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HomeMy WebLinkAbout02-07-11 (2)1505610143 REV-1500 Ex (0,_1°) OFFICIAL USE ONLI PA Department of Revenue pennsylvania County Code Bureau of Individual Taxes DEPARTMENT OF REVENUE PO 80X.280601 INHERITANCE TAX RETURN 21 Harrisburg, PA 17128-0601 RESIDENT DECEDENT Year File Number 10 0618 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 237 20 3498 04 22 2010 Decedent's Last Name Suffix ITINGER (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW ~ X~ 1. Original Return ' 4. Limited Estate I 6 Decedent. Uied Testate - (Attach Copy of ~~ril ) 9. Litigation Proceeds Received Date of Birth 12 07 1922 Decedent's Fiirst Name MI ERNESTINE E Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE V'VI1-H TIDE REGISTER OF WILLS 2. Supplemental Return _~ 4a Future Interest Compromise - -~ (date of death after 'i 2-12-82) ~ Decedent Maintained aLiving -trust L_X~ (Attach Copy of Trust) '. ' 1 d Spousal Povert Credit (date of death ~- _1 between ?2-31 ~1 and 1-1-95) 3. Remainder Return (date of death ' prior to 12-13-82) 5. Federal Estate Tax Return Required 1 8. Total Number of Safe Deposit Boxes !, ~ 1. Election to tax: under Sec. 9113(.4) ' (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALI. CORRESPONDENCE AND CONFIDEN~1AL TAX INFORMATIO~J SHOULID BE DIRECTED TO. Name Daytime Telephone Number AMY M MOXA 717 6 5 ~.~ 7 3 2 3 °~- First line of address 5011 LOCUST LANE Second line of address City or Post Office State ZIP Code HARRISBURG PA 17109 Correspondent's a-mail address: Amy@Ledererlavv.COm _.~, ___ _, .~ ~.._..t ~-- REGISTER Cif Vl~f.'L~~~ U~~E'QNLY ` - r-- " f_;..i -1 ~ ~.~ .,. __~ . _.~ _ .. 1 .....- ~. ~- ~. ~ DATE IFILED u Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and :statements, and to the best ~~f my knowledge and belies, it is true, correct and complete. Declaration of prepares other than the personal representative is based on all information of which prepares I~~js any knowledge. SIGNATURE OF PERSON R.ESF'ONSIBLE FO FILING RETURN DATE ~:~~ ~ ~, ~,~ d~{ti~~~~ ~ c;.-~ ~r.~' Tina Louise Babbs ~~' 3 ~ c:~ / / ADDRESS 3711 Saffron Drive Mechanicsbur PA 17050 __ __ SIGNATURE OF PREPA ER OTH THAN REPRESENTATIVE DATE= ~_..~ ~ 1 N.~ ` ~ 7~. Amy M. Moya ~ ` .~ - ~~> ~ -- ~ ~-- AUDRE S. l l; 5011 Locust Lane, Harrisburg, PA 17109 Side 1 15D5610143 150561D1~~3 J J 1505610243 REV-1500 EX Decedent's Social ~~e+curity Number DecedenYsName Itinger, Ernestine E. 237 20 3498 RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................ 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................................................ 4. 5~ Cash, Bank Deposits 8~ Miscellaneous Personal Property (Schedule E) .............. 5. 6. Jointly Clwned Property (Schedule F) '__, Separate Billing Requested............ 6. 7 Probate Property ansfers 8~ Miscellaneous NQn l u e G) I Separate Billing Requested............ (Sched 7. g. Total Gross Assets (total Lines 1-7) .................................................................. 8. 9. Funeral Expenses 8~ Administrative Costs (Schedule H) ..................................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)..._ .................... 10. 11. Total Deductions (total Lines 9 & 10) .................................................... ....... _ 11. 12. Net Value of Estate (Line 8 minus Line 11) ...................................................... 12. 13. Charitable anti Governmental Bequests/Sec 9113 Trusts for which an electaon to tax has not been made (Schedule J) ............................ ..... _ ..... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................. . 14. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax, rate, or transfers under Sec. 9116 15 (a)(1.2) X .00 . 16. Amount of Line 14 taxable 2 8 9, 0 4 2. 5 8 16. at lineal rate X .045 17. Amount of Line 14 taxable 0 0 0 17 . at sibling rate X 12 . 18. Amount of Line 14 taxable 0 0 0 18 . at collateral rate X 15 . 19. Tax Due... _ .. 20 FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT'. 67,831.84 40,909.11 x:07 , 865.58 ,~i16, 606.53 26,373.95 1,:L90. 00 27,563.95 ~!$9, 1J42 . 58 x'.89, 1J42 . 58 0.00 1.3,006,92 0.00 0.00 1.3 , 006.92 Side 2 1505610243 15056102~I3 REV-1500 EX Page 3 File Number 21-10-0618 Decedent's Complete Address: DECEDENT'S NAME Itinger, Ernestine E. STREET ADDRESS 3711 Saffron Drive _ - CITY Mechanicsburg STATE ZIP PA 17050 Tax Payments and Credits: 1. Tax Due (Page 2, Line ~i 9) 2. Credits/Payment~~ A. Prior Payments 12,375.34 B. Discount 631.58 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 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. (1) 13,006.52 Total Credits (A + g) (2) 13,006.62 (~~) (4 ) (`~) ~.~0 Make Check Payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPIRI~4TE BLOCKS 1. Did decedent make a transfer and: Yes No b. retain the risht toldesinnatetwho palrtuse thee ro ert transferred or its income :.... ......... ~ ~ X 9 9 P P Y ~_ x c. retain a reversionary interest; or .................................................................................................. _... L-- 1 x:- d. receive the promise for life of either payments, benefits or care? ...................................................._.. I__~ 'Lx__'. 2. If deathg~ccurgred after Decembe~12, 1982, did decedent transfer property within one year of death without [-_, receivrn ode uate consideration ............... x_J~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?....... _ __~ ~_x; 4 Did decedent own an Individual Retirement Account, annuity, or other non-probate property which , _ r i contarns a beneficiarydesignation? .............................................................................. ......................_.._.... ~_xJ J IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS FART OF THE RETURN. For dates of death or. 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. §9116 (a) (1.1) (i)]. For dates of death ors or after January 1, 1995, the tax rate imposed on the net value of transfers to ar for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1 1) (ii)]- The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirei~nents 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 ors 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 natural parent, an adoptive parent,. or a stepparent of the child is 0 percent [72 P.S. §9116 (a) (1.2)]. . The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. X91'16 1.;?) [72 P.S. §9116 (a) (1 )]. . The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §91 16 (a) (1.3)]. A sibling is defined ender Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption Rev-1503 E.X+ (6-98) SCHEDULE B s. STOCKS & BONDS ~. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMIBE:R Itinger, Ernestine E. 21-10-0618; All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE: OF DEATH 1 060505104 1,372 shares of Bank of America Corporation stock, titled to 18.275 25,073.30 Ernestine E. Itinger ($18.275/share) 2 867914103 1,478 shares of SunTrust Banks, Inc. stock, titled to 28.93 42,758.54 Ernestine E. Itinger ($28.93/share) TOTAL (Also enter on Line 2, Recapitulation) 67,831.84 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-151Dn Schel~ule E3 (Rev. 6-98) Rev-1508 EX+ (6-98) t, COMMONWEALTH OF PENNSYLVANIA In14AFRITA Nf~F TAX RFTI IRN SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBS.R Itinger, Ernestine E. 21-10-06~1f1 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE= OF DEATH 1 Certificate of Deposit, IRA Account No. 6140-894417, held at Citizens Bank, Ernestine E. 6,201.06 Itinger, owner, Milton C. Itinger, beneficiary (Milton C. Itinger died on October 4, 1995, leaving the Estate of Ernestine E. Itinger as beneficiary) ($1.08 accrued interest) 2 Savings Account No. 1500400835534, held at M&T Bank, titled to Ernestine E. Itinger ($0.33 12,988.33 accrued interest) 3 Certificate of Deposit No. 31003911043667, held at M&T Bank, titled to Ernestine E. Itinger 9,805.76 ($12.28 accrued interest) 4 Certificate of Deposit No. 31003811395711, held at M&T Bank, titled to Ernestine E. Itinger 10,332.16 ($35.39 accrued interest) 5 Check from AARP (refund of health insurance premium) 423.00 6 Check from Pennsylvania Department of Revenue (refund of personal income tax) 520.00 7 Check from Myers-Harner Funeral Home, Inc. (refund of overpayment) 64.00 8 Check from AARP (refund of prescription premium) 74.80 9 Miscellaneous personal property 500.00 TOTAL (Also enter on Line 5, Recapitulation) 40,909.11 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-15Q0 Schedule F (Rev. 6--98) Rev-1510 EX+ (6-98) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYL VANIA INHERITANCE TAX RF_TURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Itinger, Ernestine E. 21-10-06~18~ This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET °r° OF DECD'S INTEREST ExcLUS oN (IF APPLICAEILE) TAXABLE VALUE 1 Checking Account No. 622553-004-9, held at Citizens 65,509.78 100.000% 65,509.78 Bank, titled to Ernestine E. Itinger, Trustee, of the Ernestine E„ Itinger Living Trust dated 10/25/1994 2 471.37 shares of Ivy Asset Strategy Fund, held in 10,869.79 100.000% 10,869.79 Morgan Stanley Account No. 724-20293, titled to Ernestine E. Itinger, Trustee, of the Ernestine E. Itinger Living Trust ($23.06/NAV), CUSIP #466000759 3 1,365.70 shares of Investment Company of America, 37,147.04 100.000% 37,147.04 held in Morgan Stanley Account No. 724-20293, titled to Ernestine E. Itinger, Trustee, of the Ernestine E. Itinger Living Trust ($27.20/NAV), CUSIP #461308207 4 318.11 shares of Bank Deposit Program, held in 318.11 100.000% 318.'11 Morgan Stanley Account No. 724-20293, titled to Ernestine E. Itinger, Trustee, of the Ernestine E. Itinger Living Trust ($1.00/NAV), CUSIP #466000759 5 1,717.86 shares of American Balanced Fund CI B, held 29,272.33 100.000% 29,272.33 in Morgan Stanley Account No. 724-20293, titled to Ernestine E. Ntinger, Trustee, of the Ernestine E. Itinger Living Trust ($17.04/NAV), CUSIP #024071201 6 218.98 shares of Forward Banking & Finance Fund, 3,501.49 100.000% 3,501.49 held in Morgan Stanley IRA Account No. 724-65497, Ernestine E. Itinger, Trustee of the Ernestine E. Itinger Living Trust, owner, Tina L. Babbs, Naomi L. Funk and Mary Beth Jones, beneficiaries ($15.99/NAV), CUSIP #290898301 Total of Continuation Schedules See attached __ _~a eca s~_ TOTAL (Also enter on Line 7, Recapitulation) 207,865.58 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-15iD(1 Sche~~ufe C~ (Rev. 6-98) Rev-1510 EX+ (6-98) SCHEDULE G INTER-VIVOS TRANSFERS & ~.n MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN continued RESIDENT DECEDEtJT ESTATE OF (FILE NUMIBE:R Itinaer, Ernestine E. 21-10-0618 ITEM NUMBER DESCRIPTION OF PROPERTY THE DATE OFnTROANSFERSATTACH A COPYEOF THOE DEIED OR REAL ESTATDE DATE OF DEATH VALUE OF ASSET °i° OF DECD'S INTEREST ExcLUSION (IF APPLIC~>BLE) TAXABLE VALUE 7 257.69 shares of LM CBA Equity Income Builder, held 3,141.24 100.000% 3,141.24 in Morgan Stanley IRA Account No. 724-65497, Ernestine E. Itinger, Trustee of the Ernestine E. Itinger Living Trust, owner, Tina Louise Babbs, Naomi Lynn Dowden and Mary Beth Jones, beneficiaries ($12.19INAV), CUSIP #820956852 8 25.49 shares of EuroPacific Growth Fund Class, held 3,501.49 100.000% 3,501.49 in Morgan Stanley IRA Account No. 724-65497, Ernestine E. Itinger, Trustee of the Ernestine E. Itinger Living Trust, owner, Tina L. Babbs, Naomi L. Funk and Mary Beth Jones, beneficiaries ($38.65/NAV), CUSIP #298706102 9 58.06 shares of Legg Mason Clearbridge Small, held in 885.42 100.000% 885.42 Morgan Stanley IRA Account No. 724-65497, Ernestine E. Itinger, Trustee of the Ernestine E. Itinger Living Trust, owner, Tina Louise Babbs, Naomi Lynn Dowden and Mary Beth Jones, beneficiaries ($15.25/NAV), CUSIP #795479708 10 222.14 shares of Legg Mason CB Appreciation CI, held 2,938.91 100.000% 2,938.91 in Morgan Stanley IRA Account No. 724-65497, Ernestine E. Itinger, Trustee of the Ernestine E. Itinger Living Trust, owner, Tina L. Babbs, Naomi L. Funk and Mary Beth Jones, beneficiaries ($13.23/NAV), CUSIP #820957108 11 54.67 shares of Bank Deposit Program, held in 54.67' 100.000% 54.67 Morgan Stanley IRA Account No. 724-65497, Ernestine E. Itinger, Trustee of the Ernestine E. Itinger Living Trust, owner, Tina Louise Babbs, Naomi Lynn Dowden and Mary Beth Jones, beneficiaries ($1.00/NAV), CUSIP #820957108 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-15ACI ,schedule G (Rev. 8-98) Rev-1510 EX+ (6-98) ,~ SCHEDULE G t , s INTER-VIVOS TRANSFERS & a MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSY'1_VANIA INHERITANCE TAX RF_~URN continued RESIDENT DECEDENT ESTATE OF FILE NUMBER Itinger, Ernestine E. 21-10-06~1E1 _ ITEM NUMBER DESCRIPTION OF PROPERTY THE DATE OF TRANSFER.SATTACH A COPYEOF TIE DEIED ~OR REAL ESTA D . DATE OF DEATH VALUE OF ASSE1 °r° OF DECD'S INTEREST EXCLUSION (IF APPL.IC.4ESLE) TAXABLE VALUE 12 1,478 shares of SunTrust Banks, Inc. stock, titled to 42,758.54 100.000% 42,758.54 Ernestine E. Itinger, Trustee of the Milton C. Itinger and Ernestine E. Itinger Living Trust dated 10/25/1994 ($28.93/share), CUSIP #867914103 13 National Guardian Life Insurance Company (prepaid 7,966.77 100.000% 7,966.77 funeral contract) TOTAL (Also enter on Line 7, Recapitulation) 207,865.58 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-15iDn Sche(~ule G (Rev. 6-g8) REV-1151 EX+ (10-06) r..~~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMEtER Itinger, Ernestine E. _ 21-10-06'18 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER ~ - A, FUNERAL EXPENSES: See continuation schedule(s) attached B. 1 2 3 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zia Year(sl Commission paid Attorney's Fees Law Offices of Susan E. Lederer Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Tina Louise Babbs Street Address 3711 Saffron Drive city __Mechanicsburg state PA zip 17050 _ Relationship of Claimant to Decedent Daughter 13,002.00 9,500.00 3,500.00 4. Probate Fees Cumberland County Register of Wills 319.50 5. Accountant':s Fees 6. Tax Return I'reparer"s Fees 7. Other Admir~lstrative Costs 52.45 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 26,373.95 Copyright (c) 2009 form soft\hare only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06 SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Itinger, Ernestine E. 21-10-06~1EI ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Myers-Harner Funeral Home, Inc. 8,456.00 2 Myers-Harner Funeral Home, Inc. 440.00 3 Rolling Green Cemetery Company (Saturday grave opening) 450.00 4 Rolling Green Cemetery Company (interment fees) 2,415.00 5 Rolling Green Cemetery (grave marker) 1,241.00 H-A 13,002.00 Other Administrative Costs 6 Cumberland County Register of Wills (filing fee - PA Inheritance Tax Return and Inventory) 30.00 7 Verizon (final telephone bill) 3.;33 8 AT8~T (final long distance bill) 19.12 H-B7 52.45 Copyright (c) 2002 farm software only The Lackner Group, Inc. Form PA-1'x00 Schedule H (Rev. 6-98) Rev-1512 EX+(12-08) SCHEDULE 1 s. DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Itinger, Ernestine E. 21-10-06~1ft Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-15i~(1 Schedule I (Rev. 12-08) REV-1513 EX+~11-08) y~ SCHEDULE J COMMONWEALTH OF PENNSYLVANIA N BENEFICIARIES INHERITANCE TAX RETUR RESIDENT DECEDENT ESTATE OF FILE NUti1BIER Itinaer_ Ernestine E. 21-10-0618 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE ~4MOUN~T OF ESTATE NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not List Trustees I TAXABLE DISTRIBUTIONS [include outright spousal • distributions, and transfers under Sec. 9116 a 1.2 1 Tina Louise Babbs Daughter 1/3 of residuary 96,347.52 3711 Saffron Drive estate Mechanicsburg, PA 17050 2 Naomi Lynn Dowden Daughter 1/3 of residuary 96,347.53 1526 North Apple Street estate Greenfield, IN 46140 3 Mary Beth Jones Daughter 1/3 of residuary 96,347.53 1904 Crystal Lake Lane estate Hixson, TN 37343 Total 289,042.58 Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 15 00 cover sheet, as a r ~~iate. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKE=PJ B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET, Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) Jack M. Mindeck From: RV, Inheritance Tax Extension [RA-InheritanceTaxExt@state.pa.us] Sent: Tuesday, January 25, 2011 11:04 AM To: 'Jacky M. Mindeck' Cc: 'gfarner@ccpa.net' Subject: ERNESTINE E. ITINGER, EST. _,. M r5- ~~~ C ~'~'~'rli; j•.i~ ra i;1: 1~f ~,~S~I'~i3J~ ........... .. . The following message is being sent from an unmonitored account. Please do not reply. Re: Estate of ERNESTINE E. ITINGER File Number 2110-0618 Dear Sir or Madam: This is in response to your request for an extension of time to file the Inheritance Tax Return 'For the above estate. In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the timE~ for filing the return is extended for an additional period of six months. This extension will avoid the imposition of a penalty for failure to make a timely return. However, it does not prevent interest from accruing on any tax: remaining unpaid after the delinquent date. The return must be filed with the Register of Wills on or before 07/22/11. Because Section :?'136 (d) of the 1095 Act allows for only one extra period of six (6) months, no additional extension(s) will be grantE;d that would exceed the maximum time permitted. We now offer you the option to request your extension request via a-mail. Please usEa the following e- mail address: RA-InheritanceTaxExt@state.pa.us. Please contact me with any questions or concerns at: 717-787-8327. Sincerely, Claudia Maffei, Supervisor Document Processing Unit Inheritance Tax Division Please do not reply to this email This mailbox is not monitored and you will not receive a response. f=or assistance, visit us on the web at www.revenue.state.p~a.us or call us at 717-787-8327 The information transmitted is intended only for the person or entity to whom it is addressed and may contain confidential ancUor privileged material Any use of this information other than by the intended recipient is prohibited. If you receive this message in error., please send a rE~ply a-mail to the sender and delete the material from any and all computers. COMMONWEALTH OF PENNSYLVF~,f~~I~A DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 281)601 HARRISBURG, PA 1712E-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD C> 13079 BABBS TINA L 3711 SAFFRON DRIVE MECHANICSBURG,, PA 17050 -------- fold ESTATE INFORMATION: ssN: 237-20-349s FILE NUMBER: 2110-0618 DECEDENT NAME: ITINGER ERNESTINE E DATE OF PAYMENT: 07/20/2010 POSTMARK DATE: 107/19/2010 COUNTY: CUMBERLAND DATE OF DEATH: 04/ 22/ 201 0 ACN ASSESSMENT A1~1~OUNT CONTROL NUMBEF- 101 $1 2_,000.00 TOTAL AMOUNT PAID: REMARKS: RECEIPT TO ATTY CHECK# 59;3 SEAL INITIALS: WZ RE's-116? f-X1"! 1 961 RECEIVED BY: GLENDA EARNER STR/~~SBAUGH REGISTER OF WILLS TAXPAYER COMMONWEALTH OF PE=NNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT, 280601 HARRISBURG, PA 1 7 1 2 8-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD C-1 X3925 BABBS TINA L 3711 SAFFRON DRIVE MECHANICSBURG, PA 17050 --- __-- ,o~~ ACN ASSESSMENT AM(~UP~1T CONTROL NUMBER 101 ~ $375.34 ESTATE INFORMATION: SSN: 237-20-3498 FILE NUMBER: 2110-0618 DECEDENT NAME: ITINGER ERNESTINE E DATE OF PAYMENT: 01 /21 /201 1 POSTMARK DATE: 01 /21 /201 1 couNTY: CUMBERLAND DATE OF DEATH : 04/ 22/ 201 0 REMARKS: RECEIPT ~TO ATTY CHECK#105 SEAL TOTAL AMOUNT PAID: INITIALS: HMW RE_.`J 1162 EX(1'I-961 5375.34 RECEIVED BY: GLENDA EARNER STRASIBAUGH REGISTER OF WILLS TAXPAYER Last Will of ERNESTINE E. ITINGER I, ERNESTINI: E. ITINGER, a resident of Cumberland County, Pennsylvania, declare ghat this is my will. I :hereby revoke all my previous wills and codicils. Article One Introductory Provisions ' Section 1. Marital Status I am currently married to MILTON C. ITINGER, and all references to my spouse in tlvs will are to him. Section 2. Children a. The name(s) and birth date(s) of our children are: Name Birth date MARY BETH JONES NAOMI LYNN DOWDEN .~ TINA LOUISE BABBS August 14, 195E January 14, 1954 May 27, 1958 All references to our children in this instrument are to these children an,d any children subsequently born to or adopted by us. 1 Article Two Appointment of My Personal Representatives Section 1. Nomination of My Personal Representatives I appoint the following to be my Personal Representative: MILTON C. ITINGER If, for any reason, the Personal Representative(s) named above are unable or unwilling to serve, the following successor Personal Representative(s) shall serve until the succe;~sor Personal Representative(s) on the list have been exhausted. Unless otherwise specified, ii' C~o-Personal Representatives are serving, the next following named successor Personal Representative shall serve only after all of the Co-Personal Representatives cease to act as Personal Representatives. (I) TINA LOUISE BABBS (2) NAOMI LYNN DOWDEN (3) MARY BETH JONES Section 2~ Waiver of Bond No bond or undertaking shall be required of any Personal Representative nominatf:ci in my will. Section 3. General Powers My Personal Representative shall have full authority to administer my estate und~~r the laws of the State of Pennsylvania relating to the powers of fiduciaries. My Personal Representative shall have the power to administer my estate under the Independent Administration of F;;~tate~ Act. 2 Article Three Disposition of My Property Section 1. Distribution to My Revocable Living Trust I give all of my property of whatever nature and kind and wherever located to my revocable living trust of which I am a Trustor known as: MILTON C. ITINGER and ERNESTINE E. ITINGER, Trustees, or their successors in trust, under the MILTON C. ITINGER AND ERNESTINE E. I'TINGER LIVING TIZLST dated OCT 2 5 1994 and any amendments thereto Section 2. Alternate Disposition If my revocable living trust is not in effect for any reason, I give all of my property to my Personal Representative under this will as Trustee who shall hold, administer and cii.stribute my property as a testamentary trust the provisions of which are identical to those of my revocable Living trust on the date of execution of my will. Article Four Death Taxes Section 1. Definition of Death Taxes T~e term '''death taxes," as used in my will, shall mean all inlheritance, estate, succession and other similar taxes that are payable by any person on account of that person's interest in 1:he estate of the decedent or by reason of the decedent's death including penalties and. interest, but excluding the following: a. Any addition to the federal estate tax for any "excess retire~men.t accumulation" under Internal Revenue Code Section 4980A. b. Any additional tax that may be assessed under Internal Revenue Code Section 2032A. 3 c. Any federal or state tax imposed on ageneration.-skipping transfer, as that term is defined in the federal tax laws, unless the applicable tax. statutes provide that the generation-skipping transfer tax is payable directly out of the assets of my gross estate. Section 2. Payment of Death Taxes Pursuant to the terms of my revocable living trust, all death taxes whether or not attributable to property inventoried in my probate estate shall be paid by the Trustee from that trust. However, if that trust does not exist at the time of my death or if the assets ~of that trust are insu~ffic:ient to pay the death. taxes in full, I direct my personal representative to pay any death taxes that cannot be paid by the trustee from the assets of my probate estate by prorating and apportioning; those taxes among the beneficiaries of this will. Notwithstanding any other provision in my trust, all death taxes incurred by rea;~on of assets transferred outside of my trust or probate estate shall be assessed against those persons receiving such property. Article Five General Provisions Section 1. No Contest Clause If any person or entity other than me singularly or in conjunction with any other person or entity directly or indirectly contests in any court the validity of this will including any codicils thereto, then the right of that person or entity to take any interest in my estate shall cease acid that: person ~-or~entity shall be deemed to have predeceased me. Section 2. Captions The captions of Articles, Sections and Paragraphs used in this will are for convenience of reference only and shall have no significance in the construction or interpretation o~f this will. 4 Section 3. Severability Should any of the provisions of my will be for any reason declared invalid, such invalidity shall not affect any of the other provisions of this will and all invalid provisions shall. be wholly disregarded in interpreting this will. Section 4. Governing Law This wil] shall be construed, regulated and governed by and in accordance with the laws of the State of Pennsylvania. I signed this, my last will, on OCT 2 5 1994 . ERNESTINE E. ITINGER .~ 5 The foregoing Will was, on the day and year written above, published and declared by ERNESZ'INE E. ITINGER in our presence to be her Will. We, in her presence; and at her request, and in the presence of each other, have attested the same and have signed our names as attesting witnesses. We declare that at the time of our attestation of this Will, ER~IESTINE E. ITINGEF; was, according to our best knowledge and belief, of sound mind and memory and under no undue duress or constraint. TNESS `~/ Address: ~~Pfi7'~-; ~~ WITNESS Address: ~J .~ ., 6 STATE OF PENNSYLVANIA : : SS: COUNTY OF DAUPHIN : We, ERNESTINE E. ITINGER, ~~r ~ CRv3~ ,and S.t~ ~- ~-~'.,,.~.~-~, the Testatrix and the witnesses, respectively, whose names are signed to the foregoing Will, having been sworn, declared to the undersigned officer that the Testatrix, in the presence of witnesses, signed the instrument as her last Will, that she signed, and that each of the witnesses, in the presence of the Testatrix and in the presence of each other, signed the Wiil as a witness. ERNESTINE E, ITINGER WITNESS Subscribed and sworn before me by ERNESTINE E. ITINGER, the Testaa:~ix, and by a . ~ a and 5~.~~,...~ E , ~~, _,,.~ r the ~~vitnesses on ~c~ ? , 1994. .. - -- Notary Public M ~ ens: CQNNIE L. REESE, Notary Public Two Da ot~in Count MyCamr;~i~sion Expires Feb. 20, 19 7 'Che MILTON C.:[TINGER AND ERNESTINE E. ITINGER LIVING TRUST prepared for MILTON C. ITINGER .and ERNESTIN:E E. ITINGER .~ JAMES, SMITH & DURKIN Attorneys-at-Law 20 Valley Road Hershey, Pennsylvania 17033 (717) 533-3280 FAX (717) 533-279~i © James, hmith & Durkin All Rights Reserved ~5 MILTQN C. ITINGER AND ERNESTINE E. ITINGER LIVING TRUST Table of Contents Article Gne Trust Creation ................... . .......... „ ..... 1-1 Article 'Two The Trust Estate ......................... . . .. „ .. , .. 2-1 Article 'Three. Appointment of Trustees ........................ „ ..... 3-1 Article Four Trustors' Lifetime Rights . ...................... , ..... 4-1 Article Five Administration at Death of First Trustor ............ . ..... S-1 Article Six Specific Distributions of Trust Property .......... . .. „ .... , h_ 1 Article Seven Division into Survivor's Trust and Family Trust...... , . „ ..... 7-1 Article Eight The Survivor's Trust . ............. . ................. 8-1 Article Nine The Family Trust ................ . ........... , ... , . 9-1 Article Ten Common Pot Trust ............... „ ........... „ .... 10-1 Article Eleven Division and Distribution of Trust Property. .......... „ ... , 11-1 Article Twelve Distribution If No Designated Beneficiaries. .......... , .... 12-1 .. Article Thirteen ~ Trustee Administration ............., ........... , .... 13-1 Article Fourteen Trustee Investment Powers ..........., ........... ,..... 14-1 Article Fifteen General Provisions . ................................. 15-1 1 MILTON C. ITINGER AND ERNESTINE E. ITINGER LIVING TRUST Article One Trust Creation Section 1. Parties to Our Trust This trust agreement dated ~CT 2 ~ f9g4 is made between MILTON C. IT:[NGER, the husband Trustor, also known as MILTON C. ITINGER, and ERNESTINE E. ITINGER, the v~rife T'rustor, also known as ERNESTING E. ITINGER, and the following initial Trustees: MILTON C. ITINGER ERNESTINE E. ITINGER Section 2. Name of Our Trust This trust may be referred to as the: MILTON C. I"rINGER AND ERNESTINE E. ITINGER LIVING TRUST, dated OCT 2 5 Zc~gd The formal name of our trust and the designation to be used for t'he transfer of title to the name of our tr. ust i:.~ : MILTON C. ITINGER and ERNESTINE E. ITINGER, Trustees, or their successors in ,~ trust, under the MILTON C. ITINGER AND ERNESTINE E. ITINGER LIVING TR.tJST dated QCT ~2 ~~~ -~~994 and any amendments thereto Section 3. Revocable Living Trust Our Trust is a revocable living trust. Section 4. Trustors as Trustees Notwithstanding any other provisions in this trust agreement, when we are serving; as Trustees under this trust, either of us may conduct business and act on behalf of our trust ~v~~ithout the consent of any other Trustee. 1-1 Section 5. Our Family a. The name(s) and birth date(s) of our children are: Name Birth date MARY BETH JONES NAOMI LYNN DOWDEN TINA LOUISE BABBS August 14, 1956 January 14, 1954 May 27, 1958 All references to our children in this instrument are to these children and any children subsequently born to or adopted by us. .~ . 1-2 r' Article Two The Trust Estate Section 1. Initial Transfer of Property We hereby assign, devise, transfer and deliver to our Trustee al:l property set forth on Schedule '"A", attached hereto, and made part of this trust agreement. Our Trustee acknowledges receipt without consideration of all assets listed on the attached Schedule. Assets titled in the name of our trust but not listed on SchedulE: "A" shall be corisiderE;d a part of our trust estate to the same extent as if they had been set forth on the attache+~ ;schedule. Section 2. Additional Transfers to Trust We or any other person or entity may transfer or devise to our Trustee additional assets, real or personal, and may name our Trustee as the beneficiary of life insurance policies, annuities, retirement plans or similar contracts; such assets, policies and proceeds, upon delivery thereof to our Trustee, shall be a part of the trust estate, subject to all the terms of this tru.>t :agreement. Section 3. Character of Trust Assets All property transferred into our trust shall be characterized as follows: a. Joint Marital Estate Property All of our jointly held property, if any, transferred to our trust, and the pr~oc;eed~s " -'~ of -all such - roe p p rty, shall remain our jointly held property, subject toy th+„ provisions of this agreement. b. Separate Property All of the separate property, if any, of either of us transferred to our trust, and the proceeds of all such property, specifically designated as the separate property of either of us at the time of transfer to our Trustee, shall remain the sE~p;arate property of the contributing Trustor. 2-1 c. Community Property All community property or quasi-community property, if any, transferred i:o~ our trust, and the proceeds of all such property, specifically designated as comrriwlity property or quasi-community property at the time of transfer to our Trustee, sJhall remain our community property or quasi-community property, subject to the provisions of this agreement. .. 2-2 Article Three Appointment of Trustees Section 1. Definition of Trustee All references in this agreement to "Trustee" shall be deemed a reference to the person or entity who is then serving as Trustee and shall include alternate or successor Trustees or ~C'o-T'rustees, unless the context requires otherwise. Section 2. Resignation of a Trustee Any Trustee may resign at any time without court approval by giving written noticc~ to each of us or to our personal representative. If either of us is not living, written notice shall be liven to the successor Trustee, or if there is no successor, to the beneficiaries then entitled to receive income or principal distributions under this agreement, to their personal rf;presentatives, or to the persons having the care or custody of minor beneficiaries. Section 3. Removal of a Trustee Any Trustee may be removed under this agreement as follows: a. While We are Both Alive and Competent While we are both alive and legally competent and if we both agree, we shall have: the right to remove any Trustee appointed under this agreement at any time ~Nith. no requirement that the removed Trustee receive any reason for such termination. .~ b. While One of Us is Alive or Competent After the death of one of us or when both of us are alive but only one o:f tis is legally competent, any Trustee appointed under this agreement may be remc-ved. by the competent Trustor at any time with no requirement that the remc-ved Trustee receive any reason for such termination. c. Removal by Others .After the death or legal incompetency of both of us, any Trustee may be removed by a majority vote of the beneficiaries then entitled to receive income or principal 3-1 distributions under this agreement or their personal representatives. These; t beneficiaries or their personal representatives shall not be required to give any reason for such Trustee's termination. d. Notice to Removed Trustee Written notice of removal under this agreement shall be effective immediately when signed by the person or persons authorized to :make the remov~il and delivered to the Trustee personally or deposit by United States certified mail, return receipt requested. The written notice removing a Trustee shall designate a. successor Trustee. e. Transfer of Trust Property The 'Trustee so removed shall promptly transfer and deliver to the successor 'Trustee all property of the trust under its possession and control. Section 4. Designated Successor Trustees Whenever a Trustee is removed, dies, resigns, becomes legally incapacitated, or i:~ otherwise unable or unwilling to serve, that Trustee shall be replaced as follows: a. The Death or Disability of a Trustee While We are Serving; as Trustees We may serve as the only Trustees or we may name any number of Trustees to serve with us. If any of these other Trustees subsequently die, resign, become legally incapacitated or are otherwise unable or unwilling to serve as a Trustee, we may or may not fill the vacancy, as we both agree. -~~ b. _ Disability Trustees of MILTON C. ITINGER Upon the disability of MILTON C. ITINGER, if he is then serving as an irvitial Trustee, he shall be replaced by the following Disability Trustee(s): ERNESTINE E. ITINGER If, for any reason, the Disability Trustee(s) named above are unable or unw7al.ing to serve, the following successor Disability Trustee(s) shall serve untiil the successor Disability Trustee(s) on the list have been exhausted. Unless otherv~ise 3-2 specified, if Co-Disability Trustees are serving, the next following n~u~ned successor Disability Trustee shall serve only after all of the Co-Disability Trustees cease to act as Trustees. (1) TINA LOUISE BABBS (2) NAOMI LYNN DOWDEN (3) MARY BETH JONES c. Disability Trustees of ERNESTINE E. ITINGER Upon the disability of ERNESTINE E. ITINGER, if she is then serving as an i~~iitial. Trustee, she shall be replaced by the following Disability Trustee(s): MILTON C. ITINGER If, for any reason, the Disability Trustee(s) named above are unable or unwi_laing to serve, the following successor Disability Trustee(s) shall serve until. the successor Disability Trustee(s) on the list have been exhausted. Unless otheitivise specified, if Co-Disability Trustees are serving, the next following n~~rned successor Disability Trustee shall serve only after all of the Co-Disability Trustees cease to act as Trustees. (1) TINA LOUISE BABBS (2) NAOMI LYNN DOWDEN (3) MARY BETH JONES .~ d. Death Trustees of MILTON C. ITINGER Upon the death of MILTON C. ITINGER, if he is then serving as an initial TrL~st~ee, he shall be replaced by the following Death Trustee(s): ERNESTINE E. ITINGER If., for any reason, the Death Trustee(s) named above are unable or unwillvlg to serve, the following successor Death Trustee(s) shall serve until the successor Death Trustee(s) on the list have been exhausted. Unless otherwise specified,, if Co-Death Trustees are serving, the next following named successor Death Trustee shall serve only after all of the Co-Death Trustees cease to act as Trustees. (1) TINA LOUISE BABBS (2) NAOMI LYNN DO WREN (3) MARY BETH JONES 3-3 e. Death Trustees of ERNESTINE E. ITINGER Upon the death of ERNESTINE E. ITINGER, if she is then serving as an. initial Trustee, she shall be replaced by the following Death Trustee(s): MILTON C. ITINGER If, for any reason, the Death Trustee(s) named above are unable or unwialvzg to serve, the following successor Death Trustee(s) shall serve until the successor Death Trustee(s) on the list have been exhausted. Unless otherwise specific;d, if Co-Death Trustees are serving, the next following named. successor Death 'trustee shall serve only after all of the Co-Death Trustees cease to act as Trustees. (1) TINA LOUISE BABBS (2) NAOMI LYNN DOWDEN (3) MARY BETH JONES Section _5. No Designated Successor Trustees If at any time there is no Trustee acting under this agreement and there is no person or institution designated and qualified as a successor Trustee, a majority of the beneficiaries then eligible to receive distributions of income or principal under this agreement or their personal ~re;presentatives shall appoint a successor Trustee. If any trust existing under this agreement lacks, a Trustee and no successor is appointed pursuant to this Section, the vacancy shall be filled by a court of competent jurisdiction. Section 6. Responsibility of Successor Trustees A successor "Trustee shall have the same rights, powers, duties, discretions and imrriunities as if 'it-~iad been named as initial Trustee under this agreement. No successor Trustee shall be personally liable for any act or failure to act of any predecessor. Trustee or shall have any duty to examine the records of any earlier Trustee. A successor Trustee may accept the account rendered and the property delivered by or on behalf of a predecessor Trustee .~:s a full and complete discharge of the duties of the predecessor Trustee without incurring any responsibility or liability for so doing. 3-4 Article Four Trustors' Lifetime Rights Section 1. Income and Principal :~. Right to Trust Income and Principal Our Trustee shall pay to or apply for our benefit during our joint lifetimes all or such part of the income and principal of the trust estate as we may direct. We may not, however, direct our Trustee to make gifts from trust property tc- third parties. If our Trustee inadvertently makes a distribution we intended as a. gift directly from the trust to a third party, that distribution shall be construed as a distribution to us first, then a gift to the third party from us. l:Jnless directed in writing to the contrary by either of us: 1. Our Trustee shall be authorized to acc;ept and execute instructions received from either Trustor regarding distributions of the income or principal of the trust estate to or for the benefit of either or both of us. 2. Our Trustee shall be authorized to make distributions of the income or principal of the trust estate in the sole name of a Trustor as instructed by either of us. b. Trustee Liability .~ ~- Upon any distribution of the income or principal of the trust estate authori~;eci or directed by a Trustor, our Trustee shall incur no liability to the other Trustor in respect of such distribution, shall be under no obligation to seek the approval or werif cation of the concurrence of the other Trustor to such distribution and. ;s:hall have no responsibility for the application of any distribution made in the name of a Trustor. c. Tracing of Income Not Required Unless otherwise provided or specified by either or both of us during our joint lives any distributions of income to either of us shall be conclusively presumeci to be derived in respect of the joint marital estate property of the Trustors anal our 4-1 Trustee shall be under no obligation to allocate, trace or otherwise identiiy~ the actual source of such income. Section 2. Trustors' Rights During Disability a. Definition of Disability ~~ Trustor shall be considered disabled in the event a court of compei~ent jurisdiction determines that a Trustor is legally incompetent or in the event tthat a Trustor is not adjudicated incompetent but by reason of illness or me~atal disability a Trustor has been certified by two licensed physicians to be unable to properly handle his or her own affairs. b. Income and Principal Distributions Our "Trustee during the period of a Trustor's disability shall pay to or apply for that Trustor's benefit as much of the principal and net income of that Trustor's separate property estate and his or her interest in the joint marital estate property and community property, if any, as our Trustee in its sole discretion shall deem necessarv or advisable. c. Payment of Obligations Our "Trustee during the period of a Trustor's disability shall, from time to time, pay that Trustor's valid obligations, medical expenses and provide for his or her comfortable maintenance and welfare, taking into consideration his or her other income or resources. cl. Income and Principal Distributions for Non-disabled Trustor .~ During the lifetime of either or both of us, should either or both of us become disabled, then our Trustee shall pay to or apply for the non-disabled Trustor's benefit as much of the principal and net income of the disabled Trustor's separate property estate and his or her interest in the joint marital property estate and community property, if any, as our Trustee in its sole discretion shall dE;em necessary or advisable, from time to time, for the non-disabled Trustor's h.ea.lth, maintenance, support and education, taking into consideration his or her other income or resources. 4-2 e. Trustee Guidelines In making distributions under this Section, our Trustee shall give prirr~ary consideration to the needs of the disabled Trustor and secondary consideration to the needs of the non-disabled Trustor. f. Tax Planning During our joint lives should either or both of us become disabled, our T:nzstee may exercise the following powers as attorney in fact on our behalf, either alone or in conjunction with any other attorney in fact under a durable power of attorney for a disabled Trustor, but the primary concern of our Trustee shall be for our welfare and secondarily for the welfare of the our lineal descendants for tax planning: 1. Our Trustee may make additional distributions to our lineal descendants, equally by class, for the purpose of continuing any gift program initiated by us which our Trustee reasonably determines will achieve beneficial results for estate and/or income tax planning purposes. 2. Our Trustee may initiate a gift program on our behalf which our Trustee reasonably determines will achieve beneficial results for estate and/or income tax planning purposes by making distributions to our lineal descendants, equally by class, so long as such distributions are made in the form which qualify for and are limited to the annual exclusion for federal gift tax purposes. 3. During any disability of a Trustor our Trustee shall be ,~ -under no obligation to initiate, recommend or consider • any tax planning objective or program for us and any exercise of its discretion in this regard, when conducted in good faith, shall not subject it to liability to any person affected thereby. Section 3. Right to Amend or Revoke Qur Trust We shall have the right to amend, terminate or revoke our trust as follows: 4-3 ( a. Power to Revoke and Amend While Both of Us Are Living During our joint lifetimes this trust and any trust created by this agreement. may be amended, revoked or terminated, in whole or in part, by either of us acsting; alone as to any specially designated property of that Trustor and as to that: Trustor's interest in any of our joint marital estate property. However., any modification of the rights and interests of either of us in community property during our marriage may be made only with the joinder or consent of both of us.. b. Power to Revoke and Amend After Death of First Trustor After the death of the first of us to die, the surviving Trustor may at any time amend, revoke or terminate, in whole or in part, the Survivor's Trust in which the: surviving Trustor has a general power of appointment. All other trusts shall. become irrevocable and shall not be subject to amendment after the death oi' the; first Trustor. c. Method to Revoke or Amend Any amendment, revocation or termination of this trust or any trust created b;y this agreement shall be made by written instrument signed by both of us or by the; Trustor making the revocation, amendment or termination, and delivered to ou1• Trustee. If the instrument making the revocation, amendment, or termination is, signed by only one Trustor and the other Trustor is living at that time, a c~o:py of? the instrument making the amendment, revocation, or termination shall also be: delivered to the other Trustor. An exercise of the power of amen.drnent: substantially affecting the duties, rights and liabilities of our Trustee s1^iall be; effective only if agreed to by our Trustee in writing. d. Delivery of Property After Revocation .~ After any revocation or termination with respect to our joint marital estate: property our Trustee shall promptly deliver the joint marital estate property t:o the; Trustor or Trustors to the extent of their interest in the joint marital estate; property. After any revocation or termination with respect to specific;ally designated property our Trustee shall promptly deliver the designated property toy the Trustor or Trustors who originally contributed that property to the trust and. such property so returned shall be conclusively deemed to resume the same character it had immediately before transfer to our trust. 4-4 e. Trustee's Retention of Assets Upon Revocation In the event of any revocation of all or part of our trust, our Trustee sh<<ll be entitled to retain sufficient assets to reasonably secure the payment of liabi:l:ii:ies our Trustee has lawfully incanted in administering the trust and any fees that h<~ve been earned by our Trustee, until such time as those liabilities have been discharged and fees paid, unless we indemnify our Trustee against loss or expense. Section 4. Exercise of Trustors' Rights and Powers by Others Any right or power that either of us could exercise personally under the terms of this agreement, except the power to amend, revoke or terminate any trust created by this agreement, may be exercised for and on behalf of that Trustor by any attorney in fact who, at the time of the exercise, is duly appointed and acting for that Trustor under a valid and enforceable durable power of attorney executed by that Trustor or, if there is no such attorney in fac;t., by a duly appointed and acting conservator of that Trustor after petition to a court of competent ju.risdliction. The power to amend, revoke or terminate any trust created by this agreement is personal to us and may not be exercised by any other person or entity. Section 5. Rights Concerning Standby Property It is contemplated that certain assets may be added to the trust estate from time to timie with the possession and control thereof retained by or redelivered to us. If we execute and deliver to our Trustee an instrument effectively transferring such assets to our Trustee together with any :further documentation necessary to effect the record transfer thereof, in the event of a Tr~asl:or';> death or incapacity the assets shall be deemed to be assets of the trust estate and held by us as the uorriinee of our Trustee. During the period such assets are in our possession they shell be subject to the fallowing terms and conditions: ` 4-5 a. We may receive directly and devote to our own use and benefit any dividends, interest, income or distributions from or upon such assets and neither we nor our Trustee shall have any duty of accounting to the other or to any other person with regard thereto. b. Any sale, exchange or other transfer of such assets by us shall constitute a withdrawal of such assets fiom the trust estate and our Trustee shall have no further interest therein or duties with regard thereto. Though not: a condition precedent to any such withdrawal, we agree to notify our Trustee of all such withdrawals. c. We shall be responsible for the reporting of the income from such assets to the appropriate taxing authorities and our Trustee shall have no responsibility for including such income on any fiduciary returns prepared by it or for the preparation of any other income tax return with respect thereto unless we duly notify our Trustee of such income items and a full and adequate accounting thereof is made and presented to our Trustee. d. We shall protect and indemnify our Trustee against all losses, liabilities and expenses which may result directly or indirectly from our use, possession, management or control of such assets. e. Upon the death or incapacity of either of us„ our Trustee shall be entitled to the possession thereof and thereafter shall have all the rights, powers and duties with respect to such assets which are otherwise granted to our Trustee herein. It is understood that our Trustee shall be responsible only for ` the assets which actually come into its possession and control. However, it is also understood that: our Trustee shall use any reasonable and prudent means to secure possession of any trust assets of which it has knowledge. Our Trustee shall have no duty, accountability or responsibility to us or to any other person with respect to any assets of which it has no knowledge or of which it is unable to obtain possession and control. 4-6 Section 6. Trustor/Trustee Bank Accounts It is contemplated that we may establish a joint bank account or accounts with our' 1'rusl:ee and create powers of attorney in respect thereof in other persons. Deposits from time 1:o time made by us or other authorized persons into such an account shall constitute transfers to tree trust estate and withdrawals therefrom, which may be made without the co-signature of our 7'rizstef;, shall constitute withdrawals from the trust estate. However, our capacity and other authorized persons with respect to any such account shall be that of nominee of our Trustee, not co-ovrner. At any given time the trust estate shall include the then balance of any such account. Section 7. Life Insurance Premiums and Retirement Plans During our lifetime we shall have all powers over life insurance policies and retirement benefits owned by or made payable to our trust, including the following: a. Payment of Premiums .~ `JVe shall be responsible for the payment of premiums and other charges on each policy of insurance owned by or made payable to our trust. Our Trustee shall have na duty to make any payment or be responsible to determine whether such payments have been made. b. Custody of Policies Our Trustee shall not be responsible for the custody or safekeeping of any life insurance policy before its actual delivery to our Trustee nor after its withdrawal by its owner. r.. Change Beneficiaries We shall have the -right to change the beneficiary and to receive any dividends or other earnings of such policies or plans without accountability therefor t~~ our Trustee or any beneficiary in this agreement. d. Assignment We may assign any policy or plan benefits to any lender to the extent allowed by law, including our Trustee, as security for any loan to us or any other person. 4-7 e. Surrendered Policies If any life insurance policy is surrendered or if the beneficiary of any policy i;; changed, this trust agreement shall be revoked with respect to such policy„ However, no revocation of the trust with respect to any policy, whether p~;~rsuanl: to the :provisions of the preceding sentence or otherwise, shall be effective unless the surrender or change in beneficiary of the policy is accepted by the insurance; company. Section 8. Undistributed Net Income Any net income not distributed under the provisions of this Article shall be addE~d to the trust principal. . .~ 4-8 l Article Five Administration at Death of First Trustor Section 1. Trustee's Discretion to Pay Debts and Taxes After the death of the first of us to die, our Trustee, in its sole discretion, may pay all, or any part of the deceased Trustor's following expenses, debts, claims and taxes becoming dlle or ~>ayable by reason of the death of the first of us: a. Final medical expenses and all funeral costs; b. Legally enforceable claims against the deceased or the estate; c;. Reasonable expenses of administration of this trust and the decease,d's probate estate, if any; d. Any allowances mandated by a court of competent jurisdiction to those dependent upon the deceased Trustor; e. Any estate, inheritance, succession, death or similar taxes payable by reason of the death of the first of us; and f: Any penalties or interest on any of the above claims, debts or taxes owed by the deceased or the estate. Section 2. Payment by Our Trustee or Personal Representative O~' Trustee in its sole discretion may make distributions authorized under this ~~:rticle either directly to the person or entities to whom payment is owed or to the personal representative of the deceased Trustor's probate estate. Written statements by the decease~3':~ personal representative that such sums are due and payable by the estate shall be sufficient: evidE;nce of their amount and propriety for the protection of our Trustee. Our Trustee shall be under no duty to see to the application of any such payments made to the deceased's personal representative. Section 3. Tag Elections With regard to the payment of any income tax, gift tax, estate tax, inheritance tax or any other tax required because of the death of the first of us, our Trustee shall have the right t~o make any 5-1 available elections allowed under the law. Our Trustee is authorized to sign ands file <~ny tax return required because of the death of the first of us. Section 4. Payment of Death Taxes, Claims and Expenses a. Payment out of Trust Property All death taxes, claims and expenses payable under the provisions of this ~.rticle shall be paid by our Trustee out of the trust estate, except .as specifically provided for elsewhere in this agreement. h. Exception for Property Passing Outside of Trust Notwithstanding any other provision in our trust, all death taxes, claims and expenses incurred by reason of assets passing outside of our trust or probate estate shall be assessed against those persons receiving such property. c. Payment from Deceased Trustor's Share Notwithstanding any other provision in our trust, all death taxes, claims and expenses payable under the provisions of this Article shall not be paid from the Survivor's Trust as defined in Article Eight or from any property passing ~to the surviving Trustor that qualifies for the federal estate tax marital deduction. .~ 5-2 Article Six Specific Distributions of Trust Property Section. 1. No Specific Distributions Our Trustee shall make no specific distributions of trust property to any beneficiariE~;; under this trust agreement upon our death. All distributions of trust property shall be made in the Articles that follow. .. 6-1 Article Seven Division into Survivor's Trust and Family Tr~.~st Section 1. Division of the Trust Estate Upon the death of the first Trustor to die, our Trustee shall allocate and distribute the remaining trust estate, including any property that becomes distributable or payable to our T'ru.stee at the deceased Trustor's death, into two separate shares to be identified as the Survivor's Share and the Family Share. a. Surviving Trustor's Property Transferred to the Survivor's Share The Survivor's Share shall consist of: 1. The surviving Trustor's one-half (1/2) of all assets representing the joint marital property of the Trustors held by our Trustee. 2. All assets theretofore declared to be or specifically designated upon transfer to our Trustee to be the separate property of the surviving Trustor as held by our Trustee. 3 . One-half (1 /2) of all assets theretofore declared to be or specifically designated upon transfer to our Trustee by the Trustors to be the community property of the Trustors. - -'' b. Deceased Trustor's Property Transferred to the Survivor's Share The Survivor's Share shall also consist of assets having a value equal to the unlimited federal estate tax marital deduction allowable to the deceased Tru;~tor's estate, subject to the following: 1. The Survivor's Share shall be reduced by the net value for federal estate tax purposes of all other property that passes or has passed to the surviving Trustor under this trust agreement, the deceased Trustor's probate estate or otherwise that qualifies for the federal estate tax marital deduction. 7-1 2. The Survivor's Share shall be reduced by all federal i estate tax deductions actually allowed other than the marital deduction; 3. The Survivor's Share shall be reduced by the amount, if any, needed to increase the deceased Trustor's taxable estate for federal estate tax purposes to the largest amount that after allowing for the unified credit against federal estate tax, will result in the smallest, if any, federal estate tax being imposed on the deceased Trustor's estate; 4. The Survivor's Share shall be reduced by the credit for state death taxes available to the estate of the deceased Trustor, to the extent that the use of that credit does not result in or increase any death tax payable to any state; and 5. The Survivor's Share shall be reduced by any other allowable credits available to the estate of the deceased Trustor, except the credit for tax on prior transfers from a "transferor", as defined in Internal Revenue Code Section 2413, who dies within two years after the date of death of the deceased Trustor, but only to the extent that those credits do not disqualify this gift from receiving the marital deduction. 6. Notwithstanding any other provision in this Section, the Survivor's Share shall never have assets with a value less than the maximum amount of the unified credit _ against the federal estate tax as of the date of the -~~ -~ deceased Trustor's death, unless the value of the surviving Trustor's trust property, less all liabilities, and the deceased Trustor's estate gross estate less all allowable deductions except the federal estate tax marital deduction, is less than the maximum value of the unified credit against the federal estate tax, in which case the entire amount of the deceased Trustor's trust property shall be allocated to the Survivor's Share. For purposes of calculations under this subsection, the Survivor's Share 7-2 ~~ shall be reduced by the value of other property passing to it under this trust agreement, the deceased Trustor's probate estate, or otherwise that qualifies .for the federal estate tax marital deduction. c. Survivor's Share to be Administered as Survivor's Trust The Survivor's Share shall be held, administered and distributed according; to the provisions of the Survivor's Trust as set forth in ,Article Eight of this trust agreement. d. Property Transferred to the Family Share The Family Share shall consist of all assets not distributed to the Survivor's Share;. e. Family Share to be Administered as Family Trust The Family Share shall be held, administered and distributed according to the provisions of the Family Trust as set forth in Article Nine of this trust agre;ernenl:. Section 2. Allocation and Valuation of Assets In allocating assets between the Survivor's Share and the Family Share, our Trustee shall allocate the trust assets that qualify for the marital deduction between the Survivor's Share ~~n~d the Family Share in cash or in kind, or partly in each, on a pro rata or non pro rata basis, and ;in undivided interests or not; subject, however, to the following: a. Qualification for Marital Deduction ,~ Only assets that qualify for the marital deduction shall be allocated tc- the Survivor's Share. ` b. Valuations of Allocations in Kind Assets allocated in kind shall be deemed to satisfy the marital deduction ~uriount on the basis of their values as finally determined for federal estate tax purposes.; provided, however, that our Trustee shall act impartially, consistent with equitable principles, requiring impartiality among beneficiaries, in allocating assets i~a satisfaction of the marital deduction share, so that any 7-3 distribution of assets in satisfaction of the marital deduction share shall bf; made ~' of assets, including cash, fairly representative of appreciation or depreciation in the value of all property thus available for distribution. c. Income The Survivor's Share shall be entitled. to a pro rata share of the income earned on deceased Trustor's residuary probate and trust assets from the date of deceased Trustor's death, including a share of income earned on assets used to discharge liabilities. d. Foreign Death Tax Credit . Our Trustee shall not allocate assets that qualify for the foreign death tax. credit to the Survivor's Share unless all other assets or interests available for allocation. have been so allocated. e. Insurance on the Life of the Surviving Trustor Our 'Trustee shall not allocate any policy of insurance on the life of the suiti~ivin€; Trustor to the Survivor's Share that is the separate property of the deceased Trustor. f. Insurance oa the Lives of Others Any incidents of ownership to a policy of insurance on the life of a person other than. the deceased Trustor shall be allocated to the Family Share. g. Lack of Property to Fully Fund the Survivor's Share If there is insufficient property qualifying for the federal estate tax marital .~ deduction to fully fund the Survivor's Share, the funding to the Survivo~`'s~ SharE; shall be reduced accordingly. 7-4 ~~' Article 3. Intention that Survivor's Share Qualify for Marital deduction We intend that the Survivor's Share qualify for the federal estate tax marital deduction and this agreement shall be construed accordingly. All other provisions of this trust agreement shall be subordinate to that intent. If the granting of any right, power, privilege, authority.. or irr.~munity to our "Trustee or another person and the imposition of any duty upon our Trustee or another person by any provision of this trust agreement, would disqual.i:Fy an.y share or interest of a beneficiary hereunder from qualifying for the federal estate tax marital deduction provided by Section 2056 of the Code, such provision shall be ineffective if and to the; extent that the same, if effective, would so disqualify such share or interest. The provisions of this Section shall also apply to the deceased Trustor's probate estate, personal represenia~tive and all beneficiaries, devisees and legatees. Notwithstanding any other provision in this trust: agreement to the contrary, the surviving Trustor at any time shall. have the right to direct oi.~r. Trustee, in writing, to convert, within a reasonable time, any unproductive trust property to income producing property. Section 4. Disclaimer of Property Any property or portion of property that is disclaimed by the surviving Trustor sh,~il be held, administered, or distributed according to the following terms: a. Property Disclaimed .~ The surviving Trustor may disclaim any property held or distributed to or for the benefit of the surviving Trustor under this trust agreement. b. Time to Disclaim The surviving Trustor may disclaim within the time limits and undf;r the conditions permitted by the laws regulating disclaimers. c. Delivery of Disclaimer to Our Trustee A disclaimer by the surviving Trustor may be exercised by the delivery t:c- our Trustee of an irrevocable and unconditional refusal to accept any or all property interests passing to the surviving Trustor or the Survivor's Share. 7-5 d. Disclaimer of Survivor's Share i If the surviving Trustor exercises a disclaimer with respect to any or all property set aside as the Survivor's Share, such disclaimed interest shall be added t:o the Family Share. e. Disclaimer of Family Share If the surviving Trustor exercises a disclaimer with respect to any or all property set aside as the Family Share, such disclaimed interest shall be distributed under the relevant terms of this agreement as though the surviving Trustor hacl predeceased the deceased Trustor. .. 7-6 Article Eight Survivor's Trust Section 1. Rights of Surviving Trustor in the Survivor's Trust Our Trustee shall hold, administer and distribute the assets of the Survivor's Trust as follows: a. Payment of Income Our Trustee shall pay to or apply for the benefit of the surviving Trustor, so long as the surviving Trustor lives, the entire net income of the Survivor's Tni~;t in monthly or other convenient installments agreed upon by the surviving Trustor and our Trustee, but not less often than annually. b. Discretionary Payment of Principal At any time or times during the trust term, our Trustee shall pay to or apply for the benefit of the surviving Trustor so much of the principal of the Survivar's Trust as our Trustee deems proper for the surviving Trustor's comfort, welfare and happiness. In exercising discretion, our Trustee shall give the consideration that our Trustee deems proper to all other income and resources then readily available to the surviving Trustor for use for these purposes that are then known to our Trustee. c.. Right of Surviving Trustor to Withdraw Principal Our Trustee shall pay to the surviving Trustor as much of the trust principal of ithe Survivor's Trust as the surviving Trustor may from time to time demand in a - -•' signed writing_ delivered to our Trustee. d. General Power of Appointment L7pon the death of the surviving Trustor, our Trustee shall distribute all of the trust property, including the trust principal and accrued and undistributed income, to any person or entity, person or persons, and upon any trust, terms and conditions, or to or in favor of the estate of the surviving Trustor, as the surviving Tr~u~s~tor may direct by his or her last will or living trust agreement. No exercise of~ this general power of appointment shall be effective unless it refers to this trust agreement and expressly indicates an intention to exercise this general power of 8-l { ~ "" appointment. Our Trustee may rely upon any instrument admitted to probate as the last will of the surviving Trustor in carrying out the terms of the po~w-F;r of appointment and shall not be liable for any good-faith act in reliance upon that will, even if for any reason it is later determined to be invalid with respect to its purported exercise of this power of appointment. Section 2. Trustee's Discretion to Pay Debts and Taxes The Survivor's Trust shall terminate upon the death of the surviving Trustor. Our Tr.-ustee, shall hold, and administer the unappointed balance or remainder of the Survivor's Trust as follows: a. Surviving Trustor's Debts and Taxes Our 'trustee in its sole discretion may pay all or any part of the surviving; Trustor's following expenses, debts, claims and taxes becoming due or payable by reason of the surviving Trustor's death: 1. Final medical expenses and all funeral costs; 2. Legally enforceable claims against the surviving Trustor or the surviving Trustor's estate; 3. Reasonable expenses of administration of this trust and the surviving Trustor's probate estate, if any; 4. Any allowances mandated by a court of competent jurisdiction to those dependent upon the surviving Trustor; ,~ S. Any estate, inheritance, succession, death or similar taxes payable by reason of the death of the surviving Trustor; and 6. Any penalties or interest on any of the above claims, debts or taxes owed by the surviving Trustor or the surviving Trustor's estate. Section 3. Payment by Dur Trustee or Personal Representative Our Trustee in its sole discretion may make distributions authorized under this .As-ticle either directly to the person or entities to whom payment is owed or to the personal repre:>enti~tive of 8-2 ~~" the surviving Trustor's probate estate. Written statements by the surviving Tru;;tor's :personal representative that such sums are due and payable by the estate shall be sufficient evidence of their amount and propriety for the protection of our Trustee. Our Trustee shall be under no duty to see to the application of any such payments made to the surviving Trustor's :personal representative. Section 4. Tax Elections With regard to the payment of any income tax, gift tax, estate tax, inheritance tax or any other tax required because of the death of the surviving Trustor, our Trustee shall ha~ae the right to make any available elections allowed under the law. Our Trustee is authorized to ;>ign and file any tax return required because of the death of the surviving T.rustor. Section 5~. Administration of Survivor's Trust Remainder After payment of debts, expenses and taxes, our Trustee shall hold and administer the unappointed balance or remainder of the Survivor's Trust as provided in the Articles that follow. .~ 8-3 Article Nile e Family Trust Section 1. Rights of Surviving Trustor in the Family Trust Our Trustee shall hold, administer and distribute the assets of the Family Trust as follows: a. Payment of Income Our Trustee shall pay to or apply for the benefit of the surviving Trustor, so long as the surviving Trustor lives, the entire net income of the Family Tnast in monthly or other convenient installments agreed upon by the surviving Trustor and our Trustee, but not less often than annually. b. Discretionary Payment of Principal At any time or times during the trust term, our Trustee shall pay to or apply for the benefit of the surviving Trustor and our joint descendants so much of the principal of the Family Trust as our Trustee in its discretion deems proper four their health, maintenance, support and education. c. Guidelines for Trustee's Discretion In exercising discretion our Trustee may pay to or apply more for some beneficiaries than for others and may make payments to or for one or more beneficiaries to the exclusion of others. However, our Trustee shall, at all 'times, give primary consideration to the surviving Trustoe's needs and only thereafter to our joint descendants. No amount paid or applied need thereafter be repaid ~to our -'' Trustee or restored to our trust. In exercising discretion our Trustee shall give the consideration that our Trustee deems proper to all other income and resourcE;s that are known to our Trustee and that are readily available to the beneficiaries fir use for these purposes. Our Trustee shall accumulate and add to principal arty net income not distributed. d. Limitation on Discretionary Payment of Principal by Trustee We recommend, but it is not mandatory, that our Trustee shall first exhaust the principal from the Survivor's Trust before making discretionary paymentsc of principal to the surviving Trustor from the Family Trust. 9-1 e. Restriction on Surviving Trustor's Right to Receive Principal Notwithstanding any other provision in this agreement, if the surviving Trustor :has the paver to remove a Trustee of the Family Trust our Trustee shall not distribute any of the principal of the Family Trust that would, in any manner, discharge the surviving Trustor's legal obligation of support to a beneficiary of the F~ur.~ily Trust. In the event the surviving Trustor is mentally disabled and without the power to remove a Trustee of the Family Trust, our Trustee shall disregard this restriction during such period of mental disability. f.. Surviving Trustor's Right to Withdraw Principal The surviving Trustor shall have the power to withdraw from the Family 'T'rust principal each calendar year those amounts that shall not exceed the greater of five thousand dollars ($5,000) or five (5) percent of the assets, valued as of the e:nd of the preceding calendar year. The surviving Trustor shall exercise this power by a written instrument signed by him or her and delivered to our Trustee. 'T'his power is noncumulative and to the extent it is not exercised by the end of Jaiiu,ar•y of each calendar year, it shall lapse. This power shall exist each year until the death of the surviving Trustor. Section 2. Limited Power of Appointment By either a last will or by a living trust agreement, the surviving Trustor shall have the limited testamentary power to appoint to or for the benefit of our joint descendants some or all of the principal and any accrued but undistributed net income of the Family Trust as it exists at the death of the surviving Trustor. The surviving Trustor may appoint trust assets under tl':us limited testamentary power among our joint descendants in equal or unequal amounts, either directly or in trust, as the surviving Trustor directs. .~ This limited testamentary power of appointment shall not be exercised in favor o~ the Surviving Trustor's estate, the creditors of the surviving Trustor, the creditors of the surviving: Trustor's estate, or in any way which would result in any economic benefit to the surviving T:rustor. Section 3. Termination of the Family Trust On the death of the surviving Trustor, the Family Trust shall terminate. All unappointe;d and undistributed trust assets, including any accrued and undistributed net income, shall be held, administered and distributed in the Articles that follow. 9-2 Article Ten Common Pot Trust After the death of the surviving Trustor, our Trustee shall not create a Common Pot Trust. All trust property that has not been distributed under prior Articles of this trust agreement shall be held, administered, divided, and distributed according to the provisions of the Articles that :follow. .~ '~ 10-1 a Article Eleven Division and Distribution of Trust Property Section 1. Division of Trust Property Into Shares Our Trustee shall divide all trust property not previously distributed into separate shares of equal market value as follows: a. One Share for Each Living Child Our Trustee shall create one share for each of our then living children. b. One Share for Each Deceased Child Our Trustee shall create one share for each of our deceased children. Section 2. Distribution of Trust Shares for Our Living Children The trust share of each our children who survive us shall be held, administered aild distributed as follows: a. Distribution of Net Income and Principal Our 'T'rustee shall promptly distribute, free of the trust, all accumulated net incx~me and principal of the trust share to each of our living children who survive u:.. b. Distribution Upon Death of a Child Who Survives Us .~ Tf any child who survives us dies before the complete distribution of his or. her trust share that child's trust share shall terminate and our Trustee shall distribute the balance of the trust property in equal shares to the other beneficiaries n~arned in this .Article per stirpes. { ~, 11-1 f Section 3. Distributions to Underage or Disabled Beneficiaries Notwithstanding any other provision in this trust agreement, if any person otherwise entitled to receive a distribution of trust property is under 25 years of age or is mentally disabled ar regally incompetent as defined in Article Fifteen, our Trustee shall retain and administer that person's trust property for his or her benefit as follows: a. Our Trustee's Discretion Our Trustee may pay to or apply for the benefit of such beneficiary so much. of the net income and principal of the trust as our Trustee in its discretion deems proper considering all other sources of income and resour. ces available to .such beneficiary and known to our Trustee. b. Payments Made to Beneficiary or Personal Representative Our Trustee is authorized to make payments under this Section either directly to the beneficiary, to the beneficiary's personal representative or to any other person our Trustee may deem proper to be used for the benefit of the beneficiary.. c. Trustee's Decisions are Final All decisions by our Trustee as to those it makes payment to, the purposes. for which these payments are made and the amounts to be paid out of the trust ;are within our Trustee's sole and absolute discretion. d. Undistributed Net Income All undistributed net income shall be accumulated and added to the principal of the trust. -~ 11-2 e. Termination and Distribution Our Trustee shall distribute the trust property to a beneficiary under this Seaction when such beneficiary reaches age 25, or when he or she is no longer disabledl as determined by a court of competent jurisdiction, or upon certification by two licensed physicians that such beneficiary is able to properly care for his o~r her property and person, or at a later date if other trust provisions in this Article direct. f. Death of Disabled or Underage Beneficiary L1pon the death of a beneficiary under this Section, our Trustee shall distribute all of such beneficiary's remaining trust share, including the trust principal <~nd accrued and undistributed income, to any person or entity, and upon any tr~.~st, terms and conditions, or to or in favor of the estate of such deceased beneficiary, as he or she may direct by his or her last will or living trust agreement, No exercise of this general power of appointment shall be effective unless it refer:~ to this trust agreement and expressly indicates an intention to exercise this ge;nf;ral power of appointment. .~ 11-3 Article Twelve Distribution if No Designated :Beneficiaries NONE .~ 12-1 ,F-- Article Thirteen Trustee Administration Section 1. Required Vote for Co-Trustees a. Trustors Serving as Co-Trustees Ifs both of us are serving as Trustees at the same time under this agreement, either o:ne of us may make decisions and bind the trust in the exercise of all power: and discretions granted to us under this agreement without the consent of any other Trustee. b. Unanimous Vote for Two Trustees Ifs only two Trustees are serving other than the two of us, they shall act unanimously in the exercise of all powers and discretions granted to them cinder this agreement. c.. Majority Vote for More Than Two Trustees ', A.t any time that there are more than two Trustees serving under this agreement, they shall act by majority vote and any exercise of a power or discretion by a majority of the Trustees shall have the same effect as an exercise by all of them. d. Court Order Resolves Disputes Ifs the Trustees, other than the two of us, are not able to reach agreement on. any decision as set forth in this Section, they shall petition a court of comp~etf;nt -.: ~ jurisdiction for instructions and shall take no action on the disputed matter until a court order deciding the issue has been rendered. Section 2. Power to Delegate Notwithstanding any other provision of this agreement, any one or more of the Co-Trustees serving under this agreement may from time to time delegate to another Co-'I'rust:ee or Co-Trustees routine acts of trust administration. 13-1 ~` Section 3. No Bond Required No Trustee under this agreement shall be required to post any bond for the faithful performance of its responsibilities. Section 4. Trustee Compensation Our Trustee shall be entitled to reasonable compensation for services rendered pay<~b e without the need for a court order. In calculating the amount of compensation customary c,harg;es for similar services in the same geographic area for the same time period shall be used a:~ €;uidelines. Our Trustee shall also be entitled to reimbursement for reasonable costs and expenses incurred during the exercise of its duties under this agreement. Section 5. Change in Corporate Trustee Any corporate successor to the trust business of any corporate Trustee named. under this agreement or acting hereunder shall succeed to the capacity of its predecessor ~~~itho~ut re- conveyance or transfer of trust property. Section 6. Power to Divide or Combine Trusts Our Trustee shall have the power to divide a single trust into separate shares, each to be administered in accordance with the terms and conditions of the single trust from w~rluch they were created when our Trustee in its discretion determines that division is desirable o~r advisable in view of tax considerations, including considerations related to the income tax, the gift t<ix, the estate tax or the generation-skipping transfer tax or other objectives of the trusts and their beneficiaries. - .. Our Trustee shall not be required to make a physical segregation or division of the various trust shares created under this trust agreement except as segregation or division may be required by reason of the termination and distribution of any of the trusts, but my Trustee shall keep separate accounts and records for different undivided interests. Our Trustee in its discretion shall have the further power to combine two or more trusts having substantially the same terms into a single trust for purposes of administration when tax oi• other factors indicate that such combination would be desirable or advisable. 13-2 In deciding whether to combine trusts our Trustee should consider the generation-skipping "inclusion ratio" of the trusts to be combined. Trusts having the same inclusion r~rti+os may be combined. Trusts having different inclusion ratios should generally not be combined ~unles~s their inclusion ratios are maintained unchanged through substantially separate and independent shares of different beneficiaries within the meaning of I.R.C. Section 2654(b), and the applicable regulations thereunder. Section 7. Termination of Small Trust Our Trustee shall have the power in its discretion to terminate any trust created under this trust agreement after the death of both Trustors whenever it becomes so small in relation. to the costs of administration as to make continuing administration uneconomical. Upon termination, our Trustee shall distribute the principal and any accrued or undistributed net income tc- the income beneficiaries in proportion to their shares of the income. If no fixed amount of incomE; is payable to specific beneficiaries, our Trustee shall distribute the principal and any accrued or Undistributed net income in equal shares to those beneficiaries who would then be entitled to income payments from the trust. Section. 8, Limit on Trustee's Discretion Notwithstanding any language purporting to confer absolute, sole or unrestricted discretion on our Trustee in exercising any discretionary power with respect to this trust, our Trustee :>hal}, at all times act: in accordance with fiduciary principles and shall not act in bad faith or in d.isreg;ard of the purposes of our trust. Section 9. Written Notice to Trustee Until our Trustee receives written notice of any death or other event which triggers the right to payments from any trust created under this agreement, it shall incur no liability for +dstributions made in good faith to persons whose interests may have been affected by such event. Section 10. Duty to Account Our Trustee shall render accounts to the income beneficiaries under this trust agreem.e:nt at least annually at the termination of a trust created hereunder and upon a change in the Trustees in the manner required by law. 13-3 Section 11. No Court Supervision No trust created under this agreement shall require the active supervision of any stage or federal court. .. 13-4 Article Fourteen Trustee Investment Pavers Section 1. Trustee's Powers To carry out the purposes of the trusts created under this agreement and subject to ~~~~ limitations stated elsewhere in this instrument, our Trustee shall have all of the following powers in .addition to all of the powers now or hereafter conferred on Trustees by law: a. Retention of Property Our Trustee shall have the power to retain any property received into the tzust at its inception or later added to the trust without regard to whether the trust investments are diversified as long as our Trustee considers that retention is :in the best interests of the trust or in furtherance of our goals in creating the trust. b. Additions Our Trustee shall have the power to receive additions to the assets of the various trusts created under this agreement from any source. c. Business Participation Our Trustee shall have the power to terminate, to continue or to participate ixi thF; operation of any business enterprise including a corporation, a sole propriet:or~ship or a general or limited partnership and to effect any form of incorporation, dissolution, liquidation, reorganization, including but not limited to recapitaliization and reallocation of classes of shares or other change in the form of the bt~tiines:c -_ _•~ enterprise or to lend money or make a capital contribution to any such,bl~siness enterprise. d. Permissible Investments Our Trustee shall have the power to invest and reinvest the assets of the tru:~: as. our Trustee may determine to be in the best interests of the trust without limitation by any law applicable to investments by fiduciaries. The permitted investments and reinvestments may include securities such as common or preferred stock, mortgages, notes, subordinated debentures and warrants of any corporation and any common trust fund administered by a corporate fiduciary or other property :re<~l or personal including savings accounts and deposits and interests in mutual or money market funds or investment trusts, annuities and insurance whether or not :>uch. 14-1 investments are unsecured or of a wasting nature. e. Dealing with Property Our Trustee shall have the power to acquire, grant or dispose of property including puts, calls and options (including options on stock owned by the estate), for c;a:~h or on credit, including maintaining margin accounts with brokers at public ~~r private sale upon such terms and conditions as the fiduciary may deem advisable and to manage, develop, improve, exchange, partition, change the character o~f; abandon property or any interest therein or otherwise deal with property. f. Borrowing Authority Our Trustee shall have the power to borrow funds from any person including our Trustee, guarantee indebtedness or indemnify others in the name of the trust acid to secure any such obligation by mortgage, pledge, security interest or other encumbrance and to renew, extend or modify any such obligation for a term within or extending beyond the administration of the term of the trust. No lender shall be bound to see to or be liable for the application of the proceeds of any obligation and our Trustee shall not be personally liable for any obligation. g. Leasing Authority Our Trustee shall have the power to make, renew or amend for any purpose a lease as lessor or lessee for a term within or beyond the term of the trust with ~or without option to purchase. h. Natural Resources Our Trustee shall have the power to enter into any arrangement or agreement, including a lease, pooling or unitization agreement for exploration, development, "- -'~ operation, conservation and removal of minerals or other natural resources. i. Voting Rights Our Trustee shall have the power to vote a security in person or by gener~~l or limited proxy, to participate in or consent to any voting trust, reorganizal:ion, dissolution, liquidation or other action affecting any securities and to deposit securities with and transfer title to a protective or other committee. j. Title to Assets Our Trustee shall have the power to hold securities and other property in negotiable form or in the name of a nominee (including "street name" of a broker) 14-2 or by deposit to a clearing corporation with or without disclosure of the Trustc;e relationship, but our Trustee shall be responsible for the acts of any nominee or clearing corporation in connection with the property. k. Insurance Our Trustee shall have the power to insure the assets of the trust against any risk and our Trustee against liability with respect to third persons. 1. Settlement of Disputes Our Trustee shall have the power to pay or contest any debt or claim and 'to compromise, release and adjust any debt or claim and to submit any matter to arbitration. m.. Payment of Expenses Our Trustee shall have the power to pay any taxes, assessments, reasonable compensation of our Trustee and other expenses incurred in the collection, management, care, protection and conservation of the trust property. n. Principal and Income Our Trustee shall have the power to allocate items of income or expenditure to either income or principal and to create reserves out of the income, all as prov:idc;d by law and to the extent not so provided to allocate or create reserves as our Trustee in its discretion deems appropriate and our Trustee's decision made in good faith with respect thereto shall be binding and conclusive on all persor.~s~. o. Division of Trust .~ Our Trustee shall have the power to make any distribution or payment in find nor in cash or partly in kind and partly in cash and to cause any share to be composed of cash, property or undivided interests in property different in kind from any other share, either pro rata or non pro rata, without regard to differences in the: ~ti~x basis of such property and without the requirement of making any adjustment ~of the shares by reason of any action taken pursuant hereto. Any division, allocation, apportionment or valuation of the property to distribute the assets to or among any of the trusts or beneficiaries shall be made by our Trustee and the good faith determination of our Trustee shall be binding and conclusive on all parties. p. Litigation 14-3 ,~~" Our Trustee shall have the power to prosecute or defend actions, suits, claims or ~ proceedings for the protection or benefit of the trust and our Trustee in; the performance of our Trustee's duties. q. Employment of Agents (Jur Trustee shall have the power to employ agents, including attorneys, accountants, investment advisors, custodians, appraisers or others, to advise; or assist our Trustee and to delegate to them fiduciary powers and to indemnify 1:hem against liability for positions taken in good faith and with reasonable basis. r.. Corporate Fiduciary If any stock of a corporate Trustee or of any affiliate or successor of a corporate Trustee shall be included in the assets of the trust, the Trustee shall have full authority in the Trustee's sole discretion and notwithstanding any regulati.an or rule of law to the contrary to retain the stock and any increases resulting :6-om stock dividends and stock splits and from the exercise of purchase rights atlci the purchase of fractional shares needed to round out fractional share holdings that may arise concerning the stock. The Trustee shall vote the stock either directly or by proxy, except to the extent the Trustee is prohibited by law from votv1~; the stock, in accordance with the written instructions of a majority of the living beneficiaries then entitled to current distributions of income or their personal representatives. In the event there are no eligible beneficiaries to give instruc;t:ions, the Trustee is authorized to vote the stock in the best interests of the benefic:ial-ies, i:n view of the purposes for which the trust was created. s. Investment Transactions With regard to record keeping for investment transactions, our Trustee nec:ci not provide copies of confirmations or similar notifications each time a trade; or .~ - investment transaction occurs, but investment transactions shall be set forth in our Trustee's periodic accounting. t. Repairs and Improvements Our Trustee shall have the power to make ordinary or extraordinary repaurs or alterations in buildings or other structures, to demolish any improvements, tea raze existing or erect new party walls or buildings. u. Business Personnel Our Trustee shall have the power to elect or employ directors, officers, employees, partners or agents of any business and to compensate such persons, whether or not 14-4 any such person is a Trustee, director, officer, partner or agent of a Trustee ~~r a beneficiary of the trust. v. Farm. or Ranch Property With respect to farm or ranch property, our Trustee shall have the power to participate in and operate any farming (including tree farming) or ranch operation personally or with hired labor, tenants or sharecroppers to lease any farm for c;ash or a share of crops under a lease which permits or precludes the material participation of our Trustee to fertilize and improve the soil, to employ conservation practices and to participate in government programs and to perform any other acts deemed necessary or desirable to operate the property. In m~~lci.ng a decision whether to materially participate in farming or ranch operations, our Trustee shall consider whether an election should be made or has been made guider IRC ~2032A to qualify for special farm-use valuation. w. Ancillary Trustees If, for any reason, our Trustee deems it advantageous to act through an anciillary Trustee, our Trustee may designate an ancillary personal representative or Trustee qualified to serve in the jurisdiction where such ancillary Trustee is to act and may delegate to such ancillary Trustee such of the powers granted under this agreement as our Trustee deems advisable without being chargeable with loss if any arising out of such designation or delegation. Our Trustee may specify whether away corporate Trustee or any person or persons acting in an ancillary capacity hereunder shall serve with or without bond. Except as may be othen~ise specifically provided, no ancillary Trustee need comply with the provisions of airy Uniform Trustee's Accounting Act, the Uniform Trust Act or similar acts in force in any state where the fiduciary may be acting. x. Retention of Closely Held Interest .. - ._ Our Trustee shall have the power to retain any real estate interests, closely held securities or affiliated companies or business interests, and to sell or dispose of such interests only after careful consideration and after determining that sale or disposition is in the existing circumstances in the best interests of the trust ~~:r its beneficiaries. y. Exercise of Authority Except as otherwise provided in this agreement, our Trustee shall have the power to do all acts that might legally be done by an individual in absolute ownersl:~p and control of property. 14-5 z. Powers of an Interested Trustee .~ Any Trustee who has an interest as a beneficiary in this trust agreement or .any trust created by it shall be an interested Trustee. In all instances where an interested Trustee distributes or participates in the distribution of trust income c-r principal to or for the benefit of such Trustee which is limited by any stan.dG~rd other than the standards of education, health, maintenance and support, then th.e distribution shall be limited by the ascertainable standards of education, he~a.l~th, maintenance and support. No individual Trustee shall exercise or participate in the exercise of such discretionary power regarding distributions to any person or persons such. Trt~.>tee is legally obligated to support as to that support obligation. _t 14-6 Article Fifteen General Provisions Section 1. Spendthrift Protection Neither the principal nor the income of any trust created or contained under this ag~-eernent shall be liable for the debts of a beneficiary nor shall the same be subject to seizure by a:ny creditor of any beneficiary under any lien or proceeding at law or equity. Except to the extent otherwise expressly provided in this agreement, no beneficiary shall have the authority or p~awer to sell, assign, transfer, encumber or in any manner to dispose of a beneficial interest whether income or principal. 'The limitations herein shall not restrict the exercise of any power of appointment or the right to disclaim by any beneficiary. Section 2. The Rule Against Perpetuities Unless sooner terminated or vested in accordance with other provisions of this a~;rreement, all interests not otherwise vested including but not limited to all trusts and powers of appointment created hereunder shall terminate twenty-one (21) years after the death of the last slu-~-ivor of the group composed of us and our lineal descendants living on the date of the death of the first of us to die. ,At that time, distribution of all principal and all accrued, accumulated and undistributed income shall be made to the persons then entitled to distributions of uicome and in the manner and proportions herein stated irrespective of their then attained ages. Section 3. Incompetency and Disability For all purposes under this agreement, a person shall be deemed disabled, incompetent or legally incapacitated if and so long as a guardian or conservator of his or her person or estate duly appointed by a court of competent jurisdiction continues to serve, or upon certification ~by two licensed. physicians that such person is unable properly to care for. his or her person or property. Section 4. Income and Principal Payments All payments of income or principal shall be made in such of the following ways as oiu 'T'rustee determines appropriate: 15-1 a. To each respective beneficiary in person upon his or her personal receipt; b. Deposited in any bank to the credit of such beneficiary in ar~y account carried in his or her name or jointly with another or others; c.. To the parent or legal representative of the beneficiary; d. To a Custodian under a Uniform Transfers to 1Vlinors Act selected by our Trustee for such period of time under applicable law as o»- Trustee determines appropriate; e.. To some near relative, friend or institution having primacy responsibility for the care and custody of the beneficiary; f. By our Trustee using such payment directly for the benefit of such beneficiary; or g.. To our Trustee of any revocable trust of which the beneficiary is the: Trustor. Section 5. Education For all purposes under this agreement, the term "education" shall be given broad irate:rpre;tation and may include but not be limited to: a. High School Education at public or private elementary or high schools, including boar~d.ing schools.. .. _ t b. College Undergraduate and graduate study in any and all fields whatsoever, whether of a professional character in colleges or other institutions of higher learning. c. Specialized Training Specialized formal or informal training in music, the stage, the handicrafts, the arts, or vocational or trade schools whether by private instruction or otherwise. .~ 15-2 d. Other Educational Activities Any other activity including foreign or domestic travel which shall tend to develop fully the talents and potentialities of each beneficiary regardless of age. Section 6. No-Contest Clause If any person. or entity, other than one of us singularly or in conjunction with any other person or entity directly or indirectly contests in any court the validity of this agreement, including any amendments thereto, then the right of that person or entity tc- take any interest in the trust property shall cease and that person or entity shall be deemed to have predeceased both of us. Section 7. Disclaimer by Beneficiary No beneficiary shall be entitled to accelerate any distribution to the beneficiary or t:o terminate his or her trust interest and thereafter receive outright distribution by use of a dis.cl;aimer. Section 8. Simultaneous Death For purposes of this agreement, if we die under circumstances in which the order of ou;r deaths cannot be established the Trustor with the smaller taxable estate shall be deemed to have survived the Trustor with the larger taxable estate. If both of our taxable estates are equal, the husband Trustor shall be deemed to be the survivor. If any beneficiary under this agreement and either or both Trustors die under circumstances in which the order of deaths cannot be established, the Trustors or Trustor shall be deemed to have survived the beneficiary and this agreement shall be construed accordingly. .~ Section 9. Children and Issue For purposes of this agreement, "children" means the lawful blood descendants in the first: degree of the parent designated and "issue" and "descendants" mean the lawful blood desce~nclant;s in any degree of the ancestor designated provided, however, that if a person has been adapted, that person shall be considered a child of such adopting parent and such adopted child ;~n~d his or her issue shall be considered as issue of the adopting parent or parents and of anyone wh.o is by blood or adoption an ancestor of the adopting parent or either of the adopting parents. Th.e terms "child," "children," "issue," "descendant" and "descendants" or those terms preceded by the terms "living" or "then living" shall include the lawful blood descendant in the first degree of the parent designated even though such descendant is born after the death of such parent. 15-3 Section 10. Definition of Death Taxes The term "death taxes," as used in this agreement, shall mean all inheritance, estatf;, succession and other similar taxes that are payable by any person on account of that person's ii~te~rest in the estate of the decedent or by reason of the decedent's death, including penalties anal interest but excluding the following: a. Any addition to the federal estate tax for any "excess retirement accumulation" under Internal Revenue Code Section 4980A. b. Any additional tax that may be assessed under Internal Revenue Cc-cle Section 2032A. c. Any federal or state tax imposed on ageneration-skipping transfer, ~~s that term is defined in the federal tax laws, unless that generation- skipping transfer tax is payable directly out of the assets of a tr~~st created by this instrument. Section 11. Words Relating to the Internal Revenue Code As used in this agreement, the words "gross estate," "adjusted gross estate," "taxable estate," "unified credit,'" "state death tax credit," "maximum marital deduction," "marital deduction," "pass" and any other word or words which from the context in which it or they are used. refer to the Internal Revenue Code shall have the same meaning as such. words have for the purposes of applying the Internal Revenue Code to our estate. For purposes of'this agreement, our "available generation-skipping transfer exemption." means the generation-skipping transfer tax exemption provided in section 263 l of the Internal Revenue Code of 186, as amended, in effect at the time of each of our deaths reduced by the aggregate of (1} the amount, if any, of our exemption allocated to our lifetime transfers by us or by operation of law and (;2) the amount, if any, we have specifically allocated to other property of your gross estate for federal estate tax purposes. For purposes of this trust agreement, if at the time of each of our deaths either of u.s :has made gifts with an inclusion ratio of greater than zero for which the gift tax return due date has not expired including extensions and a return has not yet been filed, it shall be deemed that the generation-skipping transfer exemption has been allocated to these transfers to 1:he extent necessary and possible to exempt the transfers from generation-skipping transfer tax:. Reference to Sections of the Internal Revenue Code and to the Internal Revenue Codf; shall refer to the Internal Revenue Code amended to the date of each of our deaths. Section 12. Personal Representative 15-4 i ~" For purposes of this agreement, the term "personal representative" shall mean Trustee, executor, executrix, administrator, administratrix, conservator, guardian, custodian or any other type of personal representation. Section 13. Gender and Number In this agreement where appropriate except where the context otherwise requires, t11e singular includes the ;plural and words of any gender shall not be limited to that gender. Section 14. Definition of Per Stirpes As used in this agreement, when a distribution to beneficiaries is "per stirpes," it shall mean that the distributions are to be divided into as many equal shares as there are then livi~n;~ children of such beneficiaries and deceased children of such beneficiaries who left then-living; descendants. Each then-living child of the beneficiary shall receive one share and the share that is allocated to each deceased child of the beneficiary shall be divided equally among such de~;.e,~.sed. child's then-living descendants. Section 15. Captions The captions of Articles, Sections and Paragraphs used in this agreement are for convenience of reference only and shall have no significance in the construction or interpretation of this agreement. Section 16. Severability .~ Should any of the provisions of this agreement be for any reason declared invalid, such invalidity shall not affect any of the other provisions of this instrument, and all invalid provisions shall be wholly disregarded in interpreting this agreement. Section la. Statutory References Unless the context clearly requires another construction, each statutory reference in tlv.s agreement shall be construed to refer to the statutory section mentioned, related successor ;>E;ctions and corresponding provisions of any subsequent law including all amendments. 15-5 f Section 18. Governing State Law This agreement and the trusts created under it shall be construed, regulated and govet~ned by and in accordance with the laws of the State of Pennsylvania. We have executed this agreement on the date set forth on the first page of this agreement. We certify that we have read our foregoing revocable living trust agreement and that it correctly states the terms and conditions under which our trust property is to be held, ~.rianag;ed and disposed of by our Trustee. We approve this revocable living trust in all particulars .and request our Trustee to execute it. ~ _--- ~ ~~ MILTON C. ITINGER, rusto / -^~ r -"r- ERNESTINE E. ITINC,I?R, ~T stor • ~ ._-- MILTON C. ITINGER, Trustee .~ ~~ F?RNESTINE E. ITINGEIZ, 'TruS ee 15-6 STATE OF PENNSYLVANIA SS COUNTY OF CUMBERLAND ) ri'~ ~ _ / On this the ~~`-aa of , 19 ~~ ,before me, __ , the undersigned officer, personally appeared MILTON C. ITINGER and ERNES E E~. ITINGER, Trustors, known to me (or satisfactorily proven) to be the persons whose names ar•e~ subscribed to the within instrument and acknowledged that they executed the same for the puri~oses therein contained. In witness whereof I hereon set my -, Notary Public ~------ Title of Officer STATE OF PENNSYLVANIA hand and official seal. ,. ~~wC~~ ~:.rv T~• - a ~~nir~ Cour~~ My Commiss;os~~ txo~,re~ deb. ~r~,19 SS ~~-~ COUNTY OF CUMBERLAND ) ~ On this the ~.5~~' day of QL'~ , 19 ~ ,before me, D~C~L ~~--~_~ the undersigned officer, personally appeared MILTON C. ITINGER„ and ERNE TINE E:. ITINGER, Trustees, known to me (or satisfactorily proven) to be the persons whose names are subscribed to the within instrument and acknowledged that they executed the same for the pur)~oses therein contained. In witness whereof I hereunto set my hand and official seal. .- Notary Public N~7ARIAl_ SEAL CONNIE L. REESE, Notary Public p ~~ n auphin County Title of Officer My Coy ~mlSSion kxpires Feb. 20,1995 ~. 15-7 Ba n k of America .~~, •~~ l .~. ..:~ IMPORTANT TAX RETURN DOCUMENT ENCLOSED AUTO ALL FOR AADC 170 00007410028574 0 2 8 5 7 4 ... -~- 1{ll~~(I~I~n{I'{'I1111~~1~(11~(I~~I~((I1~1{I{1{I{{{'III{(ul~~~l ._. .'-':r Recipient ERNESTINE ITINGER ,'~ 3711 SAFFRON DR MECHANICSBURG PA 17050-7666 =. i 1 ff ~ I nn ~utershare ~" ~~ ~ Computershare P,O. Box 43078 Providence, AhodE~ Island 02940-3078 Within USA, US territories ~ Canada 800 f42 9855 Outside USA, US territories ~ Cans~da 781 575 2621 vvww.cornputershare.com/bac Holder Account Number C~00079742.~ I N D Record Date 04 Dec 2009 Check Number 0001621029 SSNITIN Certlfled Yes OOI CSOOOS.DOMLNGEQS_PG I .B AC', l 15940._27881(028574/028574li Bank of America Corporation -Combined Dividend Payment / 2009 Tax Form 1099-DIV Corrected (if checked) Form 1099 -DIV -Dividends and Distributions 2009 Copy B -For Recipient This is important tax information and is being famished to the Internal Revenue Service. IF you are required to Ble a return, a negligence penalty or other sanction may be imposed on you tF this income is taxable and the IRS determines that it has not been reported. Recipient ERNESTINE ITINGER 3711 SAFFRON DR MECHANICSBURG PA 17050-7666 4ccount Number 00000797022 Recipient's IiD No. ending in ***-**-3498 Payer's Federal ID No. 56.0906609 OMB No. 1545-0110 Dep~~rlment of the Treasury - I nternal Revenue Service L~Total Ordinary lb Qualified ~~ Nondividend a FEDERAL INCOME s Foreign Tax ~ Foreign Courltryy u Cash Ut~t~dation ~ payer's Details Dividends ($) Dividends ($) Distributions ($) TAX WITHHELD (;) Paid ($) a U.S. Possession I Distri. ($) 54.88 54.88 0.00 0.00 0.00 13ANK OF AMERICA CORPORATION C!O COMPUTERSHARE P.O. BOX 43010 PROVIDENCE R10294G-3010 Form 1099-DIV (Keep for your records) Dividend Confirmation Pa ment Date I ~ Participating I Class De ti i Dividend { Gross ~ Deduction ~ ~_ Deduction Net y scr p on ShareslUnits Rate J Dividend ($) Amount ($) ~ Type Dividend ($) 27 Mar 2009 COMMON 1,372 $0.01000 13.72 0.00 __ IVIA 13.72 26 Jun 2009 COMMON 1,372 $0.01000 13..72 0.00 IVIA 13.72 25 Sep 2009 COMMON 1,372 $0.01000 13.72 0.00 IV/A 13.72 24 Dec 2009 COMMON 1,372 $0.01000 13.72 0.00 IVfA 13.72 Year•To•Date Paid 54.88 0.00 54.88 46UTX B A c -f- 002CD70004 OORX6A-PP~(F<t) Pt_EASE CASHIDEPO5IT THIS CHECK PROMPTLY. I~AL : H is~.o~r~ca !'rjces '-or .L3ank ot~ ~~nerica Corporation Com - Yahoo! Finance Page 1 of 2 I`~e~a ~l~er'~ F~i~;c~is~~~, iig~ ire M~:Ip `f~:hor~! Mail ,,~~;_, 1 ~ ~' ~ ~ )t~_~r~a-1 Web Search Dow ~' 0.99% Ndsd~q '~" 0.72°!0 HOME ?~~~'tw~°~II4~0 NEVIS ~ ®PIN10N PERSONAL FINANCE I!dIY PORTF®LIO S ~~yl::i;H TICKER ~..~.~ GET QUOTES =i~~~,~:,~ S~arc.P~ ~t~i; Jui ,;; ~ ; '.; .,~. ., C~'~~1" ,~. t~'1<~~~~t~s ~,i:~<<~,s ~n ~.>i~~~ ~?mss}~~ Bank of America Corporation (BAC) At 9:36AM EDT: ~5.48~ -~ 0.27 (1.78~1o) T ~" ACCC3UNT ~ ArIi1lERlfi~AtiiE `' ~ ,' SERVICE I:EE , ~s ;~, ,~ l ~ FtJt ETRgbF: SECURITIES. LLC ~ - ~ - - Historical Prices SET DATE RANGE _.... Get Historical Prices for: ~v G~ C: Daily Start Date: Apr - 22 _2010 Eg. )an ~, zoio t' Weekly End Date: Apr - 22 2010 ~ Monthly C' Dividends Only ~~~t P~~~~S J PRICES Date Operi High Low Close Volume Adj Close* Apr 22, 2010 18.03 18.60 17.95 18.54 219,472,400 18.53 "Close ~,ariC.e adjusted for dividends and splits. Download to Spreadsheet ADVERTISEMENT ~C~~dak ~~ PHaTO ENI.a~~Enrll~TS• °_, ,^'~, ~ z~ ~ _ ~. ,,,ti ~ ~ . ~~ ~ BIG with the richest colors imaginable. tonl~r sa~Jidb~r~lickinghey ;~ ~1;., i~ ~~ - ~ ~ ,r . •. i''~ ?~ ( 5-~ ~~- SUt~~t~ S '`~ <-' ~ ~ ' rZj l.. '-o:;rc+`?' ~? ~~ = ' ~~~h:o<' ir::; al r! ~i?*,s (:~5erve:i. Privacy Policy -About Our Ads -Terms of Service CopyrightrlP Policy -Send Feedback ~;ri~}a! f~-,ors Ne=.,~c.rk l~liOtE5 C1C}r~yEtl £ Yi c';; P r Ir;71; <:'E'..~ O',f'e1lN!$r'; i.Jciay t'T?eS a'E; 1,`) rT'i(`~ )( f'v ~:i;1;~.:,e i~.~ J~ +r~;; !1r"`cf :;82 f.~:~:) C}r. :l}' t:'~?cS for other exchanges ;y l:;>tcS z'-`- ~ ,.,!~e ? ^~r?at,., ~ s: ~ ...: by Gr:,~p~r~`?t u;c~ cfe~s ice i_ified cn tf;e Ya^oc ~ inan::e partner pa4e ~;~4otcs ae u;;dat:~:. aish~?na ~a y. kJl,' w•II i;c t~~~e~ off http://finance.yahoo.com/q/hp`?s=BAC&a=03&b=22&c=2010&d=03&e=22&f=2010&~==d 7/13/2010 i~l/ ~r // ,~ S UST' IMPORTANT TAX RETURN DOCUMENT ENCLOSED 004735 l~ll~rllrlr~r~l~~~11111~rl~Ill~'{trlrl,II~I~1`l~l~l~'{Il~~~r{~ri{ Recipient ERNESTINE ITINGER 3711 SAFFRON DR MECHANICSBURG PA 17055 Holder Account Number 000002468~~ 1 I N D Record Date 01 Dec 2009 Check Number 0000284074 SSNlTIN Certified Yes OOICSOOOS.DOMLNGEQS PG1.STf.111249_27696/004735l004735/i SunTrust Banks, inc. -Combined Dividend Payment 12009 Tax Form 1099-DIV Corrected (if checked) Form 1099 -DIV -Dividends and Distributions 2009 Copy B -For Recipient This is important tax information and Is being famished to the Internal Revenue Service. IF you are required to File a return, a negligence penalty or other sanction may be imposed on you ff this income is taxable and the IRS determines that It has not been reported. Recipient ERNESTINE ITINGER 3711 SAFFRON DR MECHANICSBURG PA 17055 Account Number 00000246891 I Recipient's; ID No. ending in ***~**-3498 ~ Payer's Federal lD No. 58-1575035 OMB No. 1545-0110 Department cf the Treasury - internal Re~ern~e Service ~a Total Ordinary fb Qualified ~ 3 I Nondividend 4 FEDERAL, INCOME a Foreign Tax (~ Foregn Country ~e J Cash Liquidation ~ Payer's Details Dividends ($) Dividends ($) Distributions ($) TAX WITHHELD (;) Paid {$) `f or U.S. Possession 1 Distri. ($) 325.16 325.16 0.00 0.00 0.00 SUNTRUST BANKS INC CIO COMPUTERSHARE PO BOX 43010 PROVIDENCE RI 02940-3010 Form 1099-DIV {Keep for your records) Dividend Confirmation ~~ Payment Date ` Class Description I Participating ~ Dividend I Gross I Deduction Deduction I Net SharestUnits Rate Dividend ($) Amount ($) 't'ype Dividend ($) 15 Dec 2009 COMMON 1,478 $0.01000 14.78 0.00 NIA 14,78 Year-To-Date Pald 325.16 0.00 325.16 46UTX ~, Lam` i,[~ , ~, r~ l t {- ~.-. ~ _~.._ ~or~~utershare Computershare PO Box 43078 Provi~~ence, RI 02940-3078 Within USA, US territories ~ C~Inadirl 866 299 4214 Outside USA, US territories i7 Canada 312 588 4214 vvww.computershare,com/'investor S T I "~" 002CD700t]4 OORXfiA-(F2) PLEASE CASHlDEPOSIT THIS CHECK PROMPTLY. STI: I-Ii~~-or~~c~! '~' ic:ctis ''~U~r Sun~_'`~rust Banks, Inc. Common `~to - ~"ahoo" Tinance Pale 1 of ~' Jew ~1ser~' ~~'et~is,,~, '~ig;~~ !n Neip fl6(ew wooer era ~Y`af~c~~~~ Mail ~'aalbar ~~,~.'.~ ~ J = ~ I~ ~`` ' ~~; ~ , ~;I I Web :iearch Dow `~" 1.Q5ala Na5d~:q ~ U.8'i°!a ~#Ol'~1BE ;x,;~'b~.~>-~ 3~~ MEWS & OPINION PERSO~At_ FINANCE ~JfY PORTFOLIOS ~~`tAt3~ TICKER I ~,~ GET QUOTES ~,:~~~ ~~; ~ {ut=~" ~~ ~ _? ~'~t _ . W C3 ~ ~', > ~ .~,1 ~.=C'rT ~ ~ _> ~.;~, .. ~ ,r , ;' ~, ., ~ ' Y.;.'. ;~'r... SunTrust Banks, Inc. (STI) ^5" ~~; ~~~~ TRAi7~E ~ `~ _ F ~ ~ ~ ~ ~ ~ r= ~ ; E31~~tre ~~ ~ ]7a~ E*TRADE SECURITIES LLi: ~ -- -~ Historical Prices SET DATE RANGE Date Apr 22, 2010 At 9:37AM EDT: ZJ' .s~i "~` ~~.$~ ~~,S~aJu} Q' ,IfMER1TRAtDE ~~'TRADES ~, *: ~- ~ Get Historical Prices for:: ,GQ ADVERTISEMENT ~' Daily ~~ Start Date: Apr -' 22 2010 Eg. Jan 1, ~-. Weekl zolo Y End Date: Apr -' 22 2010 {" Monthly ~" Dividends Only Get Prices PRICES Open High Low Close Volume Adj Close* 29.24 29.46 28.40 29.32 9,776,300 29.31 Clo=_,e price adjusted for dividends and splits. Download to Spreadsheet ~ , s'~ "'I ~ ~~' ! ~-I, ~ ~ ~ ~~~'r e~. ALL P1~OT0 ~OC}tiS* ~~ ;~. '~ z w ~Ufl~~" V3{lti ~}iJ ~CflLIS,N'1~,.~f~.~ x ~9 ~, I~1 ~ 3'~ -... ~~ • 'E F ~ 4 ~i~P;.':y`~ ,~ 2:" i ~a:o r ,;:; I ;,:rs ° ~2rve~;t. Privacy Policy -About Our Ads -Terms of Service - Copyrr~ht/IP Policy -Send Feedback - `~:;~}~.,t; ~v:-Lvs N~- .ac; k Q[ft3L@S deli3yLaF.$ -,aCE:.- . '. ~,c,.!'e r` ~~~'ECi O'.r.';;'dJi~@ ~cla;' i.!1"IE:S a. E; ":5 r'?If'S'Ot I`~r;.; :~,'.`....!. NY;~>.. cY'~, r=,E'~EX .aeG' ~~o de`3 f" 1lG~S i'~I Otrler ~3XCnanges_ i.;i,,~I£~;S http://finance.yahoo.com/q/hp?s=STI&a=03&b=22&c=2010&d=03&~~=22&f=2010&~==d 7/1 x/2010 _ A ~ , „ ~ . 2 p p~ A~UCOUNT SERV~~E~~ 4012~27~i9 +~~~~e~ ~a~~C~ I~f l_!. ~~i I . ~ ~~~ 1 ~~ Citizens Bank January 19, 2011 At1~: ~a~anclra Re: IRA. of Ernestine E Iti~ger Tian IIa# ~-~-~-3408 Dear: C:aSandra, Retirement Serviees~ 2G Cabot Road Medford, MA 02155 8C-0 ~48.7~00 tel 781 ~9~.$692 fax This letter is in response to your request reg~rdizt~ the late Ernestine E Ytingex's Retirem~ez~t Plan. According to our reeQrds the benefiCxaries on file are: ~iXton C Itingex 100% 1'r~mary if you have aoy questions, please contact rbe Retirem~t Services department at thR~ number above, Manday through Friday, from 5.00 am to 5:00 porn. ET Sincez'ely, Keryn Hayes Retirement Services ~€RBS R~xzo~~o ~` `~~ p ~~,x 499 Mitchell Road., Millsboro. DE 19966 Adjustment Services Phone 888-5U2-4349 F ax (302) 93~}-2955 .luly 16, 2010 Susan F Lederer Attorney At L,aw 5011 Locust Lane Harrisburg, PA 17109 Re: Estate of Ernestine E Itinger Social Security: 237-20-3498 Date of Death: April 22, 2010 Dear Sir or Madam: Per your inquiry on July 6, 2010, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type c;~fAccount Acc<,~unt Number Ownership (Names of) Open ~rzg Date Balance on Date of Death Accrued Interest Total 2. Type ~?~ f 'Account Account Number Ownership (Names of} Ope~ung Date Balance on Date of Death Accrued Interest Total Savings Account 15004200835534 Ernestine E Itinger 11/02/94 $12,988.00 $ .33 $12,988.33 Certificate of Deposit 31003911043667 Ernestine E Itinger 02/24/95 $9, 793.48 $ 12.28 $9, 805.76 3. 7yp~' ~ f Account Accoi~.rrt Nu»zber Owrre~rship (Names of) Opening Date Balu~~ce on Date of Death Accr u~cl Interest Totu'1 certificate of Deposit 31003911395711 Ernestine ~ Ringer 11 /10!94 $10,296.77 $ 35.39 __. __ _ $10,332.16 For further account information, closures and/or reimbursement of funds please call the'Trindle Road Office at #1'717-7:j~'-?30E~. We were unable to locate any safe deposit box for the above-mentioned decedent. This Letter does not include any accounts in which the deceased may have been listed as Power of Attorney, (,~.stodian o1.' 1:Jniform Tranders, Representative Payee, or Trustee under a Written Agreement Sincerely, i Suzanne M Kimble Adjustment Sel- ices Date: 05~05j10 Page 1 of 1 002633 ESTATE OF ERNESTINE E ITINGER 3711 SAFFRON DR MECHANICSBURG PA 17050 . N O C'J (D i.'~ 0 ~; 0 0 c O 0 0 N IF YOU HAVE ANY QUESTIONS, PLEASE CONTACT THE COMPANY AT: CUSTOMER SERVICE REP AT 1-800-523-5800, PAYEE: ESTATE OF ERNESTINE E ITINGER c+ ~ ~ check No. 0029015831 Health REG POLICY SYM' _ POLICY NUM le PROD CODE INSURED ACCOUNT NUM S CHECK AMOUNT OBB ITI NGER 0490391761 $~*~`*'~*~`423.00 CHECK DESCRIPTION YOUR ACCOUNT IS CANCELLED. THE REFUND CHECK BELOW REPRESENTS MONTHLY PAYMENTS PAID BEYOND THE CANCELLATION DATE. Form T-258-8 Printed in U.S.A. NU• .~, ~ ~? 6 ~ 7 2 2 - - ~ , ..a e ~ - . e~ k o t a. e n ~ e ~- i 5r~' Check No.: 0029015831 50-9?~7 !-lealth Check Date: 05~05~10 213 _-- - l $~`~`**~`423.00 Pay - -- -- --- _ FOUR HUNDRED TW E NTY TH R EE AND 00/100 DOLLARS *********************************** RO PS PN PRD CDE ACCT OBB ITI NGER 0490391761 TO THE ORDER OF ESTATE OF ERNESTINE E ITINGER 3711 SAFFRON DR MECHANICSBURG PA 17050 SC JPMorg~~n ~C~ase Bank, N.A. 950 Syracuse, NY ~~~ ~~'00 290 L 58 3 Lip' ~:D 2 ~ 309 3 ~9~: 8 36 28 L998ii' r I U' R., Q~ .o Q W r W r ru ru :. r ru r .~ L!1 W O ~D < <- -n C- ~ z O r W m m~r-~ m - ~f z - C7 -~ Z Z O --~ i-r;, D , = om - ~ Ozz z -Tt o - n -n ~ Z ~ ~ ~ o D :D D Z7 C] m ~rn ~ o m ~ Cz m. ~ ~' ~ ~ W"{ G7~~z c~ r rr' - G~ m ~ O ~ -+o ' ~~ ~I ~ ~ U;I _ D ~ _ rn - _! <: ~ „ - c n'i ~' Q ~. z cn ~ ~, ~~ ' ~ ~ r o - 6 C> ~ O w = ~~ C ~ _ ~ y Cil ~r~ ~ m m D ~' ~ ._ ~' ~ O r 018223 - ~ __ 2 - --{ O ,~' ` - ~ - ~ ~ ~S ,~ .~ R p D ~~ j ~ C ~.y ~! } ~ ~ N N f I u ~- S W ~ ..t I `; i ~ U~ I ~ I 1 ~ ~ ~ y ~ ~ x, W s m~ * . D ~ N C~ C ml ~ ! O1 ~, * ~ ~ ~ " ~' ~ z 1 ` ~' ~ I -~ ~a T <i ! ~ ; .~ - m .Z7 C; ~~ . ~ ~ V I ~ z D ~ , ' N ~ r;' ~ 1 ~ ~ o- ~ o ~ o~ ^ 0 D ~ Iv p ~ ~ ~ i~ ~'~ i~~~°~ s,'t ~~ ~ ILA ~/ ( ~I ~!--`~.'Y'r'l ~~r. a \ `.~ ... ~ ~ ~~ .,~•... ,r.~_ ,~ ~...~~ ,. a _ ~„ ~~ C r.1~4P ~'i1L1_. PE.~~. `_: L ~'%~ti'lA 17i)1 - ,= ~_,~„ ~iay 12 , 2010 NIr s . Tina Babbs 3 % 11 Saffron L)r_ ive Mechanicsburg PA 17050 Services for Ernestine E. Itinger April 24, 201C} Total: Received check: from Insurance Company: Total: I;an-Guaranteed Cash Advanced Items Obituary Increase Out-of-Town Obituary Addition Certified. Copies Addition Burial C7o~n Addition Received Check ~ 581 $ 16.00 120.00 90.00 150.00 /~. ~~ZS KOSEhT H ~i-~R~FR ~,~ ~r ~rF.r~u. ~_`IER,, ~. w•:. !lat.: $ 8,456.00 - ~7, 96E~. 7 7 $ 489 $ 440.00 - _376.00 ~ ~+~~ MYERS HARNER FUNERAL HOME, INC. 1903 MARKET ST. PH. 717-737-9961 CAMP HILL, PA 17011-4702. 2867 _ _ 60-1273/313 -----~ ~~ ~ IJ PN BAN K --_ _---- ~~ol~~~J~ = a~~ ~~,~= o, ROBERT H HARNER SUPERVISOR PNC Bank 1V.A ~D40 ~~ ~ entral Y,A l ~ FOR _ ~ ~ ~~ II CI~7 28 6 ?n^ 1~^ ~ 1 ~ 1 a ? CAI' c 1 1 ~n 7 r r ~ n... _ i United Healthcare Svs Inc Page 1 of 1 PO Box 1459 MN005-N100 90-GO Minneapolis MN 55440-1459 CHEECK DATE 06-30-2010 CHECK NUMBER 70219'936 W~NIJf~R :. SINGLEPAY TOTAL USD 74.80 001577 1000504 0001 70219936 UNW1173735-00001558 06129110 21.99 SINCLEPAV 0001 75990-0001 15289 1 11 1 I I' 1~ 1 I 1 I 1 ,_. j BANK OF-AMERICA United Hea Z thCare _Svs -Inc Aso wirasor st Hartford CT 0612p PO Box 1459 MN005-N100 ._ DATE 06--30-2010 Minneapolis MN 55440--.~ 459 Pay SEVENTY-FOUR AND 80/100 DOLLARS To The Order of ESTATE OF ERNESTINE E ITINGER a 3711 SAFFRQN DR -'~ ~:MECHANICSBURG PA 17050-7666 I1~1'I'I~~I'~1~1~'~III~IIII~~~11'I~i~l~~~~~ill~~~~i~~~~~~i~~~ .00 74.80 51-4d '. 119 CHECK NO.. 70219936 272 ~-~ 8 ~ PAY ONLY ~~o AUTHORIZED SIGNATURE ~~'00 70 ~ 19 9 3 6~~' ~:0 L L 900 4 ~, 5~: 0000000 5 L 300~~' _ f', ~1 . ~~ i ~ ~ - hVr ~ 1 r ~/ l~ J ^` r ,` _ ~~ Y T ~: ~ _ T ~~ I ~. l/ L _i ~~I ~}; ~ l ~, ~ ~ ._ K 1 {l l .i / ;.~ J ~~ ,.J c~~, ~~ d~z 1 ~-~, ~ Citizens Bank° Account Nwrzxber 622553(}049 ~ Accol;int Title _ ~.,i~ix~g Trust Of ~rnestir~e ~ ~txnger DTD 10/~:5~/199~ Tina ~ Gabbs Tteel Ernestine ~ I~~ er T~teF; Date ( ~ened 11/I3/2009 N~ Account T e ~heckin ~~inci al ~alatlce as of DOD $65509,78 - -----~ Interest from Last ~o~tin to DOD $ .00 --- Account Ealance as of DOD $65509.78 -- YTD ~ntexe~t to DOD $ .00 --~T July ~14, 2010 Susan E. Lederer Law Offices Attn: Array Moya 5011 Locust Lane Harrisburg, PA 17109 Re: Estate of Ernestine E. Itinger -Date of Death Valuation Account ?24-20293 Ernestine E. Itnger, Trustee The Ernestine E. Itinger Rev Trust Open date: 11/09/95 Account 72~-65497 Ermestine E. Itinger IRA Rollover Open Date: 03/16/93 Morg~nStanley '~-rr~ith~arney Date of death valuation for accounts is attached. Please call with any other questions. Sincerely, `, Raymond A Montchal Vice Presi nt Finance Advisor MorganStanley SrrlithBarney 6%~1 ~I v For - 724-20293-550 -Ernestine E. Itinger Ttee SymboIICUSIP Description Quantity Price as of 4/22/10 WASAX IVY ASSET STRATEGY FUND 471.37 23.06 AICBX INVESTMENT COMPANY OF AMERICA 1,365.70 27.20 #BDP BANK DEPOSIT PROGRAM 318.11 1 00 BALBX AMERICAN BALANCED FUND CL B 1,717.86 17.04 TOTALS M®rc~~inStanl~ey `~rnithBarnPy /..., ~, ~-~ - ~ , For - 724-65497-550 - *'~* Ernestine E Itinger SymbollCUSIP Description HSSAX FORWARD BANKING & FINANCE FUND SOPAX LM CBA EQUITY INCOME BUILDER AEPGX E=UROPACIFIC GROWTH FUND CLASS SASMX ~_EGG MASON CLEARBRIDGE SMALL SHAPX LEGG MASON CB APPRECIATION CL #BDP BANK DEPOSIT PROGRAM TOTALS Quantity Price as of 4/2211 t) 218.98 15.!x9 257.69 12.19 25.49 38.65 58.06 15.25 222.14 13.?3 54.67 1.x)0 r'a~: gent hug 1 r'".~r"-r'iRk~] y-~'J4 214 Senare t~ yr i'zh ~hc~r (.;amp Hili . PA 17(?U~ rcl 71' ^i0 lftt)~) Eax '17 ?3(~ Ifiy4 ~~ ~~, ^r MSSI3 Chl k31,-11-1.1 X11_ : 'L~II~~ P~~ : 2/5 Mlo~gan$•t~~ley Srri~i~h~~rne~ yanr~ary ?,1, 2011 Susan ~~ Lederer Law offices rn.rt ~ ~ r •-v~s,- ; sue.. dear Ms. Lederer: 1~: ~rnestirae E ltinlger /" Il~4 Account 724-65497-16-5SQ ! have 11SterCl tor your rccurus ~ , - ~ .„'°r .r., '' ~"''~"'-~"t'~ T#±;;,crr-}cy r^+irP^~~t^~t Li1C 11211A~G~-i U~.uvi-~,~u,~~v~ iv.~ ........;.~,._ - __¢~_.~ account: Y1 11 "j~~ ~ T~i..• 1~liUA.tt~ . i iiicy ~ ~~,,.,~~ Naomli L Funk Mary Beth tones I have enclosed a distribution form for each of them to complete and return to receive: their distribution. Should you have any questions or concerns, please do not hesitate to contact me. Sincerely, ., v - J ~i~t ~ivti~. R piste ed Client Service Associate M Stanley Smith Barney .5.,`,la 1/~"' Mown Scanleq Smith Barncy ~LC. IVltmb~r $IPC. C~ I~ 1~ ~~ =' S LIST' IMPORTANT TAX RETURN DOCUMENT ENCLOSED .~ 004?36 '~- Irr lrlrrr r r II rrlr 1 r rr r Ilrl I I rl rrlrrr III l II I II 1 I ~ It 1 II III I III 1111 t ~' Recipient MILTON C ITINGER & ERNESTINE E ITINGER TR UA 25-OCT-94 MILTON C ITINGER & ERNESTINE E ITINGER LIVING TRUST 3711 SAFFRON DR MECHANICSBURG PA 17055-1536 rn utershare ~" ~ p [;omputershare PO Box 43078 Providence, 13102940-3078 Within USA, US territories 8 Canada 866 299 4214 Outside USA, US territories & Canada 312 588 4214 www.computersharfr.com/investor Holder Account Numt~er 000002469O~~ F I D Record Date 01 Dec 2009 Check Number 0000284075 SSNITIN Certified Yes 001 CSOOOS.T)OniLNGEQS _P~31.S TG. 111249_27696/00473G/00473G/i r... SunTrust Banks, Inc. -Combined Dividend Payment 12009 Tax Form 1099-DIV Corrected (if checked} Account Nunnber 00000246905 Form 1099 -DIV -Dividends and Distributions 2009 Copy B -For Recipient Recipient's; ID No. 23.7203498 Payer's Federal ID No. 58-1575035 This is important tax information and is being famished to the Intemal Revenue Service. If you are required to tRle a return, a negligence penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that it has not been reported. Recipient MILTON G ITINGER & ERNESTINE E ITINGER TR UA 25-OCT-94 MILTON C ITINGER Sr ERNESTINE E ITINGER LIVING TRUST 3711 SAFFRON DR MECHANICSBURG PA 17055-1536 OMB No. 1545-0910 Departrne~t of the Treasury -Intemal Revenue Service to Total Ordinary t~ Qualified ~ Nondividend a FEDERAL INCOME s Foreign Tax ~?J Foregn Cotx>try ~ Cash Liquidation ( {$) P ion Distri s P S id $ U Payer's Details Dividends ($) DividenCs ($) Distributions ($) . . os ess ( ) V a . a TAX WITHHELD (~) ~-T~ 325.16 32',1.16 0.00 0.00 0.00 SUNTRUST BANKS INC C(0 COMPUTERSHARE PO BOX 43010 PROVIDENCE R102940-3010 Forrn 1099-DIV (Keep for your records) Dividend Confirmation Payment Date 1 Class Description ~ participating I Dividend I Gross ~ Deduction I [)eduction SharesfUnits Rate Dividend ($) Amount ($) Type 15 Dec 2009 COMMON 1,478 $0.01000 '14.78 0.00 NIA Year-To-Date Paid 325.16 0.00 46UTX S T I Net Dividend ($) 14.78 325.16 002CD70004 OORX6A-(F2} PLEASE CASHIDEPOSIT THIS CHECK PROMPTLY, .~ i t. t ><t~L,vr tt,al .I , ll„r.,~ iVl ..7U_IJ .1 .I L,IJE .f~~Lll_fll, .IJ.lI.-. ~"1J1..1..1_IJll.11I Jll) - ]_ i:allVl)' !~ lili:lil(,;~ t';~i~C 1 OI L New User? Register Sign In Help Follow soccer an Yahlaol Mail Toolbar ~,„~ ~ ~ ~ ~. ~ ~: .. Sea, c1~ r~ Web Search Dow "~ 1.05°1o Nasdaq fi 0,85°!0 HOME INVESTING NEWS & OPINION PERSONAL FINANCE Ml! PORTFQLIOS TECH TICKER i GET QUOTES i;t~rve .`~ear;..h Tlie. Ju ': ~..O1 ~, 9~53la.F:i CDT ~~ S f:~ark~is ,;1~:.~ it ,; hrs. ? ;~;,,s SunTrust Banks, ~t1V. ~JT~~ At 9:37AM EbT: 25.83 "~'` 0.65 (2.58%) ,: " = ~' ~--;. ,°'" = ~ ,I4MER[1'R,AaE FREE TRADE :_ . ..tea ~~ T, ~ ~R f~~ ~ ~ ~ ~ ~TR~r~Es b~7 D1~'f:; - ~• Ek~TRRDE SECURITIES LLG """"' ~ - - Historical Prices SET DATE RANGE Start Date: Apr -' 22 2010 ' E9. Jan 1, zoo End Date: Apr - 22 2010 Get Price Get Historical Prices for: ~~ 1=first 4 ~~rrvieus ~ N>rx` ~ Last PRICES Date ~Jpen High Low Close Volume Adj Close* Apr 22, 2010 29.24 29.46 28.40 29.32 9,776,300 29.31 "' Ci~se price adjusted for dividends and splits. f Irst ~ Pfev'Q~fs ~ N~:X' ~ l_a$t ~`t' Download to Spreadsheet .~ ~ ~~1 ~ .X ~ ~~ "7 ~ Sees Copyriyh;'J 2:)'0 Yat•~c' in; :~'l ri~yn<s ~esesved. Privacy Policy -About Our Ads -Terms of Service - Copyripht/IF' Policy'- Send Feedback "sr~on h'-,vs Ne'•rr~rk QLlates delayed. txce,,^,t where ir:d;r_ated othr.nkise Jelay Mmes are 15 reins for (vh5~r.~. t~JYS~~ and P.n:ex. See also de=ay tames for other ex~h;ang_es. C;uotes http://finance.yahoo.com/q/hp?s=STI&a=03&b=22&c=2010&d-03&e-=22&f----2010&g=cl i/13/2010 . ,ri, .~, __ , ~~ ;903 MARK F? 5 i KE~~I ~~A~~1P HILL. PENNSYL~~~.i~:lA ~"~i~l ~ 71737-9961 May 5, 2010 ~~ational Guar:~ia~1 Life Insurance Company 1St V1.1_man .`~t~rEE~t pO~oa:119"1 Madison WI 53 X01-1191 rVices t_o:~ ~r_nesti_ne E. Itinger ., i1,t~7'11 ~~, ~U1~ G~^avesa_de Pac~age C~~~ar~es for M~ercnandise Selected `~,a~ r:C'_t ~,~5~1 ~C~VaIlCt'_Q !newspaper Novice/Local Newspaper ~Noti.ce/Out-or-Town clergy Certi_~:~~..ed ~~~opies Buri_~-~1 C1ott~ing TOtal: ~li>isFti~_~ ~; ,:~~:~~~; ., ~ ~, ~ ~_ !)1~~1~~• 12. It~l~f~k 4,020.00 v`'J ~.' , 7 ~ 0 . 0 V $ 676.00 ~~~ , +~~~ 216.00 120.00 100.00 90.00 150.00 ~RE~UNL~ED FUNERAL AGREEMENT AGREEMENT NURIRER r THIS AGREEMENT tS FUNDED BY LIFE INSURANCE -- - - _ .~ . - ~_ -- Forthe benefit of ~ -- - ~'' ~ - -- r_ - _ ._~ ~ i` Funeral Recipientllnsured ~- Social Security Number STATEMENT OF GQODS AND SERVICES GUARANTEED FUNERAL GOODS AND SERVECES FUNERAL HOME SERVICES: Basic Services of Funeral Director and Staff .............. $ Embaiming ...................................................... ..... $ Use of facilities/staff/equipment tor; per day . Visitation days ~ $ ..... $ ___ Funeral/Memorial Service .................................. ..... $ Graveside Service ........................................... ..... $ Transfer of deceased to Funeral dome ( ~? ~- Mile>) ................................. ...... $ Family car(s) Number _ ~a> ~~ each.. .....: $ Hearse ................................:............................ ...... $ Service Vehicle .................................................. ...... $ Forwarding/Receiving remains ........................... ...... $ Other Services/Facilities/EquipmE;nt: _$ $ -$ -_$ TOTAL FUNERAL HOME SERVICES ':;.,.. ....~.......... T~ ~; ~ _. ~ i,,~l . ~~--- t ~~! C ,,;,~~ i ,. .~----- ~ .~~ ; FUNERAL MERCHANDISE: Casket ...........~~~ ..~...:.....~.. ~..~ ~..~~.......t .......... ..... $ j, r ~ -- Manufacturer ~L_. ~_~~'~~ r`~ ~~! ____ ___ Model Name/Number _. ~~ Exterior MateriaUColor`~~;~- i• ~ ~ ~. ~ ;-- ~:` ~ Interior Material/Color ~ ~~ is ti. ,-+.L~~- ~~ ~- - -.-- Cremation Container ........................................ - ...... $ __ __ _ Manufacturer ~ ~ -~~ _ Model Name/Number ~ Outer Burial Container .............. ... ....... $ -` Manufacturer r -J ~ ~ . I ~! __ _ ~ ~___~_ Model Name/Number ` ___ i ~ Material _ Other Guaranteed Merchandise ( pecify) ~~ _ ___ TOTAL FUNERAL MERCHANDISE ....................,....... r i ~-.- r7 1 f ,~,~ `;;~'_`~'-~ Y TOTAL FUNERAL HOME SERVICES .......:................ TOTAL GUARANTEED FUNERAL PRICE ................... ... ~ ~„ /~ -._ - r. NON-GUARANTEED .CASH ADVANCE ITEMS Acknowledgment Cards ........... .......:...._..,...........:.. $ Obituary Notices.......:~:.~..:......`:..r,....~.~ $ ........ __ Death Certificates} (# ) ~ •••~••••• $ _Y_ _____ Flowers ...................................................l.... ......... $ Clergy Honorarium .......................................... .......:. $ Music ........................................................... ......... $ Vault lnstaliation ............................................ ........;$ Grave Opening and Closing ............................ ......... $ f`~airdresser .................................................. ......... $ Other (Specify} $ --- $ - Vile charge you for our services in obtaining the _~•' -- ~ ` v, following cash advance items: _,~~ __ $ _.~ - $ ~ ~~ cr Sa esf ~~ +~__~ $ TOTAL NON-GUARANTEED CASH ADVANCE ITEMS ...... $ TOTAL GUARANTEED FUNERAL PRICE ....................... $ TOTAL GUARANTEED AND NON-GUARANTEED FUNERAL PRICE .............................................. $ ~~' T,,.~.. rC...i.. ~~~~~ i `' ;..~! L c i ~ ~. t:: t`„~ Charges are only for items that you selected or that are required. If we are required by law or by a cemetery or crematory to use any items, we will explain the reasons in writing below. If you select a funeral that may require embalming,. such as a funeral with viewing, you may have to pay far Embalming. You do not have to pay for embalming you did not approve if you selected arrangements such as direct cremation or ~mmed~ate burial. 4f we charge for embalming, we wilt explain why below. __ __._ ~__________ Acknowledgment: By completing and signing this form, you acknowledge that you were given a copy of this Agreement, that ,you were shown general price lists prior to discussing prices of funeral services or merchandise and that you have read and understand this Agreement. L Funeral Home Name Purchaser _ _ _~ ~ ,' r ;- 'i ~~~t Address Address ~~ Signature of Authorized Funeral Home Representative Date `Signature of Purchaser Date PN-SGS-EPB G2/08 1st Copy -Company 2nd Copy -Agent 3rd Copy -Purchaser PRE~UNDED FUNERRL AGREEMENT Performance Agreement The Provider agrees to provide the funeral services as specified by the Purchaser unie~,s those services canna be performed due tc cir- cumstances beyonC ~:he Provider's control. This Agreement supercedes any and all other written agreemen~s and negotiations between the parties. This Agreement cannot be changed except by a later written agreement signed by Purchaser and PPrnrider. Funding Purchaser agrees to fund this Agreement with a life insurance policy issued by National Guardian Life Insurance Company ("Insurer") on the life of the Recipient ~~ith an ultimate face amount at least equal to the Total Guaranteed and Non-Guaranteed Funeral Price and to assign the policy proceeds to tha Provider. The policy shall be purchased within 30 days from the date of this Agreement. The insurer is not a pJ.rty to this Agreement and is not responsible for fulfillment of its terms. The responsibilities of the Insurer are solely as stated in the insurance policy. Price Guarantee The prices shown in the Statement of Goods and Services are the current retail prices. They are used to establish the amount of insurance required to fund this ,Agreement. When the Funeral Services are, provided, the current retail prices at that time wilt be charged. If the insurance policy purchased in cc~njunctron with this Agreement pays an immediate full benefit. the Provider will accept the policy death benefit as full payment for the Guaranteed Funeral Goods and Services even if the current retail price at that time is greater than the policy death benefit. If the policy death benefit exceeds the current retail prices, the excess funds shall be distributed as outlined in t'ne insurance policy. If the insurance policy purchased in conjunction with this Agreement is a limited benefit policy, the Provider will accept the policy death benefit as full paymE;nt for the Guaranteed Funeral Goods and Services only afiter the limited benefit period when full benefits are payable under the policy. If the Insured should die during the limited benefit period and the insurance proceeds are not sufficient to make full pay- ment, the difference between the proceeds and the current price of the Guaranteed Funeral Goods and Sen~ices shall be due and payable by the recipient's family or authorized representative. fn all instances prices far Cash Advance items are incidental and not guaranteed. if policy death benefit is not sufficient to provide payment in full far Cash Advance items, the difference between the available death benefit and the current price steal I be due and payable by ..the recipient's family or authorized representative. Limitation on Price Guarantee These price guarantees will not apply unless the policy death benefit paid is an amount at least equal to the ultimate face amount. Substitution of Funeral Services The Provider will furnish the items as described, but, if unavailable, reserves the right to substitute items of equal or better quality. Freedom of Choice At any time, the Purchaser, family or authorized representative may request that a new funeral home be appointed to provide the Funeral Services. This request must be in writing, .Upon acceptance by the new funeral home, Provider agrees to assign its rights and obligations in this Agreement. Insurance Policy Termination if the insurance policy is terminated for any reason, this Agreement automatically ends and the Provider is relieved oi~ all responsibility under the Agreement. This Agreement automatically ends if the insurance policy is cancelled, allowed to lapse, borrowed against, surrendered iior cash, or if annuity payments are paid out before death. Cancellation This Agreement may be cancelled at any time before the Provider provides the Funeral Services.. Cancellation of this Agreement will not cancel the insurance policy, which must be cancelled according to the specific terms of the insurance policy. If the insurance policy is cancelled or surrende~~~ed more than 30 days from issue, the cash value, if any, will be rr;funded. In the early years, the cash value maybe substantially less than the premiums paid. ENRrJLLMEfIT FORM FOR GROUP INSURANCE/ANNUITY Insured. ~~_ "~ _" - -~ - _- _. ; ~atianal Guardian fife insurance Company (NGL) Phone 800.988.0826 Fax 866.228.9927 ~ ----~ Two fast Gilman ~tre~~t PG fox 1191 Madison WI 53701-1 1 91 Agent. --,; -~--_--'-_-_-_=-- - ' - r' IRREVOCABLE ASSIGNMENT OF POLICY ~! Assignment of Ownershir>, ~:~eath Benefit and Rescission Rights: The Owner hereby irrevocably assigns to tht-~ Funeral Provider named in the Direct+on for IJayment of Proceeds al( incidents of ownership of the Pc>ficy, the right to receive al! or part of the death benefit payable ander hc~ Policy upon receipt of proof that the funeral merchandise and services have beer provided, and, if the Insurer, for any reason either rescinds or declines to issue a Policy, all rights, including the following: (1 j the sight to receive the premiurr+ pa+d (upon receil~~t of proof that the funeral merchandise and services have been provided), (2) thE~~ right to compromise claims and ;3) the right tc~ agree to rescission. The Owner acknowledges that by making the assignment irrevocable it cannot be canceled. This assignment does not affect the righi of the Owner to cancel `he Policy under the Right to Cancel provision. By making this assignment irrevocable, the Owner also acknowledges the fdlc~w+ng: 1. The. assignment of death benefit proceeds is permanent and cannot be changed by the Owner. 2 The Owner has waived all rights under the Policy to surrender for cash, to obtain a loan, to mange the Owner or beneficiary, or to receive a refund for any premium paid. 3 The OwrE~r remains responsible for the payment of all insurance premiums when due. It +s understood and agree~_~ 1:hat this irrevocable assignment in no way inhibits the Owner ar the next o` k n of tnc Insured from hereafter selecting another >==uneral Provider to perform funeral services and provide funeral merchandise ;n connection with the funeral o~ the Insured. The Insurer is not a party to this assignment and the sole responsibility of the Insurer i:> to pay the death benefit proceeds pursuant to 'he terms of the Policy as amended by this assignment. immediate Transfer (For purposes of Medicaid Eligibility ONLY) - I hereby eleca to make this irrevocable assignment effectivE; immediately. i understand that by making this election I give up all rights to cancel the Policy and receive a return of premium under the Right to Cancel provisier~ of the Policy. To make an immediate transfer election please initial here `____, ~JS~gnature o` Owner ____ gate ~` ^f AUTOMATIC PAYMENT AUTHORIZATION (Select One) ^ Monthly Electronic Funds Transfier Date of month to initiate payment (dates available are 1st I request and authorize NGL to make monthly withdrawals through 28th) -select one: against the financial institution account specified at right or -------- - any account subsequently named by me, and such Bank Name _~_ V _______ _.__ bank(s) to process these withdrawals as if I had signed Bank Routing/ABA #_ ___ ____ ,^` _ __~_ them, for the purpose of collecting premiums under this Account # ~_____~ - p1an. ff the said account is replaced by an account in ^ Checking ^ Savings another bank, this request and authorization shall also apply to such other bank. (Signature as it appears on bank rECOrds) if using a checking account, please include a void check. For savings account., please contact the bank to verify EFT __ ~-_______ _ is allowed and verify correct routing and account number. Gate) ^ Monthly Credit Card Authorization (Not on Annuity) 1 authorize the premiums due to be remitted monthly to -- (account Number} ~~ NGL through my credit card account indicated at right. This authority will remain in full force and effect until I __ _______ revoke this authorization by written notification to NGL. (Exp. oatE;) .- ____ _ 1 (Cardholder Signature) Select one only: ^ V)SA ^ MasterCard (Cardholder Addressl __ - (Printed Name) (Date) PN-STD (Page 2) 05/08 ENRGLLMENT FORM FC)R GROUP INSURANCE/ANNUITY - (PEASE PRINT} _ ~ 27,35PN-PA 05108 Series4 National Guardi::n ,_ifc I~-~surance Company (NGL) Phone 800.988.0826 Fax 866.228.99?? MAID POLICI' TO: ^ AGENT ~~-FUNERAL HOME TwoFasi G;imar~ Street PC Box 1191 Madison WI 53701-1191 , ^ OWNER PROPOSED INSURED/ANNUITANT ^ Male f~ Female ~ ~~~ _. _ ' ` ` ~~ ~ r ors! tvame ~ti ~ ~ Last Name Phone Number ~oa~3l S~ ~.uri ~Jumber Ate iaate of ~3irtl- OWNER -Complete only if other than Insured/Annuitant .4 F~^ Y ~ '~- i l r . , ~ First I`Jan~e w1' Last Name Social Security Number Relat;onst~ip ro Insured MAILING ADDRESS ~j INSURED/ANNUITANT ^ OWNER (Where to send information about this F'oiicy) -. _ _, ,~ -- -- - - ---- - - - ~,p _ _----- Street Adc7re~~ City -- ; ~~t~rP r PAYMENT PLAN PLAN PAYMENT MODE ____ f=uneral Price $ ,~ ~ j ; Ll, ~ ~ Face ,Amount $ ^ A ^ A,nnual (r~otavailablecn ~ P~:y; ~ [U Quarterly f^ Single F'ay Life '~,tl d`,j~~e~ible~Annuity $ _ ~ B ^ Semi-Annual ^ EFT `4; ,, f~lulti Pay Life: ^ 1 Year ~,^ 3 Year ^ 5 Year ^ 10 Year ~ ~ ~, Initial Premium - Mu t~ F'ay Frem~um = Total Premium Amount tW~cn a~u~ ^ E ^ NIC;NISA -Use Monthly i~irec~ Factor ^ Monthly Direct ~> ~ ~ ^ F STAI E11fIENT C)F HEA- TI-i (To be completed by Proposed Insured - Do not complete for Annuity) 1, Are you currently on oxygen, hospitalized, or confined to a nursing home or long term care facllity? ___, ^ YES ~ NO ?. During the past two years have you been advised by a medical professional to have any surgical proced~~re th~~t has not been performed' ^YES[,jNO 3. During the past two years ~~ave you been treated or are you being treated by a medical professional for any o t-he following diseases or dis~r~rders; ^ YES ^ NO Congestive Heart Failure Immune System Disorder Chronic Obstructive Pulmonary (lung) Disease Amlautation (caused by disease) Heart Disease Cirrhosis of the Liver Emphysema Stroke Drug or Alcohol Dependency Alzheimer's/Dementia Cancer (other than skin) Kidney failure (including dialysis) Diabetic Coma/Insulin Shock If the health question is not answered or answered "Yes" and you are applying for a IVlult Pay Plan, a Policy with limited death ben~~ efits during the early years ~~~iil be issued. The full death benefit is paid for accidental death. __ _ _ DIRECTION FOR PAYMENT OF PROCEEDS (These directions ma be changed any time before the funeral is provided by giving written notice to the Insures) NGL is directed to pay an amount not to exceed the death benefit of the Policy to the Funeral Provider named below, if any, upon receipt of proof that funeral r7ierchandise and services have been provided. fn the event that NGL rescinds or declines to issue the Policy, I also assign to the Funeral Provider (1) the right to receive the premium paid upon receipt of proof that funeral merchandise and services have been prw'ded, (2) the right to compromise claims and (3) the right to agree to resci:>sior~. -- r,: 1 ~ ~ ~ ~ ~ ~ ~_~, Name or Funeral Prod 4~ ! -- ,` ~ der Street Address City ~~ Stat° Zip `' Name of Primar~~ Benef+crar,r Street Address Crty State Zip RE~r~~honshi0 to Insured - ~' f ---- i APPLICANT SIGNATURES _ __ ~~ 7b the best of my knowledce and belief, the above information is true and complete. I understand that no insurance wil! be effective ' until this form is approved air the Policy is issued whi{e the Vnsured is living. 1 authorize ~JGL to share my nonpublic personal information with any Funeral Provider with whom I have a Prefunded Funeral Agreement. !f I am the Owner `or insurance on the life of the Proposed fissured. f „certify that f have an insurable interest in his or her life, I acknowledge that i havo read the fraud warning statement on the last page of this form. ,--. ,,,,_ r ,' 1 ~ ~' - i ` ----- . - - --------- -- Signed at r State t Signature vt Proposed Insured/Annuitant Date Signature of Owner (Required rf other than lnsurec+j Date AGENT'S STATEMENT ~~ f certify that any inforrna-tion recorded~y me on this form ts true and accurate to the best of my knowledge. i f Agent(s) Signature Agent Name(s) Printed NGL Agent~~ Ager t Slate uucense# °4, Agent(s) Signature Agent Name(s) Printed ~ NGL A ent # - ~ ~ .- -~~ - g Agent Mate Licenserr ~~, 2735PN-PA 05/C~ 1st Copy -Company 2nd Copy -Agent 3rd Gopy -Purchaser Use with PN-5TD (page ~?) Ei~dROLLMENT FORM FOR GROUP INSURANCE/ANNUITY i`~at~o~al C_ u<<rd,a~ + l._i`e insurance Company (NGL) Phone 800.988.0826 Fax 866.22.8.997 =- Tvvo East a~t~nan Street PO Box 1191 Madison WI X3701-1191 ACKNOWLEDGMENT OF PAYMENT This ackno~f~led~es i~~aymcr~t from ~~1~~.~_~ ~ __,__-~ n tine amount of $_~~ ~°~~~_ in connection wi~~~h the Policy applied for from NGL. If all of the conditions of the application are met and :hE~ application 's accepted, a Policy will be issue4~ 'f the application is not accepted, the Insurer's only responsibility will be to refund thE, amount for which this Acknowledgment o~ r'ayment was given. ~ ~ .~-~ ~ When you pro~ride r~ c;heck as payment, you authorize us either to use information from your check tc make aone-time electronic fund transfer from y{:cur account or to process the payment as a check transact on. When we use information from your check to make an electronic rune transfer, funds may be withdrawn from your account as soon as the same d~_~y you make your payment, and you wit! not receive ~~rc~ur check back from~our financial institution. For inquiries please call 1-800-988-0826. ~ .-;, ---- A ®nt S+gnature Daie FRAUD WARNING STATEMENT For Residents of Pennsylvania Any person wro kno~nr~ngly and with intent to defraud any insurance company or other person files an application for insurance or s?atement of claim cc;n+aining any materially false information or conceals, for the purpose of misleading, information concerning any fact material there'd commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties. "Poi~cy" is def~neci a5 th~~~ insurance policy, certificate or annuity contract for which 1 am applying. Myers-Darner Funeral Home, Inc. 1903 MARKET STREET CAMP HILL, PENNSYLVANIA 17011 Robert H. F-earner. Supervisor Phone: (717) 737-9961 Dustcn R. Baker, Funeral D~~rector S"TATEMEN'T OF FUNERAt_ GOODS AND SERVICES SIL?LECTED Charges are onl~~ for those items t}~at t~ou selected or chat are required. If we are required by law or by a cemeter}' or crematory to use an}' item<, ~s~e ~~ilJ explain sn writing below. If you selected a funeral that may' require embalming, such as a funeral with viewing, }you ma}' have to p~av fot embaln~ting You do not have to pa~T f,~u embalming }you did not approve iFvou selected arrangements such a~; a direct cremation or immediate burial. If we charged for embalm-ing, we will explain wh}` below. For the Ser~-ice of . ~-~~ ~~ ~_'` ~ ~ ~ -~~ 1 ~~ ~e- L ~_- Date of Death-~/_~SL~-~ -•-~.. `u Charge to: __ _~___1 ~ C~1 ~? ~ ~~ Namr Address City State A. CI-IAKGE FOR SEIZ~'ICF?S SI?LIC"TED: 1. PROI F:SSIONAI. SFK~'?C FS Sen~t~es of buneral Dircc.o~ Srafi . ..... . S1 nC~ . Other preparation of bod~.' Dressing ~ Cosrnotoh~g~~ ....... , ... . ~ 1 nG . Casket Placement .. - ........ , . $ 1 nC.1. -~- Cremation urn ....... , .. ..... ;, ~i'~_. (Descnpti°nj --- ---- __ ---- Urn ~'~ault ...... .... ........ , ..:h _~~/'. (Description) ~_ - " _„~~_ TOTAL M1~;RC[-IANTDISE SELECTED ............ I3 $ 76C~.~ SUB-TOTAL OF PROFESSIONAL SERVICES ..... Al $ ~~~ C. SPECIAL CHARGEES: Forwarding of remains to 2. FACILI"PIES AND S1-;RV[CI~S Use of facilities and services ±or vie~s~in«. (~'"isirat~onl~~~al,eti ~~'~V~"~G A ^ , _ $ 1~ ~~se of facilities anc', se»ic~°s for fai:eral ceremony .... .... . ~ _~ ~;se oi~facilities anc services l~~r IVlemorial Service ... ........... . ~ _~ L~~se of eduipment ~~.nd ser~'ices I~or ~ ~ravecide service- .... ........... . $ l i Other use of facilities Ofiiee Area ........ ............. . $ l (1,G~, Preparation Roo.n~ .... .......... . ~ ~~(~_ 1 SUI3-T'01AL OF FACILI'1"II:S/EQUIPMEN"I' .... A2 $~l~ 3. AUTOMOTIVE EQUIPMENT Vehicle to transfer remains tc. Funeral Home LOCaJ ........ .... ...... ..... ~ ~ ._ Hearse (Cachet Coach} I.ocaJ ........ ... ........ ..... $ ~- (~ Hower car or floral disposition Local ........ ......... .. . . ..... $ ! /~.G~ Lead car/derg~~ car Local ........ ......... .... ..... ~ a ~~ SUB-TOTAL OF AUTOMOTNE/I;QDIPMENT .. A3 $~!'1~~ -- - ~~ ._ _- { Funeral Homej Receiving of remains from 4; _ ---- (Funeral Home) - Immediate Bu:-ial ........ . ...... ~ _____^. Direct Cremation ................. ~ a SL'B-TOTA. OI? SPECIAL. CHARGES . ........... C $___, D. CASH ADVANCED: Opening Grave ..................... . ~ __-, Newspaper Notice-Local e~~'l ~ G '~ ~--< ~ ~ _ ~ ~ ~ , Newspaper Notice-Out-of-towi~.-c7? ! "~ ~ . ~ ~~ ~ Airfare .................... .... . , ------ -- ClergylMass Offering .......... .... .. $ ~~~~CC~ Certified C«pies of tie Death Certificate "_ _~ C ~.__ _-~_- each ... .. ~ ~~~.~~ blowers .......................... . $ ------ Vault Service Charge ........ .... . .. . b _______ Organist ......................... . ~.-------__ ~OIO1St ......................... .. ----- Altar Services ...................... .. h ----__ __-- Coroner Fee .......... ........... .. S _ _ -- ilage .` ........... ~ ............. ' .. 'S ---- i I~ 1C• ~~.~~ - C ~v~ ~_ ~ L ' y ~Q SUB-TOTAI. OF AT)~ ANCES ......... ........... D $ L TOTAI. OF PROFESSIONAL S]ERYrICh.S, FACILITIES AND AUTOMO"~IT'F, ~ EQLII'~I:ENT ~T?~~. U~~~. ~r.~ .... A $ e-1~~--b'~,~ I3. CHARGZ FOR MERC}~.~'~NDISF; SELECTED: Casl:er ... ..... $ _ .. (Description;i G~~~. ____ ~Q-~ ' ~ .~. Other Receptacle - .. .. .. ~ _~'' (Description) __ _ - __ _ Outer burin; container . ~ _L~' (Description; Acknowled~emenr cards .. _ .... . S ___ Register book(s) .. .. ... .. ~ Memor~,~ folders .. 5 ~,~ Prayer cards ...... . .... ~ . ~ Temporan ~ra-~~e n~arke~r . ~ _~/~ Buual clorhin:; ...5 Onc~r cloii~ing - - -- ------ - -- - S . ~-- V(~e charge you for our services in obtaining. (rpecifi~ cash adi~ances teat are ~yz~irked-rsp) Si1MMARY OF CI3ARGES :~. Professional Ser~•ices, Facilities and Equipment, and Automoti~~c .. S _ /t~r~ Lr~-7 Equipment .................. ~__ B Merchandise ............. .... ~ ~7~~~} ~~ C. Special Charges ... . ...... ....... . ~ __ _ __ D. Cash Advances .. . , . ...... .......... ~ ~~~~-~~ ~ TOTAL OF ALL SE',CTIONS ....................... $ ~~~ ~~_ PAID AT TIME OF OR PRIOR , TO ARRANGEMENTS .C`~~c-1h ~ ~~. ~ , .... }"$ yy O_ Q, B_AJ.ANCE DliE .................................. $~~ D. REASON FOR EMBALYM~:[~NG If any lay,, cemeter)~, or c;-emarury requirements ha 'e requtre~d the purchase of any of the items listed above the law or requirement i~ exala ned below. I agree than I ha~~e examined the items of goods and services selected above and found them to be correct and according to the arrangements I `lave requested. I acknowledge receipt of a co~.~}' of this Statement of Funeral Goods and Services ~cted. I represent that I have sufficient. funds available for payment of the cash price for the goods and services selected. I also ay,re :o make payment of S ~~ ~ within ~ O ___ days. I agree to be jointly and severally liable with anyone else who signs below. A late charge of S ~~ per month. amounting to ~ ~~ per year will be applied to the unpaid balance beginning 6~5:___ :lays from the date of this agreement. I will also pay ro the 1=tmeral Director all reasonable costs paid by the Funeral Director to collect amounts I owe under this a~~re~°ment. Those costs may include attorneys' fees, court costs and other costs. Any additional services or merchandise ordered or requested after the date of This agreement ~s-~11. ~ae considered part ohthis agreement and the cost thereof will lie reflected on the final bill or statement. (seal) ~~-~~~ __ - - ~ ri ~! ~_~ _1_Z~'_- ~,0 /~ (pure as r) ~_ ~~~--~ ~- F __ ~=~~ (S ~ 0~~ ~ _ ~ - °'~- ;Purchaser) ~ {Licensed Funeral Director) } - __-_ ~t ra ~ ~~ ~aA ~tl ~~ ~ i } - :__ nI F i P i ~0~8 a:~ ~~ ~a~~ 8~~3 9~~7 ~ ~ '~;~v~"' ~ >narrta+n~ ~ $11.05 t i US POSTAGE ~ PRIORITY MAIL f 071V00698445 N ~ ''~ ~~ ~ 17109 ~ ~ ~ { ~• ~ ~i A ~ ~~ ~~ E oaoooas-2 • ',~ 4~ Q ~~_ ~ r;i ~ ~ ~7 ~- ~} ~ .~ ~:? ~~ ~ -=r4 'D ~ _.... p ----~ 1 .iL/ ~~ 5011 Locust Lane Harrisburg, PA 17109 1; RegistE~r of Wills Cumberland County Courthouse 1 Courthou.~e Square Carlisle., F'!~ 17013 __.. I --_..~