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Home My WebLink About10-01-10 (4) 505610149 REV-1500 Ex (o1-10) OFFICIAL USE ONLY pe~ngy(Vanta County Code Year File Number ocvr.*rncm or rrtrr+wc PADepartmentofRevenue INHERITANCE TAX RETURN 21 1D 0942 Bureau oflndividualTaxes PO BOX 280801 Harrisburg, PA 17128-0901 RESIDENT DECEDEN ENTER DECEDENT INFORMATION BELOW MMDDWW Date of Birth MMDDYYYY Date of Death Social Security Number D 6 D 4 19 3 9 145 30 8372 D1 03 2010 MI Suffix Decedents First Name Decedent's Last Name Petko Mr• David W (If Applicable) Enter Surviving Spouse's Information Below MI Suffix Spouse's First Name Spouse's Last Name Catharine B Petko ATE WITH THE Spouse's Social Security Number THIS RETURN REG STER OF WILLS FILL IN APPROPRIATE OVALS BELOW C] 3. Remainder Return (date of death Original Return ~ 1 lemental Return Q 2. Supp prior to 12-13-82) . terest Compromise (date of O 5. Federal Estate Tax Return Required I Q 4. Limited Estate n Q 4a. Future death after 12-12-82) Total Number of Safe Deposit Boxes S ~ 6. Decedent Died Testate (Attach Copy of Will) . Q 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 11. Election to tax under Sec. 9113(A) ath ~ f d Q 9. Litigation Proceeds Received e O 10. Spousal Poverty Credit (date o (Attach Sch. O) between 12-31-91 and 1-1-95) Directed to: t be completed. All Correspondence and Confidential T D ~fm T~ b CORRESPONDENT -This section mus e phone Num Name 717 612 5 8 01 Elyse E • Rogers Esquire ,.,, T F WILLS USE-ONLY REGIS -'O c~ G7 _[~r r_~y~ t Frst line of address? ~ fJ, ~ Keefer Wood Allen & Rahal~ LLP =:~~;~-~ -v ~ ~) ~c-I ~ ~~= Second line of address ~ - :- 635 North 12th Street, Suite 4DD ~P,TEFILED W State ZIP Code ~-'' City or Post Office pA 17043 Lemoyne - -,-~ ~ ~~ _~ ~~ - i _., _...-I - ~z 3 Correspondent's a-mail address: er0 ers keeferwood.com Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correctand complete. Declaration of the preparer otherthan personal representative is based on all information of which preparer h DATE knowledge. SIGN ~ RSON RE~PONSI FOR ~ ETURN ~/j_r ~~ Mechanicsbur , PA 1 ~u 4 j~ ~.~~T~iacnFPREPARERO THAN REPRESENTATIVE 35 North 1 h~5-t eet, awtt; ~+~~ PA 17043 PLEAS FORM ONLY 1505610149 Side 1 150561D149 J 1505610249 Rev-1500 IX Decedent's Social Security Number 145 30 8372 Decedent's Name: David W • Petko Mr. RECAPITULATION 14 2 ,15 0 •0 0 ~••••••~•.••. 1. 1. Real estate (Schedule A) ••••••••••""""~'~~•••••• 298,581.97 2. 2. Stocks and Bonds (Schedule B) • • • • • • • • • ' ' ' ' ' ' ' ' ' ' ' ' ~ • • ~ ~ - ~ ~ 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) • • • • • • 3. 0 • 00 4. Mortgages and Notes Receivable (Schedule D) • • • • • • • • • ' ' ' ' ' ' ' ' • ~ ~ • • ~ ~ ~ 4. 27,132.05 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) • • • • • • • s. 0 • O 0 D Separate Billing Requested • • • • • • Jointly Owned Property (Schedule ~ 6 6• 7 8 2 , 8 8 8.2 2 . 7. Inter-Vivos Transfers & Miscellaneous NoO Separate Bilfng Requested • • • • • • ~• (Schedule G) 1, 2 5 0, 7 5 2. 2 4 ............ S. Total Gross Assets (total Lines 1 through 7)• • • • • • • • • • ' ' ' ' ' ' s. ~ - ~ ~ ............ 9. Funeral Expenses and Administrative Costs (Schedule H) • • • • • • 9. 0 • 00 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) • • • • • • • • • • • ' ' 10. 0.00 11. 7otalDeductlons(totalLines9and10) ••••••••••""""""•••••~~ 11. ]„250,752.24 . .............. 12. Net Value of Estate (Line 8 minus Line 11) • • • • • • • • • • ' ' ' ' ts/Sec 9113 Trusts for which . 12. 4 6 7 , 8 6 4 -0 2 13. Charitable and Governmental Beques an election to tax has not been made (Schedule J) • • • • • • • • • • • 13 7 8 2 , 8 8 8 •2 2 ............... 14. Net Value Subject to Tau (Line 12 minus Line 13) 14 . T/U( COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. s11 s 7 8 2, 8 8 8.2 2 1 s. ~ , ~ 0 (a)(1.2) x .o 0 0.0 0 16. Amount of Line 14 taxable 0 • 0 0 16. at lineal rate X .045 ~ • 0 0 17. Amount of Line 14 taxable 0 • 0 0 17. at sibling rate X .12 ~ • ~ ~ 1 S. Amount of Line 14 taxable 0 • ~ 0 1 S. at collateral rate X .1 s 0.0 0 ........... 1 s. 19. TAX DUE ................................. f~ 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 1505610249 Slde 2 1505610249 ....~ Fle Number Rev-1500 EX Page 3 21 10 0942 Decedent's Complete Address: DECEDENTS NAME David W . Petko Mr. STREET ADDRESS 458 Woodcrest Drive STATE ZI P ~,,,, PA 17050 Tax Payments and Credits: (1) 0.00 1. Tax Due (Page 2 Line 19) 2. Credits/Payments 0.00 A. Prior Payments 0.00 0.00 B. Discount Total Credits (A + B) (2) (3) 0.00 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Fill in oval on Page 2, Line 20 to request a refund. (5) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. 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: Q a. retain the use or income of the property transferred; • • • • • • • • • • • • ' ' ' ' b. retain the right to designate who shall use the property transferred or its income; Q 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" orpayable-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. For dates of death on or after July 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. Sect. 9116(a)(1.1)(i)]. For dates of death on or after Jan. 1, 19ue does not exempt a dransfeh to a su Uving spouse from taxi and the statutoryrrequirementsfnr disc osure [72 P.S. Sect. 9116(a)(1.1)(ii)]. The sta 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 21 years of age or younger at death to or for the use of a natur pare , an adoptive parent, or a stepparent of the child is 0 peroeM [72 P.S. Sect. 9116(ax1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. Sect. 9116(1.2) [72 P.S. Sect. 9116(a)(1)]. • The tax rate imposed on the net ~ an nd vidual who has at east onetparent n commonl'rwith the decedent7whethesbytb nod or)ado)ptionsibling is defined, under Section 9102, REV -1502 EX+(01-10) ennsylvania SCHEDULE A pPAaT~~N, aF R~v~ti~~ REAL ESTATE INH ERITANCE TAX RETU RN .,~~incn~TnFCEDENT E OF• FILE NUMBER: 21 10 0942 ESTAT David W . Petko Mr. All real property owned solely or as a tenant in common must be reported atfair marketvalue. Fair marketvalue is defined as the price at which property wou e tween a willing buyer and a willing seller, neither being compelled to buy orsell, both having reasonable knowledge of the relevantfacts. exchanged be Real property that isjointly-owned with rightof survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. Include a copy of the deed showing decedent's interest if owned as tenant in common. VALOF DEATH E j~M DESCRIPTION 142,150.00 NUMBER 1 458 Woodcrest Drive, Mechanicsburg, PA joint with Decedent's surviving spouse, Catharine B. Petko Total value $284,300 Decedent's surviving spouse disclaimed her survivorship interest in this asset TOTAL (Also enter on Line 1, Recapitulation.) 142,150.00 If more space is needed, insert additional sheets of the same size. REV - ~ 503 EX+ (8-98) COMMN ERTANCETAXRETURNANIA __._ ~.~r .~crcnG~.1T SCHEDULE B STOCKS & BONDS ESTATE OF David W . Petko Mr. All with right of FILE NUMBER 21 10 0942 must be disclosed on Schedule F. ITEM Df=SC,rn r i w~~ JMBER 1 96.6765 shares of Procter & Gamble owned jointly with Decedent s surviving spouse, Catharine B. Petko Per Estate Val 193.353 total shares Decedent's surviving spouse disclaimed her survivorship interest in this asset 2 200.5 Prudential Financial, Inc. owned jointly with Decedent's surviving spouse, Catharine B. Petko Per Estate Val 401 total shares Decedent's surviving spouse disclaimed her survivorship interest in this asset 3 1,419.404 shares of Evergreen Select Fixed Income Select Intl I owned jointly with Decedent's surivivng spouse, Catharine B. Petko Total shares 2,838.808 Decedent's surviving spouse disclaimed her survivorship interest in this asset 4 1,614.799 shares of IN oM a Catharinle 6BE Petko ned jointly with Decedent's surviving sp 3,229.598 total shares Decedent's surviving spouse disclaimed her survivorship interest in this asset Dividend on above stock declared prior to decedent's death 5 1,521.3945 shares of Pimco Fds PAC Invt Mgmt Ser Comm Realstr I owned jointly with Decedent's surviving spouse, Catharine B. Petko 3,042.789 total shares Decedent's surviving spouse disclaimed her survivorship interest in this asset 6 1,732.355 shares of Rowe T Price Real Estate Fd owned jointly with Decedent's surviving spouse, Catharine B. Petko 3,464.71 total shares Decedent's surviving spouse disclaimed her survivorship interest in this asset 7 12,591.249 shares of Evergreen PA Mun Bd CI I 25,182.498 total shares owned jointly with Decedent's surviving spouse, Catharine B. Petko Total from continuation Schedule(s) TOTAL (Also enter on line 2, Recapitulation) VALUE AT UA I t 5,897.99 10,166.35 16,010.88 13,192.91 842.60 12,597.15 23,958.47 136,237.31 79,678.31 298,581.97 (If more space is needed, insert additional sheets of the same size) Page 2 21 10 0942 Estate of: David W. Petko Mr. Schedule B -Stocks and Bonds Value at Date of Death Item Descri tion Nu_~- rviving spouse disclaimed her survivorship interest in this ' s su 7 Decedent asset 45.10 Dividend on above stock declared prior to decedent's death d R owned jointly with re h u f 32,022.30 a 8 2,130.559 s ouse Cathar ne B Petko s v o Decedent's surv g P 4,261.118 total shares Decedent's surviving spouse disclaimed her survivorship interest in this asset Stk Fd owned jointly with Decedent's 13,036.73 g 135.6015 shares of Dodge & Cox surviving spouse, Catharine B. Petko 271.202909 total shares rviving spouse disclaimed her survivorship interest in this ' s su Decedent asset h I owned jointly with 3,123.99 10 70.029 shares oi Dre su t Cat aO a BPPe ko r ouse Decedent's su 9 P 140.058 total shares rviving spouse disclaimed her survivorship interest in this ' s su Decedent asset 13,366.80 11 514.3055 shares of Evergreen Tr Strateg Grw I Catharine B. Petko spouse ivin ' , g s surv owned jointly with Decedent 1,028.611 total shares dent's surviving spouse, Catharine B. Petko, disclaimed her Dece survivorship interest in this asset f Harbor Fd S Cap Val Inst owned jointly with Decedent's 3,209.92 12 196.4455 shares o surviving spouse, Catharine B. Petko 392.891012 total shares rviving spouse disclaimed her survivorship interest in this ' s su Decedent asset res of Evergreen Intl Tr Intl Eqty CI I owned jointly with h 14,873.47 a 13 2,152.4565 s Decedent's surviving spouse, Catharine B. Petko 4,304.913 total shares iving spouse disclaimed her survivorship interest in this ' s surv Decedent asset 79,678.31 TOTAL. (Carry forward to main schedule) ..... . REV-1508 EX+(8-98) COM NONE ETANCETAXRETUYRNANIA o~cincNTnECEDENT ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER ~ ~ ~ n n942 David W . Petko Mr. Include the o nUy ownedlwltth right of survivorship must be disclosed on Schedule F. All property j VALUE AT DATE OF DEATH ITEM DESCRIPTION 16,456.08 JMBER 1 Sovereign Bank Money Market Account 1714106578 joint with Decedent s surviving spouse, Catharine B. Petko Per statement Total balance $32,914 ($32,912.16 + $1.84 accrued interest) Decedent's surviving spouse, Catharine B. Petko disclaimed her survivorship interest in this asset 0.92 Interest on above item accrued as of decedent's death 10,675.05 2 Wachovia Bank Account 1525899811 joint with Decedent's surviving Spouse, Catharine B. Petko Total value $21,350.10 Decedent's surviving spouse disclaimed her survivorship interest in this asset 27,132.05 TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) REV-1510 EX+(08-09) Pennsylvania Of.PARTA1ENi OF REVENUE INH ERITANCE TAX RETURN SCHEDULE G INTER VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY RESIDENTDECEDENT FILE NUMBER ESTATE OF 21 10 0942 David W. Petko Mr. This schedule must be completed and filed if the answerto any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECD'S EXCLUSION ITEM INCLUDE NAME OFTRANSFEREE,RELATIONSHIPTODECEDENT& NUM DATE OFTRANSFER. ATTACH COPYOF DEED FOR REAL ESTATE VALUE OF ASSET INTEREST (IF APPLICABLE 282,849.00 100 1 AXA Equitable IRA Account 304692009 Beneficiary: Decedent's surviving spouse, Catharine B. Petko Per 02/10/2010 letter 500,039.22 100 2 Wachovia Bank IRA Account 1540040836 Beneficiary: Decedent's surviving spouse, Catharine B. Petko Per Estate Val from Wachovia Trust TOTAL (Also enter on Line 7, Recapitulation) If more space is needed, use additional sheets of paper of the same size. TAXABLE 282,849.00 500,039.22 782,888.22 REV -1513 EX+(01-10) pennsylva>7ia SCHEDULE J 4FPARiMHNT OF R[Y£NUE INHERITANCETAX RETURN BENEFICIARIES RESIDENTDECEDENT ESTATE OF: David W . Petko Mr. NUMBE NAME AND ADDRESS OF PERSONS RECEIVING PROPERTY z TAXABLE DISTRIBUTIONStransfers undertSecU9ii6(a)(b2).jns, and Catharine B. Petko 458 Woodcrest Drive Mechanicsburg, PA 17050 FILE NUMBER: 21 10 0942 RELATIONSHIP TO DECEDENT AMOOF ESTATEHARE DO NOL LIST T FiiS"'~~~ ng spouse 782,888.22 I ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES I5THROUGH180FREV-1500 COVERSHEET,ASAPPROPRIAT . zz NON-TAXABLE DISTRIBUTIONS: I A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 467,864.02 1 Petko Disclaimer Trust c/o Catharine B. Petko, Trustee 458 Woodcrest Drive Mechanicsburg, PA 17050-6810 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 467,864.02 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. If more space is needed, use additional sheets of paper of the same size. IN THE COURT O LINTY, POENN YLVANIA CUMBERLAND CO ORPHANS' COURT DIVISION IN RE: ; NO. ESTATE OF DAVID W. PETKO, . DECEASED DISCLAIMER The undersigned, CATHARINE B. PETKO, being the surviving spouse of DAVID W. PETKO, intending to be legally bound, makes the following disclaimer: Disclaimant hereby disclaims the right tf trustVas prov dedin ITEM V estate of DAVID W. PETKOent dated August 6c2009 of his Last Will and Testa This Disclaimer is irrevocable and unqualified. Disclaimant ursuant to the provisions of ITEM V of understands that the property will pass, p Decedent's Will, to the Petko Disclaimer Trust. IN WITNESS WHEREOF, the undersigned has set her hand and seal ~,~ , 2010. this c11 ~daY of ~~ ~..~-. ATHARINE B. PETKO Wi~ ness COMMONWEALTH OF PENNSYLVANIA COUNTY OF 1..~ ._.,;~,~ SS On this, the~~ay ofd-~-fl , 2010, before me, a Notary Public, the undersigned officer, personally appeared CATHARINE B. PETKO, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and notarial seal. Notary Public My Commission Expires: (SEAL) COt'9Y10hlVdcAL7H QF PE.P~p,jSYLVAfU.A s NGTAP.IAL SEAL CYNTHIA J. f~ULE, Notary Pub4ic Lemoyne 9oro., Cu-nberlanb County My Commission Expires February 3, 2012 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: ESTATE OF DAVID W. PETKO, NO. DECEASED DISCLAIMER The undersigned, CATHARINE B. PETKO, being the surviving spouse of DAVID W. PETKO, intending to be legally bound, makes the following disclaimer: Disclaimant hereby disclaims all right, title and interest she may have in her survivorship interest in the following assets: Wachovia Bank Agency Account #1525899811 Sovereign Bank Premier Money Market Savings Account #1714106578 401 shares Prudential Financial Inc. 193.353 shares Procter & Gamble Real Estate located at 458 Woodcrest Drive, Mechanicsburg (Hampden Township), Pennsylvania It is Disclaimant's intention, by this Disclaimer, to disclaim fifty percent (50%) of the entire value of the property identified in this Disclaimer, retaining unto herself the fifty percent (50%) interest which she already owned at the time of the death of DAVID W. PETKO. All of the foregoing property was owned by David W. Petko and Disclaimant as tenants by the entireties. This Disclaimer is irrevocable and unqualified. ~ IN WITNESS WHEREOF, the undersigned has set her hand and seal this ~~, day of s~~~~~ , 2010. i v ~ ~ ~ - ~. Witness CATHARINE B. PETKO COMMONWEALTH OF PENNSYLVANIA n SS COUNTY OF (~ On this, the ~ `~- day of ~~~=~.. , 2010, before me, a Notary Public, the undersigned officer, personally appeared CATHARINE B. PETKO, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and notarial seal. .~ Notary Public My Commission Expires: (SEAL) C:OMMONVVEALTH OF PENNSYLVANIA NOTARIAL SEAL CYNTHIA J. RULE, Notary Public Lemoyne Boro., Cu~lberlantl County My Commission Expires Februar,~ 3, 2012 OF DAVID W. PETKO I, DAVID VV. PETKO, of Hampden Township, Cumberland County, Pennsylvania, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils by me heretofore made. ITEM I: Family Information. I am married to CATHARINE B. PETKO, and all references to my wife in this Will are to her. I have three children: STEPHEN J. PETKO, GLENN T. PETKO and CRAIG E. PETKO. These are described in this Will as "my children," or as "a child of mine." Any person born to or adopted by issue of mine is to be included as issue of mine. Provided, however, no adopted person shall benefit under this Will unless the order or decree of adoption is entered before the adopted person attains the age of twenty- one (21) years. ITEM II: Death Taxes. I direct that all inheritance and estate taxes becoming due by reason of my death, whether payable by my estate or by any recipient of any property, shall be paid by the Executor out of the residue of my estate, as an expense and cost of administration of my estate, except that no taxes shall be charged against any gift qualifying for the marital or charitable deduction in my estate. The Executor shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this V~rill. ITEM III: Debts and Final Expenses. I direct the Executor to pay the expenses of my last illness, my legally enforceable debts, and my funeral expenses from the residue of my estate as an expense and cost of administration of my estate. Page 1 ~ ~G~ ITEM IV: Tangible Personal Propertv. (a) If V~~ife Survives. If I die before my wife, CATHARINE B. PETKO, I give to her all my tangible personal property, including but not limited to, all of my household furniture and furnishings, books, pictures, jewelry, silverware, automobiles, wearing apparel and all other articles of household or personal use or adornment and all policies of insurance thereon. (b) Written List. If I survive my wife, CATHARINE B. PETKO, I may leave a written list in my safe deposit box or elsewhere disposing of certain items of my tangible personal property. The Executor shall dispose of items of my personal property as specified in the written list. If no written list is found in my safe deposit box or elsewhere and properly identified by the Executor within thirty (30) days after the probate of my Will, it shall be presumed that there is no other statement or list. Any subsequently discovered list shall be ignored. (c) If Wife Predeceases. If I survive my wife, CATHARINE B. PETKO, I give any property of the type described in paragraph (a) and not set forth in a written list to my children, to be divided among them as they shall agree. Should there be no agreement, this property shall be divided between my children by the Executor in as nearly equal portions as is deemed practical ir_ the discretion of the Executor, having due regaz•d to their personal preferences. ITEM V: Residue. I give the residue of my estate, not disposed of in the preceding portions of this Will, to my wife, CATHARINE B. PETKO, if she survives me. If my wife disclaims any property- or interest in property to which she would be entitled under the provisions of this Item, the disclaimed property shall be held by my wife, CATHARINE B. PETKO, as Trustee, IN TRUST, and shall be administered and distributed as provided in ITEM VI. If Page 2 ~~~ my wife does not survive me, the residue shall be distributed as provided in ITEM VI . ITEM VI: Disclaimer Trust. The follov~Ting provisions shall. apply to any property payable to the Trustee named in ITEM V as a result of the disclaimer of that property by my wife: (a) Income to Spouse. The Trustee shall pay to or for the benefit of my wife, CATHARINE B. PETKO, all of the net income of this Trust in convenient installments, but not less frequently than annually. (b) Principal to Spouse. The Trustee shall pay to my wife so much of the principal of this Trust as may be necessary in the discretion of the Trustee for the reasonable support, maintenance and health care of my wife. (c) Upon Death of Spouse. Upon the death of my wife, the Trustee shall divide the principal into as many equal parts as there are then living children of mine and then deceased children of mine represented by then living issue. The Trustee shall distribute one {1) share to each living child and one (1) share to the then living issue of each deceased child, per stirpes. However, if any issue of a deceased child has not attained the age of twenty-five (25) years at the time of distribution, the share of the beneficiary who has not attained that age shall be held by the Trustee, IN TRUST, for his or her benefit in accordance with paragraph (d) of this Item. (d) Trust for Issue. In each Trust established for a beneficiary under the age of tv~~enty-five (25) years (each the "Beneficiary" of his or her Trust): (i) The Trustee shall pay to the Beneficiary in convenient, at least annual, installments so much of the ~"~ Page 3 net income as the Trustee, in the discretion of the Trustee, considers necessary for the reasonable support, maintenance, health care and education, including college or other post-secondary education, of the Beneficiary. Income not distributed shall be accumulated and added to principal. (ii) The Trustee shall also pay to the Beneficiary so much of the principal as the Trustee, in the discretion of the Trustee, considers necessary for the reasonable support, maintenance, health care and education, including college or other post-secondary education, of the Beneficiary. (iii) Upon the attainment of the age of twenty- five (25) years by the Beneficiary, the Trust shall terminate and the Trustee shall distribute to the Beneficiary the remaining assets of the Trust. (iv) Should the Beneficiary die before final distribution of the assets of his or her Trust, the Trust shall terminate and the Trustee shall pay the assets of the Trust to the then living issue of the Beneficiary, per stirpes. However, if any issue has not attained the age of twenty-five (25) years at the time of distribution, the Trustee shall continue to hold the share for that issue as Custodian under the Pennsylvania Uniform Transfers to Minors Act for the benefit of that issue. (e) Trust Without Beneficiaries. If before final distribution of the assets of any Trust established for my issue, there is no living beneficiary of that Trust, it shall terminate. The assets of the Trust shall be paid to the then living issue, on a per stirpital basis, of the nearest deceased ancestor (with issue living at the time of distribution) Page 4 °~'~ ~v of the Beneficiary who is me or' my issue. However, if there is then in existence any trust created under this Will for the benefit of that issue, the share which would have been distributed to that issue shall be added to the principal of his or hex trust, to be administered and distributed as provided in this Fill. (f) Failure of Issue. In the event I am not survived by my wife or any issue, or if there are no issue of mine surviving upon the termination of any trust, the residue (or principal) shall be divided in two (2) equal parts. One (1) part shall be paid to those persons who would then be entitled to my estate under the intestate laws of Pennsylvania then in effect as if I had then died intestate. One (1) part shall be paid to those persons who would then be entitled to my wife's estate under the intestate laws of Pennsylvania then in effect as if my wife had died at that time intestate owning that part of my estate. ITEM VII: Spendthrift Clause. No part of the income or principal of any Trust created by this Will shall be subject to attachment, levy or seizure by any creditor, spouse, assignee or trustee or receiver in bankruptcy of any beneficiary prior to his or her actual receipt of income or principal distributed. The Trustee shall pay the net income and the principal to the beneficiaries specified by me, as their interests may appear, without regard to any attempted anticipation, pledging or assignment, and without regard to any claim or attempted levy, attachment, seizure or other process against the beneficiary. ITEM VIII: Administrative Powers. in addition to the powers granted at law, the Executor and the Trustee shall each possess the following powers, each of which shall be construed broadly and may be exercised without court approval, but in a fiduciary capacity only: (a) Retain Investments. To retain any investments I have at my death, including specifically those consisting of stock of any bank even if I have named that bank as the Executor or Trustee. Page 5 ~ ~~ (b) Vary Investments. To vary investments, to make loans, and to invest in bonds, stocks, notes, real estate mortgages or other securities or in other property, real or personal, without being restricted to so-called "legal investments", and without being limited by any statute ox' rule of law regarding investments by fiduciaries. (c) Division of Assets. In order to divide the principal of a Trust or for any other purpose, including final distributions, the Executor and Trustee are authorized to divide and distribute personal property and real property, partly or wholly in kind, and to allocate specific assets among beneficiaries and Trusts so long as the total market value of each share is not affected by the division, distribution or allocation in kind. The Executor and Trustee are each authorized to make, join in and consummate partitions of lands, voluntarily or involuntarily, including giving of mutual deeds, or other obligations, with as wide powers as an individual owner in fee simple. (d) Sell Assets. To sell either at public or private sale real and personal property severally or in conjunction with other persons, and to consummate sale(s) by deed(s) or other instrument(s) to the purchaser(s), conveying a fee simple title. No purchaser shall be obligated to see to the application of the purchase money or to make inquiry into the validity of any sale(s). The Executor and Trustee are authorized to execute, acknowledge and deliver deeds, assignments, options or other writings as necessary or convenient to any of the power conferred upon the Executor and Trustee. (e) Encumber Real Estate. To mortgage real estate, and to make leases of real estate. (f) Borrow Money. To borrow money from any person, including the Executor or Trustee, to pay indebtedness of mine or of my estate, expenses of administration or inheritance, legacy, estate Page 6 ~ ~~~ and other taxes, and to assign and pledge assets of my estate or any Trust established by this Will. (g) Pay Costs. To pay all costs, taxes, expenses and charges in connection with the administration of my estate or any Trust established under this Will. (h) Distributions without Court Order. To make distributions of income and of principal to the proper beneficiaries, during the administration of my estate, with or without court order, in such manner and in such amounts as the Executor deems prudent and appropriate. (i) Vote Stock. To vote shares of stock which form a part of my estate or any Trust established under this Will, and to exercise all the powers incident to the ownership of stock. (j) Reor a~ nize. To unite with other owners of property similar to property in my estate to carry out plans for the reorganization of any company whose securities form a part of my estate. (k) Disclaim. To disclaim any interest in property which would devolve to me or my estate by whatever means, including but not limited to the following means: as beneficiary under a will, as an appointee under the exercise of a power of appointment, as a person entitled to take by intestacy, as a donee of an inter vivos transfer, and as a donee under athird-party beneficiary contract. (1) Tax Returns. To prepare, execute and file tax returns of any type required by applicable law, including but not limited to filing a joint tax return with my surviving spouse, and to make all tax elections authorized by law. Page 7 ~~-!r-~ (m) Employ Advisors. To employ custodians of property; investment or business advisors, accountants and attorneys as the Executor or Trustee deems appropriate, and to compensate these persons from assets of my estate or trust, without affecting the compensation to which the Executor and Trustee are entitled. (n) Divide Trusts. To divide any Trust created in this V~'ill into two or more separate Trusts so that inclusion ratio for purposes of the generation-skipping transfer tax shall be either zero or one, in order that an election under Section 2652(a)(3) of the Internal Revenue Code may be made with respect to one of the separate Trusts, or for any other reason. (o) Allocate Expenses. To allocate administrative expenses to income or to principal, as the Executor or Trustee deems appropriate. However, no allocation to income shall be made if the effect of the allocation is to cause a reduction in the amount of any estate tax marital deduction or estate tax charitable deduction. (p) Adjust Basis. To make any adjustment to basis authorized by law, including, but not limited to increasiizg the basis of any property included in my estate, whether or not passing under this Will, by allocating any amount by which the bases of assets may be increased. The Executor shall be under no duty and shall not be required to allocate basis increase exclusively, primarily, or at all to assets which pass as part of my probate estate as opposed to other property for which a basis adjustment is allowable. The Executor shall allocate basis increase equitably among those beneficiaries receiving property as a result of my death, but shall not be liable to any person, nor subject to removal or surcharge, for any reasonable allocation of basis increase. (q) Compromise Claims. To compromise claims. Page 8 ~~ ~~~ (r) Terminate Trust. To terminate any trust, if in the opinion of the Trustee, the expense of administration of the trust is not justified. Upon termination, the Trustee shall distribute the trust property to the person(s) then entitled to receive or have the benefit of the income therefrom. If there is more than one current income beneficiary, the Trustee shall distribute trust assets to the income beneficiaries in the proportion in which they receive income, or if no proportion is designated, in equal shares to the income beneficiaries. This power ma3~ only be exercised by a Trustee vvho is an independent Trustee, and this power shall be ineffective to the extent that the effect of the power is to vest in any Trustee or beneficiary a general power of appointment. (s) Other Acts. To do all other acts in his or her judgment necessary or desirable for the proper and advantageous management, investment and distribution of the estate and Trusts established under this Will. ITEM I~: Accounting. The Trustee, on an annual basis, shall provide each income beneficiary who has attained the age of eighteen (18) years, and the Guardian of the person of any income beneficiary who has not attained the age of eighteen (18) years, statements showing transactions of each Trust established for the benefit of that beneficiary. The beneficiary, or the Guardian of the person of such beneficiary, may waive this right to receive an annual accounting. The Trustee may, at any time, settle any account, or questions concerning the administration of any Trust established under this Will, by agreement uTith the then qualified beneficiaries (as defined in the Pennsylvania Uniform Trust Act) of the Trust, if legally competent, or if not legally competent, with the Guardian of the person of the beneficiary, the legally competent spouse of the beneficiary, or the oldest legally competent relative of the beneficiary who would take a portion of the estate of the beneficiary were the beneficiary to die at that time intestate under the laws of the Commonwealth of Pennsylvania. Any settlement made in accordance with this Item shall bind all persons who have an interest in the Trust, and shall constitute a release and discharge of the Trustee with respect to transactions specified in the settlement. Page 9 ~~~~~ ITEM X: Distributions to or for Beneficiaries. The Trustee is authorized to distribute principal and/or income in any one or more of the following ways if the Trustee; in the discretion of the Trustee, considers the beneficiary unable to apply distributions to the beneficiary's oven best interests, or if the beneficiary is under a legal disability: (a) To Beneficiary. Directly to the beneficiary; (b) To Guardian or Conservator. To the legal guardian or conservator of such beneficiary; (c) To Custodian. To the Trustee, or to another person selected by the Trustee, as custodian under the Pennsylvania Uniform Transfers to Minors Act as to a beneficiary under the age of twenty- five (25) years; (d) To Relative. To a relative of the beneficiary, to be expended by that relative for the benefit of the beneficiary; or (e} Direct Application. By directly applying distributions for the benefit of the beneficiary. ITEM ~I: Survival. Any person who has died within thirty (30) days of my death, or under such circumstances that the order of our deaths cannot be established by proof, shall be deemed to have predeceased me. Any person (other than myself) who has died at the same time as any beneficiary under this Will, or in a common disaster with that beneficiary, or under such circumstances that the order of deaths cannot be established by proof, shall be deemed to have predeceased that beneficiary. ITEM III: Merger of Trusts. Should my wife, by «~ill or Agreement of Trust, establish Trusts similar to the Trusts I have established for the benefit of my issue, the Trustee of each Trust created in this Will shall have the right to merge it with the similar Trust created by my wife for the same Page 10 ~~/~ beneficiaries. If merged, the Trustee shall operate the merged Trusts as a single Trust. ITEM KIII: Trust Situs. The initial situs of each Trust created under this Will. shall be the county of my domicile at my death. The Trustee may determine, from time to time, to change the situs of any Trust established under this V~jill. However, no change in situs shall be effective until written notice is provided to the living beneficiaries of the Trust. ITEM KIV: Executors and Trustees. I make the following provisions with respect to Executors and Trustees: (a) Initial Executor and Trustee. I appoint my wife, CATHARINE B. PETKO, to be the Executor and Trustee. (b) Successor Executor and Trustee. In the event that my wife is unable or refuses to serve as Executor, I appoint my sons, GLENN T. PETKO and CRAIG E. PETKO, to serve as Co-Executors, hereinafter the "Executor." (c) Power to Appoint Additional Trustees. Each person serving as a sole Trustee shall have the power to appoint a Co-Trustee. Each Trustee shall have the power to appoint his or her successor in office. In the event of a complete vacancy in the office of Trustee, I appoint my sons, GLENN T. PETKO and CRAIG E. PETKO, to serve as Co-Trustees, hereinafter the "Trustee." (d) Power to Remove Trustee. Any Co-Trustee appointed by a Trustee ma3~ be removed by that Trustee. (e) I1~Iethod of Appointment and Removal Each appointment or removal of a Trustee shall be in writing and shall be filed with the court. in the jurisdiction which is the situs of the Trust. The written instrument shall be signed by the person having the power to make the appointment or removal. Page 11 ,~~1-!~ (f) Temporary Trustee. Each Trustee shall have the power to designate a temporary Trustee by an instrument in writing delivered to such temporary Trustee. The temporary Trustee shall serve as such only during the legal incapacity of the appointing Trustee, or, during such period of time as the appointing Trustee in writing designates, and upon the expiration of that time, or at such time as the legal incapacity of the appointing Trustee ceases, the appointing Trustee shall once again become the Trustee. (g) Dele ation. Any Trustee may delegate investment and related management functions to another Trustee, provided the other Trustee accepts the delegation in writing. To the extent accepted, the delegating Trustee shall be relieved of responsibility for the investment decisions of the Trustee to whom investment and related management functions were delegated. (h) Resignation. Any Trustee may resign upon ninety (90) days written notice to the then income beneficiary and each adult sui juris remainder beneficiary of the Trust; provided, however, that the resignation shall not become effective until and unless at least one person is then serving as Trustee of the affected Trust. (i) Responsibility. No Trustee shall be responsible for the acts or omissions of any other Trustee. (j) Duty to Investigate. In the absence of actual knowledge of a breach of trust, or information concerning a possible breach of trust that would cause a reasonable person to inquire, a successor Trustee is under no duty to examine the accounts and records of any predecessor Trustee, or to inquire into the acts or omissions of such predecessor, is not liable for any failure to seek redress for any act or omission of such predecessor, shall have responsibility only for property which is actually delivered to the Trustee by such predecessor and shall have all of the powers conferred upon a Trustee hereunder. Pa e 12 ~~ g yC-r {kj Compensation. The Executor and Trustee shall have the right to receive reasonable compensation for services rendered and reimbursement for reasonable expenses. (m) Standard of Care. The Trustee shall not be liable or accountable f'or any loss that may result from the good faith exercise of the authority gx•anted in this Vt~ill. This shall specifically include decisions of the Trustee with respect to discretionary distributions of income and/or principal to any beneficiary. (n) Securit~T. The Executor and Trustee are specifically relieved from the duty of filing bond or entering security. IN V~TITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, consisting of this and the preceding twelve (12) pages, at the end of each page of which I have also set my initials for greater security and better identification this ~a day of , 20 a`~ a~~~~ /yj/~~2~~1-/--~ (SEAL) DAVID W. PETKO VVe, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above-named Testator as and f'or his Last Will and Testament, in the presence of us, who, at his request and in his presence and in the presence of each other, have hereunto set our hands and seals the day and year first above written, and we certify that at the time of the execution thereof, the said Testator was of sound and disposing mind and memory. G{/ (SEAL) // ~ ~- ~/ ~, ~ ~ (SEAL) ~ -- ( - Residing at:~lJ~ G~-~i'~~ ~ P~ -~,~.1 ~" ~/ ~ ~i Residing at c~S `/ ~ ~ ~~,c,c.u,~/~-~i ~, f- ./ ; ~;./,~ ~ i i ACKNOV~rLEDGMENT COMMONt~jEALTH OF PENNSZ'LVANIA ) j ~ ) SS: COUNTZ' OF ~~~~-~-~-~ ) I, DAVID 4V. PETKO, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ~ ~D~~~-- DAVID Vi'. PETKO Sworn to and subscrib d before me this ~,.(~, day of 20 ~`~ -~ ~~ U Notary Public My Commission Expires: (SEAL) (SEAL) COMMONWggLT+.r OF f'ENNSY~VgNIA NOTARIAL SEAL CYNTHIA J. RULE, Notary Public Lemoyne Boro., Cumberland County MY Commission Expires February 3, 2012 AFFIDAVIT COMMONWEALTH OF PENNSYL~%ANIA ) SS: COUNTY OF ~ ;~ ~ .' ,~~ ) ~~e, ~~ S ,~ jtl/~7-~ and ~~u ~r~ ~~, ~, J, ~ the V~ritnesses vc=hose names are signed to the attached or foregoing instrument, being duly qualified according to law; do depose and say that we u=ere present and saw Testator, DAVID W. PETKO, sign and execute the instrument as his Last Will and Testament; that Testator signed willingly and that he executed said Will as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as Witnesses; and that to the best of our knowledge the Testator was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. ~ i~ _c. ~ ~ , (~-~-_~ Witness / Witnes~~J Sworn to and subscrib d before me this („~~ day of .~~'-- 20D ~1. t ~. ~?~. Notary Public My Commission Expires: (SEAL) COMMONWEgLTH OF PENNSYI.VgN~q NOTA~EAL CYNTHIA J. RULE, Notary Public Lemoyne Boro., Cumberland County My Commission Expires February 3, 2012 Date of Death: 01/03/2010 Valuation Date: 01/03/2010 Processing Date: 09/16/2010 Shares Security or Par Description 1) 401 PRUDENTIAL FINL INC (744320102) COM New York Stock Exchange 12/31/2009 01/04/2010 2) 193.353 PROCTER & GAMBLE CO (742718109) COM New York Stock Exchange 12/31/2009 01/04/2010 Total Value: Total Accrual: Total: $32,128.69 Estate Valuation High/Ask Low/Bid Estate of: David W. Petko Estate Account: 92690 Report Type: Date of Death Number of Securities: 2 File ID: Petko, David W. Estate Mean and/or Div and Int Security Adjustments Accruals Value 50.98000 49.75000 H/L 51.90000 50.19000 H/L 50.705000 20,332.71 61.53000 60.56000 H/L 61.31000 60.63000 H/L 61.007500 11,795.98 $32,128.69 $0.00 Page i 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 or www.evpsys.com. (Revision 7.1.0) "',l~Lt': >r Ica rT~:JIt P uJ ,vl ~.. .I:'1~1(Pial ~ .;c'l! .r'te' CONFIDENTIAL INFORMATION ~ f,OC ~ ~tV G~ 1~4~ t i4'_I '} ; r ~~~ r t•,I!',r,1r lE~:..a. , ~ .. , II~C:JI~` ,, h , ._. C~~:~=. Account Number Tax Year Endin __ 0000738143 12,'31 /2009 ~ 000004$107 """"""'AUTO"3-DIGIT 170 I~~~III~~~IIL~~JJ,IL~~~IL~I~J~~~~IIIL~~~I~I~L~1~1~1~~1 -~, s ;~;~,, ,-,;-5,~,~ „~, ;~, ,~ ;~,,,;_ DAVID Vd PETKO & CATHARINE B PETKO Ir 1'OU ARc SU~JEC~ T0- r"OR IGh TL,S Y~JlTHHCiDI!~C' YOJ 1MI~'_ JT TEN RECEIVE G, 1G4~-: ~OR0.?, lip ~, 5_?lan6,T E FuiAILII~G 458 WOODCREST DR M~CHANICSBURG PA 17050-6810 00 r'rOCi~i" ~. ~~CTi~il~ ~C)Il`1~.3~.':"1~, 2009 YEAR END INFORMATION Account Number Dividend Rate ~ Certificated Shares 0000738143 I 0.4400 Questions? 800-742-0253 (US and Canada) or 5i3-983-3034 • www.pa.com/investors 0 Direct Program Registration Shares ShareslSlP 0.000 193.3530 Record Date Total Shares 193.3530 Transaction History From: January 1, 2009 To: December 31, 2009 Summary Of Holdings as of December 31, 2009 Certificated Shares Direct Registration Program Total Shares i Approximate Frice! Approximate Shares Shares/SIP Per Share (~) i Vafue (5) 0 0.000 , ~ .3~0 i 9.3 ~ E,- _ . _ _ J~oO s -, ~ yo~.6~ __ Prudential IMPORTANT TAX RETURN DOCUMENT ENCLOSED _~ """«""AUTO««5-DIGIT 17050 000786/0278519 z 7 8 519 .1.. .I.. 1 . Ifrll I. . I .I ....I ...I. _ I III I I I I 1111111111111 n l l l 111111 Recipient DAVID W PETKO & CATHARINE B PETKO TEN ENT 458 WOODCREST DRIVE =- MECHANICSBURG PA 17050 (omputershare Computershai e PO Box 43033 Providence. Rhode Island 02940-3033 Within USA, US territories b Canada 8DD 305 94D4 Outside USA, US territories b Canada 732 512 3782 vdww.computershare.com/investor Holder Account Number 00030913451 J N T Record Date Nov 24 2009 Check Number 0009953311 SSNITIN Certified yes 0o i can i rn.r>ont t,>vc,er,~s_rc; i .rt<t~. i s;tios_~ar,~s; i v: _~~ss i ,,,~ Prudential Financial, Inc. -Combined Dividend Payment 12009 Tax Form 1099-DIV _______ Corrected (if checked) Account Number 00030913451 Form 1099 - D1V -Dividends and Distributions 2009 Copy B -For Recipient Recipient's ID No. 145.30.8372 Payer's Federal ID No. 22.3703799 This is important tax information and is being furnished to the Internal Revenue Service. If you are required to file a return, a negligence OMB No. penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that It has not been reported. 1545-0110 Deparfinem of the Treasury -Internal Revenue Service Recipient DAVID W PETKO & CATHARINE B PETKO TEN ENT 458 WOODCREST DRIVE MECHANICSBURG PA 17050 lia Total Ordinary tbi Qualified L3 I Nondrvidentl a ! FEDERAL INCOME s Foreign Tax ~J Foreign Country (~'' Cash Liquidation Dividends ($) Dividends ($) Distributions ($) TAX WITHHELD I$) Paid ($) I or U.S. Possession I Distri. ($) Payer'S Delail5 280.70 280.70 0.00 0.00 0.00 PRUDENTIAL FINANCIAL INC CIO COMPUTERSHARE P.O. BOX 43010 PROVIDENCE R! 02940-3010 Form 1099-DIV (Iteep for your records) Dividend Confirmation Payment Date Class Description Participating Dividend Gross i Deduction !, Deduction Net ShareslUnits I Rate I Dividend ($) i Amount ($) ~ Type I Dividend ($) 18 Dec 2009 COMMON 401 50.70000 280.70 0.00 NIA 280.70 Year•To•Date Paid 280.70 0.00 280.70 ® 46UTX PRU "'~" OORX6A-PP.(F2i PLEASE CHSHIDEPOS7T THIS CHECK PROMPTLY. ESTATE VALUATION ELIJAH WATSON 4/1/2010 THOMAS CRAVEN Date of Death: 01/03/2010 Valuation Date: 01/03/2010 Estate of: PETKO CATHY/DAVE Processing Date: 04/01/2010 Account: 000001525899611 Report Type: Date of Death Number of Securities: 12 File ID: EVI_20100401_1525899811 Shares Security or Par Description High/Ask Low/Bid Mean and/or Ad Div and Int Security justments Accruals Value 1) 21350.1 EVERGREEN SELECT MONEY MKT TR (299920306) MUN MMKT FD 21,350.10 2) 2838.808 EVERGREEN SELECT FIXED INCOME (299908830) SELECT INTL I Mutual Fund (as quoted by NASDAQ) 12/31/2009 11.28000 Mkt 11.280000 32,021.75 3) 3229.598 ING MUT FD (44980Q518) INTL R/E CL I Mutual Fund (as quoted by NASDAQ) 12/31/2009 8.17000 Mkt Div: 0.5216 Ex: 12/31/2009 Rec: 12/30/2009 Pay : 01/04/2010 6.170000 26,385.62 1,685.20 4) 3042.769 PIMCO FDS PAC INVT MGMT SER (722005667) COMM REALSTR I Mutual Fund (as quoted by NASDAQ) 12/31/20D9 8.28000 Mkt 8.280000 25,194.29 5) 3469.71 ROWE T PRICE REAL ESTATE FD (779919109) COM Mutual Fund (as quoted by NASDAQ) 12/31/2009 13.83000 Mkt 13.830000 47,916.94 6) 25182.498 EVERGREEN PA MUN BD (300326402) CL I 01/03/2010 10.62000 Accrual 10.820000 272,474.63 90.19 7) 4261.118 NUVEEN MUN TR (67065Q772) HI YLD MUNBD R Mutual Fund (as quoted by NASDAQ) 12/31/2009 15.03000 Mkt 15.030000 64,044.60 8) 271.202909 DODGE & COX STK FD (256219106) COM Mutual Fund (as quoted by NASDAQ) 12/31/2009 96.14000 Mkt 96.140000 26,073.45 9) 140.058 DREYFUS INVT FDS (26203E836) BO SCP GRWI'Y. 1 Mutual Fund (as quoted by NASDAQ) 12/31/2009 44.61000 Mkt 44.610000 6,247.99 10) 1028.611567 EVERGREEN TR (299909408) STRATEG GRW I Mutual Fund (as quoted by NASDAQ) 12/31/2009 25.99000 Mkt 25.990000 26,733.61 11) 392.891012 HARBOR FD (411511843) S CAP VAL INST Mutual Fund (as quoted by NASDAQ) 12/31/2009 16.34000 Mkt 16.340000 6,419.89 12) 43D9.913 EVERGREEN INTL TR (299924704) INTL EQTY CL I Mutual Fund (as quoted by NASDAQ) 12/31/2009 6.91000 Mkt 6.910000 29,746.95 Page 1 This report was produced with EstateVal, a product of Estate Val uations & Pric ing Systems, Inc. If you have questions please contact EVP Systems at (818) 313-6300 or www.evpsys. com. (Revision 7 , .1.1) Date of Death: 01/03/2010 Valuation Date: 01/03/2010 Processing Date: 04/01/2010 Total Value: Total Accrual: Total: $586,385.36 Estate of: PETKO CATHY/DAVE Account; 000001525899811 Report Type: Date of Death Number of Securities: 12 File ID: EVI_2D100401 1525899811 $1,775.39 $584,609.97 Page 2 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (6181 313-6300 or www.evpsys.com. (Revision 7.1.1) Sent by: MYERS & STAUFFER LC 7175411206; CATI lARIME B PE7K0 DAVID W FGTKO Account#1714906576 Balances Bepinnitta t3alance ~ -':$32,811.16 Cutrenft3alonae ` . $32,929`;92. DeDOS11s~Credlts - + $'17 70 Avcrogo Daily Balance $32,9. 12.18 ,. ~ Withdrawals,'Debils - $O.oa Interest Paid this Period' $ ~7.7tS Annual ParcentageYleld Earned :.: ,. 0;6~49rO• - Earned this Period $ 17.76 Pald Last Year $34.27 Paid Year-To-Date ~ 17.76 !. ;' 'The interest earned and the rotates[ paid ntny diNer depending on when intprwst is credited to your account. Account Activity Date QtiacriNtlon 01-01 Beginning 9dlance Additions Subtractions Balance $32,912.18 ~- ~ ,~~- 01-29 INTEREST CREDIT .. ~ $17.7F:.; ~i's4,yza.yz_ l~-~ 01-31 Ending Balance $32'929.92 ~~ ' ~ ~p~ IN (;ASC OF CRROtts OR QuGSTIOAS A90u-r Ynt IR ELECTRONIC TRANSFERS c:nLl • YUl.tft i:tJSl'tnvtOTt ;itcltVlCl: CFl•t'1'Llt A'1~'rlae Nt IMRF:R S)IUWN ON'I'lIE 1'tiP OF YOUR sfAl'EML'NT c'nt WRt'rl:i Tt.) t t-u~ nArot; 1'(')R t>IF.f31'f CAKU 15~4t=5; ~nvercign,Bank Atm; Ihbd Card Service Mn I nnt3 301 06 P.O, Bt)X SM11003 l3asrnn, MA D2284-1009 pnR ALI., t)'fl•11::R ISSUES; Soverot~,n Bank Attn: ('6rn1 Relatiolts u)-4? t-CR I P.U. L~c)X 1'!ba6 RF.AI)WG. NA 19G12-2ti4h Pleaso untCaCl us iCynu lltirtt your statement or ra:ei[[n in wrong or ify„u +wud u~klitionnl in('nnnution about a tiansPet on dte Statement or ru;elpl. WB must hoNr tYum you na IdK:r than 80 days oiler we cent you the F'IAST statement nn which the error appcarrxl. • 'Kral us your name end account number, ~ ikscril+e the carat or the transfer that you arc unsure abntrt and r:xpluin as elwrly a:; yu.~ can why • Moll us the dollar aitutunt of the Suspaelod error, you bcNctie dtcro is an error or why you need bother infannution, I1 you tell us urtdly. vye may rcyulre you to send your complaint ur yuc:,lion in writing within 1t1 busine~~ And:;. W,, will promptly in+'estiRatc the matter and call or write TD you with an answer wtthm -U business tlxye 1.10 calcndnr doy '• in A4ae.achusr-u;.1 If"we ne.d morC lithe, we may take ap to 43 days 41 (nVe4tlt6hll ynnT CUIU}+IuIM or (1uC511rm. If we du. we will r~redit your account within this 1 U-day period I'or th6 amount yt?u flunk is nt error. sn you wt11 hoer; the use aPthe ntont,~y dnrln; the time rt fakes us to wmplete our investig,9lfOn If wr ask yon In pu[ yr~ur t:rpnpl:tiot or aucntirn, rn writing and 1hL- li+l nOf iCCe1VC IL ,n'll!tln 1 U bu5incss day+, we may ehon5c not to credi[ year uccown. t~or erroN invr,lvin~ neu 3ccounis. pt+int ul~ sale purchases Or fnreipn trnnsactians. we play take up In ~Nl tl+rys a. inve3tiynrc your «,mplaim or gacainn For new acuruMS, we may take up In 20 business dayr to Crodn your ar:wunt fur dre amount you think i~: in orror We will fell you tht -exults aP cwt invesriy~* lion within 3 busirress days aircr wtnpltxing aui invastigoriun. If we doeid~ there. was no error. wu w'ill send you a written c~:plananon. You may a;k lUr copies ul' I"C docum+:nta wC ur7ed in our invr~~~iptncn. Important rnPuruml'wu about your Sovereign Debit (''nrd Tbc n~iwnrks through which +ane of your Sovereign Debll Carl purChasra ere prar;esstxf nave begun allr,wing mcwhuma t+~ procccs your purrhau,c without either a,ip.nature m• a YIN. If you arc nut required w color your PIN when you mrrke a parrhau. your purchase may be, pmecssed either [hroush the visa network or through the STAR or NY('!_ nrhworks. IFyour purchsrse is~rocessod through SPAR or NYCI:, dl(1ltLnl It:f1119 apply alyd you wdl out bC ctiEihlc fi,r the rights an protections nvlilahlc through Visa. I'leasc see your i crsonal Uepwit Ar:cnunt Agreement for more in('on„utton, 02/19/10 7:56AiuI;,J~X #764; Page 2/4 ESTATE VALUATION ELIJAH WATSON 4/1/2010 THOMAS CRAVEN Date of Death: Valuation Date: Processing Date: hares or Par 01/03/2010 01/03/2010 04/01/2010 ecurity Description High/Ask w/Bid ile Mean and/or Adjustments Estate of: PETKO CATHY/DAVE Account: 000001525899811 Re ort p Type: Date of Death Number of Securities: 12 ID: EVI 20100401 1525899811 Div and Int Security Accruals Value 1) 21350.1 EVERGREEN SELECT MONEY MKT TR (299920306) 21 3 MUN MMKT FD , 5 2) 2938.808 EVERGREEN SELECT FIXED INCOME (299908830) SELECT INTL I Mutual Fund (as quoted by NASDAQ) 12/31/2009 11 .28000 Mkt 11 .280000 32,021.75 3) 3229.598 ING MUT FD (44980Q518) INTL It/E CL I Mutual Fund las quoted by NASDAQ) 12/31/2009 8 .17000 Mkt 8. 170000 26,385.82 Div: 0.5218 Ex: 12/31/2009 Rec: 12/30/2009 Pay: Ol/D4/2010 1,685.20 4) 3042.789 PIMCO FDS PAC INVT MGMT SER (722005667) COMM REALSTR I Mutual Fund (as quoted by NASDAQ) 12/31/2009 6 .28000 Mkt 6. 280000 25,194.29 5) 3469.71 ROWE T PRICE REAL ESTATE FD (779919109) COM Mutual Fund (as quoted by NASDAQ) 12/31/2009 13 .83000 Mkt 13. 830000 47,916.94 6) 25182.498 EVERGREEN PA MUN BD (300326402) CL I 01/03/2010 10 .82000 10. 820000 272,474.63 Accrual 90.19 7) 4261.118 NUVEEN MUN TR (67065Q772) HI YLD MUNBD R Mutual Fund (as quoted by NASDAQ) 12/31/2009 15. 03000 Mkt 15. 030000 64,049.60 8) 271.202909 DODGE & COX STK FD (256219106) COM Mutual Fund (as quoted by NASDAQ) 12/31/2009 96. 14000 Mkt 96. 140000 26,073.95 9) i40.D58 DREYFUS INVT FDS (26203E836) BO SCP GKW1'Y. I Mutual Fund (as quoted by NASDAQ) 12/31/2009 49, 61000 Mkt 49. 610000 6,297.99 10) 1028.611567 EVERGREEN TR (299909408) STRATEG GRW I Mutual Fund (as quoted by NASDAQ) 12/31/2009 25. 99000 Mkt 25. 990000 26,733.61 11) 392.891012 HARBOR FD (411511843) S CAP VAL INST Mutual Fund (as quoted by NASDAQ) 12/31/2009 16. 39000 Mkt 16. 340000 6,419.84 12) 4309.913 EVERGREEN INTL TR (299929704) ZNTL EQTY CL I Mutual Fund (as quoted by NASDAQ) 12/31/2009 6. 91000 Mkt 6. 910000 29,746.95 Page 1 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 or www.evpsys.com. (Revision 7.1.1) AXA EQUITABLE redefining /standards February 10, 2010 Elyse E. Rogers Keefer Wood Allen & Rahal, LLP Attorneys at Law 635 North 12~' Street, Ste 400 Lemoyne, PA 17043 Re: Accumulator® Contract 304 692 009 David Petko (decedent) Request for Information Dear Ms. Rogers: Thank you for the opportunity to write to you. This letter is in response to your request for information concerning the above referenced Contract. Please note that the above referenced Contract was issued as a Tax Deferred Variable Individual Retirement Annuity (IRA). The Date of Death Value as of January 3, 2010 was $282,849.00. What To Do Next Our records indicate the beneficiary claim on this Contract has not been processed. So that we may assist your client in processing this claim, please contact our Customer Service Division at the toll-free number below. Thank you for the opportunity to provide you with this information. If you should have any questions concerning this letter, please contact our Customer Service Division, toll- free at 1-800-789-7771, Monday through Friday, between 8:30 A.M. to 5:30 P.M. ET. Sincerely, %~~- Nicholas Binder Client Services cc: Catherine Petko James Igo AXA Equitable Life Insurance Company 500 Plaza Drive, 6th Floor, Secaucus, NJ 07094 Estate Valuation ELIJAH WATSON 2/18/2010 THERESA HANEY Date of Death: 01/03!2010 Valuation Date: 61/03/2010 Processing Gate: 02/18!2016 Shares Security cr Par Descrip*_ion High/Ask Low/bid 1) 13::6.3 WACHOVIP. PT MONEY MARKET {99%981006; 2) 2021.9"7 PIMCO FDS PAC INVT MGMT SER 1722005660 COMM REALESR I Mutual Fund (as quoted by NASDAQI 12/31/2009 3) 3089.629 ROWE T PRICE REAL ESTATE FD (779919109) COM Mutual Fund (as quoted by NASDAQI 12/31/2009 9) 7909.902691 DELAWARE POOLED TR (246298728) SM CAP GRW EQT Mutual Fund (as quoted by NASDAQ) 12/31/2009 51 722.323011 DODGE & COY. STK FD (256219106) COM Mutual Fund (as quoted by NASDAQ) 12/31/2009 6) 3276.626957 EVERGREEN TR (299909908) STRATEG GRW I Mutual Fund (as quoted by NASDAQ) 12/31/2009 7) 1580.600285 HARBOR FG (911511893) S CAP VAL INST Mutual Fund (as quoted by NASDAQ) 12/31/2009 8) 3'60.52; TOUCHSTONE FDS GROUP TR (89155H~93) MID CP.P FD Y Mutual Fund (as quoted by NASDAQI 12/31/2009 97 8_-''.69^ DELAWARE POOLED TR (246298306) INTL EQTY PT FL Mutual Fund (as quoted by NASDAQ? 12/3%/2009 101 906.%97 MORGAN STANLEY INSTL FD INC (61794J317) INTL REALEST I Mutual Fund (as quoted by NASDAQI 12/31/2009 11) 2935.52 SSGA. FDS 089924925) EMRG 1~1KTSEL CL Mutual Fund (as qucted by NASDAQI 12/31/2009 Total Value: Tota'_ Accrual: Total: 5500,039.22 Estate of: DA.VIG W PETKO Account: 1590090E36 Report Type: Date of Dearh Number of Securities: i1 File ID: PETKOE36 Mean and/or Div and Int Security Adjustments Accruals Value 13,5'6.30 8.2EG00 Mkt 8.^<80000 16,''41.9- 13.83066 Mkt 13.830000 42,29. S. 3.%8000 Mkt 3,780000 29,880.53 96.19000 Mkt 96.190000 69,999.13 25.99000 M4;t 25.990000 85,159.52 1E.39000 Mkt 16.390000 25,82.01 11.60600 Mkt i1.600GCG 93,622.11 13.29000 Mkt 13.290000 %10,009.86 1'.80600 Mkt 1.800000 16,190.10 19.26000 Mkt 19.260000 46,908.1 S50G,C39.22 50.00 Fage i This report was produced with EstateVal, a product cf Estate Valuations v Pricing Systems, Inc. If you have questions, please contact EVP Systems at (B1Ei 313-6300 or www.evpsys.com. {Revision 7.1.1; KEEPER WOOD ALLEN &RAHAL, LLP ROBERT L. WELDON ATTORNEYS AT LAW ESTABLISHED IN 1878 EUGENE E. PEPINSKY, JR. E>35 NORTH I2T" STREET SUITE 400 - , JOHN H. ENDS ]Q GARY E. FRENCH LEMOYNE, PA 17043 OF COUNSEL: BRADFORD DORRANCE N. DAVID RAHAL JEFFREY S. STOKES PHONE 717-612-5800 SAMUEL C. HARRY CHARLES W. RUBENDALL II ROBERT R. CHURCH FAX 717-612-5805 STEPHEN L. GROSE - _ R. SCOTT SHEARER EIN No. 23-0716135 HARRISBURG OFFICE: ELYSE E. ROGERS www.keeferwood.com 210 WALNUT STREET HARRISBURG, PA 17101 CRAIG A. LONGYEAR JOHN A. FEICHTEL STEPHANIE KLEINFELTER PHONE 717-255-8000 DONALD M. LEWIS IIt October 1 2010 TODD F. TRUNTZ ~ LAUREN S. WELDON 717-612-5801 ero~ers@keeferwood.com Register of Wills of Cumberland County ~, One Courthouse Square ~? p -" o _~, ~ - Carlisle PA 17013 `' ~ ° ` ' " - ~~' U C7 -~-+ t -~~' Re: Estate of David W Petko r: ~ _" _- ' ~ ' = ' . c _ File No: 2010-00942 `~ ~ ~ `=' _ ~ _ " - ti ~ Dear Madam: -' a ~. ~ ~} a , c .c- Enclosed for filing with your office are the following: 1. Original and one copy of the Pennsylvania Inheritance Tax Return. Please note there is no tax due. 2. Inventory; 3. Check in the amount of $30 for your filing fees. Please time stamp and return the copy of this letter which is enclosed. A return envelope is enclosed for your use. If you have any questions or require additional information, please do not hesitate to contact me. Sincerely yours, c~ r Enclosures cc: Catharine B. Petko ~~ Elys E. Roger >