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Home My WebLink About04-0604COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD REV-1162 EX(11-96) OO4O93 DELLA-CROCE ROBERT N 25 NORTH 24TH ST CAMP HILL, PA 17011 ........ fold ESTATE INFORMATION: SSN: 176-16-7771 FILE NUMBER: 21 04-0604 DECEDENT NAME: BUTKIEWlCZ JANET S DATE OF PAYMENT: 06/28/2004 POSTMARK DATE: 06/28/2004 COUNTY: CUMBERLAND DATE OF DEATH: 03/31/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $17,530.80 TOTAL AMOUNT PAID: $17,530.80 REMARKS: SEAL CHECK# 3191 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARIMENT OF REVENUE DEPll 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) FILE NUMBER DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAB) 03, --3t- ~.oo,.{ o~, -20- (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) COt~N'rY CO~ YEAR SOCIAL SECURITY NUMBER OG o,-/ NUMBER THIS RETUEN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ~ 8. To~l Number of Safe Deposit Boxes [] 11. Etec'don to tax under Bac. 9113(A) (N~md~ Sch O) FIRM NAME (~) TELEPHONE NUMBER -I. t't. 'l~). 033°,/-lm'l . 1. Real Estate (ScbeduleA) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Coqx~aflon, Pateership or Safe-Pro~sh3rshif) (3) 4. Mmigages & Notes Receivabfe (Schedule D) (4) 5. Cash, Bank Dei~mits & MP~e~lansous Personal Propafly (5) (Schedule E) 6. Joinlly Owned Propar~ (Schedule F) (6) mm Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Prof~y (7) (Schedule O or L) 8. Tetel Gr~s Assets (total Lines 1-7) 9. Funeral Expenses & Admimltatra6~e Costs (Schedule H) (9) 10. Debts of Decedeat, Mortgage Uabllilies, & Liens (Schedufe I) (10) 11. Total DeducD~ (total Lldes 9 & 10) 12. Not Vale ~ Estate (Line 8 minus Line 11) TCOMPLETE MAILING ADDRESS 13. Charitable and Govemmentel Bequests/Sec 9113 Tmste for which an eldcton to tax has no( been made (Schedule J) (6) I%~] O&,~. 7_(. 14. NM Value Subject to Tax (Une 12 minus Line 13) (14) t I G. 5 q 8,. t"z-, .0. (16) .0 (16) .12 (17) x.ls (18) (19) SEE INSTRUCTIONS Off REVERSE SIDE FOR APPUCABLE RATES 15. Amount of Line 14 taxable at the sp~Jsal tax rate, o~ Iransfem under Sec. 9116 (a)(12) > > BE SURE TO AI~WER ALL QUE~'ION~ ON RE~ER~ 8JDIE AN~ RECHECK MATH c < Decedent's Complete Address: Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Pover[y Credit B. Prior Payments C. Discount ISTA Iz'P (~) I"l..'~3~q.. 3 Z Total Credits (A+ B + C) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Inferest/Penalty ( D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYlitlENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (2) tS. (3) ~ (4) ~1~2o A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No~ a. retain the use or incema of the property transferred; .......................................................................................... [] b. retain the right to designate who shall use the property transferred or its income; ............................................ [] ~/ c. retain a reversionary interest; or .......................................................................................................................... [] [~]-~, d. receive the premise for life of either payments, benef~s or care? ...................................................................... [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death / without recek, ing adequate consideration? .............................................................................................................. [] 3. Did decedent own an 'in trust 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, SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE DATE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the cet value of transfers to or for the use of the surviving spouse is 3% [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 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statuto~j 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 chitd twenty-oce 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 0% [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 lireal beneficiahes is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 RS. §9116(a)(1)]. The tax rate imposed on the net value of transfem to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or edoption~ ESTATE OF Janet S. But~ewk:z RLE ~ CD-00~095 IR VALUE AT DATE DESCRIPTION O~ DEATH PNC Bank Account 26.26 TOTAL (A~o er~, m~ [~e 5, Recapilu~a) $ 26.26 REV-1510 EX+ (6-98) COMMONVVEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF RLE NUMBER TI~ sche~Jh~ must ~ c~tad and filed if ~ an~r ~ ~y of ques~s 1 through 4 ~ the reve~ side of the REV-1500 COVER SHE~ is ~. DESCRIPTION OF PROPERTY ITEM ~c~uoe THE NA~4E ~ Tt~E TRANSFEm~ THEIR R~k~ m ~ANO DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBE~ 'n~ [~ o~ ~4s;~. A~o~ A co~' OF ~ ~;~ ~0~ f~=~. EST~T~ VALUE OF ASSET INI~REST ~ ~=~%IC~BL~ VALUE 1. TOTAL (Nso enter on li. TRecapitulation) $ ~ J3'7. (If more space is needed, inert add, tidal sheets of the ~me size) EV-1~11 EX+ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 7.10q - oc. oq Debts of decedent must be reported on Schedule ], iTEM NUMBER DESCRIPTION AMOUNT 5 FUNERAL EXPENSES: ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Represen[ative(s) Social Security Number(s)/EIN Number of Personal Representative(s) StreetAddress 'Z,.~'- ~,~. "~"~ '~"~ Year(s) Commission Paid: ~ State ~Zip I'--~O ~. I Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent Probate Fees Tax Return Preparer's Fees State __Zip '-7'-t- $ q~ TOTAL (Aisc enter on line 9, Recapitulation) $ (If more space is needed, insed additional sheets of the same size) 83/31/2884 13:59 717-257-4726 PATRIOT NEWS PAGE Bi atdot- euJs Now you Know Order Confirmation Ad Order Customer Payor Customer 0001089738 Deiie-Croce Del[a-Croce Sales Customer Aooount Payor Account g~artman 48210 48210 .Order Taker Customer Addres .s. Payor Address ghartman 139 Centre Street, 6t~ Floor 139 Centre Street, 6th Floor New York NY 10013 USA New York NY 10013 USA Order Source Fax Customer Phone Payor Phone 717-763-8599 717-763-8599 PO Number Ordered By. Robert Customer Fax Special Pri¢in~l None Customer EMail Tea_ r Sheets_ proof__._~s Affidavits 0 0 0 Invoice Text .Blind Box Pro._~mo Type <NONE> Ad Order Notes Materials Payment Method it Card - MasterCard:4 Net Amount $92.64 Payment Amount $92.64 Tax Amount $0,00 Amount Due Total Amount $92.64 Ad Number Ad Type Ad Size_ 0001089738-01 Obits Paid : 1.0 X 40 Li production Method Production Notes Ad Booker External Ad Number Ad Attributes Colo~r <NONE> Ad Released No 3/31/2004 1:5§:59PM 1 203 ! Gresen Ridge Street Dunmore, PA 18512 570-343-4048 Henry W. Degraw - Roever Supervisor Strau¢12 F U N E----~-L ~--0-~-~ Fax570-346.6872 602 Birch Street Scranton, PA 18505 570-343-0413 Rich~dJ. Strauch,Jr. Supervisor April 3, 2004 Mr. Robert Della-Croce 25 N. 24th Street Camp Hill, PA 17011 Statement for the Funeral of Janet S. Butkiewicz Charge for Set up of Tent, Greens, Chairs, and Lowering Device at Cemetery $90.00 Please make check payable to the Strauch Funeral Home al 'i-~ 6 · oo Thank You. The contract for lettering the monument will be coming from Pesavento Monuments. They will bill you directly. If you have any questions please give me a call. · Kramer DeGraw-Roever-Strauch Funeral Home 2031 Green Ridge Street, Dunmore, PA 18512 570.343-4048 STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED · Charm ar~ only for thosc.item~ that ypu selected or that are required. If we are required by law or by a cemetery or a crematory to use any items, l[~(ou se ectcd a f~aeral that mag reqmre embalming, such gsa fimeral W~th wewmg, you may bqve [o pay ;o tl~aJrmng. You. do not haye to pay for eml~alrmng y For the Service of: Janet S Butkiewicz Date of Death March 3t, 2004 Charge to: Robert Della-Croce 25 N. 24th Street Camp Hill PA Name CHARGE FOR SERVICES SELECTED: Services of Funeral Director/Staff .......... $ Embalming ........................... $ Other preparation of body Dressing, Cosmetics, Casketing 1175.00 495.00 .................................... $__ 150.00 SUB-TOTAL OF PROFESSIONAL SERVICES ........ A1 $ Address 1820.00 City Other Clothing PackaGe of Mics. Material $ Cremation Urn ..................... $ (Description), TOTAL MERCHANDISE SELECTED ........... B $ Use of facilities and services for Viewing (Visitation/Wake) ................ ~ Use of facilities and services for Funeral Ceremony ..................... $.. Use of facilities and services for Memorial Service ...................... $.. Use of equipment and services for Graveside Service ...................... ~.. Other use of facilities Prep Room, Admn Areas 385.00 SUB-TOTAL OF FACILITIES/EQUIPMENT ............ A2 $ Vehicle to transfer remains from Local ............................... Van to Cemetery Local ............................... Limousine Local ................................ Service Vehicle Local ................................ Flower car or floral disposition Local ................................ Lead car/Clergy Local ............................... Car for pallbearers Local ................................ Out of town transportation ................ 330.00 160.00 75.00 SUB-TOTAL OF AUTOMOTIVE EQUIPMENT ........... A3 $ 385.00 565.00 Forwarding of remains to $ (Funeral Home) Receiving of remains from $ (Funeral Home) Immediate Burial ................... $ Direct Cremation .................. $ $ SUB-TOTAL OF SPECIAL CHARGES .......... C $ D. CASH ADVANCED: Opening Grave .................... $ 675.00 Cemetery Equipment ............... $. Lot and Deed. $ Newspaper Notices - Local $ Newspaper Notices - Out-of-town ...... $ Telephone & Telegrams ............. $ Airfare ........................... $ Clergy/Mass Offedng $ 50.00 Pallbearers ....................... $ Certified Copies of the Death Certlficate.$ 54.00 Police Escort ...................... $ Flowers .... $ Vault Service Charge ............... $. $. $. $ $ $ SUB-TOTAL OF ADVANCES .................. D $ ~spe clf~.arge you for our ~erviqes in obtaining: ecl~y cesn aovance TOTAL OF PROFESSIONAL SERVICES, FACILITIES AND AUTOMOTIVE EQUIPMENT .................................... A B. CHARGES FOR MERCHANDISE Casket .............................. $ (Description) Hancock-18 GA. Metal Outer Receptacle .................... $ (Description) MnnticeHo SUMMARY OF CHARGES: 2770.00 A. Professional Services, Facilities and Equipment and Automotive 2460.00 Equipment ....................... $. B. Merchandise ...................... $ 129'.-0~u O. CashAdvances ................... $. 2770.00 3755.00 779.00 /~TAL OF ALL SELECTIONS ........... $ PAID AT TIME OF OR PRIOR TO ~ State 3755.00 779.00 7304.00 ............................... $__ 150.00 SUB-TOTAL OF PROFESSIONAL SERVICES .... A1 $ 1820.00 $ TOTAL MERCHANDISE SELECTED .......... B $ Forwarding of remains to $ (Funeral Home) Receiving of remains from 3755.00 Use of facillties and services for Viewing (VisitationNVake) ................ Use of facilities and services for Funeral Ceremony ..................... $. Use of facilities and services for Memorial Service ...................... $. Use of equipment and services for Graveside Service .................... ~. · Other use of facilities Prep Room, Admn Areas 385.00 Vehicle to transfer remains from Local ............................... $ Van to Cemetery Local ............................... $ Limousine Local ................................ $ Service Vehicle Local ................................ $ Flower car or floral disposition Locel ................................ $ Lead car/Clergy Local ............................... $ Car for pallbearers Local ............................... $ Out of town transportation ................ $ $ 330.00 160.00 75.00 $ SUB-TOTAL OF AUTOMOTIVE EQUIPMENT ........... A3 $ 385.00 565.00 (Funeral Home) immediate Budal ................... $ Direct Cremation ................ $ $ SUB-TOTAL OF SPECIAL CHARGES .......... C $ D, CASH ADVANCED: Opening Grave .................... $ 675,00 Cemetery Equipment ............... $. Lot and Deed .... $ Newspaper Notices - Local ....... $ Newspaper Notices - Out-of-town ...... $ Telephone & Telegrams $ $ Airfare ........................... Clergy/Mass Offering .. $ 50.00 Pallbearers ....................... $ Certified Copies of the Death Certificate.$ 54,00 Police Escort ...................... $ Flowers .......................... $_ Vault Service Charge ............... $. $. $. $ $ $ $ SUB-TOTAL OF ADVANCES .................. D $ ~/spe cb. arge you for our 8erviqes in obtaining: ecity casn aovance i~ems). 779.00 TOTAL OF PROFESSIONAL SERVICES, FACILITIES AND AUTOMOTIVE SUMMARY OF CHARGES: EQUIPMENT .................................... A $ 2770,00 A. Professional Services, Facilities and Equipment and Automotive B. CHARGES FOR MERCHANDISE Equipment ....................... $. 2770.00 Casket .............................. $ 2460.00 .B. Memhandise ...................... ~ 3758.00 (Description) Hancock-18 GA. Metal /~'-~,--A ,,C. SpecialCharges ................... /~,/]~j~ OJ.t_ ~/~'~'D.'f Cash Advances ................... $ 779.00 Outer Receptacle ..................... $ 1298.00 (Description) M.nric~llo "~'/~. /~ IiC~ ('~' /~TAL OF ALL SELECTIONS ................. $ 7304.00 Outer burial container.. $ I~ '-) ~.~,o/1~ ~~'~ PAID AT TIME OF OR PRIOR TO ~ ~ffl/~ /w ARRANGEMENTS ........................... $ 0.00 (Description). ~ ~l~tO~',o/°~c( BALANCE DUE ............................. $ 7304.00 ~[ REASON'FOR EMBALMING Acknowledgement cards $8 .............. ~ /~ y Register Book(s) $25,50,90 ............... $ Memorial folders ...................... -$. fany law, cemetery or crematory mqu rements have required thc purch~c of Prayercerds $40 ..................... -$. anyo£thcitcms stedabovcthe'laworrcquircmcntiscxplainedUclow* Temporary grave marker ................ -$* Burial clothing ........................ I ree that I have examined the terms of goods and services se ected above and found them to be correct and according to the arrangements I have request~ a.g ........... · ,'-,- o,-,-~n* of Funeral Goods and Services Selected I represent that I have suffic ent funds available for p. aym. e. nt A ate char e of amountinflto per year will be a. pp ed to the unpa dba ance beginning :}0 d Those costsJa~ay-mclot~cettorney's fees, court cosL~ and other costs Any additional services or merchandise ordered or requested after the date of this agraen will be con~der~dA~atl'-of this agrea'~ent and the.cost thereof will be reflected on the final bill or statement. , J J ",~' £ ' ~'"~/(Purch~-~J?T~ --- ~.~.~- .,('date) ~. (Purchaser) /'" ~--7' ,(Ecensed~Funeral Director) t?01, ORRM ST, AMOUNT $ 200.00 TOTAL ~ 200.00 )NUMENTS, INC. :ranmn, PA 18504 athedral Cemetery 'oll Free: 1 (888) 331-7700 342-1548 [emorialist Data April 12, 2004Phone 717-515-3154 Inagraemantwlth Estate of Janet Butkiewicz Robert Della-Croce Street 25 North 24th Street City/Stats/Zip Camp Hill, PA 17011 WORK ORDER LotNo. 158~ BK 24 BUTKIEWICZ ( STEVENS ) - Cleaning -- Repair -- Other: Tablet -- Base -- Marker -- Other: In position #2 of 3 on memorial base to the right of inscription for LEONARD F. inscribe: *Note: 1904 - 2004 If middle initial is desired please furnish and add $8 to lettering total. Thank you. Existing name on memorial: LEONARD F. (SPACE) (SPACE) i 903 I 980 Re~iuested__bv S t r au ~_h__F~_~[O~k~_ A note about cemetery lettering: It is difficult to give a completion date for any cemetery work. it must be dona under ideal weather conditions. Lettering cannot be done in winter or when temperatures are below 60°. We cannot promise .lettering for any specific date. Our portable unit is sent out periodically between June and late Fall. Your order will be completed as soon as possible after receipt of your work order. Terms: Net due upon presentation of statement to be sent upon completion of this work. 11/2% Interest per month will be charged on all past due balances, equal to 18% annual rate. Note: Contract price does not include any cemetery charges or fees. I approve this work and the specified lettering as to the correctness of the spelling, dates IDeposit of one half requested. AMOUNT: $192.00 DEPOSIT: BALANCE: and ,ocatlo.n. on t/~emor2~/~.j~ ,~o~ay t~e sum O'$192- O0 for the above work. ~ (Lot ~or Aut~brized Parson) INS?~O?IONS: PLEASE OHEOK TO BE SUrE THE INSORIPTION IS GO~REOT. SIQN COMMONWEALTH OP PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT EBTATE OF SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER '2..10~ - 0~,o~ Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH TOTAL (Also enter on line 1 O, Recapitulation) $ ~ c.~. ~'(p, (If more space is needed, insert additional sheets of the same size) REV-15~3 EX+ (gq)0), i SCHEDULE J COMMONWE^~H OE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT OECEDENT . ESTATE OF FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec 9116 (a) (1.2)] ENTER DOLLAR AMOUNTS FOR D~STRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ ~, Z~ ~ (If more space is needed, insert additional sheets of the same size) CAMP HILL UMC 417 S 221'4'D ST ' CAMP HILL, PA 17011 MRS JANET BUTKIEWICZ C/O MR ROBERT N DELLA-CROCE 25 N 24TH ST CAMP HILL PA 17011-3601 Page: 1 2nd Qtr 2004 plain Reflects 2004 Gifts 04/01/2004 to 06/30/2004 All Funds Envelope #: 262 Your contributions of time, talent and financial gifts are making a difference in the lives of persons of all ages. We encourage all our members to give in response to God's great gifts to you! Date Fund Description 05/02/2004 Building Fund 05/02/2004 Regular Giving Gift Description Amount Check $1,000.00 $4,000.00 $5,000.00 Fund Description Building Fund Regular Giving Fund Summary Amount Total Pledge Prepayments Pledge Balance $1,000.00 $0.00 $0.00 $0.00 $4,000.00 $0.00 $0.00 $0.00 $5,000.00 $0.00 $0.00 $0.00 Unless otherwise noted, the only goods or services provided are intangible religious benefits. · Merrill Lynch Important Notice JANET S. BUTKIEWICZ TTEE U/A DTD 09/05/1997 BY JANET S. BUTKIEWICZ 4905 E TRINDLE RD # 3103 MECItANICSBURG PA 17050 April27, 2004 Check Notification In accordance with your instructions, we have issued and mailed a check from your account. Details appear below. Please take a moment to review this information. Account Numlier 519- 36227 Check Amount $5,000.00 Issue Date 04/27/04 lssued To DUNMORE UNITED METIIODIST CHURCII If any of this information is incorrect, or if you have questions, please contact your Merrill Lynch Financial Advisor or call (800) MERRILL (637-7455). Hearing-impaired clients, please call (866) 657-3323 (TTY). Your Financial Advisor is: COLUMBIA, MD 10320 Little Patuxent Pkwy. Suite 1000 Columbia, MD 21044 (800) 937-0648 Code: OMCA Check Confirm v10.03 CMSSUCP9903 · Merrill Lynch Important Notice UCPI$010 000000586 JANET S. BUTKIEWICZ TTEE U/A DTD 09/05/1997 BY JANET S. BUTKIEWICZ 4905 E TRINDLE RD # 3103 MECIIANICSBURG PA 17050 April 27, 2004 Check Notification In accordance with your instructions, we have issued and mailed a check from your account. Details appear below. Please take a moment to review this information. Account Number 519-36227 Check Amount $5,000.00 Issue Date 04/27/04 Issued To CAMP tIILL UNITED METHODIST CHURCII If any of this information is incorrect, or if you have questions, please contact your Merrill Lynch Financial Advisor or call (800) MERRILL (637-7455). Heating-impaired clients, please call (866) 657-3323 (TI'Y). Your Financial Advisor is: COLUMBIA, MD 10320 Little Patuxent Pkwy. Suite 1000 Columbia, MD 21044 (800) 937-0648 Code: OMCA Check Confirm vi0.03 CMSSUCP9903 O' tJJ ILl COMMONWEALTH OF PENNSYLVANIA DEPARTMENTOFREVENUE BUREAU OFIND[VIDUAL TAXES DEPT. 28~01 HARRISBURG, PA 17128 O601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV- 1162 EX(11-96) NO. CD 004093 DELLA-CROCE ROBERT N 25 NORTH 24TH ST CAMP HILL, PA 17011 ........ fold ESTATE INFORMATION: SSN: 176-16-7771 FILE NUMBER: 2104- 0604 DECEDENT NAME: BUTKIEWlCZ JANET S DATE OF PAYMENT: 06/28/2004 POSTMARK DATE: 06/28/2004 COUNTY: CUMBERLAND DATE OF DEATH: 03/31/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $17,530.80 TOTAL AMOUNT PAID: 7,530.80 REMARKS: SEAL CHECK# 3191 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS TAXPAYER HI05 905 REV.(01/03) This is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records in accordance with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953. WARNING: It is illegal to duplicate this copy by photostat or photograph. 3131235 No. Charles Hardester State Registrar APR 0 8 ZOO4 Date CERTIFICATE OF DEATH Janet S Butkiewic= I* F~.I= I 176- 16 -- 7771 4March 31 2004 ~ Robert Dell&-Croce 014115- L 6:20 ~ March 31t 2004 ~pn O R AMENDMENT TO TMw. JANET S. BUTKIEWICZ REVOCABLE TRUST THIS AMENDMENT TO TRUST AGREEMENT is executed in triplicate on this 17th day of November, 2000, by and between JANET S. BUTKIEWICZ, now of Country Meadows, Trindle and Sporting Hill Roads, Mechanicsburg, Cumberland County, Pennsylvania (herein called "Settlor',), and JANET S. BUTKIEWICZ, now of Country Meadows, Trindle and Sporting Hill Roads, Mechanicsburg, Cumberland County, Pennsylvania (herein called "Trustee"). WHEREAS, Settlor established "The Janet S. Butkiewicz Revocable Trust,, by trust agreement dated September 5, 1997; and WHEREAS, Settlor now desires to amend said trust agreement as expressly permitted by the terms thereof. NOW THEREFORE, know all men by these presents that: I. Paragraph 4.03 of "The Janet S. Butkiewicz Revocable Trust" dated September 5, 1997, is hereby amended to read as follows: "4.03. Termination and Distribution of Trust.. Upon the Settlor's death, this Trust shall terminate, and the remaining trust estate shall be distributed as follows: A. FIVE THOUSAND AND 00/100 DOLLARS ($5,000.00) shall be distributed to the memorial fund of the DUNMORE UNITED METHODIST CHURCH, South Blakly Street, Dunmore, Pennsylvania; B. FIVE THOUSAND AND 00/100 DOLLARS ($5,000.00) shall be distributed to the CAMP HILL UNITED METHODIST CHURCH, 417 South 22nd Street, Camp Hill, Pennsylvania; and C. The balance of the trust estate shall be distributed to the Settlor's niece, ANN H. DELLA-CROCE, and her husband, ROBERT N. DELLA-CROCE, or to the survivor of them, or if they have both predeceased the Settlor, then to their surviving issue in equal shares, per stirpes; provided, however, that no distribution shall be made to their son, JOHN R. DELLA-CROCE, because such distribution would only be consumed by the cost of his medical care. D. Settlor has intentionally omitted any distributions hereunder to her son, LEONARD F. BUTKIEWICZ, JR. a/k/a LEONARD F. BUCK, or his issue." II. In all other respects, "The Janet S. Butkiewicz Revocable Trust" dated September 5, 1997, is hereby ratified and confirmed. IN WITNESS WHEREOF, the Settlor and Trustee have hereunto set their hands and seals as of the day and year first written above. WITNESS: {L/JANET S. BUTKIEWICZ, SET~eL-OR (SEAL) COMMONWEALTH OF PENNSYLVANIA : : SS: COUNTY OF CUMBERLAND : On this, the /~~ day of ~ , 2000, before me, a Notary Public, the undersigned officer, personally appeared MARK E. HALBRUNER, known to me (or satisfactorily proven) to be a member of the bar of the highest court of said state and a subscribing witness to the within instrument, and certified that he was personally present when JANET S. BUTKIEWICZ and the above witnesses, whose names are subscribed to the within instrument, executed the same and that said persons acknowledged that they executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Notary Public My Commission Expires: Notarial Seal 1 Teri L. Walker, Notary Public Lemoyne Boro, Cumberland County My Commission Expires Jan, 20, 2003 Member, Pennsylvania Association ol Notaries 2 The foregoing Amendment to Trust Agreement was delivered, and is hereby accepted, at Mechanicsburg, Pennsylvania, on November 17, 2000. WITNESS: ET S. BUTKIEWICZ, TRUS~ 3 THE JANET S. BUTKIEWICZ REVOCABLE TRUST THIS TRUST AGREEMENT is executed in triplicate on this 5th day of September, 1997, by and between JANET S. BUTKIEWICZ, now of 109 May Drive, Apartment %1, Camp Hill, Cumberland County, Pennsylvania 17011 (herein called "Settlor"), and JANET S. BUTKIEWICZ, now of 109 May Drive, Apartment #1, Camp Hill, Cumberland County, Pennsylvania 17011 (herein called "Trustee"). ARTICLE I. PARTIES, PERSONAL DATA AND TABLE OF CONTENTS 1.01. Parties and Personal Data. The Settlor is a widow, her husband, LEONARD F. BUTKIEWICZ, having passed away on July 23, 1980. The Settlor's sole child is LEONARD F. BUTKIEWICZ, JR. a/k/a LEONARD F. BUCK. 1.02. Table of Contents. PAGE ARTICLE I. PARTIES, PERSONAL DATA AND TABLE OF CONTENTS 1.01 Parties and Personal Data .................. 1 1.02 Table of Contents .......................... 1 ARTICLE II. TRUST ESTATE 2.01 Transfer to Trust .......................... 2 2.02 Additional Transfers to Trust .............. 2 ARTICLE III. LIFE INSURANCE POLICIES 3.01 Transfers of Life Insurance to Trust ....... 3 3.02 Payment of Premiums ........................ 3 3.03 Rights in the Life Insurance Reserved to Settlor ................................. 4 3.04 Duties of Trustee Regarding the Life Insurance .................................. 4 ARTICLE IV. DISTRIBUTIONS FROM TRUST 4.01 Distributions During Settlor's Life ........ 5 4.02 Settlor's Special Power of Appointment ..... 5 4.03 Termination and Distribution of Trust ...... 5 ARTICLE V. POWERS OF TRUSTEE 5.01 General Powers ............................. 6 ARTICLE VI. SPENDTHRIFT PROVISION 6.01 General Provisions ........................ 10 ARTICLE VII. CONSTRUCTION OF TRUST 7.01 Choice of Law ............................. 10 7.02 Code ...................................... 10 7.03 Other Terms ............................... 10 7.04 Captions and Table of Contents ............ 10 7.05 Situs of Trust ............................ 11 ARTICLE VIII. COMPENSATION OF TRUSTEE AND APPOINTMENT OF SUCCESSOR TRUSTEE 8.01 Compensation .............................. 11 8.02 Removal or Resignation of Trustee ......... 11 8.03 Successor Trustee ......................... 11 ARTICLE IX. PERPETUITIES CLAUSE 9.01 General Provisions ........................ 11 ARTICLE X. REVOCATION AND AMENDMENTS 10.01 Reservation of Powers .................... 12 10.02 Effect of Settlor's Incapacity ........... 12 ARTICLE XI. PAYMENT OF TAXES, FUNERAL EXPENSES AND EXPENSES OF ADMINISTRATION 11.01 Payment of Death Taxes and Other Estate Settlement Costs .................. 13 ARTICLE II. TRUST ESTATE 2.01. Transfer to Trust. Settlor does hereby assign, transfer and deliver to the Trustee and her successors and assigns the property described in Schedule "A" attached hereto and made a part hereof, or as Schedule "A" may be amended. As further evidence of such assignment, the Settlor has executed or will execute or cause to be executed such other instruments as may be required for the purposes of completing the assignment or transfer of title to such property to the Trustee. The Trustee accepts such transfer and assignment to herself as Trustee, and the Trustee undertakes to hold, manage, invest and reinvest the assets of this Trust, and to distribute the income and principal of the Trust, in accordance with the provisions of this Agreement. 2.02. Additional Transfers to Trust. The Settlor, and any other person with the consent of the Trustee, shall have the right at any time to make additions to the corpus of this Trust or any shares thereof hereby established. All such additions shall be held, controlled and distributed by the Trustee in accordance with the terms and conditions of this Agreement. 2 ARTICLE III. LIFE INSUP~=NCE POLICIES 3.01. Transfers of Life Insurance to Trust. If any insurance policies are transferred into this Trust, the Trustee shall be vested with all right, title and interest in and to the transferred policies of insurance, and the Trustee is authorized and empowered to exercise and enjoy, for the purposes of the Trust herein created and as absolute owner of such policies of insurance, all the options, benefits, rights and privileges under such policies, including the right to borrow upon and to pledge them for a loan or loans. The Trustee takes all rights, title and interest in and to such insurance policies subject to any prior split-dollar life insurance agreement which may be in effect at the time of the transfer. The insurance companies which have issued such policies are hereby authorized and directed to recognize the Trustee as absolute owner of such policies of insurance and as fully entitled to all options, rights, privileges and interests under such policies, and any receipts, releases and other instruments executed by the Trustee in connection with such policies shall be binding and conclusive upon the insurance companies and upon all persons interested in this Trust. 3.02. Payment of Premiums. It is the intention of the Settlor to pay any and all premiums, assessments or other charges necessary to keep each policy included in the Trust in force unless such premiums shall be paid by the insured thereunder (where the insured is someone other than the Settlor) or in some other manner, but the Settlor shall be under no duty in this respect and shall incur no liability to the beneficiaries of the Trust or to any other person if the Settlor shall permit any such policy to lapse for nonpayment of premiums, assessments or charges, or otherwise permit any such policy to become uncollectible. The Trustee shall be under no obligation to pay the premiums which may become due and payable under the provisions of any policy of insurance which may be transferred or assigned to this Trust, or to make certain that such premiums are paid by the transferor of such policy, or to notify any persons of the nonpayment of such premiums, and the Trustee shall be under no responsibility or liability of any kind in case such premiums are not paid, except that the Trustee shall apply any dividends received by the Trustee on such policies to the payment of premiums thereon. Upon notice at any time during the continuance of this Trust that the premiums due upon such policies are in default, or that premiums which will become due will not be paid, either by the transferor or by any other person, the Trustee, within her sole discretion, may apply any cash values attributable to such policy 3 to the purchase of paid-up insurance or of extended insurance, or may borrow upon such policy for the payment of premiums due thereon, or may accept the cash values of such policy upon its forfeiture. In the event that the Trustee receives the cash value of such policy upon its forfeiture for nonpayment of premiums, the amount received shall be added to the corpus of this Trust and shall be administered according to the terms of this Agreement. If the insured under such policies of insurance becomes totally and permanently disabled within the meaning of any policies and because thereof the payment of premiums, or any of them, shall be waived during the pendency of such disability, then upon receipt of such knowledge, the Trustee shall promptly notify the insurance company which has issued such policies and shall take any and all steps necessary to make such waiver of premium provision effective. 3.03. Rights in the Life Insurance Reserved to Settlor. The following rights, exercisable without the consent of the Trustee or the beneficiaries of the Trust, are expressly reserved by the Settlor during the Settlor's lifetime with respect to each policy included in the Trust insuring the Settlor's life and owned by the Settlor and made payable to the Trustee hereunder: (1) to exercise all options, elections, rights and privileges accorded to the Settlor under the terms of any such policy, (ii) to obtain all or any part of the loan value of any such policy, (iii) to use any such policy as collateral for a loan, (iv) to sell, assign or pledge any such policy, (v) to receive any dividends, distributive shares of surplus earnings, disability benefits, surrender values or the proceeds of matured endowments, (vi) to change the named beneficiary to whom the proceeds of such policy are payable on the insured's death and (vii) to convert any or all policies into other forms of insurance or annuities or to permit the same to lapse. The Trustee agrees to execute any and all instruments that may be necessary to permit the exercise of any such rights by the Settlor, without liability to anyone for so doing. Upon the maturity of any llfe insurance policy included in the Trust, whether at the insured's death or at any other time, the Trustee shall collect the proceeds thereof. 3.04. Duties of Trustee Regarding the Life Insurance. The Trustee shall be under no obligation or duty whatsoever except with respect to the safekeeping of such policies of insurance and the duty to receive such sums as may be paid to her, in accordance with the requirements of this Trust, by the companies issuing such policies, and to hold, manage and disburse such proceeds subject to the terms of this Agreement. Upon the death of the insured, the Trustee shall make reasonable efforts to carry out the provisions of this Agreement, including the maintenance or defense of any suit; provided, however, the Trustee shall be under no duty to maintain or enter into any litigation unless her expenses, 4 including counsel fees and costs, have been advanced or guaranteed in an amount and in a manner reasonably satisfactory to her. The Trustee may repay any advances made by her or reimburse herself for any such fees and costs from any corpus or income of this Trust. ARTICLE IV. DISTRIBUTIONS FROM TRUST 4.01. Distributions During Settlor's Life. The Trustee shall pay to, or apply for the benefit of, the Settlor: (1) so much of or all of the income and so much of or all of the principal as the Trustee deems desirable for the most comfortable care, support, maintenance, welfare, education, happiness, luxuries and any needs arising from illness, accidents or other emergencies of the Settlor; and (2) so much of or all of the income and so much of or all of the principal as the Settlor shall request. 4.02. Settlor's Special Power of Appointment. The Settlor shall have the power at any time, exercisable by instrument(s) in writing delivered to the Trustee during the Settlor's life specifically referring to this Subparagraph 4.02, to appoint all or any portion of the principal and any accumulated and accrued income of this Trust, except any policies of insurance on the life of the Settlor. Any appointment made under this Subparagraph 4.02 may be upon any terms and conditions (including further trusts) to or for the benefit of any one or more individuals as the Settlor deems advisable. However, no such appointment may be made to the Settlor's estate, the Settlor's creditors or the creditors of the Settlor's estate, nor may any general powers of appointment be created by the exercise of the special power of appointment created herein. 4.03. Termination and Distribution of Trust. Upon the Settlor's death, this Trust shall terminate and the remaining trust estate shall be distributed as follows: A. FIVE THOUSAND AND 00/100 DOLLARS ($5,000.00) or THREE PERCENT (3%) of the remaining trust estate, whichever is less, shall be distributed to the Settlor's daughter-in-law, MARGARET M. BUCK, if she survives the Settlor; B. SIXTY THOUSAND AND 00/100 DOLLARS ($60,000.00) or THIRTY- SIX PERCENT (36%) of the remaining trust estate, whichever is less, shall be distributed to the Settlor's grandson, GREGORY B. BUCK, or if he has predeceased the Settlor, then to his surviving issue in equal shares, per stirpes; C. TWENTY-FIVE THOUSAND AND 00/100 DOLLARS ($25,000.00) or FIFTEEN PERCENT (15%) of the remaining trust estate, whichever is 5 less, shall be distributed to the Settlor's niece, ANN H. DELLA- CROCE, or if she has predeceased the Settlor, then to her surviving issue in equal shares, per stirpes; provided, however, that no distribution shall be made to her son, JO~N R. DELLA-CROCE, because such distribution would only be consumed by the cost of his medical care; D. FIVE THOUSAND AND 00/100 DOLLARS ($5,000.00) or THREE PERCENT (3%) of the remaining trust estate, whichever is less, shall be distributed to the memorial fund of the DUNMORE UNITED METHODIST CHURCH, South Blakly Street, Dunmore, Pennsylvania; E. FIFTEEN THOUSAND AND 00/100 DOLLARS ($15,000.00) or NINE PERCENT (9%) of the remaining trust estate, whichever is less, shall be distributed to the Settlor's nephew, RICHA/%D T. STEVENS, or if he has predeceased the Settlor, then to his surviving issue in equal shares, per stirpes; F. FIFTEEN THOUSAND AND 00/100 DOLLARS ($15,000.00) or NINE PERCENT (9%) of the remaining trust estate, whichever is less, shall be distributed to the Settlor's nephew, JOSEPH P. HATCH, JR., or if he has predeceased the Settlor, then to his surviving issue in equal shares, per stirpes; and G. The balance of the trust estate remaining after satisfaction of the foregoing distributions shall be distributed to the Settlor's niece, ANNE H. DELLA-CR0CE, and her husband, ROBERT N. DELLA-CROCE, or to the survivor of them, or if they have both predeceased the Settlor, then to their surviving issue in equal shares, per stirpes; provided, however, that no distribution shall be made to their son, JOHN R. DELLA-CKOCE, because such distribution would only be consumed by the cost of his medical care. H. Settlor has intentionally omitted any distributions hereunder to her son, LEONARD F. BUTKIEWICZ, JR. a/k/a LEONARD F. BUCK. ARTICLE V. POWERS OF TRUSTEE 5.01. General Powers. In addition to such other powers and duties as may have been granted elsewhere in this Trust or by law, but subject to any limitations contained elsewhere in this Trust, the Trustee shall have the following powers and duties: A. In the management, care and disposition of this Trust, the Trustee shall have the power to do all things and to execute such deeds, instruments or other documents, as may be deemed necessary and proper, including the following powers, all of which may be exercised without order of or report to any court: (1) To sell, exchange or otherwise dispose of any property, real, personal or mixed, at any time held or acquired hereunder, at public or private sale, for cash or on terms, without advertisement, including the right to lease for any term notwithstanding the period of the Trust, and to grant options, including an option for a period beyond the duration of the Trust. (2) TO invest all monies in such stocks, bonds, securities, investment companies or trust shares, mortgages, notes, choses in action, real estate, improvements thereon, and other property as the Trustee may deem best, without regard to any law now or hereafter in force limiting investments of fiduciaries; except that a corporate Trustee may not invest in any stock or securities issued by such corporate Trustee or issued by a parent or affiliate company of such corporate Trustee. (3) To retain for investment any property deposited with the Trustee hereunder; except that a corporate Trustee may not retain for investment any stock or securities issued by such corporate Trustee or issued by a parent or affiliate company of such corporate Trustee. (4) To vote in person or by proxy any corporate stock or other security and to agree to take any other action in regard to any reorganization, merger, consolidation, liquidation, bankruptcy or other procedure or proceedings affecting any stock, bond, note or other security held by this Trust. (5) TO use lawyers, real estate brokers, accountants and other agents if such employment is deemed necessary or desirable, and to pay reasonable compensation for their services. (6) TO compromise, settle or adjust any claim or demand by or against the Trust and to agree to any rescission or modification of any contract or agreement affecting the Trust. (7) TO renew any indebtedness, as well as to borrow money, and to secure the same by mortgaging, pledging or conveying any property of the Trust, including the power to borrow from the Trustee (in the Trustee's individual capacity) at a reasonable rate of interest. 7 (8) TO retain and carry on any business in which the Trust may acquire any interest, to acquire additional interests in any such business, to agree to the liquidation in kind of any corporation in which the Trust may have any interest and to carry on the business thereof, to join with other owners in adopting any form of management for any business or property in which the Trust may have an interest, to become or remain a partner, general or limited, in regard to any such business or property and to hold the stock or other securities as an investment, and to employ agents and confer on them authority to manage and operate the business, property or corporation, without liability for the acts of any such agent or for any loss, liability or indebtedness of such business if the management is selected or retained with reasonable care. (9) TO register any stock, bond or other security in the name of a nominee, without the addition of words indicating that such security is held in a fiduciary capacity, but accurate records shall be maintained showing that the stock, bond or other security is a trust asset, and the Trustee shall be responsible for the acts of the nominee. (10) To merge this Trust with any other trust created in Settlor's will or otherwise, with similar provisions and purposes and the same beneficiary or beneficiaries, but only to the extent that the merger of the trusts will not cause the imposition of gift tax, estate tax or generation-skipping tax, federal or otherwise. B. Whenever the Trustee is directed to distribute any trust principal in fee simple to a person who is then under twenty-one (21) years of age, the Trustee shall be authorized to hold such property in separate trust for such person until he becomes twenty- one (21) years of age, and in the meantime shall use such part of the income and principal of the separate trust as the Trustee may deem necessary to provide for the proper support and education of such person in the standard of living to which he has become accustomed. If such person should die before becoming twenty-one (21) years of age, the property then remaining in separate trust shall be distributed to the personal representative of such person's estate. C. In making distributions from the Trust to or for the benefit of any minor or other person under a legal disability, the Trustee need not require the appointment of a guardian, but shall be authorized to pay or deliver the distribution to the custodian of such person, to pay or deliver the distribution to such person without the intervention of a guardian, to pay or deliver the 8 distribution to the legal guardian of such person if a guardian has already been appointed, or to use the distribution for the benefit of such person. D. In the distribution of the Trust and any division into separate trusts and shares, the Trustee shall be authorized to make the distribution and division in money or in kind or in both, regardless of the basis for income tax purposes of any property distributed or divided in kind, and the distribution and division made and the values established by the Trustee shall be binding and conclusive on all persons taking hereunder. The Trustee may, in making such distribution or division, allot undivided interests in the same property to several trusts or shares. E. If at any time after Settlor's death the total fair market value of the assets of any trust established or to be established hereunder is so small that a corporate trustee's annual fee for administering the trust would be equal to or less than the minimum annual fee set forth in the trustee's regularly published fee schedule then in effect, the Trustee in its discretion shall be authorized to terminate such trust or to decide not to establish such trust, and in such event the property then held in or to be distributed to such trust shall be distributed to the persons who are then or would be entitled to the income of such trust. If the amount of income to be received by such persons is to be determined in the discretion of the Trustee, then the Trustee shall distribute the property among such of the persons to whom the Trustee is authorized to distribute income, and in such proportions, as the Trustee in its discretion shall determine. F. The Trustee shall be authorized to lend or borrow, including the right to lend to or borrow from the Settlor's estate, at an adequate rate of interest and with adequate security and upon such terms and conditions as the Trustee shall deem fair and equitable. G. The Trustee shall be authorized to sell or purchase, at the fair market value as determined by the Trustee, any property including any property to or from Settlor's estate, or any trust created by Settlor during life or by will, even though the same person or corporation may be acting as executor of Settlor's estate or as trustee of any such other trusts and as the Trustee of this Trust. H. The Trustee shall have discretion to determine whether items should be charged or credited to income or principal or allocated between income and principal as the Trustee may deem equitable and fair under all the circumstances, including the power to amortize or fail to amortize any part or all of any premium or 9 discount, to treat any part or all of the profit resulting from the maturity or sale of any asset, whether purchased at a premium or at a discount, as income or principal or apportion the same between income and principal, to apportion the sales price of any asset between income and principal, to treat any dividend or other distribution on any investment as income or principal or to apportion the same between income and principal, to charge any expense against income or principal or apportion the same, and to provide or fail to provide a reasonable reserve against depreciation or obsolescence on any asset subject to depreciation or obsolescence, all as the Trustee may reasonably deem equitable and just under all of the circumstances. I. The Trustee is hereby authorized and empowered to purchase such insurance policies as she deems appropriate. ARTICLE VI. SPENDTHRIFT PROVISION 6.01. General Provisions. No beneficiary shall have the power to anticipate, encumber or transfer his interest in the trust estate in any manner other than by the valid exercise of a Dower of appointment. No part of the trust estate shall be liable for or charged with any debts, contracts, liabilities or torts of a beneficiary or subject to seizure or other process by any creditor of a beneficiary. ARTICLE VII. CONSTRUCTION OF TRUST 7.01. Choice of Law. This Trust shall be administered and interpreted in accordance with the laws of the Commonwealth of Pennsylvania. 7.02. Code. Unless otherwise stated, all references in this Trust Agreement to section and chapter numbers are to those of the Internal Revenue Code of 1986, as amended, or corresponding provisions of any subsequent federal tax laws applicable to this Trust. 7.03. Other Terms. Unless the context otherwise requires, the use of one or more genders in the text includes all other genders, and the use of either the singular or the plural in the text includes both the singular and the plural. 7.04. Captions and Table of Contents. The underlined captions set forth in this Trust Agreement at the beginning of the various divisions hereof and the Table of Contents appearing at the beginning of this Trust Agreement are for convenience of reference 10 only and shall not be deemed to define or limit the provisions hereof or to affect in any way their construction and application. 7.05. Situs of Trust. The Trust shall have its legal situs at Cumberland County, Pennsylvania. ARTICLE VIII. COMPENSATION OF TRUSTEE AND APPOINTMENT OF SUCCESSOR TRUSTEE 8.01. Compensation. The Trustee shall receive as her compensation for the services performed hereunder that sum of money which the Trustee normally and customarily charges for performing similar services during the time in which she performs these services. 8.02. Removal or Resignation of Trustee. Settlor, during Settlor's lifetime, may remove the Trustee at any time or times, with or without cause, upon thirty (30) days written notice given to the Trustee. After Settlor's death, a majority of the current beneficiaries may remove the Trustee at any time or times, with or without cause, upon thirty (30} days written notice given to the Trustee. The Trustee may resign at any time upon thirty (30) days written notice given to the Settlor, or after Settlor's death, upon thirty {30) days written notice given to the current beneficiaries hereunder. Upon removal or resignation of the Trustee, a Successor Trustee shall be appointed in accordance with the terms set forth in Paragraph 8.03, below. 8.03. Successor Trustee. Upon the death, resignation, removal or incapacity of the Trustee, then ROBERT N. DELLA-CROCE is hereby appointed as Successor Trustee. Upon the death, resignation, removal or incapacity of ROBERT N. DELLA-CROCE as Successor Trustee hereunder, then Settlor's niece, ANN H. DELLA- CROCE, is hereby appointed as Successor Trustee hereunder. Upon the death, resignation, removal or incapacity of the above-named Successor Trustees, then additional successor trustee(s) may be appointed by the Settlor during Settlor's lifetime, or after Settlor's death, by a majority of the current beneficiaries hereunder. Any Successor Trustee shall succeed to all the duties and Dowers, including discretionary powers, herein granted to the Trustee. ARTICLE IX. PERPETUITIES CLAUSE 9.01. General Provisions. Notwithstanding anything to the contrary in this Trust Agreement, each disposition Settlor has made herein, legal or equitable, to the extent it can be referred in its 11 postponement of becoming a vested interest to a duration measured by some life or lives in being at the time of Settlor's death is definitely to vest in interest, although not necessarily in possession, not later than twenty-one (21) years after such lives (and any period of gestation involved); or to the extent it cannot be referred in any such postponement to such lives, is to so vest not later than twenty-one (21) years from the time of Settlor's death. ARTICLE X. REVOCATION AND AMENDMENTS 10.01. Reservation of Powers. Settlor expressly reserves the powers to: (i) revoke this Trust Agreement by an instrument in writing delivered to the Trustee while the Settlor is alive, (ii) to alter, amend or modify this Trust Agreement at any time or from time to time by instrument(s) in writing delivered to the Trustee while the Settlor is alive, but no such alteration, amendment or modification shall increase the duties nor change the basis for compensation of the Trustee without the Trustee's written consent, and {iii) withdraw from this Trust any life insurance policy or other property forming a part of this Trust, which property or the proceeds therefrom was added to this Trust by Settlor. Any such withdrawal by the Settlor shall be considered a revocation of this Trust solely with respect to the policy or property withdrawn. 10.02. Effect of Settlor's IncaPacity. A. If Settlor Incapacitated. If at the time of any attempted exercise of (a) powers reserved to the Settlor or (b) any other powers to demand and receive the principal of this Trust, the Settlor is incapacitated (as defined below in subparagraph (C)), through illness, age or other cause, then the Trustee shall disregard any instructions from the Settlor which have the effect of remaking, altering, amending or modifying this Trust Agreement in whole or in part or enabling the Settlor to withdraw from the Trust any life insurance policy or any other property forming a part of this Trust. B. Settlor's Retained General Power of Appointment. Notwithstanding the above provisions, the Settlor shall always have the right to exercise a general power of appointment, by a will specifically referring to the reservation of the general power of appointment in this subparagraph (B), to appoint all of the Trust property to the Settlor's estate, the Settlor's creditors, or the creditors of the Settlor's estate. C. Definition of Incapacity. For purposes of this Trust, the Settlor or Trustee shall be deemed to have become incapacitated 12 upon the happening of either one of the following events: (1) Admission of Incapacity. Delivery, by hand or by mail, to the Trustee then serving, of a written instrument from the Settlor or Trustee declaring that said person no longer considers that she should possess the power (as Settlor) to exercise any of the powers reserved by the Settlor in this Article X or any other powers to demand and receive the principal of this Trust, except the general power of appointment reserved above in subparagraph 10.02(B), above, or the power (as Trustee) to continue to serve as Trustee, o__r (2) Medical Certification of Lack of Capacity. Delivery, by hand or by mail, to the Trustee then serving, of written instruments by two physicians licensed to practice medicine, one of whom must be a board certified psychiatrist and the other of whom must be a board certified internist, that the Settlor or Trustee no longer has the capacity, as a result of illness, age or other cause: (i) in the case of the Settlor, to exercise any powers reserved by the Settlor over the Trust under the terms of this Article X or any other powers to demand and receive the principal of this Trust, except that notwithstanding any other provision to the contrary, the reserved general power of appointment of the Settlor, as set forth in subparagraph 10.02(B), above, shall always be exercisable by the Settlor or (ii) in the case of a Trustee, to continue to serve as a Trustee. (3) Powers Personal to Settlor. The powers reserved by and to the Settlor in this Article X shall be personal to the Settlor and shall not be exercisable by any conservator, committee, guardian or like fiduciary, except a valid power of attorney, nor shall they be assignable to nor extend to the executor or administrator of the Settlor's estate, nor to any beneficiary named herein. Upon the death of the Settlor, this Trust shall be deemed irrevocable. ARTICLE XI. PAYMENT OF TAXES, FUNERAL EXPENSES AND EXPENSES OF ADMINISTRATION 11.01. Payment of Death Taxes and Other Estate Settlement Costs. The Trustee shall ascertain from the legal representative of the Settlor's estate whether the legal representative has sufficient assets to pay the legacy, succession, inheritance, 13 transfer, estate and other death taxes or duties levied or assessed against the Settlor's estate (including all interest and penalties thereon), all of which taxes, interest and penalties are hereinafter referred to as the death taxes, interest and penalties. If the legal representative advises the Trustee that insufficient funds exist to pay all the death taxes, interest and penalties, the Trustee shall then pay to the legal representative from the trust property, an amount equal to all the death taxes, interest and penalties in excess of the funds available to the legal representative for this purpose, which payments are to be made without apportionment. In making the payments, the Trustee shall use only those assets or their proceeds which are includable in the Settlor's gross estate for purposes of the United States estate tax. If the Settlor's legal representative advises the Trustee that there are sufficient funds available to pay the death taxes, interest and penalties, then the Trustee may nonetheless pay to the legal representative from the trust property, all or any portion, as the Trustee in her sole discretion deems advisable and in the best interests of the Settlor's beneficiaries named in this Trust Agreement, of (a) any such death taxes, interest and penalties, whether or not on property held in or payable to the Trust, said payments to be made without apportionment, (b) the Settlor's funeral expenses, (c) claims and other debts of the Settlor, whether allowed against the Settlor's estate or not, (d) expenses of administering the Settlor's estate, and (e) bequests under any will or codicil executed by the Settlor. In making any such payments, other than to satisfy bequests under any will or codicil executed by the Settlor, the Trustee shall use only those assets or their proceeds which are includable in the Settlor's gross estate for purposes of the United States estate tax. [THIS SPACE HAS BEEN INTENTIONALLY LEFT BLANK.] 14 IN WITNESS WHEKEOF, the Settlor and Trustee have hereunto set their hands and seals as of the day and year first written above. WITNESS: ANE? S. BU?X EWZCZ, SE '.OH (SEAL) COMMONWEALTH OF PENNSYLVANIA : : COUNTY OF CUMBERLAND : SS: On this, the 5th day of September, 1997, before me, a Notary Public, the undersigned officer, personally appeared JANET BUTKIEWICZ, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within Trust Agreement, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official Seal. N~Ct a/~r ~ublic ' 5{y Commission Expires: I Notarial Seal 1 Janet C. Naclerio, Notary Public Lemoyne Bore, Cumberland County My Commission Expires April 1S, 1999 Member, Pennsylvania Assodation of Notarbs The foregoing Trust Agreement was delivered, and is hereby accepted, at Lemoyne, Pennsylvania, on September 5, 1997. 15 SCHEDULE "A" SCHEDULE REFERRED TO IN THE ANNEXED TRUST AOKEEMENT DATED SEPTEMBER 5, 1997 FROM JANET S. BUTKIEWICZ, SETTLOR TO JANET S. BUTKIEWICZ, TRUSTEE PROPERTY DESCRIPTION: COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' B~EAU OF INDIVIDUAL TAXES INhERITANCE TAX DIVISION PO BOX Z80601 HARRISBURG PA 171Z8-0601 "'T,r,- i",~OTICE OF INHERITANCE TAX ~ 'APPRAISEMENT, ALLOWANCE OR DISALLOWANCE '~FQEDUCTIONS AND ASSESSMENT OF TAX REY-1547 EX AFP (12-D41 iO iO II: If 7 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-21-2005 BUTKIEWICZ 03-31-2004 21 04-0604 CUMBERLAND 101 JANET S Cl F'r:)k' ......_ 1:\ nnr'\J t.\ 1\;, if"" ROBERT N DELLAr+~~~i~!'l:::' 25 N 24TH ST \j\i CAMP HILL PA 17011 Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ Rl.v :r!l;'f.EX..AFp..r~r:O!".Noi".I.CE.OF.iNHErtiflNCE.i".AX.A.PPRAfsE'rEN'~..ALLowlNcE.bR.............. ... DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BUTKIEWICZ JANET S FILE NO. 21 04-0604 ACN 101 DATE 03-21-2005 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 92.12 .00 137.039.00 (8) NOTE: To insure proper credit to your account, sub.it the upper portion of this forll with your tax paYllB"t. 137,131.12 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) UO) 7,673.00 60.00 (11) (2) (13) (4) 7.733 00 129,398.12 12,500.00 116,898.12 NOTE: I~ an assessment was issued previously, lines 14, IS and/or 1&, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due .00 X 00 = .00 .00 X 045 = .00 .00 X 12 = .00 116,898.12 X 15 = 17 ,534 . 72 (9)= 17,534.72 ~ TAX CRE TS: I'A' ..~-~_. l+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-28-2004 CD004093 876.74 17,530.80 TOTAL TAX CREDIT 18,407.54 BALANCE OF TAX DUE 872.82CR INTEREST AND PEN. .00 TOTAL DUE 872.82CR . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) REV,1470 EX (6-88) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box. 280601 HARRISBURG PA 17128-0601 DECEDENTS NAME REVIEWED BY SCHEDULE ITEM NO. 2,3 Janet S. Butkiewicz Harry Herr INHERITANCE TAX EXPLANATION OF CHANGES EXPLANATION OF CHANGES Deleted from schedule I and added to schedule E. ROW FILE NUMBER ACN 2104-0604 101 Page 1 BUREAU OF INDIVIDllAI.;ymS ::-~; (-, ,:E INtERITANCE TAX DIVISION - "" PO BOX 280601 '.\" HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REY-16D7 EX AFP (03-05 20D5/'11rf /6 Pi! 2: 45 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 04-25-2005 BUTKIEWICZ 03-31-2004 21 04-0604 CUMBERLAND 101 AoIount R..Ht.d JANET S C' EC': or L no, I ORDWnl'r, c'r llf"'- I i I tf-\J" U Jl. L.d1! ROBERT NCIll[Ljf'ltRQi:~ 0_ Pi\ 25 N 24TH ST CAMP HILL PA 17011 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper crBdi CUT ALONG THIS LINE _~ ............................... REV-1607 EX AFP (03-05) to your account, subnit the upper portion of this for. "ith your tax payment. RETAIN LOWER PORTION FOR YOUR RECORDS ~ ............................................................................... ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF BUTKIEWICZ ANET S FILE NO.21 04-0604 ACN 101 DATE 04-25-2005 THIS STATEHEIfT IS PROVIDED TO AD lSE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAKED ESTATE. SltOlIN BELOW IS A SUHHARY OF THE PRINCIPAL TA DUE, APPLICATION OF ALL PAYHEIfTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED IIfTEREST FIGURE. DATE OF LAST ASSESSMENT 01 RECORD ADJUSTMENT, 03-21-2005 PRINCIPAL TAX DUE, 17,534.72 PAYMENTS (TAX CREDITS): PAYMENT DATE 06-28-2004 04-04-2005 RECEIPT NUMBER CD00409 REFUND DISCOUNT (+) INTEREST/PEN PAID (-) 876.74 .00 AMOUNT PAID 17,530.80 872.82- ~ TOTAL TAX CREDIT BALANCE OF TAX DUE . IF PAID AFTER THIS DATE, SI~ REVERSE SIDE FDR CALCULATION OF ADIIzTIONAL IIfTEREST. I IF TOTAL DUE IS LESS THAN (1, NO PAYHEIfT IS REQUIRED. IF TOTAL DUE IS REFLECTED ,S A "CREDIT" ICRJ, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORK FOR INSTRUCTIONS. ) TOTAL DUE 17 , 534 . 72 .00 .00 .00 INTEREST AND PEN.