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HomeMy WebLinkAbout01-06-10 (2)J 1505607121 REV-1500 EX (Of3-05) OFFICIAL USE ONLY PA DepartrneM of Revenue Bureau of Indviduat Taxes County Code Year File Number P080X28080t INHERITANCE TAX RETURN 2 1 0 9 0 6 1 3 Harrisburg, PA 1 7 7 28-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Sodal Security Number Date of Death Oate of Birth 1 9 9 0 7 4 8 3 1 0 6 2 1 2 0 0 9 0 1 0 3 1 9 2 0 Decedents Last Name Suffix Decedent's First Name Mt T O D D O Z E L L A D (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Sodal Security Number FILL IN APPROPRIATE OVALS BELOW ® 1. Original Retum 4. Limited Estate ® 6. Decedent Died Testate (Attach Copy of Will) 9. Litigatlon Proceeds Received THIS RETURN MUST BE FLED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Retum 4a. Future Interest Compromise (date of death after 12-12-82) O 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) 3. Remainder Reium (date of death prior to 12-13-82) 5. Federal Estate Tax Retum Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sdt. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SNOULD BE DIRECTED TO: Name Daytlme Telephone Number I V O V O T T O I I I 7 1 7 2 4 3 3 3 4 1 Firm Name (If Applicable) M A R T S O N First line of address 1 0 E A S T Second line of address City or Post Office C A R L I S L E State ZIP Code P A 1 7 0 1 3 REGISTER OF WILLS USE ONLY c - o ~ ~~ rte-- ~. - ~ ~ >. ~~ ~ rG'i ~ ' I r:, T ~ j l O . . ,.. ., ~ C ~~ L ~ DAB FILED .. _: ~~ i :: .r _.-% ~i T~ W ,-~,.._ L~ 12 Correspondent's e-mail address: I O T T O a M A R T$ O N L A W. C O M Under pane of pe , I declare that I have exartwned this rehim, includirq accortlpanying schedules and statements, and to the best of my krawledge and belief, a is true, and e~cleretion~i preparer other than the personal representatNe s based on of infomxrtbn of which preparer has any leawledge. SIG OF P P FILINS'i RETURN HATE LANl UR1Vt A-yUL R OTFKRTHAN REPRESENTATNE 10 EAST HIGH STREET CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY L A W O F F I C E S H I G H S T R E E T Side 1 1505607121 1505607121 Continuation of REV-1500 Inheritance Tax Return Resident Decedent OZELLA D. TODD 21 09 0613 Decedent's Name Page 2 File Number Correspondents Name Finn Name (If Applicable) First line of address Second line of address City or Post Office Conespondent's e-mail address: Daytime Telephone Number State ZIP Code Under penalties rJury, I declare that I have examined Ihis return, including eocompanying schedules and statements, and M the best of my Ivawledge and belief, ft is true, correa(arx rnple~, Dedaratlon of preparer other than the personal representalNe ~a based on all intOrmatbn of whklh preparer has any krawledge. SIGNATURE PE QN RESPON E F06L~ING RETURN DALE ADDRESS 1 HILL STREET MT HOLLY SPGS PA 17065 1505607221 REV-1500 EX Decedents SoGal Security Number Dacadonrs Name: O Z E L L A D• TODD 1 9 9 0 7 4 8 3 1 RECAPITULATION 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 8 Notes Receivable (Schedule D) ........................ 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... B• 7. Inter-Vivos Transfers & Miscellaneous N -Probate Property (Schedule G) ~] Separate Billing Requested ....... 7. 8. Total Gross Assets (total Lines 1-7) ........................... 8. 7 7 8 0 6 5.1 7 7 2 7 D? 2.9 6 3 7 3 5 8 9, 7 1 1 8 7 8 7 2 7.8 4 9. Funeral Expenses & Administrative Costs (Schedule H) ..... ........... 9. 3 4 9 3 5 . 5 4 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . ........... 10. $ 9 2 , 3 2 11. Total Deductions (total Lines 9 8 10) ................ ...........11. 3 5 5 2 7. 8 6 12. Net Value of Estate (Line 8 minus Line 11) .............. ........... 12. 1 8 4 3 1 9 9 , 9 8 13. Charitable and Governmental eequests/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. 1 8 4 3 1 9 9 , 9 8 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or Vansfers under Sec. 9116 (ax1.z) x.o _ O D 0 15. 0. 0 0 i6. Amount of Line 14 taxable at lineal rate x .045 1 8 2 8 1 9 9. 9 8 t g, 8 2 2 6 9. 0 0 17. Amount of Line 14 taxable 0 0 0 17 D D D at sibling rate X .12 . . . 18. Amount of Line 14 taxable 1 5 0 0 0 0 0 2 2 5 0 0 0 at collateral rate X .15 . 1 g, . 19. Tax Due ................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 8 4 5 1 9. 0 0 Stde 2 1505607221 1505607221 J REV-1500 EX Page 3 Decedent's Complete Address: Flle Numt~er 21 09 0613 DECEDENTS NAME OZELLA D. TODD STREET ADDRESS 1 LONGSDORF WAY CITY CARLISLE STATE PA ZIP 17013 Tax Payments and Credits: t • Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments 80,000.00 C. Discount 4,210.40 3. InterestlPenalty if applicable D. Interest E. Penalty (1) 84,519.00 Total Credits (A + B + C) (2) 84,210.40 Total InteresUPenalty (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Une 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 0.00 5. if Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 308.60 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) 308.60 Make Check Payable to: REGISTER OF WILLS, AGENT F .; _ r s Y a.Pr+ra e. ~«+ ;,s,~k3y,~~s ~~4i~,. ~+ r4~ ~z~s, ~P ~ *a~; r t Sru~a. .. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer aril: Yes No a. retain the use or Income of the property transfened : ...................................................................... ^ b. retain the right to designate who shall use the property transfened or its income : ............................... ^ c. retain a reversionary interest; or ................................................................................................ ^ d. receive the promise for life of either payments, benefits or care? ....................................................... ^ 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... © ^ 3. Did decedent own an 'intrust for' or payable upon death bank account or security at his or her death? ......... © ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................................................................................. ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. . >. ~,-,"~`f ..'?.~ ,~~. °", 3"x^..~'? 3a ~ ,°i.;~' l s..~d ;.:"re~:~'..oa4+`P.~ai'~u"h, ..a. ~.t~~Y~;HZ ed`e",~•,.,1 '.. ~ s .;y Ro.e ~~kru r~ daw & ~ ^''x oar r d a`i„~,~ tims hyu For dates of death on or after July 1,1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)j. For dates of death on or after January 1,1995, the tax rate imposed an 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)j. 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. §91 i6(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blend or adoption. REV-1503 EX + (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER OZELLA D, TODD 21 09 0613 Ali property jointly-owrred wNh rlgM of survivorship must be discbeed on ScheduN f. ITEM I VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. SmithBarney Account No. 724-12996-14, see attached inventory 771,065:17 2. ~ 1750 shares Cronos Global Income Fund XVI @ 4.00 7,000.00 TOTAL (Also enter on line 2, Recapitulatlan) ~ E (If more space is needed, insert additional sheets of the same size) REV-1508 EX+(8-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE E CASH, BANK D~~OSItS, & MISC. PERSONAL PROPERTY is I a t t yr rat nuMntn OZELLA D. TODD 21 09 0613 Include the of Ntigatlon and the date the roceeds were received by the estate. All p owned with M of survly mud be dlecbeed on ScheduN F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. First National Bank of Chester County, Checking #105376 9,458.87 (C. Robert Todd predeceased decedent herein) 2. First National Bank of Chester County, Money Market #117145 (C. Robert Todd predeceased decedent herein) 3 First National Bank of Chester County, C.D. #0290003585 4 ~M&T Bank, Checking #1267469 (spouse, C. Robert Todd, predeceased) 5 ~MBcT Bank, C.D. #31003909231743 (spouse, C. Robert Todd, predeceased) 6 ~M&T Bank, C.D. #31003919231751 7 ~ MorganStanley SmithBarney Acct. No. 724-12996, Bank Deposit Program 8 ~ PA Dept. of Revenue, 2008 income tax refund 9 ~ Diakon Lutheran Social Ministries, refund of account credit 10 ~Cignature RX, refund 11 ~ Highmark Blue Shield, refund of premium TOTAL (Also enter on line 5, Recapitulation) ~ S (If more space is needed, insert additional sheets of the same sae) 64,155.78 250,117.83 13,045.69 200,401.97 100,200.99 87,400.88 45.03 1,854.40 39.50 352.02 REV-1510 EX + (&9B) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER OZELLA D. TODD 21 09 0613 This schedule must be completed and filed if ttre answer to arty of questbns t through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY ~M~ul0ET1EMwE~PTIffTRNI6PHiEF~TX~NpEUTIpN$NIPTODEC®@1Tµp ~DATEOPTfUNSFER.~TTAp1~COPYOFTHEUFEpFVRpFA~EgTAIE DATE OF DEATH VALUE OF ASSET %OFDECD'S INTEREST EXCLUSION nr,vPUC~q TAXABLE VALUE 1. First National Bank of Chester County, CD 290004340, 7/28!07, 250,589.71 100. 0.00 250,589.71 Ozella D. Todd in trust for Charles R Todd III, William S. Todd & Lisa T. Webber (sons and granddaughter) 2 $12,500 Cash to Charles R. Todd III, 12/25/08, son 12,500.00 100. 3,000.00 9,500.00 3 $12,500 Cash to William S. Todd, 12/25/08, son 12,500.00 100. 3,000.00 9,500.00 4 $5,000 Cash to Lisa T. Webber, 12/25/08, granddaughter 5,000.00 100. 3,000.00 2,000.00 5 $5,000 Cash to Steven W. Todd, 12/25/08, grandson 5,000.00 100. 3,000.00 2,000.00 6 $13,000 Cash to Charles R. Todd III, 04/09, son 13,000.00 100. 3,000.00 10,000.00 7 $13,000 Cash to William S. Todd, 6/11/09, son 13,000.00 100. 3,000.00 10,000.00 8 $13,000 Cash to Marjorie A. Todd, 6/11/09, daughter-in-law 13,000.00 100. 3,000.00 10,000.00 9 $13,000 Cash to Steven W. Todd, 6/15/09, grandson 13,000.00 100. 3,000.00 10,000.00 10 $13,000 Cash to Jeanine A. Todd, 6/15/09, granddaughter-in-law 13,000.00 100. 3,000.00 10,000.00 11 $13,000 Cash to Derek A. Todd, 6/15/09, great-grandson 13,000.00 100. 3,000.00 10,000.00 12 $13,000 Cash to Lisa T. Webber, 6/15/09, granddaughter 13,000.00 100. 3,000.00 10,000.00 13 $13,000 Cash to William R. Webber, 6/15/09, grandson-in-law 13,000.00 100. 3,000.00 10,000.00 14 $13,000 Cash to Kathryn O. Webber, 6/15/09, great-granddaughter 13,000.00 100. 3,000.00 10,000.00 15 $13,000 Cash to William T. Webber, 6/15/09, great-grandson 13,000.00 100. 3,000.00 10,000.00 TOTAL (Also enter on Ilne 7 Recapitulation) ~ S 373 589 71 (If mare space is needed, insert additbnal streets of the same size) REV•1511 EX+(10-08) SCHEDULE H COMMONWEALTH OFPENNSYIVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER OZELLA D. TODD 21 09 0613 Datris of daaderd must be rsporled on Sehe~rk I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Hoffman-Roth Funeral Home 9,911.75 2 Westminster Cemetery, inscription 190.00 3 Whimsical Poppy, memorial service flowers 122.64. 4 Carlisle Country Club, reception 836.40 5 Kenneth Stoner, reception 100.00 6 First United Church of Christ, memorial service 100.00 B. I ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Street Address City State Zip Year(s) Commission Paid: p, Attorney Fees Manson Law Offices (estimated) 20,000.00 3. Famtiy Exemption: (If decedent's address is rwt the same as cleimenCs, attach explanation) Claimard Street Address City State Zip Relationship of Claimant to Deosdent 4. p~~ pis Register of Wills, Cumberland County 1,014.00 5 ~ Accourdant's Fees 6. ~ Tax Return Preparers Fees 7. Charles R. Todd III, air fare for funeral arrangements and re estate administration 2,082.00 8 Stock valuation report 38.75 9 Register of Wills, filing fee, inheritance tax return 15.00 10 Overnight mail 25.00 11 Reserved for additional probate and filing fees, investment fees and miscellaneous 500.00 TOTAL (Also enter an line 9, Recapitulation) I S (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE( DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF -FILE NUMBER OZELLA D. TODD 21 09 0613 Repoli debts incurred by the decedent prior to death xlhictl remained unpaid as of the date of death, including unreimburaed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. (Discover Card, outstanding check on date of death 2 (Cumberland-Goodwill, account payable 3 (Discover Card, account payable 4 I Continuing Care RX, account payable 5 IU.S. Treasury, refund of overpaid V.A. benefit 98.47 88.75 28.96 253.14 123.00 TOTAL (Also enter on line 10, Recapitulation) I $ (If more space is needed, Insert addidonel sheets of the same size) REV-1513 EX + (9-00) SCHEDULE J COMMONWEALTH OF PENNSVLVANW BENE~~C~AR~ES INHERITANCE TAX RETURN ESTATE OF FILE NUMBER OZELLA D. TODD ~ i no n~ i z RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Llst Trustee(s) OF ESTATE l TAXABLE DISTRIBUTIONS [include o M spousal distritwtlons, and transfers under Sec. 9116 (a (1.2)] 1. Chazles R. Todd III Lineal 83,529.90 95-270 Waikalatri Drive A-301 Sch. G, Item 1 Mililani, HI 96789 2 William S. Todd Lineal 83,529.90 1 Hill Street Sch. G, Item 1 Mt. Holly Springs, PA 17065 3 Lisa T. Webber Lineal 83,529.91 53 Tanger Road Sch. G, Item 1 Boiling Springs, PA 17007 4 Charles R. Todd III Lineal 19,500.00 Sch. G, Items 2 & 6 5 William S. Todd Lineal 19,500.00 Sch. G, Items 3 & 7 6 Lisa T. Webber Lineal 12,000.00 Sch. G, Items 4 & 12 7 Steven W. Todd Lineal 12,000.00 629 Bullfrog Valley Road Sch. G, Items 5 & 9 Hummelstown, PA 17036 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET S ~n mwe space Is neeoea, )Haan addmonal sneers of me same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent OZELLA D. TODD 21 09 0613 Decedent's Name Page ~ File Number Schedule J -Beneficiaries -1 NUMBER NAME AND ADDRESS OF PERSO S RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not Ust T s AMOUNT OR SNARE OF ESTATE I TAXABLE DISTRIBUTIONS (include outright spousal distributions) 8 Marjorie A. Todd Lineal 10,000.00 1 Hill Street Sch. G, Item 8 Mt. Holly Springs, PA 17065 9 Jeanine A. Todd Lineal 10,000.00 629 Bullfrog Valley Road Sch. G, Item 10 Hummelstown, PA 17036 10 Derek A. Todd Lineal 10,000.00 629 Bullfrog Valley Road Sch. G, Item 11 Hummelstown, PA 17036 11 William R Webber Lineal 10,000.00 53 Tanger Road Sch. G, Item 13 Boiling Springs, PA 17007 12 Kathryn O. Webber Lineal 10,000.00 53 Tanger Road Sch. G, Item 14 Boiling Springs, PA 17007 13 William T. Webber Lineal 10,000.00 53 Tanger Road Sch. G, Item 15 Boiling Springs, Pa 17007 1. John R. Donsen Collateral 15,000.00 301 Wimbledon Drive Specific bequest Mt. Pleasant, PA 15666 15 Charles R. Todd III Lineal 727,305.14 (1/2 residue) 16 William S. Todd Lineal 727,305.13 (1/2 residue) Estate Valuation-SmithBarney 724-1 Date of Death: 06/21/2009 Estate of: Ozella D. Todd Estate Valuation Date: 06/21/2009 Account: 4269.2 Processing Date: 07/09/2009 Report Type: Date of Death Number of Securities: 25 File ID: 4264.2.sb Shares Security Mean and/or Div and Int Security or Par Description High/Ask Low/Bid Adjustments Accruals Value 1) 8000 MERCK & CO iNC (589331107; MRx) COM NYSE 06/19/2009 26.54000 25.81000 H/L 06/22/2009 25.74000 25,15000 H/L 25.810000 206,480.00 Div: 0.38 Ex: 06/04/2009 Rec: 06/08/2009 Pay: 07/01/2009 3,040.00 2) 4000 BLACRROCR STRAT DIVD ACHIEVERS (09299Y107; BDT) COM NYSE 06/19/2009 7.51000 7.39000 H/L 06/22/2009 7.90000 7.20000 H/L 7.375000 29,500.00 Div: 0.1625 Ex: 06/11/2009 Rec: 06/15/2009 Pay: 06/30/2009 650.00 3) 2000 BLACi(ROCR INSD MUN INCOME TR 1092479104; BYM) COM NYSE 06/19/2009 12.87000 12.59000 H/L 06/22/2009 12.99000 12.21000 H/L 12.665000 25,330.00 Div: 0.0685 Ex: 06/11/2009 Rec: 06/15/2009 Pay: 07/01/2009 137.00 4) SD00 EATON VANCE INS PA MUN BD FD (EIP) COM ASE 06/19/2009 11.76000 11.50000 H/L 06/22/2009 11.71000 11.17000 H/L 11.535000 Div: 0.06458 Ex: 06/19/2009 Rec: 06/23/2009 Pay: 06/30/2009 + 0.064580 11.599580 57,997.90 51 10000 CAMBRIA CNTY PA HOSP DEV AUTH HOSP REV (132037AP7) FT Zntr. DTD: 09/01/1978 Mat: 09/01/2011 7.6258 06/19/2009 105.64700 105.62700 A/B 06/22/2009 105.63200 105.61100 A/B 105.629250 10,562.93 Int: 03/01/2009 to 06/21/2009 232.99 6) 25000 PHILADELPHIA PA AUTH FOR INDL LEASE REV (71781QBR8) FT Intr. DTD: 12/01/2001 Mat: 10/01/2026 5.1256 06/19/2009 109.37700 109.37700 A/B 06/22/2009 109.96200 109.46200 A/B 109.419500 27,354.88 Int: 09/01/2009 to 06/21/2009 289.72 7) 15000 UNION CNTY PA HOSP AUTH HOSP R REV BDS (906460BV1) FT Intr. DTD: 02/15/1997 Mat: 04/01/2012 6.258 06/19/2009 97.92700 97.78100 A/B 06/22/2009 97.92900 97.78200 A/B 97.854750 14,678.21 Int: 04/01/2009 to 06/21/2009 208.33 B) 20000 LEHIGH CNTY PA GEN PURP AUTH R HOSP REV 1524805Y69) FT Intr. DTD: 07/01/2003 Mat: 08/15/2033 5.3758 06/19/2009 113.13500 113.13500 A/B 06/22/2009 113.38200 113.38200 A/B 113.258500 22,651.70 Int: 02/15/2009 to 06/21/2009 376.25 Page 1 This report was produced with 8stateVal, a product of Estate Valuations ~ Pricing Systems, Inc. if you have questions, please contact EVP Systems at (818) 313-6300. IAevision 6.4.1) Date of Death: 06/21/2009 Valuation Date: 06/21/2009 Processin Date: 07/09/2009 g Shares Security or Par Description High/Ask Loa/Bid Estate of: Ozella D. Todd Estate Account: 4264.2 Report Type: Date of Death Number of Securities: ZS File ID: 4269.2.sb Mean and/or DiV and Int Security Adjustments Accruals Value 9) 25000 DELAWARE CNTY PA RUTH HOSP REV REV BDS 1296006MNT11 FT intr. DTD: 04/01/1998 Mat: 12/01/2013 5.1256 06/19/2009 93.95700 93.73800 A/B 06/22/2009 93.95900 93.74100 A/B 93.898750 23,462.19 Int: 06/01/2009 to 06/21/2009 71.18 10) 25000 WEST SHORE PA AREA HOSP RUTH H REV BDS (955817DA6) FT Intr. DTD: 12/01/2001 Mat: 01/01/2015 5.758 06/19/2009 98.09200 97.89200 A/B 06/22/2009 98.23000 97.98000 A/B 98.036000 24,509.00 Int: 01/01/2009 to 06/21/2009 678.82 11) 20D00 DELAWARE CNTY PA RUTH REV REV HDS (245913EA2) FT Intr. DTD: 12/01/1996 Mat: 12/15/2016 66 06/19/2009 104.89500 104.84300 A/B 06/22/2009 104.84500 104.84300 A/H 104.844000 20;968.80 Int: 06/15/2009 to 06/21/2009 20.00 121 30000 BERKS CNTY PA MUN RUTH REV REF REV B (084538EZ6) FT Intr. DTD: 10/15/1998 Mat: 05/15/2018 5.78 06/19/2009 88.93600 88.57800 A/B 06/22/2009 88.94100 88.58300 A/B 88.759500 26,627.85 Int: 05/15/2009 to 06/21/2009 171.00 13) 20000 VIRGIN ISLANDS WTR & PWR RUTH REF REV B (927686CP4 ) FT Intr. DTD: 06/01/1998 Mat: 07/01/2018 5.3$ 06/19/2009 95.11000 94.97700 A/B D6/22/2009 95.11100 94.97800 A/H 95.044000 19,008.80 Int: 01/01/2009 to 06/21/2009 500.56 14) 20000 LEBANON CNTY PA HEALTH FRCS AU HOSPITAL (522455BE3) FT Intr. DTD: 03/11/2009 Mat: 11/15/2018 4.59 06/19/2009 88.28300 88.03300 A/B 06/22/2009 88.91700 88.16700 A/B 88.225000 17,645.00 Int: 05/15/2009 to 06/21/2009 90.00 15) 25000 PENNSYLVANIA ST HIGHER EDL FAC GO SCH HD (70917PCU1 ) OTC DTD: 12/18/2003 Mat: 04/15/2020 5.45$ 06/19/2009 84.52800 84.13500 A/B 06/22/2009 89.53000 84.13800 A/H 89.332750 21,083.19 Znt: 04/15/2009 to 06/21/2009 Zgg,79 16) 40000 WEST SHORE PA AREA HOSP RUTH H REV BDS (955817CN9) FT Intr. DTD: 06/01/1997 Mat: 01/01/2022 5.78 06/19/2009 96.44700 96.27800 A/B 06/22/2009 96.70200 96.53200 A/B 96.489750 38,595.90 Int: 01/01/2009 to 06/21/2009 1,076.67 17) 15000 WALLENPAUPACK PA AREA SCH DIST GO BDS (932432RG4) FT Intr. DTD: 10/15/2005 Mat: 09/01/2022 4.1$ 06/19/2009 94.55400 94.30400 A/H 06/22/2009 99.74400 94.49400 A/H 94.524000 14,178.60 Int: 03/01/2009 to 06/21/2009 187.92 Page 2 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If yov have questions, please contact EVP Systems at (818) 313-6300. (Revision 6.4.1) g-~ ~ zi ~~ Date of Death: 06/21/2009 Valuation Date: 06/21/2009 Processing Date: 07/09/2009 Estate of: Ozella D. Todd Estate Account: 4264.2 Report Type: Date of Death Number of Securities: 25 File ID: 4264.2.sb Shares Security Mean and/or Div and Int Security or Par Description High/Ask Low/Bid Adjustments Accruals Value 18) 25000 PENNSYLVANIA ST HIGHER EDL FAC GO REV BD (70917NZR8) FT Intr. DTD: 10/01/2003 Mat: 05/01/2023 5.25$ 06/19/2009 93.09200 92.56000 A/B 06/22/2009 93.09300 92.56100 A/H 92.82650C Int: 05/01/2009 to 06/21/2009 19) 15000 PENNSYLVANIA ST HIGHER EDL FAC REV BDS (70917NQ72) P7' Intr. DTD: 01/12/2005 Mat: 09/01/2025 4.25$ 06/19/2009 99.77200 99.52200 A/B 06/22/2009 100.00400 99.75400 A/H 99.763000 Int: 03/01/2009 to 06/21/Z009 20) 25000 CUMBERLAND CNTY PA MUN AUTH RE IMPT 8D5 (230614BQ1) FT Intr. DTD: 01/01/2003 Mat: 12/01/2026 5$ 06/19/2009 85.03900 84.48300 A/B 06/22/2009 85.04100 84.48500 A/B 84.762000 Int: 06/01/2009 to 06/21/2009 21) 45000 MONR'(.OMERY CNTY PA INDL DEV AU REV BDS (61360PAV2) FT Intr. DTD: 12/01/1998 Mat: 11/15/2D28 5.25$ 06/19/2009 91.46500 90.82600 A/B 06/22/2009 91.46600 90.82700 A/H 91.146000 Int: 05/15/2009 to 06/21/2009 22) 15000 MASSACHUSETTS ST DEV FIN AGY R REV BDS (57583 FDMO) FT Intr. DTD: 02/01/1999 Mat: 02/01/2029 5.758 06/19/2009 78.154D0 77.66300 A/B 06/22/2009 78.15700 77.66600 A/B 77.910000 Int: 02/01/2009 to 06/21/2009 23) 25000 MONTGOMERY CNTY PA HIGHER ED & HOSP REV (613604UR6) FT Intr. DTD: 10/22/2002 Mat: 06/01/2032 5.1258 06/19/2009 84.05300 83.84400 A/B 06/22/2009 89.16700 83.95800 A/B 84.005500 Int: 06/01/2009 to 06/21/2009 24) 20000 LEHIGH CNTY PA GEN PURP AUTH R HOSP REV (524805Y44) FT Intr. DTD: 05/21/2003 Mat: 07/01/2033 5$ 06/19/2009 82.77900 82.56700 A/B 06/22/2009 82.89500 82.68200 A/B 82.730750 Int: 01/01/2009 to 06/21/20D9 25) 15000 MONTGOMERY CNTY PA HIGHER ED & REV BDS (613603PX1) FT Intr. DTD: 01/13/2006 Mat: 01/01/2036 5.25$ 06/19/2009 72.99800 72.47000 A/B 06/22/2009 73.00000 72.47100 A/B 72.734750 Int: 01/01/2009 to 06/21/2009 Total Value: Total Accrual: Total: $771,065.17 23,206.63 182.29 14,969.95 194.79 21,190.50 69.49 41,015.70 236.25 11,686.50 335.42 21,001.38 71.18 16,546.15 972.22 10,910.21 371.88 $761,156.47 $9,908.70 Page 3 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (818) 313-6300. (Revision 6.4.1) Q-1 C3I3) 7.f Iii s(;f"'~, ;t.it"-,A4' !'!l CL~i,`ti First National Bank of Chester County July 9, 2009 Manson Law Offices 10 East High Street Carlisle, PA 17013 1tE: Estate of Ozella D Todd SSN:199-07-4831 Date of Death: 6/21/2009 Dear Sir/Madam: 9 N. High Street P.O. Box 523 West Chester, PA 19381 a 484.881.4000 w lnbenk.com Per your request, I submit information concerning the accounts of the above-referenced decedent held at the bank at the time of her death. Account # Title Bah~nce @ Accrued Total Balance @ DOD Interest Date of Death DOD Checking C Robert Todd $9,444.85 $14.02 $9,458.87 #105376 Ozella D Todd Opened 4/28/2003 Checking C Robert Todd $64,138.52 $17.26 $64,155.78 # 117145 Ozella D Todd Opened 5/20/2008 CD Ozella D Todd $250,000.00 $117.83 $250,117.83 #290003585 Opened 12/17/2006 CD Ozella D Todd $250,000.00 $589.71 $250,589.71 #290004340 Charles R Todd III Opened William S Todd 7/28/2007 Lisa T Weber C-~z) SCN- '?~'' it-~,Y+ t 5CN• nE " S}c~..n L 5CN. ~~~rt ~ }t.,., 3 ~i-~,,., A Subsidiary of First Chester County Corporation Our records indicate no other accounts in the decedent's name at the time of her death. The 2 checking accounts were opened with C Robert Todd as the primary account holder and Ozella D Todd as joint. if you have any questions or should you require any additional information, please do not hesitate to call me at (484) 881-4264. Sincerely, Michelle Greiner Customer Service Operations First National Bank of Chester County G, ~ Q ~B~ 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Manson Law Offices 10 East High Street Carlisle, Pennsylvania 17013 Re: Estate of Ozella D. Todd Social Security: 199-07-4381 Date ofDeath: June 21. 2009 Phone (888)502-4349 Fax (302)934-2955 July 3, 2009 Dear Sir or Madam: ' Per your inquiry dated July 0l, 20009, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 1267469 Ownership (Names o,0 Ozella D Todd * Jr' C~ . ~\ ~ ~~ C Robert Todd' _ ~~~ ~ Opening Date 12/26/95 Balance on Date ofDeath $13,045.65 Accrued Interest $ 0.04 Total -- --.-_ _,.. $13.045.69 ... _._. _ .............. 2. Type ofAccount Cert~cate of Deposit Account Number 31003919231743 5 G }} , ~\ ~, ~- Ownership (Names o~ Ozella D Todd' ~ ~'~ S C Robert Todd' Opening Date 9/22/08 Balance on Date of Death $ 200,000.00 Accrued Interest $ 401.97 Total $ 200,401.97 ..............._. (llz) 3. Type of Account Certificate of Deposit Account Number 31003919231751 Ownership (Names o,~ Ozella D Todd' sC ~ • ~~ E ~~ ~~'" ~O Opening Date 9/21/08 Balance on Date of Death $100,000.00 Accrued /merest $ 200.99 Total $ 100,200.99 4. Type of c Safe Deposit B ~ ~ S .d ~ GtJ ~ S Box Number/Location ON0028/Stonehedge (~Q S C~ ~('C 0 r ~ Ownership (Namgsef}'"~ D Todd"` ~Q~~ J '~ G ~ C Robert Co-owner * If upon reviewing the information above, you believe there are additional accounts not referenced, please provide us with an account number and/or name of any possible joint account holder. For any addNional information on the above sccounb, including ownership and any changea, cbsures and/or reimbursement of funds, etc., please contact our Stonehedge Office # 717-240-4SZ4. Sincerely, ~~~~ _ Tracie Hare Adjustment Services (ZI2 J MARTSON DF,ARDQ ?F W ILLIAMS OTTO ~1 [LROY & ~'AI,LER MARTSON LAW OFFICES WiLLIAbt I? MARTSON JOHN B. FOWLER III DAmEi K. DEARDORFF THOMAS J. Wu.Iav~rs* No V. Caro III HuHERT X. GILROY GEORGE B. FnLLER JR* 'Boma Carom, Dnvln A. FITLSIMONs CHRISTOPHER E. RICE JENNIFER L.. $PEARS SETTi T MOSEBEY TRUDY E. FEHLINGER KA17E J. MAxwELL JACOa M. THEIs a Cm~ 7ku~ Ssacuuat 10 E.~sr HIGH STTeEET CARLISLE, FENNSYI.vANIA 17013 TELEPHONE (717) 243-3341 FACSiMIIE (717) 243-1850 INTT:xIVET wwwmattsonlawcom Pennsylvania Department of Revenue Hamsburg District Office Lobby, Strawberry Square Harrisburg, PA 17128-0101 July 23, 2009 RE: Estate of Ozella D. Todd, deceased File No. 21-09-00613 Safe Deposit Box: M&T Bank, 960 Walnut Bottom Road, Carlisle, PA 17013 Dear Sir or Madam: By letter dated July 9, 2009 (copy enclosed), I was authorized to inventory a safe deposit box registered to the above decedent. We previously spoke on two separate occasions with representatives of M&T Bank at the above office to confirm the existence of a box, indicating that the Executors had the understanding that the box had been closed prior to death and that they could find no keys for the box. On both occasions, the representatives of the bank indicated that the box was not closed. Therefore, a meeting was scheduled for July 21, 2009, at the bank to conduct the inventory. It was our understanding that a locksmith was also scheduled to drill the box since keys could not be found. After arriving at the bank to conduct the inventory, we were advised by a bank representative that the box had, in fact, been closed by the decedent and her late husband on November 21, 2008. The bank provided a copy of the signed Release for the safe deposit box, which is enclosed herewith. Therefore, no inventory will be filed in this matter. Should you have any questions, please either contact me or M&T Bank. Very truly yours, STM/clm Enclosures e~FTl.waa roaaNas~.a.an.i MARTSON LAW OFFICES ~8.,~ 1. ~~-~ Seth T. Mosebey INFORMATION ADVICE ADVOCACY SM P~~FILE$~UATAPRE¢gre Pl~oiogMi61.3.r.rri0.i001 ~o~rr LAST WILL AND TESTAMENT I, OZELLA D. TODD, of South Middleton Township, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declaze this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me made. ITEM ONE I direct that all my legally enforceable debts, funeral expenses, testamentary expenses and all inheritance taxes shall be paid to the extent possible from the assets held or passing under ITEM SEVEN hereof as soon as practicable after my decease and as part of the administration of my estate. ITEM TWO In the event my husband shall predecease or fail to survive me by thirty (30) days, then I give such items of personalty as aze itemized in a certain list, if any, attached hereto to the persons named thereon, which list is signed and dated by me at the end thereof. ITEM THREE I give, devise and bequeath the sum of FIFTEEN THOUSAND DOLLARS ($15,000.00) to my nephew, JOHN R. DONSEN. ITEM FOUR I bequeath any automobiles or motor vehicles I may own at my death, my personal effects, such household goods if any as maybe my individual property and not the property of my husband or owned jointly by me with my husband, and other tangible personal property of like nature (not including cash or securities), together with any existing insurance thereon, to my husband, C. ROBERT TODD, providing he survives me by thirty (30) days. Should my husband predecease me or die on or before the thirtieth day following my death, I bequeath such tangible personal property and insurance thereon to such of my children as aze living on the thirty-first day after my death, to be divided between or among them with due regazd for their personal preferences in as neazly equal shares as practical and as they shall mutually ag;ee. I direct that any of the foregoing articles not selected by such children or about which there is no agreement shall be sold at public or private sale by my personal representative(s), and I further direct that the net proceeds thereof shall be administered and distributed as a part of the residue of my estate. Page 1 of 7 Pages ~.~.J [Initials] ITEM FNE If my husband, C. ROBERT TODD, is living thirty (30) days after my death, then I give, devise and bequeath all of my estate, both real and personal property, unto my said husband, absolutely. If my said husband does not so survive me, then I give, devise and bequeath all the rest, residue and remainder of my estate, both real and personal~property, unto my Trustees to beheld or distributed by such Trustees under ITEM SEVEN hereof. ITE SIX In the event my said husband shall disclaim all or any portion of any devise or bequest made to my husband under the foregoing ITEM FNE, then the amount otherwise payable shall be held by my Trustees under ITEM SEVEN hereof. For purposes of the Trust established under ITEM SEVEN hereof, my said husband shall not be deemed to have predeceased me by virtue of my said husband's exercise of the right to disclaim set forth herein. ITEM SEVEN RESIDUARY AND DISCLAIMER TRi TST My Trustees shall hold the assets received under ITEMS FNE and SIX hereof, if any, for the following purposes: A. My Trustees shall pay the net income, at least quarter-annually, to my husband, C. ROBERT TODD, for life. In addition, my Trustees, in my Trustees' sole discretion, may invade the principal of the Trust for the proper and adequate support of my said husband. B. In addition to the above provisions, my said husband shall have the power to direct my Trustee to pay to him or to apply out of the principal of this Trust in each yeaz, including the year of my death, an amount not in excess of the greater of Five Thousand ($5,000.00) Dollazs or five (5%) percent of the then aggregate value of the principal of this Trust. This power shall be noncumulative and may be exercised only by an instrument in writing signed by him and delivered to my Trustee within the first thirty (30) days of fiscal year of this Trust. C. Upon the death ofmySaid husband, or upon my death ifmy husband shall not survive me by thirty (30) days, my Trustees shall distribute the principal of the Trust to my children, CHARLES R. TODD, III and WILLIAM S. TODD, in equal shazes, absolutely. ~(~~ [Initials] Page 2 of 7 Pages D. In the event that either of my said children shall fail to survive my husband and me, but shall leave issue surviving, then such deceased child's shaze shall be held by my Trustee and the net income therefrom shall be used for the support, maintenance and education of the issue of such deceased child. My Trustee shall use as much of the principal as it shall deem desirable for said purposes. My Trustee shall distribute absolutely the principal of such share of such deceased child to the issue of such deceased child per stirpes as each shall attain the age of thirty (30) years. In the event that either of my children shall fail to survive my husband and me and not leave issue surviving, then such deceased child's share shall be added to the shaze of my other child as if originally a part thereof. ITEM EIGHT POWERS OF EXECUTOR AND TR TEES In addition to the powers conferred by case law, by statute, and by other provisions hereof, my Executor and Trustees, and their successors, shall have the following discretionary powers applicable to all property held by them which powers shall be effective without order of any court and shall exist until final distribution. A. To retain any property of any nature received by them for whatever period they shall deem advisable; B. To invest and reinvest all or any part of said property in such stocks, bonds, common trust funds, securities, accounts, certificates of deposit (including, but not limited to, stocks, bonds, common trust funds, securities, accounts or certificates of deposit of my Trustees) or other property, real or personal, as in their discretion they shall deem proper, without regazd to statutes limiting the property which a fiduciary may purchase; C. To sell, transfer, exchange or otherwise dispose of, any part of said property, for cash or on terms, publicly or privately, or to lease, even for a term exceeding five (5) years or the duration of any trust herein, without liability on the purchasers or lessees to see to the application of the proceeds, and to give options for these purchases without the obligation to repudiate them in favor of a higher offer; D. To execute and deliver any deeds, leases, assignments or other instruments as may Page 3 of 7 Pages [Initials] be necessary to cazry out the provisions of any trust hereunder; E. To borrow money, including the right to borrow money from any bank and to mortgage or pledge any asset of the estate as security; F. To assume continuance of the status of any beneficiary with regazd to death, marriage, divorce, illness, incapacity and the like in the absence of information deemed reliable without liability for disbursements made on such assumption; G. To pay from the trust, or the income therefrom, all debts or claims against my estate, or any taxes or similar charges on my estate; H. To make any distribution hereunder either in kind or in money, or partially in kind and partially in money. Distribution in kind shall be made at the market value of the property distributed, and my Trustees, in my Trustees' absolute discretion, may cause the share distributed to any distributee to be composed of property similaz to or different from that distributed to any other distributee; I. To exercise any subscription right in connection with any security held hereunder, to consent to or participate in any recapitalization, reorganization, consolidation or merger of any corporation, company or association, the securities of which may be held hereunder, to delegate authority with respect thereto, to deposit investments under agreements, to pay assessments, and generally to exercise all rights of investors; J. To invest in endowment, insurance or annuity policies on the lives of beneficiaries of any trust hereunder; K. To continue in any partnership, joint venture, joint ownership or other business enterprise of which I am a part at the time of my death; L. To compromise claims; M. To continue for whatever period of time as they shall deem necessary any ownership as a tenant in common or as a partner, in real estate or other property and to act as I could have done had I been living; N. To lend money to my estate or to any trust created hereunder or to purchase from the estate or from any trust created hereunder, at the mazket value thereof at the time of purchase, any 1 J, Initials] Page 4 of 7 Pages securities or other property tendered to them by my estate or any trust created hereunder at any time and from time to time within a period of nine (9) months after my death; O. In the event that any amounts aze payable hereunder or under any trust created hereunder to a minor, or to a person otherwise under legal disability, or to a person not adjudicated to be an incapacitated person, but who, by reason of illness or mental or physical disability is, in the opinion of the fiduciary(ies) hereunder, unable to properly administer such amounts, such amounts may be paid by the fiduciary(ies) hereunder in his, her or their sole discretion in any of the following ways as he, she or they may deem best: Directly to such beneficiary; 2. To a legally appointed guardian of such beneficiary for the benefit of such beneficiary; 3. To a person having custody of such beneficiary for the benefit of such beneficiary; 4. By the fiduciary(ies) hereunder using such amounts directly to the benefit of such beneficiary. Evidence of the application of payment of an amount in such a manner shall be a full and complete dischazge of the fiduciary(ies) hereunder to the extent of such payment or application. This paragraph shall be applicable to payments of income as well as principal. P. To employ agents, attomeys and proxies and to delegate to them such power as my personal representative and Trustees consider desirable and to pay reasonable compensation for such services as may be rendered by such agents, attorneys and proxies; Q. To conduct an inventory of any safe deposit box necessary to the administration of my estate. R. To do all other acts in their judgment necessary or desirable for the proper management, investment and distribution of my Estate. ITEM NINE PROTECTNE PROVISIONS All income or principal held for the use and benefit of the beneficiaries of any trust hereunder _ `/ [Initials] Page 5 of 7 Pages shall not be in any way or manner subject to anticipation, assignment, pledge, sale or transfer, nor shall any such interest, while in the possession of my Trustees, be liable for or subject to the debts, contracts, obligations, liabilities or torts of any beneficiary, or to attachments, executions or sequestrations under process of law. TEEM TEN APPOINTMENT OF EXECUTORS AND TRUSTEES I nominate, constitute and appoint my husband, C. ROBERT TODD, as Executor of my estate. In the event he is unwilling or unable to act in such capacity, then I appoint my sons, CHARLES R. TODD, III and WILLIAM S. TODD, or the survivor, as co-Executors of my estate. I nominate, constitute and appoint my husband, C. ROBERT TODD, and my sons, CHARLES R. TODD, III and WILLIAM S. TODD, or the survivor, as Trustees of any trust created hereunder. TEEM ELEVEN WAIVER OF BOND I direct that neither my Executor nor my Trustees, or their successors, shall be required to file any bond in any jurisdiction to secure the faithful performance of their duties, nor shall they be required to obtain any order or approval of any court for the exercise of any power or discretion set forth in this Will. IN WITNESS WHEREOF I have hereunto set my hand and seal this 7~ day of ~c ~~-~. , 2~y ~ . +~~d`,c~ (SEAL) Ozell .Todd SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who at her request, have hereunto subscribed our. names as witnesses thereto, in the presence of the said Testatrix and of each other. Q Page 6 of 7 Pages COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND . SS. We, Ozella D. Todd, No V. Otto III, and t~ ~! 2 A. ker ,the Testatrix and the witnesses, respectively, whose names aze signe to the foregoing instrument, being first duly sworn, do hereby declaze to the undersigned authority that the Testatrix signed and executed the instrument as her last Will and that the Testatrix has signed willingly, and that the Testatrix executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as a witness and that to the best ofhis/her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. lJ/ , / d~~ Oze D. Todd, Testatrix Witness i •s Subscribed, sworn to and acknowledged before me by Ozella D. Todd, the Testatrix, and subscribed and sworn to before me by No V. Otto III and t7LLC u~l ~./4 ..l7e' ker ,the witnesses, this ~~day of ~'G~dE~ , 2C+Oy L-~ e Notary Public NOTARUIL SEAL VICTORIA 1. OTTO NOTARY PUBLIC CMIY 60MM855R01~ EXPMRE3 DECD2 2006 Page 7 of'7 Pages