~7033 SIGNORE OF PREPA~R O~ER MAN REPRESE~ATIVE Hershey, PA 17033 DATE For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of traansfera to or for the use of the surviving spouse is 3% [72 P.S. § 9916 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfem to or for the use of the surviving spouse is 0% [72 P.S. § 9116 (a) (1.1) (ii)] The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparant of the child is 0% [72 P.S. § 9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use ofthe decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. § 9116(1.2) [72 P.S. § 9116(a)(1 )]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% (72 P.S. § 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. W4646 1.000 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1 162 EX(11-96) CD 002977 HERSHEY TRUST COMPANY 100 MANSION ROAD EAST P O BOX 445 HERSHEY, PA 17033-0445 ........ fold ESTATE INFORMATION: SSN: 467-32-6781 FILE NUMBER: 2103-0495 DECEDENT NAME: LUCAS MARY G DATE OF PAYMENT: 09/04/2003 POSTMARK DATE: 09/03/2003 COUNTY: CUMBERLAND DATE OF DEATH: 06/07/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 ~55,000.00 REMARKS: TOTAL AMOUNT PAID: HERSHEY TRUST COMPANY 955,000.00 SEAL CHECK# 062330 INITIALS: SK RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS TAXPAYER REV-1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER Lucas, Mary ~ 21-2003-00~95 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION ~,0 shs Prudenti&l Financi&l Inc VALUE AT DATE Of DEATH 3-,326.50 TOTAL (Also enter on line 2. Recapitulation) $ 3-, 3 2 6.5 0 2w4696 3.000 (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Luc&s, Mary (3 21-2003-00495 Include the 3roceeds of litigation and the date the proceeds were received by the estate. All property Jointly-owned with the right of survivomhip must be dieclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH PDAIS - refund of premium paid 5/28/03 PNC Bank Checking Account ~5002896800 Accrued interest to date of death TOTAL (Also enter on line 5, Pecapitulation) 252.15 20,466.16 3.97 20,722.28 2W46AD 2.000 (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Lucas, Mary G 21-2003-00495 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIP~ON OF PROPER~ % OF ITEM INCUJOE 3HE NNVE OF ]I-E TRANSFE~E, ~EIR ~TD~HIP TO DATE OF DEATH DECD'S EXCLUSION DECEDENT~ ~-E ~ OF TRANSFER A~A~ A ~PY OF ME TAXABLE VALUE NUMBEF DEED FOR REAL ESTA~. V~UE OF ASSET INTEREST (FAPPUC~) 1. Inter Vivos Trust of Mary G. 1,314,323.88 100.00 0.00 1,314,323.8~ Lucas dated March 23, 1999 (See attached list of assets) 2 Mary G. Lucas Individual 62,230.98 100.00 0.00 62,230.9~ Retirement Account. Beneficiary= Inter Vivos Trust of Mary G. Lucas dated March 23, 1999 3 Gift of Cash - John Lucas Jr 8,000.00 100.00 0.00 8,000.00 1/2/2003 $11,000 less $3,000 exclusion 4 Gift of Cash - Mary Ellen 8,000.00 100.00 0.00 8,000.00 Frame 1/2/2003 $11,000 less $3,000 exclusion TOTAL(Alsoenteronline7, Reca~tulation) $ 1,392,554.86 (If more space is needed, insert additional sheets of same size.) 2W46AF 2.000 REV-1511 EX+ (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Lucas, Mary G FILE NUMBER 21-2003-00495 Debts of decedent must be reported on Schedule I. ITEM NUMBER 5. 6. 7. 8 9 10 11 DESCRIPTION FUNERAL FXPENSES' ~6over--~u~eral Homes and Crematory Inc 1225 W Chocolate Avenue Hershey, PA 17033 The Hershey Golf Club - reception following funeral services ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) See Schedule attached Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State __ Zip Year(s) Commission Paid: Attorney Fees Name: Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Sta~ __ Zip Relationship ~ Claimant ~ Decedent ~o~te Feas Accoun~nt's Fees Tm Return Pm~m~s Fees The Cumberland Law Journal - estate advertising The Hershey Chronicle - estate advertising Register of Wills Cumberland County - short certificates Hershey Trust Company - trustee fees through 2/26/2004 Hershey Trust Company - estimated trustee fees 1 from continuation pages .... TOTAl. (Also enter on line 9, Recapitulation) $ AMOUNT 5,630.00 386.30 2,500.00 1,000.00 0.00 99.00 0.00 0.00 75.00 39.00 6.00 4,581.24 1,000.00 200.00 15,516.54 2W46AG 2~000 (If more space is needed, insert additional sheets of same size) Estate of: Lucas, Mary ~ Schedule H, Part B -- Administrative Costs Page 2 21-2003-00495 Item No. Description 11 through 8/31/2004 Amount 12 Register of Wills - filing fees 200.00 TOTAL. (Carry forward to main schedule) ...... 200.00 state of: Lucas, Mary G Schedule H, Part B -- Personal representatives~ Commissions Item No. Description Name: Hershey Trust Company Social security number: 23-0692150 Address: PO Box 445 100 Mansion Koad East Hershey, PA 17033 Year(s) commissions paid: Page 2 21-2003-00495 Amount 2,500.00 TOTAL. (Carry forward to main schedule) ...... 2,500.00 REV-1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Lucas, Mary' G 21-2003-00495 Include unreimbursed medical expenses. ITEM NUMBER 4 5 6 DESCRIPTION MS~C Physicians Oroup - balance due on statement dated 6/14/03 Messiah Village - room and board for May Messiah Village - room and board, and hospice services 6/1/03 6/6/03 Messiah Village - miscellaneous supplies to 6/6/03 US Treasury - balance due on 2001 federal income tax return Hershey Trust Company - trustee fee for services through 5/31/03 paid 6/27/2003 TOTAL (Also enter on line 10, Recapitulation) $ AMOUNT 102.22 5,917.25 1,140.00 7.50 1,184.88 1,017.80 9,369.65 2W46AH 2.000 (If more space is needed, insert additional sheets of the same size) REV-1 $13 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Lucas Mar~ G FILE NUMBER 21-2003-00495 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLEDISTRIBUTIONS[indu~ ~trights~us~di~ri~tions, andEans~m underS~.9116(a)(1.2)] M Lucas fbo John Lucas Jr Trust C/O Hershey Trust Company PO Box 445 Hershey, PA 17033 M Lucas fbo Mary Frame Trust C/O Hershey Trust Company PO Box 445 Hershey, PA 17033 Frame, Mary E 2430 Opal Road York, PA 17404 Lucas, Jr, John J 140 Riverside Drive New York, PA 10024 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Child Child AMOUNT OR SHARE OF ESTATE 686,858.73 686,858.72 8,000.00 8,000.00 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00 2W46AI 1.000 (If more space is needed, insert additional sheets of the same size) WHEREAS, on the 18th dated March 23rd 1999 Register of Wills of CUMBERLAND County, Pennsylvania Certificate of Grant of Letters No. 2003-00495 PA No. 21-03-0495 ESTATE OF LUCAS MARY G (~A~'±', P'±~'i', Mi~) Late of UPPER ALLEN TOWNSHIP Deceased Social Security No. 467-32-6781 day of June 2003 an instrument was admitted to probate as the last will of LUCAS MARY G (~'1', P'I~S'I', late of UPPER ALLEN TOWNSHIP , CUMBERLAND County, who died on the 7th day of June 2003 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, DONNA M. OTTO , Register of Wills in and for the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to HERSHEY TRUST COMPANY who has duly qualified as Executor(rix) and has aqreed to administer the estate according to law, all of which fully appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my Office the 18th day of June 2003. - k. ~egisuer c~nwi~'s ~~k **NOTE** ALL AIAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) LAST WILL AND TESTAMENT OF MARY G. LUCAS I, MARY G. LUCAS, having my legal residence at 724 Linden Road, Hershey, Dauphin County, Commonwealth of Pennsylvania, do hereby declare this to be my Last W'fll and Testament, revoking all other Wills and codicils heretofore made by me. My children, John J. Lucas, Jr. and Mary Ellen Frame, are living at the date of the execution of this, my Last Will and Testament. ITEM ONE: I direct that the expenses of my last illness and funeral be paid fi.om my estate as soon as practicable after my death. ITEM TWO: I give and bequeath any personal clothing or jeweky, formerly belonging to my husband, John J. Lucas, that I may own at the date of his death, to my son, John J. Lucas, Jr., and all of my personal clothing or jewelry to my daughter, Mary Ellen Frame, provided my children, John J. Lucas, Jr. and Mary Ellen Frame, survive my death by ~ (30) calendar days. ITEM THREF.: I give and bequeath all shares ofHershey Foods Corporation, in my dividend reinvestmem account and shares held in certificate form, to my grandchildren, John J. Lucas, 111 and Katherine 1L Lucas, per stirpes. Ifa grandchild is under twenty-one (21) years of age, the Hershey Foods Corporation stock is to be transferred to their dividend reinvestment plan, which is currently in existence. If a grandchild should predecease me and without issue, then his or her share shall be distributed to the surviving grandchild. Page -1- ITEM FOUR: The residue of my estate, of whatever nature and wherever situate, shall be distributed to the Hershey Trust Company of Hershey, Pennsylvania, or its corporate successor, as Trustee under an Inter Vivos Trust Agreement which was created on the ~ :~?t~ day of /r~:~t,~ ,1999, to be administered in accordance with the terms of that Trust Agreement and all amendments thereto. ITEM FIVE: I am granted a special power of appointment under Item 11 (13) (2) of the Inter Vivos Trust Agreement of John J. Lucas, dated July 15, 1992, of the residual benefits of the John J. Lucas Family Trust. I hereby exercise that power of appointment and direct that at my death, the residue of the John J. Lucas Family Trust shall be distributed, accumulated income and principal, to the Inter Vivos Trust Agreement of Mary G. Lucas, dated July 15, 1992, as amended. ITEM S/X: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid fi-om my residuary estate as part of the expense of administration of my estate, subject to the discretion which I have invested in Hershey Trust Company of Hershey, Pennsylvania, or it corporate successor, as Trustee under the aforesaid Inter Vivos Trust Agreement. ITEM SEVEN: I appoint the Hershey Trust Company, or its corporate successor the Executor of this Will and direct that they be permitted to serve without bond and without any intervention of any court except as required by law. I authorize my Executor to sell, encumber, mortgage, invest, distribute in kind, or retain any items of property of my estate in such manner as they shall deem proper, limited only by their own discretion. "T14 ~/ ~. Page -2- IN WITNESS WI~.REOF, I have hereunto set my hand this .~,~./day of 1999. Page -3- The preceding instrumem, consisting of this and two other type-written pages, each identified by the signature of the Testatrix, Mary G. Lucas, was on the date thereof signed, published and declared by Mary G. Lucas, the Testatrix therein named, as and for her Last Will and Testament, in the presence of us, who, at her request, in her presence and in the presence of each other have subscribed our names as wimesses hereto. ~ ,/-'~' '*~'~,/_~'~¢-/~;~ ~-~-~x. Residence Page -4- INTER VIVOS TRUST AGREEMENT OF MARY Go LUCAS THIS IS AN INTER VIVOS TRUST AGREEMENT OF MARY G. LUCAS, presently residing and domiciled at 724 Linden Road, Derry Township, Dauphin County, Pennsylvania ("Settlor") and Hershey Trust Company of Hershey, Pennsylvania or its corporate successor ("Trustee"), executed by the Settlor on the ~ day of ~=~ , 19~, and thereafter accepted by the Trustee. For the purposes of clarity and understanding the Trust Agreement has been drafted in the first person singular. PUR, POSEB OF THE TRUST I am establishing this Trust to meet several desires that I have as Settlor. A. As a management vehicle into which I may deposit funds from time to time for investment purposes and either derive the income therefrom or to have it accumulate during my lifetime. B. To take the maximum advantage which is allowed me under the Federal Estate Tax law to conserve against the impact of death taxes. C. In the event of my death, to enable my children to reliably consult an institutional Trustee to guide them not only in the financial matters that are pertinent to this trust arrangement, but also other financial matters in which they may be interested. At the present time, the members of my immediate family are as follows= My children= John J. Lucas Jr. and Mary Ellen Frame My grandchildren= John J. Lucas III and Katherine R. Lucas At some time in the future, I may fund this trust to relieve myself of management responsibilities. I have provided for this possibility with ITEM I hereafter. Upon my death, the trust will become funded with additional assets, including the proceeds of any life insurance policies upon my life. I have also provided a "pour-over" provision in my Will that part of the residue of my probate estate is to be distributed to the Trustee. THEREFORE, in view of the purposes stated, I set forth the following instructions which the Trustee accepts and agrees to perform to the best of its ability= ITEM I: The Trustee shall hold, manage, invest and reinvest the trust estate, and shall collect the income thereof and dispose of the net income and principal as follows: (a) During the lifetime of the Settlor, the Trustee shall pay to or for the use of the Settlor, in quarter annual or more frequent installments, the net income of the trust estate. Any income not so distributed may be accu- mulated and invested in the same manner as the corpus of the trust estate. In addition to the income, there shall be paid to the Settlor or applied for her use out of the corpus, at any time and from time to time, such amounts, if any, as the Trustee in its discretion shall determine to be necessary for her maintenance, medical, dental, surgical, nursing, hospital, institutional and psychiatric care, comfort and welfare. In addition to such discretionary invasions of principal, the Trustee shall pay to Settlor at any time and from time to time such portion or all of the principal as she may request for any purpose including gifts to others. (b) The primary purpose and intent in creating this Trust is to provide for the income beneficiary, MARY G. LUCAS. The rights and interests of remain- dermen and/or the Settlor~s estate are subordinate and incidental to that purpose. The provisions of this agreement shall be construed liberally by the Trustee in the interest and for the benefit of MARY G. LUC&S during her lifetime. (c) Upon the Settlor~s death, the Trustee is authorized to pay to the personal representative of her estate or to expend directly such sums as the personal representative shall request, in writing, to supplement her estate, if necessary, in order to pay debts, bequests, funeral expenses, death taxes, and administration expenses~ PROVIDED, however, that no assets shall be used for this purpose which are not otherwise included in Settlorls gross taxable estate~ and PROVIDED, further, that if the Trust Estate contains any United States Government Bonds which are redeemable at par in payment of Federal estate taxes, Trustee shall apply them directly in payment of Settlor~s estate taxes, regardless of the sufficiency of assets in her estate or any direction in her Will to pay all such taxes from her probate estate. ITEM II: Upon my death, the trust shall continue or a trust established, if I have not funded the trust during my lifetime, for the benefit of my children, JOHN J. LUCAS, JR. and MARY ELLEN FRAME, as follows: A. The net income shall be distributed equally to my children, JOHN J. LUCAS, JR. and MARY ELLEN FRAME. If my son should predecease my daughter, then at the death of my son, the net income is to be distributed one-half (1/2) to my grandchildren, JOHN J. LUCAS, III, and KATHERINE R. LUCAS, and one-half (1/2) to my daughter, MARY ELLEN FP~ME. If my daughter should predecease my son, then at the death of my daughter, the net income is to be distributed to my son, JOHN J. LUCAS, JR. The Trustee shall apply, in its sole discretion, amounts of principal for the support, health, education, maintenance and welfare of my son and daughter. Upon the death of the survivor of my son and daughter, the accumulated income and principal shall be distributed equally to my grandchildren, JOHN J. LUCAS, III and KATHERINE R. LUCAS, per stirpes, then living. If a grandchild should predecease the survivor of my son and daughter, and without issue, then his or her share shall be distributed to the surviving grandchild. B. If any issue shall be under the age of thirty-five, the share of such issue shall be held by the Trustee, IN FURTHER SEPARATE TRUST, for the following uses and purposes= (1) If the issue is under age twenty-one, to expend and apply so much of the net income (any income not expended or applied to be accumulated and added to principal) and so much of the principal of each trust as the trustee shall consider advisable for the support and education (including college education, both graduate and undergraduate) of that issue until he or she attains the age of twenty-one years. (2) After the child attains age twenty-one, thereafter to pay to such child the net income together with so much of the principal thereof as trustee shall consider advisable for the support and education (including college educa- tion, both graduate and undergraduate) of such issue after taking into consi- deration his or her other readily available assets and sources of income. (3) Up to one-third of the then remaining principal and accumulated income at age twenty-five on the request of the child shall be distributed to that child at or after age twenty-five~ up to one-half of the then remaining principal and accumulated income at age thirty on the request of the child shall be distributed to that child at or after age thirty~ and up to the entire balance of principal and accumulated income then remaining on the request of the beneficiary shall be distributed to that child at or after age thirty-five. Distributions at or after these stated ages shall be made only in the event the child 6 requests such distribution by writing intended to take effect during lifetime, executed by that child upon or after attaining each of the stated ages and delivered to the corporate trustee. (4) If any such issue shall die before receiving final distribution of his or her entire share, the undistributed balance shall be distributed outright to his or her surviving issue, per stirpes, and in default of any such issue, then to my then living issue, per stirpes, the share of any child whose original share is then being held IN TRUST to be added to and treated as a part of that trust. ITEM III: I authorize the Trustee, Trustees and any successors in trust to exercise the following powers in its sole discretion which shall be effective without Court Order or approval: A. To retain any or all of the assets of my estate, without regard to any principal or diversification, risk or productivity. B. To invest in all forms of property without restrictions to investments authorized for any type of fiduciary. C. To compromise any claim or controversy. D. To loan money to or to purchase property from my probate estate. E. To borrow money from any person, including any executor or Trustee, and to mortgage or pledge any real or personal property. F. To sell at public or private sale, to exchange or to lease for any period of time, any real or personal property, and to give options for sales, exchanges or leases'all for such prices and upon such terms and conditions as it deems proper. G. To allocate receipts and expenses to principal or income or partly to each as it deems proper. H. To repair, alter or improve any real or personal property. I. To distribute in cash or in kind or partly in each, at valuations fixed by the Trustee. J. To purchase investments at premiums and to charge premiums to income or principal or partly to each. K. To subscribe for or to exercise options for stocks, bonds or other investments; to join in any plan of lease, mortgage, merger, consolidation, reorganization, foreclosure or voting trust and to deposit securities thereunder; and to generally exercise all the rights of security holders or employees of any corporation. L. To register securities in the name of a nominee or in such manner that title shall pass by delivery. M. To assume continuance of the status of any beneficiary, with reference to death, marriage, divorce, illness, incapacity, or other change in the absence of information deemed reliable, without liability for disbursements made on such assumption. N. To add to the principal of any trust created by this instrument any real or personal property received from any person by Deed, Will or in any other manner. O. To exercise all power, authority and discretion given by this instrument after the termination of any trust created herein until the same is fully distributed. P. To co-mingle the assets of any trust estate created by this instrument in any one or more common funds for greater convenience and flexibility. Q. To employ attorneys, accountants, engineers and such other persons, professional or otherwise, as may be necessary for the proper administration of this estate or trust, and to pay their compensation from such funds. R. To purchase from the trust fund or funds any type or manner of insurance which it deems to be in the best interest of the beneficiary. S. I authorize the Trustee, in its sole discretion, to advance funds from the trust fund to my probate estate for the payment of any part or all of the death taxes 9 or costs of administration or any obligation that I may have at my death. ITEM IV= All rights of every nature which accrue to me under the terms of the respective insurance policies which would fund this trust upon my death I hereby retain and if the consent of the Trustee or Trustees is necessary at any time to effect any of these rights the Trustee agrees to give its consent and this consent shall bind all the beneficiaries of this trust agreement. ITEM V: The Trustee shall be entitled to receive annual compensation for its services hereunder in accordance with its schedule in effect when the services are performed, but not in excess of such compensation as would be approved by a court of competent jurisdiction. ITEM VI: I reserve the right to alter, amend, supplement or revoke this Trust Agreement, as well as any Will of mine which has been coordinated with this Agreement. The consent of the Trustee shall be necessary in all cases, except the act of revocation which I alone may perform by Notice of Revocation delivered to the Trustee. ITEM VII. This Trust Agreement has been created under the laws of the Commonwealth of Pennsylvania and its validity, construction and administration shall be determined by the laws of that State. IN WITNESS WHEREOF, I, MARY G. LUCAS, the Settlor of this Trust Agreement, have set my hand and seal the day and year first above written and the Trustee has thereafter caused it to be accepted by an appropriate authorized officer, and its corporate seal affixed. WITNESS: SETTLOR / (SEAL) ATTEST HERSHEY TRUST COMPANY e President ~nd Trust Officer 11 ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA: :SS: COUNTY OF DAUPHIN On this, th~,~/~,O day of //'~£e tq ,1999, before me, a Notary Public, the undersigned officer personally appeared Raymond T. Cameron, who acknowledged himself to be Vice President of Hershey Trust Company, and he as such Vice President of Hershey Trust Company, being authorized to do so, executed the foregoing instrument for the purposes therein contained by signing the name of the corporation by himself as Vice President. IN WITNESS WHEREOF, I hereumo set my hand and official seal. Nd'taiy' Public (f" HERSHEY TRUST COMPANY 100 MANSION ROAD EAST · P.O. BOX 445 HERSHEY, PENNSYLVANIA 17033-0445 Register of Wills Cumberland County Court House High & Hanover Streets Carlisle, PA 17013 BUREAU OF ZNDZVTDUAL TAXES TNHERTTANCE TAX DTVTSTON DEPT. 280601 HARRISBURG, PA 17128-0601 CONMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-ZS,~? EX AFP (02-03) HERSHEY TRUST CO 100 MANS/ON RD EAST PO BOX qq5 HERSHEY DATE Oq-26-ZOOq ESTATE OF LUCAS DATE OF DEATH 06-07-2005 FILE NUHBER 21 05-0~95 COUNTY CUMBERLAND ACN 101 Amoun~ Remitted MARY 6 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF MILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~ DISALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF LUCAS MARY G FILE NO. 21 05-0R95 ACM 101 DATE Oq-Z6-ZOOq TAX RETURN NAS: (X) ACCEPTED AS FTLED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORZGZNAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schadula B) {2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) q. Nortgagas/Notas RaceivabZa (Schedule D) (q) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXENPTIONS: 9. FunaraZ Expansas/Adm. Costs/Nisc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule Z) (10) 11. Total Deductions 12. Nat Value of Tax Return 1/326.50 .00 20/722.28 .00 .00 NOTE: To insure proper credit to your account, suba/t the upper portion .00 of th/s fora w/th your tax payaant. 15,516.5~ 9/369.65 (11) (12) 1,$89,717.q5 13. NOTE: ASSESSMENT OF TAX: 15. Amount of L/ne lq at Spousal rata (15) 16. Amount of Line lq taxable mt L/neal/Class A rata (16), 17. Amount of Line lq at S/bling rata (17) 18. Amount of L/ne lq taxable at Collateral/Class B rata (18) 19. Pr/ncipal Tax Due rAX CREDITS PAYMENT DATE 09-05-2005 0$-0q-200q RECEIPT NUHBER CD002977 CD005638 UZSCOUNT ZNTEREST/PEN PAZD (-) Z,89q..7q .00 . O0 x O0 = . O0 1,389,717.q5 x Oq5= 62,537.29 · O0 x 12 = . O0 · 00 x 15 = .00 (19)= 62,537.29 AMOUNT PAID 55,000.00 q,6q2.65 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE Charitable/governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) . O0 Nat Value of Estate Sub,~ect to Tax (lq) 1,$89,717.q5 Zf an assessment was issued prevlcusly, lines 14, 15 and/er 16, 17, 18 and 19 reflect figures that include the total of ALL returns assessed to date. ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 62,537.39 · IOCR .00 · ZOCR ( ZF TOTAL DUE TS LESS THAN $1, NO PAYMENT 1S REDUZRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) 1/$92/55q.86 (8) 1,qlq,60$.6q RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December ZZ, 19BZ -- if any future interest in the estate is transferred in possession ar enjoyment to Class 8 (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 lawful Class B (collateral) rate on any such future interest. To fulfill the requirements of Section 2160 of the Inheritance and Estate Tax Act, Act Z$ of 2000. (72 P.S. Section 9140). Detach the top portion of this Notice and submit aith your payment to tho Register of #ills printed on the reverse side. --Make check or money order payable to: REGISTER OF HILLS, AGENT A refund of a tax credit, which Has not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-I:51$). Applications are available at the Office of the Register of gills, any of the Z~ Revenue District Offices, or by calling the special Z4-hour answering service for forms ordering: 1-800-:56Z-lOS0; services for taxpayers ~ith special hearing and / or speaking needs: 1-800-447-:50Z0 (TT only). Any party in interest not satisfied ~ith the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 171lB-lOll, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Ravia~ Unit, Dept. ZB0601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. Sea page S of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-lEO1) for an explanation of administratively correctable errors. If any tax due is paid within three ($) calendar months after the dacedant's death, a five percent [SI) discount of the tax paid is allo~ad. The 15Z tax amnesty non-participation penalty is computed on tho total of tho tax and interest assessed, and not paid before January 18, 1996, the first day after the and of tho 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 is charged beginning with first day of delinquency, or nine (9) months and one (1) day from tho date of death, to tho date of payment. Taxes ~hich became delinquent before January 1, 198Z bear interest at tho rate of six (6Z) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 198Z will bear interest at a rate ~hich ~ill vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 200q are: Interest Daily Interest Daily Year Rate Factor Year Rate Factor 1982 207.. . O00S4B ~J'~- X991 117. .000:501 198:5 167. .000458 199Z 97. .000247 19Bq* 117. .000:501 199:5-1994 77. ,000192 1985 1:57. .000:556 1995-1998 97- .000Z47 1986 107. .000274 1999 77- .O00lgZ 1987 107. .000274 ZOO0 77. .000192 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID Interest Daily Year Rate Factor LrBTi_ 9Z .000Z47 ZOOZ 6Z .000164 Z00:5 57. .000157 ZOO4 4Z ,000110 X NUHBBR OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (la) days beyond the date of the assessment. If payment is made after the interest computation date sho~n on the Notice, additional interest must be calculated. BUREAU OF ZNDZVZDUAL TAXES *[NHERTTANCE TAX D1*VTS/ON DEPT. ZB0601 HARRZSBURG, PA 171Z8-060]. CONNONNEALTH OF PENNSYLVANZA DEPARTNENT OF REVENUE NOTZCE OF DETERNZNATZON AND ASSESSNENT OF PENNSYLVANZA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN '04 APi~ £d HERSHEY TRUST CO 100 HANSTON RD EAST ~ , PO BOX 445 ~,., HERSHEY PA 170:~:~': -J; ~ DATE 04-26-2004 ESTATE OF LUCAS DATE OF DEATH 06-07-2005 FZLE NUHBER 21 05-0495 Zi~OUNTY CUHDERLAND ACN 201 I Aeoun~ Reei~ed REV-~iB$ EX 4FP (01-05) HARY G HAKE CHECK PAYABLE AND REH/T PAYHENT TO: REGTSTER OF NTLLS CUHBERLAND CO COURT HOUSE CARLTSLE, PA 1701:5 NOTE: To insure proper credit: ~co your account, sube/~ ~he upper portion of ~his fore wi~h your ~ax payeen~. CUT ALONG TH'rS L'rNE ~'~ RETA]:N LONER PORTZON FOR YOUR F'rLES ~ REV-483 EX AFP (01-03) ~x NOT'rCE OF DETERH'rNATTON AND ASSESSNENT OF PENNSYLVANTA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN x# ESTATE OF LUCAS HARY G FZLE N0.21 0:5-0495 ACN 201 DATE 04-26-2004 ESTATE TAX DETERHTNATZON 1. Credit For State Death Taxes as Verified Pennsylvan/a ZnherAtance Tax Assessed (Excluding DAscount and/or Znterest) :5. Inheritance Tax Assessed by Other States or TerritorAes of the Un/ted States (Exclud/ng Discount and/or Interest) 4. Total 1nheritance Tax Assessed 5. Pennsylvania Estate Tax Due TAX CRED/TS: 59~6q2.55 .00 28;190.98 59z6q2.55 .00 PAYHENT RECEZPT DZSCOUNT (+) DATE NUHBER ZNTEREST/PEN PAZD (-) AHOUNT PAZD ~ZF PAID AFTER THZS DATE, SEE REVERSE S/DE FOR CALCULATZON OF ADDZTZONAL ZNTEREST. TOTAL TAX CREDZT I .00 BALANCE OF TAX DUEl .00 'rNTEREST AND PEN. . O0 TOTAL DUE . O0 (.rF TOTAL DUE TS LESS THAN $1, NO PAYHENT TS REQU1*RED TF TOTAL DUE 'rs REFLECTED AS A "CREDTT" (CR),, YOU NAY BE DUE A REFUND. SEE REVERSE S'rDE OF TH'rS FORH FOR 'rNSTRUCT'rONS.) PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADH/N- ISTRATIVE CORRECTIONS: PENALTY: INTEREST: To fulfill the requirements of Section ZlqO (b) of tho Inheritance and Estate Tax Act, Act 25 of 2000. (7Z P.S. Section 91q0). Detach the top portion of this Notice and submit mith your payment to the Register of Mills printed on the reverse side. -- Make check or money order payable to: REGISTER OF HILLS) AGENT. 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 Mills, any of the Z3 Revenue District Offices or from the Department's Z4-hour answering service for forms ordering: 1-800-36Z-ZgSO; services for taxpayers with special hearing and / or speaking needs: 1-800-447-~0Z0 (TT only). 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. ZBiOZ1, Harrisburg, PA 171lB-lOll, --eIecting to have the matter determined at audit of the personal representative, OR --appeal to the Orphans' Court. OR Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of IndividuaI Taxes, ATTN: Post Assessment Review Unit, Ompt. lB0601, Harrisburg, PA 171ge-0601, Phone (717) 787-6S05. See page S of the booktet "Instructions for Inheritance Tax Return for a Resident Decedent" (RE¥-ISO1) for an explanation of administratively correctable errors. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and nat paid before January 18, 1996, the first day after the end o{ tho tax amnesty period. This non-participation penalty is appealable in the same manner and in tho tho same time period as you would appeal tho tax and interest that has been assessed as indicated on this notice. 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 {roe the date o{ death. For dates of death prior to 10-3-91, Pennsylvania Estate Tax based on the Federal Estate Tax return becomes delinquent at tho expiration of eighteen (18) months {rom the date of death. Taxes which became delinquent before January 1, 198Z bear interest at tho rate of six (6g) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on or after January 1, 198Z wi1! bear interest at a rate which will vary free calendar year to calendar year with that rate announced by the PA The applicable interest rates {or 19BI through ZOO4 arm: Department of Revenue. Interest Vea.._.r Rate 1982 198S 1984 1985 1986 1986 Daily Interest Daily Factor Year Rate Factor ZOZ .O00Sq8 1988-1991 llZ .000301 16Z .000q38 1992 9X .000247 11Z .000501 1995-1994 7Z .OOO19Z 132 .000356 1995-1998 92 .000247 IOZ .000274 1999 7Z .OO019Z IOZ .000274 ZOOO BX .OOOZX9 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID Interest Daily Yea~ Rate Factor ZOO1 9Z .O00247 ZOOZ 6Z .000164 ZOO3 5Z .000157 2004 42 .000110 X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date o{ the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. Estate No. Name of Decedent: Mary G. Lucas Date of Death: June 7, 2003 REGISTER OF WILLS of CUMBERLAND COUNTY STATUS REPORT UNDER RULE 6.12 2003-00495 State FILE NO. 21-03-0495 Social Security Number: 467-32-6781 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 )~ 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 b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes ~)~ No 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:/~~/, 2 OtO~/A HerO, Trust Company_~utor Sign/~flre Vice President Ra_~fiond T. Cameron Name 100 Mansion Road. East, P.O. Box 445 Hershey~ Pa. 17033 Telephone No. (717} 520-1130 Capacity_: X Personal Representative Council for personal representative BUREAU OF ZNDTVZDUAL TAXES TNHERXTANCE TAX DXyZSZON DEPT. Z80601 HARRISBURG, PA 171Z8-0601 HERSHEY TRUST CO PO BOX qq5 HERSHEY PA COMMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER . DATE ESTATE OF DATE OF DEATH FILE NUMBER ? 2 :I ~OUNTY ACN 11-01-200q LUCAS 06-07-2005 21 05-0~95 CUMBERLAND Amount: Remi**ed REV-756 EX ~FP (07.-02) MARY G MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF HILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper cred/* *o your account, submi* *he upper portion of *his fore wi~ch your 'mx payment. CUT ALONG THIS L/NE ~ RETA/N LONER PORT/ON FOR YOUR F/LES ~ REV-736 EX AFP (01-02) xx NOTICE OF DETERMZNATTON AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER x# ESTATE OF LUCAS MARY G FILE NO.Z1 05-0~95 ACN 202 DATE 11-01-200~ ESTATE TAX DETERMINATION 1. Credi~ For Sta~e Death Taxes as Verified Z8,190.98 Z. Pennsylvania Inheritance Tax Assessed (Excluding Discoun~ and/or Interest) 59,6q2.55 .00 Inheritance Tax Assessed by O~her S~a~es or Territories o~ ~he United S~a~es (Excluding Discount and/or Interest) q. To~a! Inheritance Tax Assessed 59~6~2.55 5. Pennsylvania Estate Tax Due .00 .00 .00 6. Amount of PennsylvanAa Estate Tax Prev/ously Assessed Based on Federal Es~a~e Tax Re~urn 7. Additional Pennsylvania Estate Tax Due TAX CREDITS PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) ~XF PAXD AFTER TH/S DATE, SEE REVERSE S/DE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDTT BALANCE OF TAX DUE XNTEREST AND PEN. TOTAL DUE (/F TOTAL DUE TS LESS THAN $1, NO PAYMENT TS REQUIRED ZF TOTAL DUE TS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE S/DE OF TH/S FORM FOR /NSTRUCT/ONS.) .00 .00 .00 .00 PURPOSE OF NOTICE: PAYNENT: To fulfill the requirements of Section Zl~O of the Inheritance and Estate Tax Act, Act Z$ of 2000. (72 P.S. Section 91~0). Detach the top portion of this Notice and submit with your payment to the Register of NiIIs printed on the reverse side. -- Make check or money order payable to: REGISTER OF NZLLSj AGENT. REFUND (CR}: OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: PENALTY: INTEREST: 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 Nills, any of the Z3 Revenue District Offices or from the Department's Iq-hour answering service for forms ordering: 1-800-36Z-ZOSO; services for taxpayers aith special hearing and/or speaking needs: I-BOO-q47-30ZO (TT only). Any party in interest not satisfied with the assessment of tax as shown on this notice may object eithin sixty (60) days cf receipt of this Notice by: --~ritten protest to the PA Department of Revenue) Board of Appeals) Dept. Z810Z1) Harrisburg, PA 171Z8-10~1, --electing to have the matter determined at audit of the personal representative, OR --appeal to the Orphans' Court OR Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue) Bureau of Individual Taxes) ATTN: Post Assessment RevieN Unit, Dept. za060i, Harrisburg, PA 17IZB-060i) Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. The 15Z 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. 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, I982 bear interest at the rate of six (6Z) percent par annum calculated at a daily rate of .00016q. A11 taxes which became delinquent on or after January 1, 1982 will bear interest at a rate which mill vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOq are: Interest Daily Interest Daily Interest Daily Yea__r Rate Factor Year Rate Factor Year Rate Factor 198Z lOX .0005q8 1988-1991 11Z .000301 ZOO1 9Z .OOOgq7 1983 lex .000q38 1992 9Z .0002~7 ZOO2 6Z .00016~ 198q 11Z .000501 1993-199~ 7Z .00019Z 2003 5Z .000137 1985 13Z .000556 1995-1998 9Z .O00Zq7 ZO0~ qZ .000110 1986 IOZ .OOOZ7~ 1999 7Z .000192 1987 92 .O00Zq7 ZOO0 82 .000219 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent mill 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.