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a S" ~ 15056041114 '~ REV-1500 EX (06-05) OFFICWL USE ONLY PA Depa~lrrx~nt nr Rern~iua County CodE Yeai Fite Nwnber Bureau of individual Taxes INHERITANCE TAX RETURN Po Box 280601 Harrisburg, PA 17128.0601 RESIDENT DECEDENT 2~-o~-osos ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 178-24-6336 06292007 05041933 DFSCecient's Labt Name Suffix Decedent`s Fira;t Nanie Mi BURNS THELMA R (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's 5ociai Security Number THIS RETURN MUST BE FILED IN DUPLICATE 1WITH THE REGISTER 4F WILLS FILL iN APPROPRIATE OVALS BELOW Q 1. Original Return ~ 2. Supplemental Retum 0 3. Remainder Retum (date of death prior to 12-13.82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of 0 5. Federal Estate Tax Retum Required death after 12-12-82) 6. Decedent Died Testate Q 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 0 9. LRigation Proceeds Received 0 10. Spousal Poverty Credft {date of death 0 11. Election to tax under Sec. 9113{A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MtiST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOOED BE DIRECTED TO: Name Daytime Telephone Number SHARON WILKINS GLENN, ACCOUNTANT 724-532-1884 Finn Name (If Applicable) First line of address 1300 LIGONIER STREET Second line of address City or Post Office State ZlP Code LATROBE PA 15650 REGISTER OF 1MLL3 USE ONLY n.~ r,- C~ O -:.i ~+ ~ ~ t ~ C`.4 {~ LED __ ..._) s ~_..`. i .%, { r :,,-'7 ., •1 J f'.,> +.. ~ ~3 -; Correspondent's e-mail address: EAS SURANCE @AT TGLOBAL .NET DATE 1300 LIGONIER STREET; LATROBE, PA 15tS50 PLEASE USE ORIGINAL FORM ONLY Side 1 ~. 15056041114 15056041114 ,~.~, 52$2 EAST 123RD COURT; THORNTON, CO 80241 J REV-15t~Ci EX I~ecedenYs Name: THELMA R BURNS Decedents Social Security Number 178-24-6336 RECAPITULATION 1. Real estate (Schedule A} .............................................. 1. NONE 2. Stocks arxi Bonds (Schedule B) ......................................... 2. NONE 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ........ 3. NONE 4. Mortgages & Niles Receivable (Schedule D) ............................... 4. N UNE 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) .......... 5. 3 0 0 7 . 0 0 6. Jointly C+wned Pn~perty (Schedule F) Separate Billing Requested .......... 6. N UiV E 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested .......... 7 5 6 3 2 8 3. 0 0 .............. a. 56620.00 8. Total Gross Assets (total Lines 1-7) ...................... . 9. Funeral Expenses 8 Administrative Costs (Schedule H) ...................... 9. NONE 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) .................. 10. % 4 $ 8 . 0 0 11. Total Deductions (total lines 9 8 10) .................................... 11. 7 4 8 8.0 0 12. Net Value of Estate (Line 8 minus Line 11 } ................................12. 5 5 8 8 0 2 . 0 0 13. Charitable and Govemmentaal Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ........................... 13, 0 . 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) .......................... 14. 5 5 Ij 8 0 2 . 0 0 TAXCOMPUTATION -SEE INSTRUCTfONS FOR APPLICAf3LE RATES 15. Amount of Una 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0 0 15. 0. 0 0 16. Amount of Line 14 taxable atilr~airatex.o 45 558802.00 1s. 25146.00 17. Amount of Line 14 taxable at sibling rate X . 12 17. 0 . 0 0 18. Amount of Line 14 taxab~ at collateral rate X , 15 18. 0.0 0 19. TAX DUE .......................................................... 19. 2p. FILL IN THE OVAL IF YOU ARE REfaUESTiNG A REFUND OF AN OVERPAYMENT Side 2 15056042115 25146.00 ~., 15056042115 150560421.15 ~,..,~ REV-1500 EX Peke 3 178-24-633(1 Decedent's Complete Address: File Number 21-07-0906 DECEDENTS NAME IiELMA R BURNS DECEDENTS SOCIAL SECURITY NUMBER 178-24-6336 STREET ADDRESS 4 W MAIN STREET CITY PtAtNt'tELD STATE PA 21P 17031 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Paymerrts A. Spousal Poverty Credit B. Prror Payments C. Disrxrunt 3. Interest/Penalty if applicable D. Interest E. Penafly 24042.00 1199.58 (1 } '5146.00 Total Credits (A + g + C) (2) 25241.58 Total InterestlPenalty (D + E) (3) 0.00 4. if Line Z is greater than Line 1 + Line 3, enter the difference. This is the 01fERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 95.58 5. If Line 1 + Lire 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. (5A) B. Enter the total of Une 5 + 5A. This is the BAt.ANCE DUE. (gig) 0, p0 Make Check Payable to: REGISTER OF W/LLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" tN THE APPROPRIATE BLOCKS 1. Dki decedent make a transfer and: Yes No a. retain the use or income of the property transferred : ........................................... ^ ^ b. ruin the right to designate who shall use the property transferred or its income : .................... ^X ^ c. retain a reversionary interest; or .......................................................... ~ ^ d. receive the promise for life of either payments, benefits or care? ................................. a ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate considerationl ..................................................... ^ ^X 3. Did decedent oven 3n "in trust for" or payable upon death b2nk account or security at his or her death? ...... ^ o 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................. .......... ............... D ^ IF THE ANSWER Tt? ANY OF THE ABOVE QUESTIONS IS YES, YOtJ MUST CWiAPLETE SCHEDULE G AND FILE R 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 (O) percent [72 P.S. §9116 {a) {1.1) (ii)]. The statute does not exemet a transfer to a surviving spouse from tax, and the statutory requirements for clisciosure of assets and filing a tax return are stiff 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 (12j percent [72 P.S. §9116(aj(1.3j]. A sit~iing is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 217 REV-1508 EX+ (s-88) SCHEDULE E CASH, BANK DEPOSITS, ~ MISC. ~~ NNERrrANCECTAX RNETURN RNA PERSONAL PROPERTY Burns, Theima R 21-07-t}9t36 Include the proceeds of litigation and the date the proceeds were received by the estate. (rr more saace is needed, insert additional sheets of the same size} 217 REV-1510 EX+ (B-96) CntitMONWEAtTH nF PENNSYLVANLA INHERRANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY lUtF i3urns, Thelma R 21-07-0906 This schedule must be completed and filed if the answer to arty of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes, DESCRIPTION OF PROPERTY ITEM INCLUpETi1ENM1E0F'IFiETRAN$FEREE,IF~IRRELATONSMPTOpECEDEtiTANDTHEDATEOF DATE OF DEATH %OFDECD'S EXCLUSION TAXABLE NUMBER *R~+sFER•~rr~~coProFrrEOEEOFORREwESrnrE. VALUE OF ASSET INTEREST '~""'""'~`£' VALUE 1. Real Property Parcel iD#46-18-1394-093 64 W Main Street; Pianfieid, Cumberland County, PA 17081 2. Members First Credit Union, Mechanicsburg, PA 146, 000 100.00% 146, 000 Savings Account #213212-00 9,123 100.00% 9 123 3. Members First Credit Union, Mechanicsburg, PA , Checking Account #213212-11 8,881 100.00% 8 881 4. Members First Credit Union, Mechanicsburg, PA , 3 month CD #213212-40 1,448 100.00% 1 448 5. Members First Credit Union, Mechanicsburg, PA , 6 month CD #213212-41 1,492 100.00% 1 492 6. Members First Credit Union, Mechanicsburg, PA , 12 month CD #213212-42 7,735 100.00% 7 735 7. Members First Credit Union, Mechanicsburg, PA , 18 month CD #213212-43 7,956 100.00% 7 956 8. Pacific Life Nonqualified Variable Annuity #VR00009853 37,826 100.00% , 37 826 9. Pacific Life Nonqualified Variable Annuity #VR01025867 27,135 100.00% , 27 135 10. Pacific Life IRA Variable Annuity #VR00000508 315,687 100.00% , 315,687 TOTAL Also enter on line 7 Reca itulation $ 563 283 (If more space is needed, insert additional sheets of the same size) V,w10m ~leY ilr OO~OIIh brw falD-0 ne9 NNrFeaR1JOS4 - ~~ ` CHESAPEAKE TITLE INC W SERVICES f a Settlement Statement us.Daptrbnento-Holakp andthbenDeareloplnert OaABNo•250Q-0¢86(exdree1113012009 . " & ESCRO . 8. TYPE OF LOAN 1 1500 Croceridge Or., Suite 1 00 Owings Mills, MD 211 17 1. BFHA 2 pFmHA 3. pCom.lMbs. 4. A 5. Canv.lns. & FlLE NUMBER SO4-0~2 7. LOAN NUMBER 310020676 I;. NOM: Mrs~wMM"0-aal"ww PW aM~W MraleN~in Ypw~kwl«M«wMlq~aArprP ~wanY~iel~ww~bllMa~/ *~~F«AMitrbw'~7W~HUsf~.~CeN1001 & MORTGAGE INSURANCEI.ASE NUMBER e.a~.~ w~WweatMaMNd MIh~M~Yls. T~lE71p9iS$..~~..• ~aMl~Wk~1~010.~~ D. NAME OF BORROWER BtltrMlr Moftln ADDRESS: 6 NAIiE OF SEilER: Bfrtot MexWwr Sttcoapor TnaMa d Ua TMNa R. errors Tnal daMd Oclobar 6, 2001 ADDRESS: F. NAME OF LENDER: CarrNtd FltandM Co LTD PaArarahip ADDRE~; 444 Jadatomr8le Wamtlmter PA 18974 G. PROPERTY ADDRESS: 64 Want Main 84raat, PWnRald, PA 17069 H. SEITLEMB4T AGENT: ChaplpNkfl Escrow SMYIcM, Ntc. RACE aF SETTLEMENT: 11500 Drtw Str>b 1 MD 21117 I. SEi'Tt EMO1T DATE: 0912411008 900.OR08S AMOUNT DUE FROM BORROW6t 101. Contact soles 146 .00 400.OROSB AMOUNT DUE TO SELLER 401. Contract sets 1 102 Priraonal 402 Personal 103. SeltlenalN b barower 1 10842.58 403. 1a. 4a. 105. ~. for keme Ileller t 1 advenoe fOr iMme eeYer h advarl0e 106. Ibvatt~s 03128108b041SU04 107. Mxas 03128108b04130104 806.08 32.28 406. rowntar~s 03R4108b04131108 407. telces 03128108b04130f08 408.E 32.28 109. 409. 110. tortes 27.63 410. 111. Taxes 295.68 411. 112 Tames 120.OROSS AMOUNT DUE FROM BORROVVHt 200. AMOUIRS PAID BY ON BEHALF OF eOR 23.29 158 .52 ROMIER 412 420. GROSS AMOUNT DUE TO SELLER 500. REDUCT10183 N AMOUNT DUE TO 8ELLER 1 .38 201. oreamest 500.00 501. Excecs seetlstladlons 202, amount of naw bens 1 .00 502 Se6klrark b seler 1 9010.00 203. stern b 503. s taken b p4, 504. of Ftd Loan 205. ~ 206. SeNer 8 760.00 506. Soler 8 760.00 207. 507. Esaaw 128 766.38 C Escrow In 208. Rent Badt 03IffiO/N2 300.00 508. Rent Back 03/2&04102 300.00 209. ~. for Nants un telNr for Ilona saNar 213, 513. ~4, 514. 215. 515. 218. 516. ~7, 517. fig, 516. 21g, 220. TOTAL PAID BYIFOR eORROWBt 300. CASH AT SETTL~1lT FROM OR TO BORR 301. Gross alnolad due from borrower 120 1 15.00 OWER 158 027.52 519. 520. TOTAL REDUCTION AMOUNT DUE SELLER 600. CASH AT 8ETREME1iT TO OR FROM SELLE 801. Gross amoud due b seler R 146838.36 146 838.36 302 Less anaur4s Ibr borrower 220 1 15.00 802 Less nxAlctlon amount dua seler 520 146 .36 303. CASH FROM BORROWER 3 12.52 603. CASH TO SELLER 0.00 a11p11r1I1E G~01W ewr ~eTA7~BaU~fFyT~r~YOiw~ne~~y~ ibMt~pewMIdIM Na~AM~I~1Mt~ R~Mr M~ nOO~M1~7M 0a~~WMhwb~i~aiW m~~«4 Y~7 W«~- mower traM HaaW afMY Yrreaoe. seuataalluerrowk reeswrw....yr w.ra.wa»,s.r«e.+rwaww+n.lr.onwer.lye.r,.lrr«.~a.wer~;aaw.r...elle... •a~ww*Mi rrrbp~aMbew~Merwlaa~t/K7i~c ID Mec w~ywooMOt~mr«ii~io~~M~e«.eywb~OlMawMyaw~Olwaty~«IY~Me~le~ ^~RY~ rI M~~y~etbtlN «wY~Y~Ilrin MPdw MINR~MdMy.lorry Wt1Ir-i~w~t Nsw M11t~YY~MtY 4mlwatoMe~l li~~~ ~w~Yr. tw: ~ ew.errler elowsrllaeAk r enaeleq wow rwrre eoolwec e NI011[ Mealer: M """ P~le~s MIeOM M 06~abY U.S. DEPARTA63JT OF HOUSING AND URBAN DEVELOPMENT FNe Number: 508-0992 SETTLEMENT STATEMENT TIa3Exolass sae~ent Svslem T lam NUD•f (!Mp nIHW4aak 4fB6.t PAGE 2 L. SETTLEr~Ni CHARGES PAID FROM PAID FROM 700. TOTAL SALESIBR010=R'S COhpdISS10N based on S1 .00 5.000 ~ 7300.00 BORROWERS SELLER'S DivNton of corlnYssbrl as toMovrS: FUNDS AT FUNDS AT 701. 3 .DO b Dawn 8: SETTLEMENT SETTLEMENT 702 3 T5.00 b Ks6er W611ame of CeMnll PA 703. ComNssbn atSedlenlela 6 .00 704. 50aoo POC Earnest remised as of oonrdssion KeYer Wwla,ne of central PA 500.00 705. Trensaceon tea b Dawn b Asaoelates 195.00 800. ITEMS PAYABLE 64 CONNECTION WRH LOAN 801. Lone Fee % 802 Loan Distant 0.000 %CaMbtal FNwIllai Co L11) P 750.00 eoa Fee a Aceuhlat American 915.00 804. cradle b Amerian 30.73 805. Tax SerNoe Fee 808. Flood CeltlNcadon Fee b CFCI 1st AmeriGrl 30.00 807. Fee b CardklN FNwtciM Co LTD ParNershi 65.00 808. BlDloar Fee b Ameridn Service LLC 1 809. tee b Amerk~tt Service LLC 600.00 810. YSP POC b Cardkurl b American Servkoe LLC A8 POC Lender 811. 900. REMS REQUIRED BY LENDER TO BE PAD M ADVANCE 901. blmrest Fran 0312601006 b 011M12008 23.8100 /de 4 902 Insurance Premiun is b CardNIN Financial Co LTD 110.73 803. Hazard Irlsurerloe Premium fa b WeeMMd .O.C. 750.00 904. 905. 1000. RESERVES DEPOSITED WITH LENDER FOR 1001. Hazard Irlsurerloe 3 mo. 62.50 Imo 187.50 1002 Illstranoe mo. x.13 hra 1003. Taxes 2 mo. 2.35 hno 4.70 1004. Taxes 2 mo. 25.14 hno 30.28 1005. Arralal AssessnleMs mo. Imo 1008. School nixes 10 mo. 156.17 hno 1561.70 1009. b CardlnM FMarlclal Co LTD x21.47 0.00 1100. TITLE CNARGES 1101. Seltlenlentar fee b C EscrowServbee Nrc. 995. 1102 Abstract or title search 1103. TI6e examinaloll 1104. TNk Ylslrenoe bklder 1105. Doclerlent 1106. Fees 1107. lees above Hams No: 1108. Tlee IIISIrallce b Stewart TMN 1197.62 abase Hams No: 1109. Lender's 1 .00 - 1110. Ownefs 1 .00 -1197.62 1111. 100 No 300 Suva 900 E b 8tewaR TNN 150J10 1112 AddNlonal Fndolselrbnls b StewaR 1'Itle 50.00 1113. b TNIe 35. 1200. GOVERNMENT RECORDNtG AND TRANSFER CHARGES 1201. Fees Deed 98.50 110.50 • Release 1 1202. Deed 1 .00 1 .00 1203. Sm1e T Deed 1 JDO 1 .00 1204. 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. 1302 Wagr Test b Houle 285.00 1303. Coudx Fee b C Fetter hlc. 60.00 1304. Tralsar4on tee b Ke6er W6Name 250.00 1305. 1308. 1307. 1308. 1100. TOTAL. SET'TLBiEl4T CHARGES enter on Ines 103 SecOon J and Section 10 .58 9 0.00 Iuo fxltrlAa-von os euvea wm anise IYrr ww.wax.xuofe.~.ter..at.wrww.ragY~wl~~dYW[er.rrwaoowbq~~ta.e ~...w.wrawwwrrs aw a.oa~txyr ~MdM~eM~r~lNr~~~~wMi rar~o4rliiyMrrNID•1 MYr~ter~MrM.la~rbMiar NINYMSY11r~wnafwp~ga~WleraM MM~~baM~ WM~~A~R~1l~MID~~igt ~~InMenM O~O~NV~a:710N M~arrd~vMOrr~Ib/w~rb MM~Iwiwl i~kama~Ara~iwM tli ~IMlwrt~MM Ms~atlx Ili a1DE eEC110a f001 MID 1010. 217 REV-1737-6 EX + (9-00) REVERSE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE H FUNERAL EXPENSES ~ ADMINISTRATIVE COSTS Schedule H ONLY for proportionate god of tax computation. ESTATE OF FILE NUMBER 21-07-0906 Debts of decedent must be re rted on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Funeral 6 922 2. Grave opening 1,200 3. Grave Marker 1, 551 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) EIN Number of Personal Representative(s) Street Address City State Zip Y~r(s} Commission Paid 2. Attorney Fees 3. Probate Fees 4. Accountant's Fees 5. Tax Return Preparer's Fees 6. Miscellaneous Expenses Postage Real Estate Appraisal Fee Travel expenses Property Insurance premium 150 100 500 280 353 __ ~ v ~.~,~ tHiso Inter on nne a Kecapltulation)I ; 11 {If more space Is needed, insert addltlonal sheets of the same size} REV-1512 EX+ (12-03) SCHEDULEI Ga~,anoNwE,a~TH o~ c~NNSr~vaN~a DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER 21-07-0906 Report detris incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimburssd medical expenses. 217 REV-1513 EX+ (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA I BENEFICIARIES INHERITANCE TAX RETURN ESTATE OF FILE NUMBER /1.1 n7 AnnL~ RELATIONSHIP TO DECmENT - vvv AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [indude outright spousal distributions, and trerisfers under Sec. 9116 (a) (1.2)) i. Bruce Madden 5282E 123rd Court; Thornton, CO 80241 son 10096 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THR OUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET j to more space is neeaea, insert etlrldional sheets of the same size) April 2, 2008 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG, PA 17128-0601 Sharon Wilkins Glenn, Accountant 1300 Ligonier Street Latrobe, PA 15650 . Telephone (717) 787-3930 FAX (717) 772-0412 ,9``?~ D ~, ~"c~'° > Re: Estate of THELMA R. BURNS File Number 2107-0906 Dear Sir or Madam: This is in response to your request for an extension of time to file the Inheritance Tax Return for the above estate. In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for filing the return is extended for an additional period of six months. This extension will avoid the imposition of a penalty for failure to make a timely return. However, it does not prevent interest from accruing on any tax remaining unpaid after the delinquent date. The return must be filed with the Register of Wills on or before 09/29/08. Because Section 2136 (d) of the 1995 Act allows for only one extra period of six (6) months, no additional extension(s) will be granted that would exceed the maximum time permitted. Sincerely, ~,_ laudia Maffei, Supervicc~ Document Processing U Inheritance Tax Division NAME OF TRUST DATE ESTABLISHED: SETTLOR: ADDRESS: TRUSTEE: THELMA R BURNS . ~ab~~ (o, o24oJ TI~I.MA R BURNS .! PO BOX 90 PLAINFIELD, PA 17081 'TI~LMA R BURNS SUCCESSOR TRUSTEE: BRUCE W. MADDEN, SON 5282 EAST 123 COURT THORNTON, CO 80241 ALTERNATE SUCCESSOR TRUSTEE: JOANNE MADDEN TITLE TO ALL ASSETS INCLUDED IN THIS DECLARATION OF TRUST IS TAKEN IN THE - NAME OF: THELMA BURNS, TRUSTEE UNDER DECLARATION OF TRUST DATED, (~t~~~-r 1~ ~2u(~ I FOR TRUST BUSINESS, ALWAYS SIGN NAME AS: THELMA R BURNS, TRUSTEE ~. ~ ~ ZUD 1 UNDER DECLARATION OF TRUST (U/D/'T) DATED, DL o ~ During the lifetime of the Settlor, this trust is revocable and the Settlor's assets may be transferred to or moved from this trust at anytime. Upon Settlor's death, this trust then becomes irrevocable. All income or loss resulting from any mist transactions is to be reported on the Settlor's individual tax Keep this document in a protected place accessible to both Trustee and the Successor Trustee at all times. SELF-DECLARED REVOCABLE DEED OF TRUST Made the~_ day of C ~'v~' 2001 THELMA R BURNS of CUMBERLAND COUNTY, PENNSYLVANIA, as the Settlor and THELMA R BURNS, as the Original Trustee hereby agree as follows: ONE: The 3ettlor declare herself Trustee and hereby tra~fet the property listed in Schedule "A" attached hereto, including all of her interests therein, to be held IN TRUST for her benefit during her lifetime and thereafter for the benefit of others as provided herein. Upon Settlor's death , or in the event of her prior resignation as Trustee, or of her incapacity to serve as such, as certified by her attending physician, Settlor's son, BRUCE W. MADDEN, shall serve as the Successor Trustee of the Trust Estate. In the event BRUCE W. MADDEN is unwilling or unable to serve in this capacity, then JOANNE MADDEN shall serve as Successor Trustee . The successor Trustee shall be responsible only for the trust assets which he can identify as forming part of the trust estate and shall not be liable for any prior actions taken, or neglected to be taken, by the Settlor as Trustee. As used herein, the term "Trustee" shall mean the original Trustee or the successor Trustee or both of them, as the case maybe. TWO: The Trustee shall hold said property, together with such other assets hereafter acquired or hey by the Settlor, as a Trust Estate, and shall invest and reinvest the same and shall distnbute the ._~net income (hereinafter called "Income") and principal as set forth in the following provisions. A. So long as the Settlor is living, the Trustee shall pay to her or expend for her benefit such amounts from Income and principal as Settlor directs in writing. If the Settlor gives such directions, then the Trustee shall pay or expend such amounts as he deems advisable to pmvide tier the welfare and comfortable support of the Settlor and to continue her accustomed pattern of giving to individuals and organizations. Any unexpended Income shall be added to principal and 'invested as .. such. ' B. The bank shall be fully authorized. to effect transactions upon instructions of the Trustee acting alone. No banking or savings institution dealing with the Trustee hereof or at which an account is maintained by the Trustee shall have any duty or liabdity to inquire into the adminishation of the trust or the application of any funds by the Trustee, and upon the transfer of the right, title and interest in and to such account by Trustee designated hereunder, said bank shall conclusively treat said transferee as the sole owner of said account, untd the bank shall receive from some person interested in this trust, written notice of any death or other event upon which the right to receive may depend, the bank shall incur no liability for paymeYrts made in good faith to persons whose interest shall have been affected by such event. The bank s1~all be protected in acting upon a~ notice or other instrument or document believed by it to be genuine and to have been signed or preseirted by the proper party or parties. C. The Trustee shall have the power to create brokerage accounts and margin aocouirts amd~may authorize a~ use debit cards or authorizations on such accounts all as he deems appropriate. The persons accepting the Trustee's debit accounts or transactions shall have no liability for honoring any debit signed by the Trustee and shall have no duty to look to the application of any funds hereunder. `i 2 THREE: Upon Settlor's death, the Trustee is authorized to pay to the personal represeIItative of her estate, or to expend directly, such amounts as said personal representative shall request in writing to suppleme~rt the estate in order to pay debts, funeral expenses, death taxes, legacies and administration expenses; PROVIDED, however, that no assets shall be used for this purpose unless included in the Settlor's gross taxable estate under State or Federal law. Subject to such payment, the principal remaining at Settlor's death and any accrued or undistributed income shall be held or distributed by the Trustee as follows: A. Upon Settlor's death, the whole of the Trust Estate shall be distributed to Settlor's son, BRUCE W. MADDEN. B. l:n the .event Settler's son, BRUCE W. MADDEN, should fail to survive to take hereunder, the Trust Estate shall be distributed equally to the surviving issue of BRUCE W. MADDEN. FOUR: A. If any beneficiary under the foregoing provisions is a minor and is entitled to a share, each share shall vest in said beneficiary, but, shall be retained by the Trustee in a separate trust uuhl the eighteenth (18th) birthday of said beneficiary, at which time the trust shall terminate and the principal shall be transferred and delivered to him or ber free of trust. During such minority period, the Trustee may pay directly to the person having custody of said beneficiary any portion of the aforesaid vested income and principal without liability on the part of the Trustee to see to the •.~plication of the monies. Trustee may also expend directly so much ofthe Income and principal as he • or she deems advisable or prudent for the welfare, comfortable support and education of said beneficiary. If there is any excess Income, it shaIl be added by the Trustee to principal and 'invested as such. In the event of the death of said beneficiary during minority, the Trustee is authorized in his 3' discretion to pay part or ail ofthe funeral expenses, and the remaining principal shall be transferred and delivered to said beneficiar}+'s estate. B. The interest of any 'beneficiary under this Trust, including a in income or principal, shall not be subject to assignment, alienation, pledge, attachment or claim of creditors tuitil after payment has actually been made by the Trustee as hereinbefivre Proms C. Upon the death of any Income be~ficiary, any Income accrued or received by the Trustee subsequent to the last Income payment date shall be paid to the person or persons for whose benefit the Principal Producing such Income is continued in trust or to whom such prir~ipal is distnbuted under the terms hereof. D. Corporate distn'butions received in shares of the distnburting corporation shall be allocated to principal, regardless of the nuunber of shares and however described or designated by the distn`butmg corporation. FIVE: A. The Trustee hereuuider shall have the foIlowing powers exercisable at the Trustee's sole discretion at any time, and from time to time on such terms and in such manner as Trustee may deem advisable, in addition to and not in limitation of those granted by law: to accept assets- in kind from Settlor, her estate or elsewhere, to purchase assets from the estate and to retain such assets in kind; to sell, convey or exchange assets and to invest and reim~est the proceeds and any -.,ether cash is any kind of property, real or personal, or part interest therein, located ffi United States or abroad, inchuding interest-bearing accouurts or in certificates and securities, all statutory and other >~ations as to the investment of fluids, now or hereafter enacted or in force, being waived; to hold income cash uninvested uuml the next regular payment date, wrthourt liability for interest thereon; to 4 retairi or to purchase policies of life nisurance, to pay premiums thereon from income or principal and to exercise all rights of ownership thereover, to encumber, pledge, exchange or mortgage rest or personal property and to lease the same for terms exceeding five (5) years; to give options for sales, leases and exchanges; to borrow money; to compromise claims, to vote shares of corporate stock, in person or by proxy, in favor of or against management proposals; to carry securities in the name of a nomiizee, including that of a clearing corporation or depository, or in book entry form or unregistered or in such other form as will pass by delivery; to do all such acts, take all such proceadmgs and exercise all such rights and privileges as could be done, taken or exercised by an absolute owner of the mist property; and to make division or distn'bution hereunder either in cash or in kind and to allocate to di~ierent shares di$erent kinds of or interests in property and property having diffierent bases for Federal income tax purposes, all as the Trustee deem equitable. The Trustee shall have no liability for airy mistake or error of judgment made in good faith. , B. The individual Tnistees may delegate from time to time any other Trustee by an instrument in writing, airy, or all of said individual Trustee's rights, powers and duties C. If the Senior designates the Trustees as beneficiary of the proceeds of any policie~,of insiiranc~ on her life, the duty and responsibility for the payrrrent of P and other charges on such policies during the Senior's shall rest solely upon her unless the Settbr expressly directs the Trustees in writing to pay the same from Income or principal; otherwise, the only duty of the Trustees shaIl be the safekeeping of such policies as are deposited with them, and the Trustees shall be under no duty to notify the Settlor that any such preanium or other charges are due ~ ,grid payable. All options, rights, privileges and benefits exercisable by or acxruing to the Settlor during her lifetime by the terms of the policies shall be for the Settlor's sole benefit and shall not be subject to this mist; the Senior agrees, however, not to exercise any options whereby the proceeds would be payable to the Trustees other than in one sum. Upon the written request of the Senior, the Trustees 5 shall execute and deliver such consents and in~5truments as may be required to enable the Settlor to exercise or avail herself of auy option, right, privilege or benefit grairted by any of the policies. Upon the Settlor's death, or at such ]stet time as may be specified in the policies, the net proceeds of airy policies then payable to the Trustees hereunder shall be collected by the Trustees; the receipt of the Trustees for such proceeds shaIl release the insurance companies from liabdity on the policies, and the insurance companies shall be under no duty to see to the application of such proceeds. The 'Trustees may take all steps necessary in their opinion to enforce payment of said policies and shall be entitled to indenmification out of any property held hereunder against all expenses incurred in taking such action. D. Settlor may also designate the Trustees as beneficiary of certain employee death benefits. In such case, the Trustees shall collect the proceeds receivable therefrom upon the Settlor's death and hold them as part of the Trust Estate. The receipt of the Trustees from such proceeds shall be a full acquittance to the administrators of such benefits, and said admu>istrators shall not be liable to see to the proper application of such proceeds. To the extent that such proceeds are not inchided in the Settlor's estate for Federal estate tax purposes, they shall not be used for the payment of death taxes or any administration expenses of his or her estate. The Trustees may select " auy option ava~able to them as to the time and method of payment of such proceeds and may also exercise any option with respect to the income or death taxes thereon as the Trustees in their sole discretion deem advisable, and their decision in these matters shall be binding upon, and shall not be subject to question by the beneficiaries. _ E. Any Trustee may resign at any time during either Settlor's lifetime by awritten notice to them 6 AMNNI)MN;N'1'OK KN;VIM'A'17l)IV UN' ~7tlllf SIX: A. 'The Settlor, or others, may add hereto, try Will, urter vivos transi~er or beneficiary designation, cash, real estate or such property m kmd as ~ acceptable to i rustees. B. During Settlor's lifetime, this trust, or any provision hereof, may be REVOKED, or terminated, in whole or in part, by written notice signed by 5ettlor and delivered to trustee. C. The Settlor further reserves the right to amend thts lamed of l rust at any time by a proper irk in vvr~ting executed by the Settlor delivered to the Trustees during Setttor's lifetime and accepted by the 1 rustees. D. If the entire trust is revoked by the Settlor, the 't'rustees shall transfer to Settlor all of the Trust estate and shall execute and deliver to the Settlor all instruments which are necessary or appropriate to release all urterests of the 'i rustees m the 1 rust. E. If not previously terminated, alt trusts created hereunder shall terminate twenty-one years after the death of Settlor and issue then living at 5ettlor's death, at which tune Trustees shall distnbube the principal to the persons then receiving income in the same propomons as their right to income at such tune. SEVEN: A. As used in this lleed of '!rust, the s~gufar may include the ptural and the phual the singular, and the use ot~auy gender shall be applicable to all genders. 13. 'Phis lleed of'1'rust has been delivered to and accepted by the 'livstees in the Commonwealth of Pennsylvania and shall be governed in all respects h'Y the laws of said • ~C;ommonwealth. C. If any put, clause, Provision, or condition of this lleed of l rust ~ neia void, invalid, or inoperative, such voidness, invalidity, or iaoperativeness shall not affect any clause, rnovision or condition hereof; but the remainder of the Deed of Trust shall be et3ective as ttiougn such rla„ce_ nmvision or condition had not been contaityed herein. WITNESS the due execution hereof the day and year atoresua. ~:.~ W1~1N~5~: - ~~. ~ - WITNESS: ~~~-~~n~ fQ td~ '° ~ `.,? ~I~-• (SEAL) THELMA R BURNS Settlor WITNESS: _ WITNESS: (~ - ~ ~) cr~~, 2~r1 7curL~e~ ~ ~7 ~ v i r~~-C~~,cs ~ • i_°~•4 (SEAL) THELMA R BURNS Trustee 8 COMMONWEALTH Ur !'~NNaYLVAlv1a ) ~ ss: COUN 1 1~ cUr j . `p~`~'iU~iiur~ l On this, `~ ~ U~ll„o , 2001, before me, a Notary Public, personally appeared TT-iELMA R BURNS, as Settlor and as Trustee, lrnowri to me (or satisfactory proven) to be the persons whose name is subscribed to the within insrtt~tzment, and acimowiedged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF I hereunto set my hand and official seal --~ e Notary Publi ~~-~ Notarial Seal Lobe Boro~ ~Wi atnronel~:trd County My Comotiscioa Bupitea Sept. 3, 2005 ~~~ ~ A~oCitttl0l'10f 1~lOt8rl96 •.,.. ~~ pw~,~ `,.. . ~ ~.~~' i 9 LOCAL REGISTRAR'S CERTIFICAtION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 ,,1,1 ~,,,ll~~~~-~------. y~ __ This is to certify that the information here given is ,~~' A~ZH OF pf-. ~' ~c. N correctly copied from an original Certificate of Death a`~ G duly failed with me as Local Registrar. The original =` ye certificate will be forwarded to the State Vital ~ _= ~ -' n~ Records Office for permanent filing. P 13620940 `~`~q9r E~~"~?~, i1.~ c~ z 2 ~ Certification Number "°MENT 1 !!"'~ Local Registrar Date Issued ~~ N,Obte3 REV nrmos COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS TYPElPRNi N CERTIFICATE OF DEATF! (Sae InaMnecMena rew .,,.eee..e...... ....~_. i ' - -' STATE FlLE NUMBER ,. Nm a Derdre (Fnl, e+dsa Net riRq 2. sr 9. Sodr swig NuOM ~. Deb a Daam (MaM, eer, rrM Thelma Burns female 178 - 24- 6336 June 29, 2007 6. Axe liraBMdey) UMr1 lwelrl O. Oaad BiM 7. aaeWa se:. Plaeea DSelh C6ea ar 76yrs ~+• ~* ~.. N~ Oc*_ober 1, 19 0 Branchdale, P "°~"'" oMa va ^ hipM4a ^ ER! WptlrM ^ DOA ^ taeewp'~Nar ©Raewirca ^pMr • sP.cxy: eb ca.n a a.n ea air, Bua Tga Ord, ed Feeery Nrr (n ea . pua eaea ra ~dM a . wr Derarn a xra.ac odpnT C3 No ^ rr ,o. wr.: Amrlrn war. BNd~ vdr., ae ~ Cumberland West Pennsboro residence / 64 West Main St ( ~ white . RrdOW gnae) n. Derane twer a waw dr. nea a r.: DO nei rr ,x. Wr DerMnl ew b Ms ,s. D.rd.~ti Eaman (,p.dir arr NyMei oanpNwi( u. MeaelBbdr: Meaed Naver ,s. suvNwp Sbare(N.de, pr maar, n.me) Nwr a rka I°''z~ ra.u° c'+a a.~ wwa'°°' Dw~.a (sr,.a» secretarial menu u i ~ r ^ L~INe y r widowed 10. Denare9 MergAarer Iseeet dr / rw+. erb, aP md.l Daorlwra P l 64 W ennsy est Main St. Plainfiel /dr'Rwarr,r.sm, vania ,m.~1Tea,Derardureb West Pennsboro ~ PA 17081 +rn.cowrCumberland +Td^~ a d.E+~ ~ ,6 Fetlae'e Neae IFliN. Md1s, leel eeEU ' Cwy 19am i9. Molrre Nenr (Flat midile, nrbr eunwne) William Wet l ze Helen Klin er xo. werneer~ Nan (ryy.I PMe) Bruce Madden tab. wdonml'e McNnpAdrre (s6rt ay I ban, era, do Waal 5282 East 123rd Ct. Thornton CO 80241 x,tMNwoaaDrPeeeb• ^CrMr ^Dan6m 2,6.DwaorpOWbnpAaan,M•Y•eA 2,c.PwreaDlycaem(eWneaarnarr,aarnaayaeerrger) 2d.lareuen(plrrlOm,reb,xlPCOde) B""' ^ Rrnea 'r"a""wuraDarb^AUnaire Jul . 6 2007 Cumberland Valle Memorial 'Carlisle PA 17013 ^ br Mead Evwber! caarn ^ Yea ^NO y Y . 23. Rerol. (aprer raels 2x6. Uceire NUr6er aZe Nems rdAdrreaF ~ 1i A 138504 Hoffman-Roth Funeral Home & Cremat~r 219~NP Hanover St . m w.~rle r b zae ro e^ mr a.r~ ooaa.a a n. ry, ap..na oicc. ard. (spurn ra wrl ~~~ l xa/n~u,~r/r Nuror ® zx s~prd lMmm. d.r/s~.«I ary rwa a a.w ,,~.~'9'(Q~ Syr-~ C4~N~_LIi~Z ~ ~ n ~ ! ~ (ii / !V JC/Y ~ C~( O ~L. a'ZC J~ 7. ~ ~O T e a Dann I1111i x17D eul r q preai xe. Twn zs oeb Dra (MaMt aer, rr0 xe. wee c.r ROwrnd b Me6rl EgmwrrY Caorr ra a Raeem Otlw awO Cnmetlen a Darem7 ~~ ~ ! :.7 V CAUSE OF DEAM leer MehuONOm aatl , AWmhMO YMxNt Pr1A: Fps atlOr Item T7. Prlt FnMNa~ye~'yarr,Y{ulr,amn0ilar-h130AycartllM dMiw. DO NOT anYrMNW wwaesM rorUr mq, i ffi~^F~! bDeahl rOp.bR'rrt a rrYblerMeer~ rwhad ehoeYp tlr abbpr. lW aay ar ouea r aedi Ilse. , Ora b DaNb '6el M rriMp b tlk aerdlwp care plwn h Pea L amrbo wasp ieN) ~ ' -' e. A ri t w i,.~_..Aq ~ [ ; 2Y. N Fmr: ~a ~p Dr b(ara di. a~ , ^ Na ppmt WYn Peelyrr [~ -~,.~ ~, i / B,a.,b~, oeurYrdonY~iea b. L / ~GdE~` ^ Pnvraauradern Dueb(vr n.e r + "um r u E NB W ll a E q encs l. , a r, ea / ~ p~ w y ~rr 0~ ~ ° Nd PaPwd. hIR psprl° NXN^ ~2 dlys ~~arr~Bb de.iww 1 `Abf . Die b (« r e oareprrw OQ: i a death i ^ Na peprM, ba gepra e9 deye b t yev d. ~ haae deeM 30e. NYerAubpey 36b. Wr0AM/~'V 3,. aDeeh ^ Ue00rnlpaOwe eNYl the pNyer 32e. DeM al wNY p1dN, dY, YM 3x6.Oerdhe How wyay Orcend Pedanrd7 A I P ~r rY dab OrOleeeO axe Pler d wwy~u~.. Nar, Fenn, 96ee1 F acrr.aoernT NebN ^NOnidae OErBUA6q,ab(Spedy) °d01r. ^ we ~NO ^ A ^ NO ^ Aaaare ^ ~q bwa4amn Ida TYr a bNr 3xs. ~'tl rlawr A21. N Tr+~waaleeen ~Y (Syeayi 32G toaeen a ~' ( dy lbwn, etehl ^ Sdtlde ^ CeuN Na a Dewwmwrd ^ ree ^ NO ^ Darn OPaabr ^ Prwpv ^Pedeebhn ~ Otlr s9e. CenEw lrAadiaarar) • D«~MVPMaw'+rIP6r+~c«eA+wo.uraaeen w6r.nnr P6Mdr 6r ocewird aer,wenipere wm x3) 3x6. eMTN.a Csrtlwer TObleaaeer bi•eeed0e. deaN aerrMdwbMearNN •Od~raaM_.______ ^ ___ ________~~_________ Piawebwp eN erWrwg plyelcbn(Phrebr bah pagarwp deah adorxybpbeeur ddeeri) • ___ ~ . ThNrlMarry lewdrp, deeN Oe.rnedatlr tlme, dey end pboe, entldrblM Orrye)endanrrr aYMd___ ~ b~ Der .deY, YeM ______________ • Ytle/Eir.Yrr/Daar ~y//~1~ ` Dn db 6eeY aerwblee and 1 a wrrrnpeda~, b mr Oaidat deeM oaurnd a tlr ding dw. end pbr, end dr b Nw axayq end ewner r awNed ^ (/V _ 94. ~ ~~ ~ 1 x`+I b r E. spree end - Dqe Fovea (Mdeh, e.r ra 4 J ~ rn Le ~ `~8' ' ~ ~ i l i a i( i 0 i ~ ~ Dhpaeltlm Pemil No. _ 'Q~_5 ~~~~ - - NAME OF TRUST DATE ESTABLISIt~D: SETTLOR ADDRESS: ~_4 ~ ., SUCCESSOR TRUSTEE: THII,MA R BURNS Tf~iE[dVIA R BURNS PO BOX 90 PLAIIVFIELD, PA 17081 TI~LMA R BURNS BRUCE W. MADDEN, SON 5282 EAST 123 COURT THCI~VT~ON, CO $0241 ALTERNATE SUCCESSOR TRUS3F.E: JOANNE MADDEN TITLE TO ALL ASSETS INCLUDID IIJ THIS DE(~.ARATTON OF TRUST' lI; TAKEN IN THE NAME OF: '1 HF:LMA R BURNS, 'TRUSTEE UNDER DECLARATION OF TRUST DATED, f.~c~;~6€ i- ~, ~ Z%~ ~ FOR TRUST BUSINESS, ALWAYS SIQT NAME AS: TI~LMA R BURNS, TRUSTEE UNDER DECLARATION OF TRUST (U/D,tT) DATED, ~L~i ~~ ~ • ,~C:G [ IAir~g the tie of the Senior, this trots revocable and the Setdoc's assets may be ~ to or removed from thB tcvst at any tom. Upon Seti'lor's death, this t~vst then becomes hie. All inc;oms or ~ from ~,y trust 8 tb be repotted on the Setdor's individaai tax rexurn. ~ ~ dock m a P 1~ aooessahie is both TrusGoe sod the S`uocessor Trusfioe at alt tm~es. SELF-D ~ ~ REVOCABLE DEED OF TRUST Made the~~ day of C.`~"~~` 2001 TIffi.MA I~. BURNS of C D COUNTY, PE[JNSYLVANIA, as the Settbr and TAELMA R BURNS, as the Original Trustee hec~eby agree as falbvrs: ONE: The Settbr dec)e<ie Lerself Tree and hereby transfer the property h9tsd ffi Schedule "A" attached hereto, erg of Kerr to be held IN TRUST lhr her befit during her mime and d fior the beaefit of others as provided heresc. iJpan Settbr's death , or m the evem of her prior ron as Tivsboe; err of her io~c:apacity to serve as ~ as certified by her attending per, Settlo~r's son, BRiK~ W. MADD~ shag serve as the Suoce~r Trngtoe of the Trust Estate. In thie event BRiTCE W. MADDENs or unable to serve in this capacity, then JOANNE MADDEN stag serve as S~iooessor Ti~usbae . The successor Trustee shaIl be reapon4ble only far the trust assets vvhic~ he can identify as lorming pact of the trust estate acd shall not be liable far eery prior adians taloeo, ~' to be by the Settlor as Tn As used herein, the. term "Tncsfioe" shag mean the owl Tncsbee or the sccooessor~ Tncsbee err both of them, as the case maybe. TWO: The Trustee shaIl hold said property, together with such other assets hereaf~ acquired or held by the Setrlor, as a Trust Estate, and shag mveat and reio~vest tb~e same and stag distnb~rte the net iDCO.me ~ called'Znoome'~ and principal as set f~ in the £ogovviog provisions. A So b®g as the Settbr is livid the Tnutee shag pay m her or exp®d ~ hex benefd s~ amounts fry Income and priocapai as Settbr d'eiocls am vim. Ifthe Settlor ~ such duectioffi, then the Trustee shaIl pay or ea~peird such amoebs as he deems advi4aiile to provide ipr the welfare and oom~rrabie support of the Settlor and m oonfi~nuie her aoc~omed pattern of giving to individuals and org~izatioffi. Any une~gamclod ~oome shaIl be added to papal and in€v~ested as such B. The bank shall be fiilly aid m e~et hanmcdons upon ofthe Trustee acting alone. No baribng or savings i~Gid~ion dea~g with the Tnrsboe he~f or at which an aooount is mimed by the Trustee shaIl have any duty or TmbrTity tin iognire ioto the adnoion of the trust or the appficsition of any fiords by the Tivsboe, and upon the trams of the light, tilde and i is and to such aooamt by Trmbee dosed haemder, said bank sbaIl oanciosvely treat said tra~ee as the sole owner of said aooo~mt, ud~ the ba®k shall receive from some person interested in this trust, written n~ of any death or athar event upon which the ~ tp neoeiv+e may depend, the bank ahaIl iaear m laity ~ paymeds made in $9ood faith m perms whose i shaIl have been a~ecbed by such event. The book abaft be protected is aging upon any no#ioe or ~ or dock believed by it to be a and m have been signed or presa~tod by ~ PmP~' p~Y or C. The Trustee shaft have the poro~ to ormabe brolae~age accounts sad margin aooouots and may a~utho~riae acid use debit cards or author~ations on such aooonots aIl as lie deems p~~ T~ pew aooeptigg the Trustee's debit aooo~mts or tira shaIl have m liab~ty foI' hOnD~S ffiy debr~ sgned by the Trustee and. ~. have m daily to look to the appl~tion of any funds . l T~3REE: Upon Settlo~s dead the Trustees mod to pay to the perso~ml represe~tive of her estate, or to expend directlSr, such amootu~s ffi said pa~sonal representative shaIl request in wrung to suppiemmt the estaote in order ~ pay debts, fiimaral dearth tames, per legacies and adn~istiaotio~n PROVIDED, however, that m assets shaIl be used for this purpose unless included ~ the Seth's grass a ere under State or Federal latiu Subject to such paymea~t, the prncipai remening at Settlor"s death and any aocanaed or utdistr~buted ~OOme shall be held or disbribubed bythe Trastoe as A. Upon Settler's death, the whole of the Tivst Estate shaIl be distr~rted to Settkn's son, BRUCE W. MADDEN. B. In the eva~ Settler's son, BRUCE W. MADDEN, should fad to survive to take hereimcier, the Trost Estate shag be ~Stributed equally m the suvivng issue of BRUCE W. MADDEN. FOUR A. If airy baa;!icriay order the Bong pcvv is a moor and is enxikled to a sharer each space shaft vest is said bey, ~ shai be tetaned by the Tivstee is a separate trnst ur~tcl the (1 ~ batl,day of said bead'iciarjr, at which tore the trust shaIl tie and the prncipal shall be trod and delivot+ed to Trim or her flee of tirast. Ducacg such mnority period, the Trustee may pay diroc~ly to the pagan havigg ca~tody of said berry ady portion of the afpresaid veered noome e®d princa~al witho~ ~iy an the part of the Trustee m see to the application ofthe monies. Trashes may a19o expend daectly so much ofthe Ineo~ne and prncipal as he or she deems advisable ~ pcude~ot for the va~te, o~ and edtxartion of said berry. If thex+e is say senses Imo h shaft be added by the Tiugbee m priocanal andarvested as such. In the evert ofthe death ofsaid baa~y dc~ ~y,the Trustee is a~rthormad in lris 3' disc~tion to pay part or afi of the fimaat e~esy and the rig principal shaIl be tnms~red ~ defivesed to said bc~`s estate. B. The of any 'Y under this Trust, inchxiing a xemaindemaao in income or pciacipal, shafl ~ be subject tD aa~cnent, aeration, piedge, ~ or claim of c~ediCors uatd aver pa~ymart hay any been made by the Tn~sbee as hereinbefore 1~~- C. Upon the death of any Income benefiCaary, a1ry Income acxn~ed or reveived b9 the Trustee sabaogcnDt to the ~ Inoonre payment date shalt be peed to the person or persons fin whose bencGt the pcia®pal prodnc~og s~ Inooooe is oorthned io tn~st or t+o whom such princinat is domed under the temB hereof D. Co~rpo~rate s ieoeived in shares of the distnbuting corporation shalt be allocated to princdpat, r of the nn~ber of shares and however descnbed or by~~~~- FIVE: A The Tn~sbee heremxler shaIl have the fofiovviQg pov~ers eble at the Trustee's sole discretion at any time, and from_time tD time on snch terms and am sucdl as Trustee may deem advisable, in addition m and not in of those granbod by law: to accept wets in kind fi+offi Setdor, her estate or elsewlracq m p assets fiom the estate and to rexain such assets in kind; to sell, convey or a assets and tD iav~st and the proceeds aai nay other cash is any kind of property, real or person or pert iobaest thci+e~, jocabed in Unified S~abes or a~~, inctudmg interest-bearing acoouds or is c and sea~rities, sIl s~vtory and othea as to the invest'mant of finds, now or h enacted or in fume, berg waived; to hold income cash wed until the newt ' PaYi~ ~ - for mtereedt thereon; to retain or to p~n+drese policies of ~e iagtuaace, do pay p~iim~s the~+eon from iaoome or principal and to exercise all rights of ownership thereov~er; to , Pledge, exchange or mortgage real or Personal property and to lease the same for terms exaoeadmg five (~ years;.. to give options for sales, leases and each to borrow money to cotga~omiise claim, to vote shares of corporate stock, in person or by proxy, in favor of or against a®t pi+oposel~ to ~Y securities in the name of a nominee, inchx~ng that of a clearing corporation or depository, or in book entry foam or Bred or in such other form as vvdl pass by delivery; to dQ aIl such acts, take aIl such proceedings and exercise all such rights and pc~ivilege4 as oouid be daney takcsi or mad by an absolute owner of the trust property, and to make division or n bem~mder either m ~ or in kind and to allocate to differenot shares di~+ent kinds of err interests iB pa+opeity and property having dim bases far Federal income tax purposes, aIl as the Trustee deem equitable. The Trustee shaIl have nD liability for any mistake or error of judgm~t made is good fah. B. The individual TnBtees may delegate from time m time airy other Tnastee by an i~nanent in writing, any, ~ all of said individtml Trustee's rights, powers and duties ham. C. If the Settlor designates the Tn~.stees as beoeficiars- of the proceeds of any polices of ios,uanoe on her ~, the duty and n~ ~ the payment of pte:niums and other charges on such polices diaagg the Settlofs lime shall rest solely upon her unless the Settler expressly d~ects the Tn~stees in wrltiog to pay the same from Imome or principal; othetvvise, the only duty of the Trustees shall be the g of such poTraes as aye with them, and the Trustees shall be under m duy do notify the Settbr t~ any such prem~m or other charges are due and payable. All option, rights, priv'leges and bed exa+c~able by or aaxt>~g to the Bettor during her life by the terms of the policies shaIl be for the Bettor's sole benefit and shaIl not be subject to tins trust; the Settlor agrees, however, not to eaaa+cise eery option whereby the proceeds would be payable to the Tn~stees other than ffi one sum Upon the. written request of the Settlor, the Trustees 5 re4aII- or to pt~e policies of ~ insurafloe; do pay pc®iums fi~ income or ptia~pal and to eaaerr~e all ruts of ov~mersbip thenoover; m ate, pledge, eaocheoge or mortgage real or P~~ pr'oP~Y and to lease the: same far teams eaooed'gg five {~ years; to give aptiovs for sales, leases and eat to borrow money; to oomp~e claims, do vote shades of coarporate stock, in person or by proxy, is favor of or ag~t marca~t pcoQosals; do cant' secodties is the Winne of a nanainee, iochcdmg that of a clearing oorporatio~n ac' d~epos~ary, ar in book entry farm or ueced or in such other form as w~l pass~by delivery; tD cb all each acts, take aIl such pr+ooeed~s and ere all such and privileges as ooukl be doca; tak+ea ar eaaeroi9od by an ab®ohtte owntr of the trust property, and to make division or dish3a~ion heracoda~ either is cash or in I®d acrd to allocate to diet shmrs di~a+wt loiuds of or s in property and property having didfet!ent bases for Federal income tax purposes, aIl as ifie Tn~ebee deem equitable. The Tncstee shaIl have na y for a~-crostake or error of,~dgmea~ made io good fah. B. The individual Trca~es may deie~e fi+o®a tine do time any other Trustee by as iosbrt~t is writing, aay, aa~ aIl of said i<c~+idaai Trustce's rights, pov~as and duties ham. C. If the Settbr motes the Tn~eES as bey of the proceeds of ~Y policies of i~'moe on her ~, the dart' and respo~ty for the paymert of pce~cros and other ~ each Pow dosing the Settlo~'s ~etitne shall rest solely upon her ups the Settbr exp~siy directs the Tn~baes in writ~g to pay the sa®ue ft+oam Income or principal; othervvise, the only duty of the Tnmtees shsIl be the sew of sum po&aes as ace deposited with thean, and the Tn shalt be under m duty t+a notify the Settles that any sack pc~miaan or other claages are due and Pte- ~ ~offi, righsy privileges and benefits ~ b9 or aa~ugg to the Settbr during her lifetime by the tams of the policies shaft be far the Settbr"s sale bed and shall not be sub9ect to this trust; the Settbr agiees, however, not m e any options whereby the proceeds would be payable to the Tncstees oar than is one sum. UPS the v~ regaest of the Settbr, the Tivstees 5 shaIl execute and deliver snch oon~s and as may be roque~ad m e~aie the Settbr to e or avarl hemelf of arty option, right, privilege or benefit gcantod b9 any of the pol'rcdes. Upon the Settlor's death, or ~ such ~ time as may be apecdiod n the policies, the net pr+oceecLg of any pol'r~es then payable tD the Tn~stces heretrn~det shaIl be oogaet+ed by the Trustees; the receipt of the Trustees £or such pinoeeds sheIl reuse the instuance companies fc+om liab~y on the policies, and the woe coanpaoies shaft be under m duty ~ see to the app~ation of such proceeds. The Trustees may tame aIl steps necess~y is them o~o~n to e~omoe paytnaot of said poLcdes and shall be errtitled to indenm~iwation out of day pro~ty held herermdex aIl inc~ared in taking sack action. D. Settbr may atgo die the Tn~ees as bey of certaai e~bye+e death berets. In such ~ the Trustees shaft co)iac~ the pr+ooeeds receivable therehvm upon the Settlor<s death and hold them as pint of the Tiust Evta~ The receipt of the Ti~rsbees from such proceeds shaIl be a fiill aoquhtance to the admira~ratozs of each benefits, and said aerators shall nit be liable to sae to the proper ~ of such proceeds, To the east that sash proceeds are nat included in the Settbr's estate for Federal estaba tint purposes, they shaIl not be used for the pary~ of death taxes or any admita~tion des of his or her estate.. The Tnffitses may select any option avat~able to them as to the time and method of pa~moeat of such procs~eds and may also exercise any option with respect to the iooonoe or death roes thereon as the Trustees in their sole dis~tion doom advisable, and theme daci~i~on in these matters ahaII be ba>diog upon, and shall mt be ~ ~ b9 the berries. E- Any Trustee may at etry time either Settio~s lifiei~e try written notice m them. 6 SIX: A. The Settbr, or others, may add hereto, by Wdt, idea vivos transom or beneficiary desion, ~ real estate ~ each pnopetiy is l®d as is a~ooeptable to Tilts. B. During Semi's lifetime, this frost, or aqy provi~ioh haeoi; may be 1tEVOI~D, or abed, in whole or is pert, b9 writbeu notice signed by Settio~ acd delivet+ed to Trustee. C. The Setdoa~ fiathar nerves the right do amend this 'Deed of Tntst at anY time ~' a properantnma~t is writaig e~eamed by the Settbr delivered to the Tn~sbees during Setdor's lifetime and accepted by the Tnt. D. If the entire trust is revoked by the Setdor, the Trustees shell to Settlar aIl of the Txast estate and shaIl es~oa~be and deliver to the Se'ttlor all which are necessary or appropriaote to release alt iobcerests of the Tn>s~s is the Tnt9t. E. If not PAS' alt trusts cxeabod heietmdez shalt tetmioate twenty-one years a$er the death of Seitlor and issue then living at Sertlor's death, at which time Trusbeas shaIl c~'bu~e the p~ocapal to the persons then rooeivigg ioc~oane iQ the same pr+oportans as their right to income at sucdi time. SEVEN: A. As used is this Deed of Twat, the singular may ioc~tle the phual and ~ 1 ~ s®gular, and the nse ofany gender shag be appfiCabie to sIl genders, B• This Deed of Trost has bees dehvec+ed to and aooepbe~ by the Trustees is the Cornmnweaih of Paonsylvania and shalt be gove~ed is aIl respects by the laws of said Commu~realth. C. If nary pest, cl®~ provision, or oouditian of this Deed of Trust ~ heid void; m~valid, or inopeaetive, suds witioess, imra>idiy, or imperativeness shaIl not a~oct airy cla~e, provision or c~ond6on hereoi; but the remeiocier of the Deed of Trost shaIl be e~ectiv~e as though such clause, pt+ovision ~ condition bad nat been contained WITNESS the due ~artion hereof the day and year aforesaid. W~IQT,,N~SS: ~ w ~. ~ !~~ ~ (SEAL,} 1~I.,1V1A R BURNS Settbr WI'1TiESS_ WITNESS: ~, WITNESS: TT~d,MA R BURNS Trustme s W r~ ' ^O ~ O ~..1 + ~ Q U m /~ O oozr~ .z ~ a¢JCNiop _o Nat ~>¢ L11 0 _ X70 O Z Z -~ ~= M ~- O ~~ ^_ k ~' ~~~ ~~ 4' W U `a' o 0 QN O FW.Q ~ ~P ~ a .-.~~~ .~ ..~.~~ a o 0 --~ ° -~~ o .~.~~.. m -~~~ ,~ •~~, ,~ ~•~ o -~~ o M1 ~, ~~ ~~ ~~,~ "``¢ ~` ~-~,~•~ v .,, ~~ ~° -~ ~~ ~'t 1 _~ ---._ 5~.. ~ ..-_.