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Home My WebLink About09-17-09 1505607120 REV-1500 PA Department of Revenue EX (06-05) OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number Po Box 2sosol INHERITANCE TAX RETURN . Harrisburg, PA 1712$-0601 RESIDENT DECEDENT 2 1 ~ ~$5 ~"I ENTER DECEDENT INFORMATION BELOW Social Security Number Da te of Death Date of Birth 201 18 6308 0 6 11 2009 06 17 1925 Decedent's Last Name Suffix Decedent's First Name MI REMALY HELEN M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI REMALY JDHN M Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW X 1. Original Return 2. Supplemental Return 3, Remainder Return (date of death prior to 12-13-82) 4. Limited Estate 4a. Fuwre Interest Compromise '~ 5. Federal Estate Tax Return Re wired (date of death after 12-12-82) - I Q ~( 8 Decedent Died Testate (Attach Copy of Will) ~i- - ~ Decedent Maintained a Living Trust ~ (Attach Copy of Trust) O 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received ~ ' 10. spousal Poverty Credit (date of death 11. Election to tax under Sec. 9113 A between 1231-91 and 1-1 -95) ( ) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number MARCI S MILLER 717 540 4332 Firm Name (If Applicable) HAZEN ELDER LAW Fi t li f dd ~~ t~~~ i 1 j`\, rs ne o a ress j ~ i 2000 LINGLESTDWN RDAD Second line of address SUITE 202 City or Post Office State ZIP Code HARRISBURG PA 17110 Correspondent'se-mail address: mmiller@hazenelderlaw.com unaer penalties or per)ury, 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. SIGNATURE PERSON RESPONSIHI F FOIR FII W(: RFTI IRAI Susan Stake ~ - ~6 _ O 107 Merrihill Drive, Carlisle, PA 17015 SIGNA R OF PREP RER OTHER THAN REPRESENTATIVE DATE Marci S. Miller ~ _ r0 _ ~ 9 2000 Linglestown Rd. Suite 202, Harrisburg, PA 17110 Side 1 1505607120 1505607120 J 15D5607220 REV-1500 EX Decedent's Social Sec urity Number oeoede~rs Name. Helen M. Remaly 2 0 1 1 8 6 3 0 8 RE CAPITULATION 1. Real Estate (Schedule A) ...................................................................................... ... 1. 2. Stocks and Bonds (Schedule B) ............................................................................ ... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)....... ... 3. 4. Mortgages & Notes Receivable (Schedule D) ....................................................... ... 4. 5 Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .............. .. 5. 4 , 8 9 0 5 0 6. Jointly Owned Property (Schedule F) ~ I Separate Billing Requested ........... .. 6. 7. Inter-Vivos Transfers & Miscellaneous No_n-Probate Property (Schedule G) Separate Billing Requested ........... .. 7. 1 3 3 5 2 7 5 8. Total Gross Assets (total Lines 1-7) ..................................................................... .. 8. 1 8 2 4 3 2 5 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... .. 9. 1 1 4 7 6 5 9 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. .. 10. 6 0 4 6 5 11. Total Deductions (total Lines 9& 10) .................................................................... .. 11 1 2 0 8 1 2 4 12 Net Value of Estate (Line 8 minus Line 11) ........................................................... .. 12, 6 , 1 6 2 0 1 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................................................ . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................... .. 14. 6 1 6 2 0 1 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .o0 6 1 6 2 0 1 15. 0 0 0 16. Amount of Line 14 taxable at lineal rate X .045 0 0 0 16. 0 0 0 17. Amount of Line 14 taxable at sibling rate X 12 0 0 0 17. 0 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0 0 0 18 0 0 0 19. Tax Due .................................................................................................................... . 19. 0 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 1505607220 1505607220 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 2 ~ __ DECEDENT'S NAME Helen M. Remaly STREET ADDRESS __ Chapel Pointe 770 South Hanover Street CITY Carlisle ~ STATE PA ZIP 7013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 0.00 2. Credits/Payments - -- A. Spousal Poverty Credit B. Prior Payments C. Discount 0.00 Total Credits (A + g + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2 Line 20 to request arefund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. nter the interest on the tax due. (5A) ___ B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) (7.0 O __ _ Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No b. retain the right toldes gnatetwho hall~use the pr perty transferred or its income :.................................... I I z c. retain a reversionary interest; or .................................................................................................................. ~ X. d. receive the promise for life of either payments, benefits or care? .............................................................. X' 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................................... I_ xl 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... x ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...................................................................................................................... x IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent (72 P.S. §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 stepparent of the child is zero (0) percent (72 P.S. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)J. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rev-1508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, ~ MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Remaly, Helen M. 21__ Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with the right of survivorship must be disclosed on schedule F. to more space Is neeaea, aodlnonal pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1510 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF Remaly, Helen M. 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. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 ING Annuity Contract #AE T000511 0000200045 - 5,076.27 100.000 5,076.27 Helen M. Remaly, owner and annuitant; John M. Remaly, spouse and beneficiary. 2 M&T Bank checking account #2676033810 - 679.14 100.000 679.14 0.00 added daughter, Susan Stake, as joint owner on 6123/08 3 Allianze prepaid funeral/bural account -paid 8,276.48 100.000 8,276.48 directly to Hoffman-Roth Funeral Home and Crematory, Inc. TOTAL (Also enter on Line 7, Recapitulation) I 13,352.75 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) FILE NUMBER 21-- REV-1151 EX+ (12.99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS t51AlE OF Remaly, Helen M. Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION A. FUNERAL EXPENSES: Hoffman-Roth Funeral Home 8 Crematory, Inc. FILE NUMBER 21-- AMOUNT 9,676.59 B. 1 2. Attorney's Fees Hazen Elder Law 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission paid 1,800.00 TOTAL (Also enter on line 9, Recapitulation) I 11,476.59 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+t6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Remaly, Helen M. 21 __ Include unreimbursed medical expenses. III Inure space Is neeaea, aaalnonal pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-g8) REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Remaly, Helen M. NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] 1 John M. Remaly 770 South Hanover St. Carlisle, PA 17013 FILE NUMBER 21-- RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE DECEDENT (Words) ($$$) Do Not List Trustee(s1 Husband I One Hundred Percent ~ I Total 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 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) LOCAL REOISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, X6.00 ~. Certification Number This is m certify that the information here given is correctly copied from an original Certificate of Death duly tiled with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Oftice for permanent filing. ~~~ ~~~-0~.c.~~~t-~ JU~ 1 5 20(19 Local Registrar Date Issued H1o6-td3 REV 11noo6 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS TYPEIPRINT IN PB ACKINK CERTIFICATE OF DEATH (See instructions and examples on reverse) __.__ _.. _ _ _ ___ 0 1. Name a Decedea (Rrsl, natrAe, last, s~xl 2. Sex 3. Sala) Sauriry Number - ~~ ~ ~ _ ~ ~-~ ~ • ~•~ d. Date of Death (Monts, daY, Year) Helen M. Remaly Female 201 -18 - 6308 June 11, 2009 5. Age (Last Birthtlay) Uneer 1 year Under t say 6. Date of 81dh (Monet, day, year) 7. &dhplace (City aM State a bregn ceunlry) Ba. Place of Deam (C)lack only one) xlwww aYa aw.a IAA June 17, 1925 Carlisle, PA Hospirel: Omar 83 vrs ^ Inpatient ^ ER l Outpatient ^ DOA ®Nursing Mane ^ Rasidercs ^Omar - Spairy: Sb. Canry of Deem Ik. Ciry, Born, Twp. a Deam fid. Facniry Nama (lf rlol insfiWkm, give street aM Harmer) . 9. Was Decedent a Hbpanb Odgin7 ®No ^Ves 10. Race: Amerban 1~ n, Black, While. att. Cumberland Carlisle BOro Chapel Pointe at Carlisle Ut es s ed C O y . p ry u en, (SAM Mexican, Puano Rican, etc.) White 11. Deceanrs Usual don Kind a won done most a life. DO na srere ran 12. Waz Daedem ever in the 13. DecetlanYS Etluwtbn (Seedy onry highest grade Completed) 14. Medtel Srelus: MardeQ Never Married, 15. Surviving Sbouse (It wile, glue maiden name) Kits of Wak KIM of Busaess / 6xMntry U.S. Armatl Forces? Elementary /Secondary (P12) College (1 ~a a 6.) Widowed, Diwrced (Spea'M Teacher ublic School ^Yea ~7Ne 4 Married John M. Remal ' 16. Daedenl s MaHrq amass (S)teel, ceY /lows, slate, zp mde) Decedents DM Decedent 770 South Hanover St . , Apt . 306 Mtual ResiderKe t7a. rata PA Lh,e b a „p, ^ yaz ,,, ~,~, m Twp r nanpa Carlisle, PA 17013 ,ro. camry Cumberland ,7d.® 1 I~red wmrn Carlisle ~ cM/Bae 16. FemeYS Nama (Frsl, middle, lad, suffix) 19. MOmelb Name (First, mitldle, maiden surname) Berman R. Meals Florence Weigel 209. Inbmuml'9 Name (Type / PnM) 20b. InhnnreM's Meiag Address (SIr991, city I rewn, state, zIp Code) John M. Remaly 770 South Hanover St.y Apt. 306, Carlisle, PA 17013 21 a. Aretlxld d DLSposnbn ! ^ Cramelion ^ Deletion ~1 ~~ ^ "e~~ !wasRemeeonarDawtlonAUtMrIxM ~ 21b. Date a Disposilbn iMam,, day, year) June 16, 2009 21c. Prece of Dlapoeitlon (Name a cemetery, crernatay a other Pie) Westminster Cemetery 21 e. Loc9da (Cny /lows. stale, sip wee) Carlisle PA 17013 ^ Otlrer - ./ ' I M' Taal ExamNbr/ Ceromr7 ^Ves ^ No ~ , 22a. S' re 22b. license Number 22c. Name aM Address a Fadliry Hoffman-Roth Funeral Home & Crematory, Inc ~ - 138504 e Hems 23a~c when cerntyirp pnysidan 0 na availaNe at tlme a seam b 23a. Tome beat a ,deem atoned t rime, date and prew . iSignaWre aM Nre) 230. Licerse Number 23c. Date Signed (Monet. tlay year) aermy ~ a deem. ~ R71 a 3 S86 ~ ~ I ?1J o f tlems 2426 mrst a conplered by person wM pronounces deem. 2<. Timed am •~ 2S. Da M Deatl ( Ih, ,years ~ ~. 26. Wes Casa ReferrM to Mediral Examiner /Coroner fora Other than Crematbn a Donatbn? . al. M. Cr ^Yes ~No CAUSE OF DEATIi (See Inatrodlona antl amplea) r Approximele interval: Ham 27. Paa I: Enter Ule dnin a evens -diseases, nryurres, a complications - Ihat directly wusetl ttre deem, NOT enter terminal evenu suds as cerdac arses) Part II: Enter abet ~r:r =~I mMiliora t'b~' I ^m, 26. Did Tobago Use Colmibute to Deem? , respiretory angst a ventncurer fibdllaBon wtllglq showing me atiobgy List oay one cause an each Ilre. r Onset re Deem ba not resulting in me urdedyhg cause gNen in Pan L ^Yes ^ Probably IMMEDIATE CAUSE fFYW tlisease or n ( ' ~ r w eili A i b d ' ^ No ^ Unbrown rr an res l rg y - ,. 1 ,. ~ eem) _' a. ~.y.G ~~ x ""'"~ ~~ cJ' 1 `(J. l (/ / ~~ 29. tt Female: Due to (or az a nsequence al: ^ Not pregnant wnNn pest year napy list Car6tions, a an . ~adrq to the cause pyM on Rny a 0~ i ^ Pregn9a al time of death Fmx Bra UNDERLVWG CAUSE Due to (or as a consequence otl: l (daeaae a njury Thal anBated me ^ Not Pregnant, but pregnant wtlhin 42 days c. evens resalin9 in tleam) LAST. d tleath Duero (or as a consequeae off: ~ r ^ Not pregrlvll, but preplam 43 days re 1 year d. r before loam ^ Urrknawn B pregnant wIIMn the pest Year 30a. Was an Aaapsy 30b. Were Autopsy Partings 31. Mama d Death Penamed? Avan9Ne Prior to CompeBm ~aI 32a. Data a In'ryry (Monet, day, year) 32b. Dascdbe Haw Injury Occurred 32c. Place of Injury: Home, Farm, Street F atl~• a Cau%M Deem? Jd N9Mal ^ HomcMie - Office BuYdrg, etc. (Seed)y) ^ Ves tc~ No ycv Ves No ^ ^ ^ Acddent ^ Pending Invesligatbn 32d. Taw a Injury 329. InWy at Won? 32f. II Transporredm Inury (svedM 32 . tacatbn of In 9 PaY (Street city I town, slate) ^ Sddtle ^ Ccub Ibl a Detemuried ^Ves ^ No ^ Ddver l Operator ^ Pes ^Pedesldan M Other ~ Spscity: 33a. Cenifier Ichedr or'IY one) 336. SignaNre ant • camlyxg gryablan (Physkean worrying rouse of seam when ananar Physician naa pmrrounced Beam ant wmprelM Ham z3l - TotMhealolmY~NdW, deem occurred due to the Cauee(claM manner ea areterL________________________________ ~ Pranwncing eM wndydng Phyaiaan (Physician bah prawuair deem ant ceniyi b l e [• g ng cause c eaml To tine hest of mY ImorvNdge, deah occurred et Ina time, dale, and plan, ant due to me ease(s) ant manner as stat9d ^ 33c. Lkense N 33d. Date Signed IMOnm, day Year) _ _ _ _ _ _ _ _ _ _ _ _ _ _ Medical Exeminerl Coroner ---- • On the Delia a exa i ti d I i ~I O~ 15 ~ L ~ / ~~ /O l•/ l m na on an or nrestigetlon, In my oplnbn, tlealh accunM al the tlme, dale, ant place, and due to the wuaefe) ant manner as stated_ ^ 39. Nama and Atldmas al Person Wtp Completed Cause of Deem (Ite m 27) Typa I Print 3s Registrar's ant r • 0a.cav2 tX' I ~ I I ~ I 1 1 DereFned(Mam day year) Dr. Darryl Guistwite ~ I , . ~ 6 ~. q 56 Ashton St., Carlisle, PA 17015 Disposnian Pemnil No. CXJ tp I ~ L'TO y y ~• f FEE F DURABLE POWER OF ATTORNEY FOR JOHN M. REMALY Prepared by: Law Office of Marielle F. Hazen 2000 Linglestown Road, Suite 303 Harrisburg, PA 17110 (717) 540-4332 NOTICE THE PURPOSE OF THIS POWER OF ATTORNEY IS TO GIVE THE PERSON YOU DESIGNATE (YOUR "AGENT")BROAD POWERS TO HANDLE YOUR PROPERTY, WHICH MAY INCLUDE POWERS TO SELL OR OTHERWISE DISPOSE OF ANY REAL OR PERSONAL PROPERTY WITHOUT ADVANCE NOTICE TO YOU OR APPROVAL BY YOU. THIS POWER OF ATTORNEY DOES NOT IMPOSE A DUTY ON YOUR AGENT TO EXERCISE GRANTED POWERS, BUT WHEN POWERS ARE EXERCISED, YOUR AGENT MUST USE DUE CARE TO ACT FOR YOUR BENEFIT AND IN ACCORDANCE WITH THIS POWER OF ATTORNEY. YOUR AGENT MAY EXERCISE THE POWERS GIVEN HERE THROUGHOUT YOUR LIFETIME, EVEN AFTER YOU BECOME INCAPACITATED, UNLESS YOU EXPRESSLY LIMIT THE DURATION OF THESE POWERS OR YOU REVOKE THESE POWERS OR A COURT ACTING ON YOUR BEHALF TERMINATES YOUR AGENT'S AUTHORITY. YOUR AGENT MUST KEEP YOUR FUNDS SEPARATE FROM YOUR AGENT'S FUNDS (UNLESS I HAVE AUTHORIZED THAT JOINT ASSETS MAY BE HELD IN MY NAME AND MY AGENT'S NAME). A COURT CAN TAKE AWAY THE POWERS OF YOUR AGENT IF IT FINDS YOUR AGENT IS NOT ACTING PROPERLY. THE POWERS AND DUTIES OF AN AGENT UNDER A POWER OF ATTORNEY ARE EXPLAINED MORE FULLY IN 20 PA. C.S. CH. 56. IF THERE IS ANYTHING ABOUT THIS FORM THAT YOU DO NOT UNDERSTAND, YOU SHOULD ASK A LAWYER OF YOUR OWN CHOOSING TO EXPLAIN IT TO YOU. I HAVE READ OR HAD EXPLAINED TO ME THIS NOTICE AND I UNDERSTAND ITS CONTENTS. i ~. 6 DATE ACKNOWLEDGMENT I, Susan R. Stake, have read the attached Power of Attorney and am the person identified as the agent for the principal. I hereby acknowledge that in the absence of a specific provision to the contrary in the Power of Attorney or in 20 Pa. C.S. when I act as agent. I shall exercise the powers for the benefit of the principal. I shall keep the assets of the principal separate from my assets (except where a gift of assets may be titled jointly in the names of Principal and Agent). I shall exercise reasonable caution and prudence. I shall keep a full and accurate record of all actions, receipts and disbursements on behalf of the principal. Agent ACKNOWLEDGMENT Date I, Nancy R. Speck, have read the attached Power of Attorney and am the person identified as the agent for the principal. I hereby acknowledge that in the absence of a specific provision to the contrary in the Power of Attorney or in 20 Pa. C.S. when I act as agent. I shall exercise the powers for the benefit of the principal. I shall keep the assets of the principal separate from my assets (except where a gift of assets may be titled jointly in the names of Principal and Agent). I shall exercise reasonable caution and prudence. I shall keep a full and accurate record of all actions, receipts and disbursements on behalf of the principal. ~ ~z ~ ~' ~~ ~~ ~ D Agent Dat DURABLE POWER OF ATTORNEY FOR JOHN M. REMALY I, JOHN M. REMALY, of Cumberland County, Pennsylvania, hereby revoke any and all prior Powers of Attorney and hereby appoint my daughters, SUSAN R. STAKE and/or NANCY R. SPECK to act jointly and/or individually as my Co-Agents (hereinafter referred to as "my "Agent") for me and in my name and place to transact all my business and to manage all my property and affairs as completely as I myself might do if personally present, including but not limited to, exercising the following powers contained in this document. 1. Personal Property. To engage in tangible or intangible personal property transactions, including the power to sell, assign, transfer, exchange or otherwise dispose of, or to purchase any interest in any tangible or intangible personal property upon any terms. 2. Real Property. To engage in real property transactions, including the power to lease, sub-let, and manage in all respects any real estate now or hereafter owned or leased by me; and to sell, exchange or otherwise dispose of my real estate on any terms, and to do all things and execute and deliver all documents in connection therewith, including, but in no way limited to, deeds, notes, mortgages, lease agreements and sales contracts. These powers shall specifically include, but not be limited to, my real property located at 311 Avon Drive, Carlisle, Pennsylvania 17013. 3. Securities. To engage in stock, bond and other securities transactions, including the power to exercise all securities holders' rights, and to sell, cash or otherwise dispose of Treasury Securities, bonds (including U.S. Savings Bonds), or other instruments and to engage incommodity and option transactions. To vote in person or by proxy at any meeting, to join in any merger, reorganization, voting-trust .plan or other concerted action of security holders, to make payments in connection therewith, and in general to exercise all rights of a security holder. 4. Investments. To invest and reinvest my assets in all forms of real and personal property without any restriction whatsoever as to the kind of investment, including, but not limited to, life insurance, annuity contracts and United States Treasury Bonds which are redeemable at par in payment of federal estate taxes. 5. BankAccounts. To sign checks, drafts and other instruments or otherwise make withdrawals from any checking, savings, transaction or other deposit account in my name, and to endorse checks payable to me and receive the proceeds thereof in cash or otherwise; to open and close checking, savings, transaction or other deposit accounts in my name; to purchase and redeem savings certificates, certificates of deposit or similar instruments in my name; to exercise and deliver receipts for any funds withdrawn or certificates redeemed; and to do all acts regarding any checking account, savings account, savings certificate, certificate of deposit, or similar instrument which I now have or may hereafter acquire, the same as I could do if personally present. -1- 6. Individual Retirement Account and Retirement Beneta"ts. To request and receive distributions from any of my Individual Retirement Accounts; to give instructions for the purchase and sale of securities in those accounts; to execute on my behalf any powers of attorney or, other instruments needed for those purposes; to endorse notes, checks, drafts and bills of exchange; to make contributions to those accounts; and to engage in retirement plan transactions of any nature. 7. Governmental Benefits. To exercise complete dominion and control over any and all social security, veteran, county, state and federal benefits to which I may now or hereafter be entitled. 8. Insurance. To procure, alter, extend or cancel insurance against any and all risks affecting property and persons, and against liability, damage or claims of any sort. To request and authorize change or changes in the mode of payments of premiums of any policy of insurance on my life or property; to execute premium extension agreements; to receive and receipt for any dividend due or to become due under said policies; to request, authorize and obtain loans on policies; to execute necessary loan documents to keep policies in force; and to execute all necessary documents to obtain loans against policies and/or to obtain the cash surrender values of policies. 9. Bonds. To purchase forme United States of America Treasury Bonds of the kind which are redeemable at par in payment of federal estate taxes; to borrow money and obtain credit in my name from any source for such purpose; to make, execute, endorse and deliver promissory notes, drafts, agreements or other obligations for such bonds and, as security therefore, to pledge, mortgage and assign any stocks, bonds, securities, insurance values and other properties, real or personal, in which I may have an interest, and to arrange for the safekeeping and custody of any such Treasury Bonds. 10. Safe Deposit Boxes. To have access to and control over the contents of any safe deposit box rented by me, to rent safe deposit boxes in my name, to close out and execute and deliver receipts for safe deposit boxes in my name, and to do all acts regarding any safe deposit boxes in my name, which I now have or may hereafter acquire, the same as I could do if personally present. 11. Loans. To borrow money in such amounts for such periods and upon such terms as my Agent shall deem proper and to mortgage or pledge my assets as security, and to execute and deliver any documents in connection therewith. 12. Debts. To pay and discharge my debts, present and future, and to compromise any of them on any terms. 13. Execution of Contracts. To enter into, perform, modify, extend, cancel, compromise, enforce, or otherwise act with respect to any contract of any sort whatsoever -- including but not limited to, notes, leases and mortgages -- and to pay any money or to transfer title and possession to -2- any real or personal property that maybe required to be paid or transferred by any contract or in the performance of any obligation entered into or incurred by me or on my behalf. 14. Execution of Documents. To execute, deliver, file of record, cancel, modify, endorse, acquire or dispose of any instrument including, but not limited to: stock and bond powers; vehicle registrations; financing statements and related filing documents; reports of any sort to any government, authority or agency, as required or permitted by law; deeds with or without covenants or warranties; and any other document appropriate for carrying out any of the foregoing powers. 15. Registration of Property. To hold property unregistered or in the name of a nominee; to apply and re-apply for registration of any automobile or other property or business requiring licensure or registration; 16. Receipts and Approval ofAccounts. To receive payment of any kind, including a bequest, devise, gift or other transfer of real or personal property to me in my own right or as a fiduciary for another, and to give full receipt and acquittance therefor, or a refunding bond therefore; to approve accounts of any business, estate, trust, partnership or other transaction whatsoever in which I may have any interest of any nature whatsoever; and to enter into any compromise and release in regard thereto. 17. Institution or Settlement of Claims. To ask, demand, sue for, receive, receipt for and give discharge of all property, debts, inheritances, and any pension, welfare, insurance, social security or other benefits due me, and to compromise any claims on any terms; to compromise or arbitrate any claim in which I may be in any manner interested, and for that purpose to enter into agreement to compromise or arbitrate, and either through counsel or otherwise to carry on such compromise or arbitration and perform or enforce any award entered in arbitration; to institute, prosecute, defend, compromise, or otherwise dispose of, and to appear forme in any proceedings at law or in equity or otherwise before any tribunal for the enforcement or for the defense of any claim, either alone or in conjunction with other persons, relating to me or to any property of mine or any other person (including the authority to sue if this power of attorney is not honored); and to retain, discharge and substitute counsel and authorize appearance of such counsel to be entered forme in any such action or proceeding. 18. Taxes. To prepare, execute and file in my name and on my behalf any return, report, protest, application for correction of assessed valuation of real or other property, appeal, brief, claim for refund or petition including petition to the United States Tax Court in connection with any tax imposed or purported to be imposed by any government, authority or agency, or claimed, levied or assessed by any government, authority or agency and to pay any such tax and to obtain any extension of time for any of the foregoing; to execute waivers of restrictions on the assessment and collection of deficiency in any tax; to execute closing agreements and all other documents, instruments and papers relating to any tax liability of mine of any sort; to institute and carryon either through counsel -3- or otherwise any proceeding in connection with contesting any such tax or to recover any tax paid, or to resist any claim for additional tax or any proposed assessment or levy thereof, and to enter into any agreements or stipulations for compromise or other adjustment or disposition of any tax. 19. Employment of Others. To employ accountants, attorneys-at-law, investment counsel, custodians, Agents, servants, and others, and to delegate to them, to remove them, and to pay them such remuneration as my Agents shall deem proper. 20. Designate Beneficiaries. To make or change any designation of beneficiary or contingent beneficiary or to make or change any distribution option for any qualified retirement plan, IRA, annuity, insurance policy or other program for which I am entitled to so do. 21. Disclaimer. To execute, deliver and file or record disclaimers of any part or all of any property, power or interest passing to or for me under any will, deed or trust or otherwise; and to direct my spouse's executor to elect to qualify or to elect not to qualify for the marital deduction any portion or all of a marital deduction trust created for me by my spouse. 22. Spousal Election To release or disclaim any interest in property on behalf of me (the Principal). I direct my Agent to disclaim any and all interest in any and all property if it impacts or delays my eligibility for private and public benefits, including state, local, and federal benefits; specifically, I direct my Acgent(s) to refuse to take or claim a spousal election if it will impact or delay the receiving or eligibility of Medical Assistance benefits. I specifically direct my Agent to refuse to claim an election share in such a situation, and I consider refusing to take or claim a spousal election a part of my estate planning, and it is my wish and reflects my intentions regarding my estate planning and my directions of my estate to refuse to take or claim the elective share if it impacts or delays my eligibility for any private or public benefits. 23. Gift Making Powers. To make unlimited gifts, as set forth below, either outright or in trust, revocable or irrevocable, or, in the case of minors, in accordance with the Uniform Gifts to Minors Act and, for gifts made in trust, to persons, including my Agent, as original or successor trustees. This power includes the right to make additions to an existing trust and does not require my Agent to treat the donees equally or proportionately and may entirely exclude one or more permissible donees. The pattern followed on the occasion of any such gift (or gifts) need not be followed on the occasion of any other gift (or gifts). The gifts shall be restricted to the following: my spouse; my lineal descendants, including my Agent(s) hereunder; any trust(s) for my benefit and/or for my spouse's benefit and/or for my lineal descendant(s)' benefit; and any organization described in IRC Section 501(c)(3). My Agent and the donee of the gift shall be responsible as equity and justice may require to the extent that a gift made by my Agent is inconsistent with my directions and planning of my probable intent with respect to the disposition of my estate. The ability of my Agent to make gifts of my property shall be limited by and shall only be made in conformity with my prenuptial agreement, if any such agreement exists. -4- I specifically direct my Agent to make gifts to any and all persons listed in the above paragraph who he/she deems appropriate, and further direct my Agent to make transfers including gifts in order to accelerate or preserve my eligibility for public and private benefits, including Medical Assistance and Supplemental Security Income, so to allow me and/or my spouse or any family member to receive state, local, and federal benefits at the early possible time/date. It is my intention and my direction that my Agent be hereby empowered to make gifts to anyone and to transfer assets to anyone to obtain such benefits. Further, I consider transfers and gifting in order to obtain such benefits to be in accordance with my estate planning, and I direct such action to be taken to obtain said benefits for me. Any and all transfers and gifts are not inconsistent with my estate planning and in fact reflect my intention and direction with respect to the disposition of my estate. Specifically, I do not restrict or limit the amount of money or assets to be transferred and gifted, and direct the funds available for such gifts or transfers include principal and income. _~~~ I specifically and expressly waive any requirements in effect now and Initials in the future to have my assets kept separate from my Agent's assets. 24. Create a Trust. To execute a deed of trust, designating one or more persons (including my Agent) as original or successor trustee(s) and to transfer to the trust any or all property owned by me as my Agents may decide. The income and principal of the trust may, but need not, be distributed to me or to the guardian of my estate, or be applied for my benefit, and upon my death, any remaining principal or unexpended income of the trust may, but need not, be distributed to my estate. Furthermore, this trust or deed of trust may be amenable or revocable at any time by me or my Agents, or the trust or deed of trust may be irrevocable by me or my Agent. The establishment and funding of a Trust, either revocable or irrevocable, is not inconsistent with my estate planning, and in fact reflects my intention and direction with respect to the disposition of my estate. 25. Fund the Trust. To add at any time, any or all of the property owned by me to trust in existence for my benefit when this power was created. The income and the principal of the trust may, but need not, be distributable to me or to the guardian of my estate or be applied for my benefit during my lifetime and upon my death any remaining principal and unexpended income of the trust, may, but need not, be distributed to my estate. The establishment and funding of a Trust, either revocable or irrevocable, is not inconsistent with my estate planning, and in fact reflects my intention and direction with respect to the disposition of my estate. 26. Healthcare Decisions. To consent, refuse or withdraw consent to any and all types of medical care, treatment, surgical procedures, diagnostic procedures, medication, blood and blood products, and the use of mechanical or other procedures that affect any bodily function, including, but not limited to, artificial respiration, nutritional support and hydration, kidney dialysis and cardiopulmonary resuscitation; -5- To authorize, or refuse to authorize, any medication or procedure intended to relieve pain, even though such use may lead to physical damage, addiction or hasten the moment of (but not intentionally cause) my death; To request and/or terminate anout-of-hospital do-not-resuscitate order on my behalf in accordance with Pennsylvania law; and To consult to the same extent as I am able with all medical providers, including but not limited to physicians, psychiatrists, nurses, physician assistants, nurse practitioners, therapists, technicians and all hospital personnel, regarding my care, condition and treatment. My Agent shall have access to medical records and information, including psychiatric records, to the same extent that I am entitled to, including the right to disclose the contents to others. In addition to the other powers granted by this document, my Agent shall have the power and authority to serve as my personal representative for all purposes of the Health Insurance Portability and Accountability Act of 1996, (Pub.L.104-191), 45 CFR Sections 160 through 164. My Agent shall be considered my personal representative for heath care disclosures under the 2004 federal HIPAA regulations and shall have full authority to review my medical records and to execute releases of confidential information from medical providers and insurers or other third party payors. 27. Placement in an Institution. To take charge of my person in case ~of illness or disability of any kind; to authorize my admission to a medical, nursing, residential or similar facility, and to enter into agreements for my care; and to remove and place me in such institutions or places as my Agent may deem best for my personal care, comfort, benefit and safety after giving consideration to any wishes I have previously expressed on this subject. 28. Guardianship. If incapacity proceedings are hereafter commenced, I nominate my Agent designated herein to act as guardian over my estate and/or person. 29. Substitution. I empower my Agent to make, constitute and appoint one or more persons as substitute or substitutes in the place and stead of my said Agent and to revoke the same at pleasure, giving and granting unto such substitute or substitutes full power and authority to act hereunder in the place and stead of my said Agent, but in my name and on my behalf. 30. General. To do, in addition, all other acts or things whatsoever, and to exercise all other powers on my behalf, whether or not referred to herein, as fully as though herein specifically expressed, which in the sole discretion of my Agent may be deemed advisable to be done for me and in my name, as fully and completely as I might or could do personally, giving and granting to my Agent for that purpose full and complete power and authority to have, use and take all lawful means in my name for the purposes aforesaid. The enumeration of the specific powers conferred herein shall not be deemed to exclude herein any other power, it being my purpose and intent to give my -6- Agent power to do any and all things on my behalf as fully as I could do myself. The descriptive headings of this general power of attorney are inserted for convenience only and shall not be deemed to affect the meaning or construction of any of the provision hereof or to limit in any way the construction thereof in the broadest possible manner. 31. Liabili .Any person who is given instructions by my Agent in accordance with the terms of the Power of Attorney shall comply with the instructions. Any person who without reasonable cause fails to comply with these instructions shall be subject to civil liability for any damages resulting from non-compliance. Reasonable cause under this subsection shall include, but shall not be limited to, a good faith report having been made by the third party to the local protective services agency regarding abuse, neglect, exploitation, or abandonment. However, I consider qualifying for medical assistance benefits to be prudent planning. Any actions taken to hasten and facilitate my eligibility for Medical Assistance shall not be challenged by a third party, including the local protective services agency. My Agent is authorized to proceed to obtain incidental and consequential damages, including court costs and attorneys' fees, pursuant to 20 Pa.C.S.A. §5608, for any delay caused by a third party's refusal to honor this Power of Attorney. 32. Third Party Immunity and Ratification. Any person who acts in good faith, reliance on my Power of Attorney shall incur no liability as a result of acting in accordance with the instructions of my Agent. This power of attorney shall continue in full force and effect and may be accepted and relied upon by anyone to whom it is presented despite my purported revocation of this power, the age of this power, the issuance of a court decree declaring my incapacity or my death, until written notice of such event is received by such person. For the purpose of inducing any bank, trust company, savings bank, brokerage firm, or any other financial institution, and their respective successors and assigns, to recognize this instrument, I hereby agree that any such bank, trust company, savings bank, brokerage firm, or other financial institution shall beheld harmless from any loss suffered or liability incurred by it or them in acting hereunder until a certificate of death certifying to my death shall issue and actual notice thereof be received by said bank, trust company, saving bank, brokerage firm, or other financial institution, and their respective successors and assigns or until actual notice or revocation or lawful termination according to law shall be received by it or them. I hereby ratify and confirm all that my Agent or the substitute or substitutes therefore shall lawfully do or cause to be done by virtue hereof. 33. Compensation and Reimbursement for Expenses. My Agent shall be entitled to reasonable compensation based on the actual responsibilities assumed and performed. My Agent shall also be entitled to reimbursement for actual expenses advanced on behalf of the Principal and to reasonable expenses incurred in connection with the performance of my Agent's duty. 34. Effect of My Disability. This power of attorney shall survive and not be affected by my future mental or physical incapacity, disability or incompetence if such should occur. -7- 35. Severability. Should any of the provisions of this document be for any reason declared invalid, such invalidity shall not affect any of the other provisions of this document and powers, and all invalid provisions or powers shall be wholly disregarded in interpreting this document. 36. Conies of this document. I expressly direct that for all purposes, a photocopy of this Power of Attorney be deemed an original and any person shall be authorized to act upon such a copy as if it were an original. Dated , 2004. JOH . REMALY '~ ~ _ 3e ~ /7ri~ -s- COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF DAUPHIN On ~ v2 ~ , 2004, before me a Notary Public for the Commonwealth of Pennsylvania, personally appeared JOHN M. REMALY, known to me to be the person whose name is subscribed to the within instrument and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. of ub is Notarial Seal Marielle F. Haan, Notary Public Clry of Harrisburg, Daup}~m County My Commission Expires Sept. 23, 2006 -9- X360999555 ING 12.31 10 03-24-:?009 2/2 ING Scott Swensen Sr. Policy Services Coordinator June 9, 2009 MARCI MILLER HAZEN ELDER LAW VIA FAX: #717-540-4313 Dear Ms. Miller: Re: Contract Number: Annuitant Name: AE T000511 0000200045 HELEN M REMALY This letter is to confirm that Helen M. Remaly received fixed monthly annuity payments of $308.45 under the above referenced 15 year period certain annuity contract. Payments began November 29, 1995 and will continue through October 29, 2010. The amount paid to Helen Remaly through 5/29/2009 was $50,358.95. The commuted value of this account as of June 11, 2009 was $5,076.27. The original investment amount was $38,553.50. The owner of the contract is Helen Remaly. If you have any questions, please call our toll free customer service line between 8:OOam and S:OOpm EST, at 1-800-238-6273, please select option 2. Sincerely, ,~ /~~, -Y~•1•, Scott G. Swensen ING Life Insurance and Annuiry Company Payout Services, C2S One Orange Way Windsor, CT 06095 Tel.: 800-238-6273 option 2 Fax: 800-435-5366 Regeslered Prineipa! of LNG Financial Advisers, LLC • ,Member SLPC Q MBT Bank August 18, 2009 Hazen Elder Law 2000 Linglestown Road, Suite 202 Harrisburg, PA 17110 499 Mitchell Street, Millsboro, DE 19966 RE: Estate of Helen Remaly Date of Death: June 11, 2009 Social Security Number: 201-18-6308 Dear Ms. Miller: In response to your request, please be advised that at the time of death, the above- named decedent had on deposit with this bank the following accounts. 1. Account Type ........................... Checking Account Account Number ....................... 2676033810 Ownership (Names ofl .............. Helen Remaly, John Remaly, Susan Stake ~ 12.3IoB Opening Date ...........................09 / O l / 67 Balance on Date of Death .........$679:13 Accrued Interest $ 0 O 1 Total ....................................... $679.14 The above named decedent did not have a safe deposit box * If upon reviewing the information above, you believe there are additional accounts not referenced, please provide us with an account number and/or the name of any possible joint account holder. For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, please contact our Stonehedge branch at 960 Walnut Bottom Road, Carlisle, PA 17013 or # 717-240- 4524. Sincerely, ' . ~~~~~~~ l~~ w Charlene Warrington, Adjustment Services 1-888-502-4349 ~. ~~_~~ ~~~ ~ r~ ~e~ l1~4 iv 'V ^~::J ~~r {11{{{ a a Hoffman-Roth Funeral Home & Crematory, Inc. 219 North Hanover Street Carlisle, PA 17013 (717)243-4511 June 30, 2009 John M. Remaly 770 South Hanover Street, Apt. 306 Carlisle, PA 17013 The Funeral Service for Helen M. Remaly 15653-138 We sincerely appreciate the confidence you have placed in us and will continue to assist you in every wa we can Pl feel free to contact us if you have any questions in regard to this statement. y . ease THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANG , EMENTS. OUR SERVICE: Traditional Funeral Service Package $4150.00 FUNERAL HOME SERVICE CHARGES $4150.00 SELECTED MERCHANDISE: Hancock Casket - 18 gauge , $3065 00 THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE . THAT YOU HAVE SELECTED _ $7215.00 Cash Advances Opening Grave charged by cemetery $1495.00 Newspaper Obituary Notice- Sentinel , _ $156.27 Newspaper Obituary Notice -Patriot News _ $329.32 Organist $50.00 Clergy Offering _ $200.00 Certified Copies of Death Certificates , $48.00 Flowers . . . . . . . . . . . . . . . Hairdresser $159.00 ` ! Additional Death Certs _ $40.00 ~l_'"~ $24 00 ~ ~~ Hairdresser -Credit . ,~~ $-40.00 ~O TOTAL CASH ADVANCES AND SPECIAL CHARGES . $2461.59 ~ ~ Total Total Cost . . . . . . . . . . . . . . . . $9676.59 History 06/30/2009 Allianze , _ _ $-8276.48 TOTAL AMOUNT DUE $1400.11 This statement is net and payable in full within 30 days of receipt. ~N ~~ LAw An Estate Planning, Elder Law and Special Needs Planning Law Firm 2000 Linglestown Road, Suite 202 Harrisburg, PA 17110 z~.: (71'~ 540-4332 F.ax: (717) 540-4313 September 10, 2009 CERTIFIED MAIL Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 Re: Estate of Helen M. Remaly File No.: 21-09 Social Security No.: 201-18-6308 Inheritance Tax Return To: The Register of Wills: www.HazenElderLaw.com Marielle F. Hazen, CELA* Marci S. Miller, Associate n h V J i~ ~ ~. ~ 1 -v , ~ ; c~ =3~ ;~_; ~ _, sa ~~ _ - ~. N , _- Enclosed for filing please find the original and one copy of the above-referenced Inheritance Tax Return, along with a copy of the first page of the Inheritance Tax Return. Please date stamp the first page of the return and return it to my office in the enclosed self-addressed envelope. Also enclosed is a check for the filing fee in the amount of $15.00. If you have any questions or require any additional information, please do not hesitate to contact me. Sincerely, Corinne Eggers Woodhouse Paralegal Enclosures cc: Susan Stake 'Certified Elder Law Attome_y by the National Elden Law Foundation as authorized by the Pennsyl~~aara Supreme Court N ~ J ° ( ~@ r ~_' ~ ;i h(" hn i r'ti"(' iii h cam,., V ~~(J~~ 1 ~~~'~ . ~ y.. ~ ~P ~, ~ 2QQ4 SEI' I I Aft f 1: 2 1. p ~ 7 ~ ... ~~ b '~+s ~~ t\ rr,.,i .. ~FFI-i' i :~ .i ~ m . .~~ -o ~~ N ~~ .~~.- ~ T ~ ~~ ~ O ~~. O ~~ D ~~~ O .~~ ~ u'1 ~~ D ~~ ~ O ~ ~~ ~ r ~ ~ ~ ~ ~ C ~ 00 ~ ~ ~ ~ ~ ~ O Q U ~ O ~ ..~ O ~ ~ ~ ~ ~ ~ G ~ ~ P-~ W ~ ~ ~ ~ p ~ ~UOU - ~c~x ~