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HomeMy WebLinkAbout04-0885PETITION FOR GRANT OF LETTERS OF ADMINISTRATION also known as .Charles L. Mabius Social Security No. 171-28-4267 To; Deceased. The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, appl¥ (&b.n.; pendente Kite; durante absentia; durante minoritate) Register of Wills for the County of Cumberland Commonwealth of Pennsylvania in the for letters of administration on the estate of the above decedent. Decedent was domiciled at death in Cumberland h is last family or principal residence at 70 Cherry Lane, Carlisle, Pennsylvania (list streeL number, Twp or Boro) Decedent, then 68 years of age, died 9/16/2004 at Hol S iritHos itar East PensboroTownshi Cam Hill Penns Ivania Deccdent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal properly (If not doJniciled in Pa.) Personal property in Pennsylvania (if not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ County, Pennsylvania, with $ 9,800.00 $. $ Petitioner after a proper search ha s the following spouse (if any) and heirs: Name Amy A. LeBard Wilhelm Mabius / Marqaret M. Wilbert Thomas Mabius ister brother sister brother ascertained that decedent left no will and was survived by Relationship Residence Box 138 Mt. HollySprinqs PA 17065 107 Varley Street Summerdale PA 17093 1730 Palmer Avenue W¥omissinq PA 19610 738 Pisgah Road Shermansdale PA 17090 THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the appropriate tbnn'~:o the uncle;signed. ~-~, ~_ --~-~--~ 738 Pisgah Road Thomas Ma" s Shermansdale PA 17090 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF Cumberland) SS Thc petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best i: of the knowledge and belief of petitioner(s) and that as personal representative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. t Sworn to or affirmed and subscribed before me this 2 ' 1 · dayof Estate of Charles Larry Mabius , Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW ,.~i ~ t , in consideration of the petition on the revcrse side hereof, satisfactory proof having been presented before mc, IT IS DECREED that Thomas Mabius is/are entitled to Letters of Administration, and ill accord with such finding, Letters of Administration are hcrcby granted to Thomas Mabius in thc estate of Charles Larry Mabius FEES Letters of Administration. ..... $ Short Ccrtificates ('_5) ...... $ Renunciation ............ $ TOTAL--. S Filed .............. A.D. Susan E. Lederer 44861 ATTORNEY (Sup. Ct ID No) 4811 Jonestown Road, Suite 226 Harrisburq PA 17109 ADDRESS 717-652-7323 PHONE £P 1 $1004 ~,Cumber land COMMONWEALTH OF PENNSYLVANIA · DEPAR[MENT OF HEALTH - VITAL RECORDS CERTIFICATE OF DEATH /VlAi~luoc' 2 iVl [~171 - 28 -4267 E. Pennsboro '~:7~,%?,~Ir'~ du ~g;,~,'Ag,~" B e t h 1 e h em ,Tablemill Operato: 70 Cherry Lane ~s~)~,~ ~ Carlisle, PA 17013 .... ~,~ John H. Mabius Thomas Mabius 9-16-04 ~,,k-I x~O ~,~ ~,r~ ~,~,~ ,o White Holy Spirit Hospital [~,~,~, ~o~ .......... is~,l~ ~ ~[~] ~o[~ U NK'''~'~'~ [] c .............. ~ 9-21-04 738 Pisgah Rd. Shermansdale, PA 17090 ~ndiantown Gap ~ Lebanon, PA ~, /'//~/*~' ~//-~K6~<e%'~-~ [=~ FD014993 I~Sullivan FH 51 N. Enola Dr. Enola PA [] 2 Estate of Charles Larry Mab~us RENUNCIATION also known as Charles L, Mebius Deceased NO. The undersigned,Margaret M. W~ibert~ sister the above Decedent, hereby renounce(s) the right to administer the estate and respectfully requestts) th~at Letters of Administration be issued to Tiqomas Mabiu8 Witness hand this.,_~ ~__ day of ~ ~¢¢, a~ , '1730 ~[mer Avenue ~issinq PA 19610 Sworn tO or affirmed and suoscribed before me this ")'"'% day of My Commission Expires: COMMDNWEALTH OF PENNSYLVANIA Notarial Seal ] Amy M. Moya, Notary Public Lower Paxton Twp.. Dauphin County My Commission Expires Jan. 29, 2008 Member, Pennsyfvanla Association of Notaries of NotE: RW-3 Estate of Charles Larry Mabius RENUNCIATION NO. aisc known as Charles L. MaDius , Deceased The undersigned. Amy A. LeB. ~rci, sis[er the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters of Administration be issued to Thomas Mabius W~t.~,ss hand t~i~ ;;;L~ day o~ ~¢')'~ '~'~ A~ Box 138 ¢ Mt WoW Spr tis PA 17065 Addressl of Sworn to or affirmed and subscnbed before me this "%-5..'~ day of My Commission ~xpi~es: ~OMM~NWEALTH OF PENNSYLVANIA Notarial Seal Amy M. Moya, Notary Public Lower Paxton Twp. Dauphin County My Corem ss on Expires lan. 29, 2008 Member, Pennsylvania Association of Notades 0flit al qbs#ltod t0 admmieter oaths Show NOTE; required in some counties ~o be notarized, RW.3 RENUNCIATION Estate of Charles Larry Mabius also known as Charles L. Mabius Deceased No, The undersigned,wilhelm Mabius, brother the above Decedent, hereby renounce(s) the right to adminisfer the estate and respectfully requestts) that Letters of Administration be issued to Tho~,s Mabius W,tness __ hand ,h,s. ~ day of~ ~"J'~ .~. i 07 Valley Street Summerdaie PA 170,93 Sworn to or affirmed and subscribed before ma t~ls ',~ '~ day of My ~ommission Expires: of NOTEr RW-3 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Charles Larry Mabius a/k/a Charles L. MabiM~ Date of Death: 9/16/2004 Will No. Admin. No. 2004-00885 To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on 10/5/2004 : Name Address Wilhelm Mabius P.O. Box 373, 107 Valley Street Summerdale PA 17093 Thomas Mabius RD 1, Box 253, 738 Pisgah Road ShermansDale PA 19090 Amy A. LeBard Box 138 Mt. Holy Sprinqs PA 17065 Margaret M. Wilbert 1730 Palmer Avenue W¥omissinq PA 19610 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except. Capacity: Signature Name: Susan E. Lederer. Esauire Address: 4811 Jonestown Road. Suite 226 Harrisbura PA 17109 Telephone (652) - 7323 Personal Representative X Counsel for Personal Representative . AE~-l'O<IH+(o.<IOJ w ~ ~~ ,,~ w. zO ,,~ . ~ < '* l REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT --~~- (ii'FICi,'\I_iE'YCi'j!y o 2. Supplemental Return o 48. Future Interest Compromise (date 01 deatt; alter 12-12-82) o 7. Decedent Maintained a Living Trust (AlIaeh copy of Trusl) o 10. Spousal Poverty Credit {dale of death between 0 ii.Election to tax under Sec. 9113(A) (Allaeh Seh 0) \:&QRR'~~c1~W~~~~-;~~6:PQNWip~~l1A~l[AXj"NFPR:~~'\J1Q:til'ii1Q:Ij"!g;Q'S'QJfi~~oJTP~I~1m\fmjm;1*~!mH~I\lm;jm~Mm COMPLETE MAILING ADDRESS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT.2B0601 HAFlf\lSBURG, PA 1712'8.0601 DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Mabius, Charles L ~ w c w " w c DATE OF DEATH {MM-DD-YEAR} DATE OF BIRTH {MM-DD-YEAR) 09/16/2004 09113/1936 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, fIRST AND MIDDLE INlTlAL) ~ ,. Original Return 0 4. Limited Estate 0 6. Decedent Died Testate {Attach copy o(Willj 0 9. Litigation Proceeds Received <h~ Ww ~c "'z 00 ,,~ tHls'll~4Trof'iUSTBE t::OM~' TEMIC AME Susan E. Lederer lAM NAME (If applicable) Law Offices of Susan E. Lederer ELEPHONE NUMBER 717/652-7323 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) z o ~ ~ ~ ~ ;: < " w ~ 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly OWned Property (Schedule F) o Separate Billing Requested 7.lnter.Vivos Transfers & Miscellaneous Non.probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) NUMBER 21 04 COUNTY CODE YEAR SOCIAL SECURITY NUMBEA 17 '-28-4267 0885 NUMBEFi_ THIS RETURN MUST BE FilED IN DUPLICATE WITH THI: REGISTER OF WILLS SOCIAL SECURITY NUMBER o o 3. Remainder Return (date of death prior to 12-13 82) 5. Federal Estate Tax Return Required R Total Number 01 Sale Deposit Bo}(es 4811 Jonestown Rd. Suite 226 Harrisburg, P A 17109 (1) None (2) None (3) None (4) None (5) 9,050.06 (6) None (7) None (9) 9,791.00 (10) 7,861.61 om,I ., (":", ['0<:; C) (8) 9,050.06 (11) 17,652.61 (12) insolvent 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax (Une 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) z o 16. Amount of Une 14 taxable at lineal rate g ~ 17.Amount of Une 14 taxable at sibling rate o " E 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ""i<><> ::lHY, ,:;:i\0H,'" "''''':'C)'''''' ,:, BE SIlRIHO.4NSWER.Al\..ollESTIONS ON.REVERSE SIDE AND RECHECK MATH <<. Copyright 2000 form software only The Lackner Group. Inc. ~..... Form REV-1500 EX (Rev. 6-00) O,ecedent's Complete Address: STREET ADDRESS 70 Cherry Lane CITY Carlisle ISTATE PA [ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) Tolal Credils (A + B + C) (2) 0.00 3. InteresVPenalty if applicable D. Interest E, Penalty (3) 0,00 (4) (5) 0,00 (5A) (5B) 0.00 TotallnteresVPenalty (D ... E) 4. If line 2 is greater than Line 1 + Une 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Une 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT 1. Did decedent make a transfer and: a. retain the use or income of the property trans1erred;........... ............................................................ b. retain the right to designate who shall use the property transferred or its income;.............. .................. c. retain a reversionary interest; or................... ........................................ ............................. ....................... d. receive the promise for life of either payments, benefits or care?..... ........................ .............................. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ......... ....... ..... ........................ ...... .... .................. ............................... 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?..... 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .......... ............ ............................................... .................. ... .......................... PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS '~ I o o o 181 181 181 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties 01 pe~ury, I declare that I have examined Ihis retum. including accompanying schedules and statemenls, and to Ihe best 0' my knowledge and beliel. it Is true, correct and complete. Declaration of preparer other than the personal representative is based on all informalion 01 which preparer has any knowledge. SIGNATURE OF PERSON R~SP.oUSIBLE FOR FlUNG RETURN ADDRESS Thomas .Mablus-ir'''-:::::=-- >~ .~ ~~ / ..c:- SIGNATURE OF PERS ONSIBLE FOR FILING RETURN R.D, I, Box 253 738 Pisgah Road Shermansdale, P A 17090 DATE G/d.-. . ;).0<>5'" ADORESS DATE C. 81 ATURE OF REPARER OTHER THAN REPRE ENTATIVE Susan E. Lederer ADDRESS ot:>:') DATE Rd, PA 17109 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P,S, ~9116 (a) (1,1) (i)), For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the SUrViving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)J. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at dea parent, an adoptive parent, or a stepparent of the child is 0% [72 P .8. ~9116 (a) (1.2)l. N fJ fj) The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, ex 1.2) [72 P.S, ~9116 (a) (1)J. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P .S. ~911 € under Section 9102, as an individual whO has at least one parent in common with the decedent, whether by blood c :r '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Mabius, Charles L I FILE NUMBER 21 - 04 - 0885 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 I DESCRIPTION VALUE AT DATE OF DEATH 425.47 Checking Account # 2672046881, held at M&T Bank, titled to Charles Larry Mabius 2 1997 Pontiac Grand Am. titled to Charles L. Mabius (sold at auction) 1,850.00 3 lawnmower (sold at auction) 210.00 4 Snowblower (sold at auction) 330.00 5 Mobile Home, titled to Charles L. Mabius (sold at auction) 2,600.00 6 Allstate (refund for automobile insurance) 48.96 7 Allstate (refund for Mobile Home insurance) 113.00 8 Highmark Blue Shield (refund of health insurance) 218.54 9 VFW death benefit 250.00 10 cash found in mobile home 100.00 11 Verizon (refund of telephone service) 17.89 12 Litigation proceeds, Estate of Larry C. Mabius v. Harbison WalkerlHalliburton (asbestos claim), check received February 17,2005 2,886.20 TOTAL (Also enter on Line 5, Recapitulation) 9,050.06 .. 1- SCHEDULE H FUNERAl... EXPENSES & ADMINISTRA11VE COSTS COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Mabius, Charles L I FILE NUMBER 21 - 04 - 0885 ESTATE OF Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION FUNERAL EXPENSES: Sullivan Funeral Home B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Thomas Mabius Social Security Number(s) I EIN Number of Personal Representative(s): 207-22-0612 Street Address R.D. 1, Box 253. 738 Pisgah Road City Shermansdale State ~ Zip 17090 Year(s) Commission paid (estimate) Attorney's Fees Law Offices of Susan E. Lederer 2. 3. Family Exemption: (If decedent's address is not the sarna as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip 4. Probate Fees Cumberland County Register of Wills 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Other Administrative Costs Brickers Auctions (cost of auction) 2 short certificate Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) -I AMOUNT 4,58000 452.50 3,000.00 80.00 520.00 3.00 1,155.50 9,791.00 *' SchecUe H FI.I1eI'aI Expenses & Adninislralille Costs CClI'lIiooed COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER 21-04-0885 ESTATE OF Mabius, Cbarles L 3 Cumberland Law Journal (estate advertising) 75.00 4 Carlisle Sentinel (estate advertising) 88.43 5 Law Offices of Peter G. Angelos (Attorney's fees for asbestos litigation) 962.07 6 Filing Fee for PA Inheritance Tax Return and Inventory 30.00 Page 2 of Schedule H '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS CCMMCNWE.I\L TH OF PENNSYLVANIA INHERlTANCETAX RETURN RESIDENT DECEDENT ESTATE OF Mabius, Charles L I FILE NUMBER 21-04-0885 Include unreimbursed medical expenses. ITEM NUMBER I 2 4 10 II 12 20 DESCRIPTION AMOUNT New Century Financial (check written before death, cleared after death) 150.00 Highmark Blue Shield (direct withdrawal from account) 149.00 3 Liberty Medical Supplies (check written before death, cleared after death) 58.27 New Century Financial Services, Inc. (unpaid) 4,416.74 5 Discover Financial Services, Inc (unpaid bill) 467.00 6 Department of Veterans Affairs (unpaid bill) 42.00 7 Lowe's (unpaid bill) ] ,734.38 8 Country Manor West (mobile home lot rent) (unpaid bill) 330.50 9 Country Manor West (water bill) (unpaid bill) 1.21 Penny G. Davis, Tax Collector (unpaid bill) 11.00 AT&T (unpaid) 5.62 Holy Spirit Hospital (unpaid bill) 6.36 13 Holy Spirit Hospital (unpaid bill) 19.08 14 um (Torres Credit Services, Inc) (unpaid bill) 21.00 15 um (NCa Financial Systems, Inc) (unpaid bill) 21.00 16 um (service contract) (unpaid bill) 148.50 17 PP&L (unpaid bill) 53.01 18 25.16 AT&T (paid bill) 19 um (paid bill) 44.93 Verizon (paid bill) 27.92 Total of Continuation Schedule(s) TOTAL (Also enter on Line 10, Recapitulation) 128.93 7,861.61 '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS continued COMMONWEAlTH OF PENN$Y\.VAtllA. lNHERlTANCETAX RETURN RESIDENT DECEDENT ESTATE OF Mabius, Charles L I FILE NUMBER 21 - 04 - 0885 Include unreimbursed medical expenses. ITEM NUMBER 21 UGI (paid bill) DESCRIPTION AMOUNT 44.93 22 Allstate (Mobile Home insurance) (paid bill) 84.00 Page 2 of Schedule I RE~-1513 EX+ (~OO) '* SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Mabius. Charles L I FILE NUMBER 21-04-0885 RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY _ ~_ECEDENT OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) I Amy A. LeBard Sister 1/4 of estate Box 138 Mt. Holly Springs, P A 17065 2 Wilhelm Mabius Brother 1/4 of estate 107 Valley Street Summerdale, P A 17093 3 Margaret M. Wilbert Sister 1/4 of estate 1730 Palmer Avenue Wyomissing, P A 19610 4 Thomas Mabius Brother 1/4 of estate 738 Pisgah Road Shermansdale. P A 17090 Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II. ENTER TOTAL NON.TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I . Register of Wills of Cumberland County, Pennsylvania INVENTORY , Deceased No. 21 - 04 - 0885 Date of Death 9116/2004 Social Security No. 171-28-4267 Mabius, Charles L Estate of also known as Tbomas Mabius The Personal Representative(s) of the above Estate, deceased, verity that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its lair value as 01 the date of the Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. l!We verify that the statements made in this Inventory are true and correct. l!We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Personal Representative .-.,:;' Signa!~~~~~:__ ." "> Thomas M~/ Signature: ~/' Attorney: Susan E. Lederer 1.0. No.: 44861 Signature: Address: Address: R.D. 1, Box 253 738 Pisgah Road Shermansdale, P A 17090 4811 Jonestown Rd. Suite 226 Harrisburg, P A 17109 Telephone: 717/652-7323 Telephone: 717-582-4203 Dated: G 1;).1 J...Oo:'}- Personal Property Checking Account # 2672046881, held at M&T Bank, titled to Charles Larry Mabius 425.47 1997 Pontiac Grand Am, titled to Charles L. Mabius (sold at auction) ('-1 1,850.00 lawnmower (sold at auction) 210.00 Snowblower (sold at auction) ':.' 330.00 Mobile Home, titled to Charles L. Mabius (sold at auction) 2,600.00 ---I AIlstate (refund for automobile insurance) r<: o 48.96 AIlstate (refund for Mobile Home insurance) 113.00 Highmark Blue Shield (refund of health insurance) 218.54 VFW death benefit 250.00 cash found in mobile home 100.00 (Attach additional sheets if necessary) Total Personal Property and Real Estate $9,050.06 )-- . Register of Wills of Cumberland County, Pennsylvania INVENTORY continued Estate of Mabius, Charles L . Deceased No. 21 - 04 - 0885 Date of Death 9/16/2004 Social Security No. 171-28-4267 also known as Verizon (refund of telephone service) 17.89 Litigation proceeds, Estate of Larry C. Mabius v. Harbison WalkerlHalliburton (asbestos claim), check received February 17, 2005 2,886.20 Total Personal Property $9,050.06 2 08-22-2005 MABIUS 09-16-2004 21 04-0885 CUMBERLAND 101 APPEAL DATE: 10-21-2005 (See reverse side under Objections) Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE _ RETAIN LOWER PORTION FOR YOUR RECORDS +- REy:is47-EX-AFP-C03:0s3-NOTicE-OF-iNHERiYANCE-YAX"APPRAiSEMENT:"ALLOWANCE-OR--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX CHARLES L FILE NO. 21 04-0885 ACN 101 BUREAU OF INDIVIIiIIOOn- r,r:F!l't- (l INtERITANCE TAX DIy~'v~'::t7...)\ iV J PO BDX t8D6Dl CCr-r:T=!:;' {',[ -.': HARRISBURG PA 17128-060.--.0< COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTIGE OF INHERITANCE TAX APPRAISEMENT, ALLOIIANl:E OR DISALLOIIANl:E OF DEDOCTIONS AND ASSESSIIENT OF TAX ZOG511,UG 30 p;; II: 24 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN ('J r:'~:'/ (":c .,,)L,_, i'\ 1,_.' On- " JIY -,' ,~j SUSAN iE' ,(jEDERER V' S E LEDERER LAW OFFC 4811 JONESTOWN RD 226 HBG PA 17109 ESTATE OF MABIUS *' REV-1547 EX AFP (06-05) CHARLES L TAX RETURN tlAS: I X) AGGEPTED AS FILED ) GHAHGED DATE 08-22-2005 I~ an assessment was issued previously, lines 14, 15 and'or 16, 17, IB and 19 will re~lect ~i9ures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 .t Spousal rete (5) 16. Aaount of Line 14 taxable at Lineal/Class A rete (16) 17. A..unt of Llno 14 .t Sibling r.t. 117) 18. A.aunt of Line 14 taxable at Collateral/Class B r.t. (18) 19. Principal Tax Due T X RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R..l Est.t. ISch8du18 Al 2. Stocks ond Bonds ISchodu1. B) 3. Closely Held Stock/Partnership Interest (Schedule CJ 4. I1ortgages/Notes Receivabl. (Schedule DJ 5. Cashl8ank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Proporty ISchedul. F) 7. Transfers (Schedule Q) 8. Tot.l Assets III (2) 13) 14) IS) (6) 17l .00 .00 .00 .00 9.050.06 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/AdtI. Costs/"isc. Expenses (Schedule HJ 10. Debts/Mortgage Liabilities/Liens (Sch~le X) 11. Tot.l Deductions 12. Net Velue 01 T8)( Return 13. Charltable/Govern..ntsl Bequestsj Non-elected 9113 Trusts (Schedule J) l'i. Net Value of Estate Subject to Tax 19) \10) 9,791.00 7.861.61 \11) (12) \13) (14) NOTE: .00 X .00 X .00 X .00 X + INTEREST'PEN PAID 1-) AMOUNT PAlD DATE _BEft ~ TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAlO AFTER OATE INDIGATED. SEE REVERSE FOR GALGULATIOH OF ADDITIONAL INTEREST. NOTE: To insure proper eredit to your account, subait the upper portion of this form with your tax P8Yll8l\t. 9,050.06 17.657 61 8,602.55- .00 8,602.55- 00 = 045 = 12 = 15 = .00 .00 .00 .00 .00 (19)= .00 .00 .00 .00 I IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS RE1lUIREO. IF TOTAL DUE IS REFLEGTEO AS A "GREDIT" ICRI, YOU HAY BE D1JE A REFUND. SEE REVER~F c.TnJ;' ftl:' ........... ___u - Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of Mabius, Charles L No. 21 - 04 - 0885 also known as Date of Death 9/16/2004 , Deceased Social Security No. 171-28-4267 Thomas Mabius The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. l!We verify that the statements made in this Inventory are true and correct. l!We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Personal ReprestmlGlllvt:: Attorney: Susan E. Lederer Signature' I.D. No.: 44861 Signature: Signature: Address: 4811 Jonestown Rd. Suite 226 Harrisburg, P A 17109 Telephone: 717/652-7323 Address: R.D. 1, Box 253 Shermansdale, P A 17090 Telephone: 717-582-4203 Dated: \ ;}-1l'5 ) d-OO S- Personal Property Litigation proceeds, Thomas Mabius, Personal Representative of the Estate of Larry C. Mabius v. Celotex Corporation (asbestos claim), check received August, 24, 2005 1,412.00 C") :'cco Total Personal Prope~ ~r.J 1_' ~:4$1 ,412.00.' C'; 01-.-.... ;..J C.,,) N (Attach additional sheets if necessary) Total Personal Property and Real Estate $1,412.00 v I BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (06-05) 02-20-2006 MABIUS 09-16-2004 21 04-0885 CUMBERLAND 101 APPEAL DATE: 04-21-2006 ( See reverse side under Objections) Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WIllS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ...... RETAIN LOWER PORTION FOR YOUR RECORDS +- ------------------------------------------------------------------------------------------- REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX CHARLES l FILE NO. 21 04-0885 ACN 101 DATE 02-20-2006 TAX RETURN WAS: ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE '- ..' DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN CHARLES l SUSAN E lEDERER S E lEDERER lAW OFFC 4811 JONESTOWN RD 226 HBG PA 17109 ESTATE OF MABIUS RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Mortgages/Notes Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets NO. 01 .00 .00 .00 .00 1.412.00 .00 .00 (8) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax 1,412.00 (9) nO) 500.67 431.25 (11) (2) (3) (4) 931 92 480.08 .00 8,122.47- NOTE: I~ an assessment was issued previously, lines re~lect ~igures that include the total o~ ALL ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS. 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. (5) (6) (7) (8) .00 X 00 = .00 X 045= .00 X 12 = .00 X 15 = (9)= .00 .00 .00 .00 .00 . "'".nen f+l AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 · IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. @ IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DU ! A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ) ~ REV-1470 EX (6-88) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME REVIEWED BY ITEM SCHEDULE NO. Charles L. Mabius Sheila Megonnell INHERITANCE TAX EXPLANA TION OF CHANGES Applied excess deductions from prior return(s). EXPLANATION OF CHANGES ROW FILE NUMBER ACN 2104-0885 101 Page 1 Susan E. LedlHler February 23, 2006 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, P A 17013 RE: CHARLES L. MABIUS SOCIAL SECURITY NO. 171-28-4267 FILE NO.: 21-04-0885 To Whom It May Concern: Enclosed for filing with your office is one (1) completed Supplemental Pennsylvania Inheritance Tax Return, in duplicate, together with date of death valuations for the above decedent, and a $15.00 check for filing fees. Also enclosed for filing with your office is one (1) original Supplemental Inventory for the above referenced Estate. Please advise if any additional fees or expenses are due with regard to this matter. One (1) additional photocopy of the front-page of the completed Supplemental Pennsylvania Inheritance Tax Return and one (1) additional photocopy of the front-page of the completed Supplemental Inventory for the Estate has been provided. Please time/date stamp these copies as recei~edAnd return them to me in the envelope provided. c::> r'..) If there are any questions or further requirements regarding this return, pleas,eJ;io -,~ not hesitate to contact me. ',--, }/lcerelY, ~J/t~ /1r Amy M. Moya r-~ en Enclosures 4811 Jonestown Road. Suite 226 . Harrisburg, PA 17109 · Phone 717.652.7323 · Fax 717.652.7340 · susan@ledererlaw.com www.ledererlaw.com REV. 15lKl EX + 16-l10) ~ 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82) 6. Decedent Died Testate (Attach copy 0 7. Decedent Maintained a Living Trust (Attach of Will) copy ofTrust) 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95 THISSECTIONMUSTBECOMPt.:.ETED.ALL...CO~R.ESPON[)ENCE:ANDCONF'IDENllA.LTAX1NF'ORMATIONSHOLJl...DBEDIRECTEDTO: AME COMPLETE MAILING ADDRESS Susan E. Lederer I II 4811 Jonestown Rd. Suite 226 I Harrisburg, P A 17109 *' REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT \1 C)FFfGiAL USE ()t..JL"'t !\ il r FILE NUMBER i 21 04 I COUNTY CODE YEAR SOCIAL SECURITY NUMBER 0885 NUMBER COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17126-0601 I- Z W o w u w o I DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Mabius, Charles L DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) ! 09/16/2004 I 09/13/1936 i (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) ! 171-28-4267 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Retum (date of death prior to 12-13-82) o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) 1, Real Estate (Schedule A) (1 ) None 2. Stocks and Bonds (Schedule B) (2) None 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) None 4. Mortgages & Notes Receivable (Schedule D) (4) None 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 65.16 (Schedule E) 6. Jointly Owned Property (Schedule F) (6) None z o Separate Billing Requested 0 ~ 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) None ~ ::) (Schedule G or L) ~ 0: 8. Total Gross Assets (total Lines 1-7) <( u w 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 36.72 0: 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) W I- lII::~U) uO:lII:: wA.O :I:OO oO:..J A. CD A. C( 10 10 10 I 10 4. Limited Estate OFFiCIAL USE: ONLY r'._~ :!"o ", I ......... (8)j 65 .-1 6 1. Original Return I- Z W Q Z o A. IRM NAME (If applicable) : Law Offices of Susan E. I.ederer IrELEPHONE NUMBER I 717/652-7323 1 \- j (11 ) 36.72 (12) 28.44 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ~?'.BESlJRETOANSWER)\LliQlJES;l"lONSrONRe\,1'ERSESI[)EAN[)R.ECHE.CKMATH<~ Form REV-1500 EX (Rev. 6-00) Copyright 2000 form software only The Lackner Group, Inc. (13) (14) 28.44 15. Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) z .045 (16) 0 16. Amount of Line 14 taxable at lineal rate x i= C( ~ ::) A. 17. Amount of Line 14 taxable at sibling rate x .12 (17) ::IE 0 u >< 18. Amount of Line 14 taxable at collateral rate C( x .15 (18) I- 19, Tax Due (19) Decedent's Complete Address: STREET ADDRESS 70 Chell)' Lane I STATE PA I jZIP 17013 CITY Carlisle Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (3) 0.00 (4) (5) 0.00 (SA) (5B) 0.00 Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This i~ theOVERPA YMENT Check UUX 011 P...~t: 'I Lme 2u to request C:t (efli!ld 5. If Line 1 + Line 3 is greater than Line 2, enter the difference, This is theTAX DUE A. Enter the interest on the tax due. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;.............................__.............................................. 0 ~ ~: ;::::~ :~e~~~~i~~:~s:~~ea:s~~~.~~~lIu.s~ t~~.~r~~~_rty. .t~.n.sf~'.re.d..o.r .i~.in.C()~~;...............................:::::::: ::::: ..... B ~ d. receive the promise for life of either payments, benefits or care?........................................................... D ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?...................... ..... ........ .... .................. ........... ......... .......... ..--..... ..... ........... D ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?........ 0 181 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?............................. ...................... ....... m_.................................................. D 181 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaratiol preparer other than the personal representative is based on all information of which preparer has any knowledge. ADDRESS SIGNATURE OF P ON RESPONSIBLE FOR FILING RETURN ~~ SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE Susan E. Lederer ) DAJE d- ~1/~~ DATE ci) ~] I). 06~ DATE R.D.) Box 253 Shennansdale, P A 17090 ADDRESS ADDRESS 4811 Jonestown Rd. Suite 226 Harrisburg, PAl 71 09 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. S9116 (a) (1.1) (i)). For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. S9116 (a) (1.1) (ii)]. The statutedoes not exemota transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. S9116 (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%, except as noted in 72 P.S. 39116 1.2) [72 P.S. 39116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 39116 (a) (1.3)). A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Mabius, Charles L I FILE NUMBER I 21 - 04 - 0885 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 1 DESCRIPTION VALUE AT DATE OF DEATH 65.16 Litigation Proceeds, Thomas Mabius, Personal Representative of the Estate of Larry C. Mabius v. Harbison Walker/Halliburton (asbestos claim), check received February 10,2006 TOTAL (Also enter on Line 5, Recapitulation) 65.16 . SCHEDULE H FUNERAL EXPENSES & ADNIINIS1RATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Mabius, Charles L i FILE NUMBER I 21 - 04 - 0885 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. B. DESCRIPTION I I I I I I I I i I I I I I I I I I I I I i I I I I I I I I AMOUNT FUNERAL EXPENSES: 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City Y ear( s) Commission paid State Zip 2. Attorney's Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Other Administrative Costs Law Offices of Peter G. Angelos (Attorney's fees for asbestos litigation) 21.72 2 Filing Fee for Supplemental Inheritance Tax Return 15.00 TOTAL (Also enter on line 9, Recapitulation) 36.72 REV-1513 EX+ (9-00) . SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Mabius, Charles L I FILE NUMBER 21 - 04 - 0885 RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE Do Nnt I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 Amy A. LeBard Sister 1/4 of estate Box 138 Mt. Holly Springs, P A 17065 2 Wilhelm Mabius Brother 1/4 of estate 107 Valley Street Summerdale, P A 17093 3 Margaret M. Wilbert Sister 1/4 of estate 1730 Palmer A venue Wyomissing, P A 19610 4 Thomas Mabius Brother 1/4 of estate 738 Pisgah Road Shermansdale, P A 17090 Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover shee t II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEEr L/\\Xi Or-FICES PETER G. ANGELOS A PROFESSIONAL CORPORATION GOVERNOR'S PLAZA SOUTH BUILDING 3, SUITE 330 2001 N. FRONT STREET HARRISBURG. PENNSYLVANIA 17 102 (717) 232-1886 FAX (717) 232-4189 (800) 283-9240 OTHER OFFICES: PHILADELPHIA, PENNSYLVANIA BETHLEHEM, PENNSYLVANIA WilMINGTON, DELAWARE KNOXVILLE, TENNESSEE PETER G. ANGELOS (MD, DC, TN, NY) r ebruary 1 1'"\ '"" r\ r\ ./ 1 U, LU\JO Thon1as IVlabius, PR of Estate of Charles Mabius RD 1 ~ Box 253 738 Pisgah Road Shcrnlansdale. P A 17090 Re: Supplemcnt~l Scttlerilent Payment froui. previous agreement with Halliburton/ Harbison Walker/ Dresser Industries Asbestos Litigation b)T Estate of Larry C. Mabius, aka Charles Mabius Dear Mr. Mabius: 'I' ou Inay recall that last year this office sent you, on behalf of the above-referenced Estate. a settlelllent check fro111 the above mentioned cOlupanies. Vie advised you at that tinle that the payment ,vas not 1000/0 of the $3,075 al110unt which had been agreed upon because of the increased nlunber of settlelnent clailTIs sublnitted to these cOlllpanies. As a result of the an10unt of 1110ney then available to pay the then-current claillls, we inforn1ed you that the Estate ~ scheck represented paY111ent of 93.860/0 of the original an10unt of the settlen1ent. As a follov.'-up to that, a supplen1ental payn1ent now has been issued by these con1panies. J';'s of October 28, 2005, Halliburton Company con1pleted its review and detennination of all qualified individuals in the settlen1ent. Upon that cOlnpletion, it detennined that everyone previously paid would be able to receive a supplemental paYl11ent. The supplemental payment - per the enclosed check - represents an increase over the Estate's initial paYlllent last year of 2.1190/0. Thus, the total amount paid by Halliburton is equal to 95.9790/0 of the originally intended settlen1ent amount. While the enclosed check does not amount to a very large supplemental payment, it is neveliheless an additional payn1ent to which the Estate is entitled. Weare glad we are able to get this paYlllent to you. Please find the Estate's check attached to your copy of a usual Settlelnent And Distribution Sheet. Also enclosed are (1) the original of the Settlement Sheet and (2) a postage-prepaid return envelope. We ask that you please sign the original Settlement Sheet at ONE CHARLES CENTER 100 N. CHARLES STREET BALTIMORE, MD 21201-3804 410-649-2000 (800) 252-6622 FAX 410-659-1780.61.82 UNION PARK CENTER 5905 HARFORD ROAD BALTIMORE, MD 21214-1846 410-426-3200 18001492-3240 FAX 410-426-1269 COURT TOWERS. SUITE 300 210 W. PENNSYLVANIA AVENUE TOWSON. MD 21204 410-625-7300 FAX 410-296-2541 STEELWORKERS' HALL 540 DUNDALK AVENUE BALTIMORE. MD 21224-2997 410-633-6100 FAX 410-633-0480 63 HENDERSON AVENUE CUMBERLAND. MD 21502-2452 301-759-2700 FAX 301-759-2703 @~~ LAW OFFICES PETER G. ANGELOS Tho111aS lvlabius February 10c 2006 Page T\\1o RE: Halliburton Supplen1ental Payn1ent the red X, and pron1ptl:y ll1ail the signed paper back to us as this office's receipt for having distributed this payn1ent to you on behalf of the Estate. Of course, if there are any questions, please feel free to call our Harrisburg office at 1-800-283-9240. Thank you for your cooperation. \,1 ery truly yours, -P~As~~~ Peter G. Angelos PGA/kms Enclosures Copy: Susan E. Lederer, Esquire LAW OFFICES OF PETER G. ANGELOS SETTLEMENT AND DISTRIBUTION SHEET 171-28-4267 PA54679 100% E Check No.: 684519 THOMAS MABIUS I Personal Representative of The Estate of LARRY C. MABIUS V. HARBISON WALKER/HALLIBURTON PAYM 18 SETTLEMENT: HARBISON WALKER/HALLIBURTON PA YM 1 B $ $ $ $ 65.16 $ TOTAL: $ 65.16 $ 65.16 ATTORNEY'S FEE: (33.33% of Settlement) $ 21.72 MEDICAL BillS: $ 0.00 cr .u TOTAL: $ 0.00 $ 0.00 CASE EXPENSES: $ $ $ $ 0.00 TOTAL: 0.00 $ 0.00 TOTAL DEDUCTIONS: $ 21.72 BALANCE TO: THOMAS MABIUS . Personal Representative of The Estate of LARRY C. MABIUS $ 43.44 I understand and acknowledge that the funds being paid to me in regard to this settlement have been maintained in a trust account in a financial institution located outside of the Commonwealth of Pennsylvania, and that settlement monies payable to me from a settling party in any future settlement, and / or monies payable to me as a result of any verdict or judgement in my case, upon receipt by the LAW OFFICES OF PETER G. ANGELOS, P.C., will be placed into such a trust account and, less attorneys' fees and expenses, will be paid thereafter to me as expeditiously as circumstances allow. I hereby give my consent to this in regard to this present settlement and in regard to all monies payable to me as a result of any future settlements, verdicts, or judgements. AND NOW, this day of ,_, I / We do hereby declare that this Settlement and Distribution Sheet has been read and is understood and approved and that the deductions for expenses and other items shown hereon are true and correct and receipt of a copy of this Settlement and Distribution Sheet is acknowledged. WITNESS THOMAS MABIUS, Personal Representative of The Estate of LARRY C. MABIUS WITNESS WITNESS WITNESS WITNESS , .", .""~~,, "\Vc'J \) " C:\ ~Q (:I "\ \ \ '~ ,; ,,.; ~~1 f~ \'\ \1 \- rB 21 \ \ J (')~(')~ ~ (')~ ~ 0.. 0 'a ,.-.' ~. ~ ~~ ~~~~ ~ \;:t~o ~~~~ )7~~~ ~ d'\(')~ -l V J. 0 i-"" ~~ ~ (f) ~~~ G (') ~ s. ~ (f) G -;::::-- -::=" . --. ~. ..:::.~ ............. ;-: -:. -. -. - -::- -. -' ~: :;:. -' -. -' -. -' -. . -::::. ~. -:E, -:::. , ,,-'i~\\. C\= \;:,'~~'S \ . \,-.,\ . ~ o .. ~re~ ~~~ .....0 ~NO ~~~ ~ ~ ~ % ~ p :; ~ ~ ~ ~ po. ~ \ ~ ~ ~ ~ ..J -- g~~~ U'~ ~~ 'b~ o~ g~ ;~ ~~ , ~ U'~ '!~ -n -- -t <A- n ."",- ~ en ~ ~. --- PfY. fIM lR r %iEl ' REV-1500 o I iaaL usF c;NLY COMMONWEgLTN OF PENNSYLVANIA INHERITANCE TAX RETURN FlLE DEPARTMENT OF REVENUE NUaeER _ __ DEPT. 2e0Ee1 IWRR186URG PA 1 7136 0 0 01 RESIDENT DECEDENT ~ zl oa oass --'- -- ~-- _ __ DECEDENT'S NAME (LAST FIRST AND MIDDLE INITI ~ -~ - COUNTY CODE -YEAR NUMBER -- - , , Mabius, Charles L AL) ~ SOCIAL SECURITY NUMBER C , DATE OF DEATH (MM-DD-YEAR] __ DATE OF BIRTH (MM-DD-YEAR) ---- 171-28-4267 -I ~ 09/16/20 7X13 RETURN MUST BE FlLED IN DUPLICATE w1TN THE c 04 09/13/1936 ..----.---- _ _-- ocr_ICren .~~..,... ~. (LAST, FIRST AND MIDDLE INITIAL) w I_,t ~. Odginel RCtum 2. SUpplamental Return ^ 3. Remainder Retwn (date o/daelh prior to 12-13-e2) m ~ Y w ^ 4. Limited Estate ^ qa, Future Interest compromise (data a deem Baer 12 ^ 5 Federal Estate T R t R -12-e2) . ax e urn wired eq ~ $ ~ ^ 8. Decedent Died Testate (AIteM wpy 9r winl ^ 7. Decedent Maintained a Living Trust (AUech 9. Total Number of Sate Deposit Boxes g _- ^ .... ~:. 9. Lltlgatlon Proceeds Received .... -.... ... ^ -. mpyaTa,sO 10. Spousal Poverty CredH (date a seam Itehveen 12-31-91 and 1-1-951 -- ^ 11. ElecHOn to tax untler Sec. 9113(A) (Attaeh sch OI „ 5 Susan E. Lederer b~mr1-ueMAILING ADDRESS ---- ~ t S ~ ~IRM NAME (H aPPlicsbb) aX g Law Offices of Susan E. Lederer 4811 .lOneStOWn Rd. _ ___ Suite 226 ___ _ ~rELEPHONE NUMBER _ _ H8ITI5bUCg, PA 17109 r`> - 717/652-7323 ,-~ - ~ 1 - 1. Real Estate (Schedule A) (1) - - None ~, ~ _ n=rPFFi~aAL VS13CNLYr e_-~ ' 2. Stocks and Bonds (Schedule B) (2) - ~.L; ' `I _ None - -._ .~ ~,~ 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) ~'T' ~ ~~> 4. Mortgages 8 Notes Receivable (Schedule D) (q) = ' ' -~~° ~I. 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (5) None - _ _ _ --- _, -J (Schedule E) 1,4 12.00 -- C,.'+ I 6. Jointly Owned Property (Schedule F) (6) __ _ ~ _ fv ~ ^ Separate Billing Requested None -- .. _ 5 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property ~ (7) - --_ None (Schedule G or L) °~ 8. Total Gross Assets (total Lines 1-7) (8) ~ 9. Funeral Expenses 8 Administrative Costs (Schedule H) (g ) _ _ -- 1,412.00 -~-_-- --~------~-- _-- _ 500.67 I 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule 0 (10) ._ _ -. 43 1.25 ', 11. Total Deductions (total Lines 9 8 10) (11) 931.92 ~i 12. Net Value of Estate (Line 8 minus Line 11) (12) 480.08 ', 13. Charitable and Governmental Bequests/Sec 9113 Trusts for whi ~. made (Schedule J) ch an election to tax has not been ___ (13) __ 14. Net Value Subjeet to Tax (Line 12 minus Line t3) - __ I_-_..--- -.. _.- _ -.-. (14) 480.08 EE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES I 15.Amount of Line 14 taxable at the spousal tax rate, ~ o t f x 00 (15) I r rans ers under Sec. 9116(a)(1.2) - ----.- . .. ._ ..-. z °c 16.Amount of Line 14 taxable at lineal rate x .045 (i6) a - - 0 o 17.Amount of Line 14 taxable at sibling rate O __ -- x .12 _. - .. _ _ (17) I, 18. Amount of Line 14 taxable at collateral rate __ __ x .15 (ie) 19. Tax Due (19) ~ e e .___--_.._- .. .. ~ i~ ... .... :: ~ .. ~ ~ ISGWE~Itb~ ~ '.- Copyright 2000 form software only The Laekner Group, Inc. Form REV-1500 EX (Rev. 6-00) gecedent's Complete Address: 70 Cherry Lane CITY _ - -- ._~.--__---- -- Carlisle i STATE PA ztr [ 7013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credks/Payments (1) A. Spousal Poverty Credit __ B. Prior Payments C. Discount Total Credits (A + g + C) (2) 0.00 3. InteresUPenalry if applicable D. Interest E. Penalty Make Check Payable to: REGISTER OF WILLS, AGENT ~- - - _ ___._ X[R'A~ PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1 Did d d ace ant make a transfer and: Yes No a. retain the use or income of the ro P Party transferred :........ ................................................................... b. retain the right to designate who shall use the property transferred or its income : ................................ c. retain a reversionary interest; or .. ..................... d. receive the promise for life of either payments, benefits or care? ........... ... 2. If death occurred after December 12, 1982, did decedent transfer ro ~~~~~~~~~~~~~~~~~ P Party within one year of death without receiving adequate consideration? ............ ^ 3. Did decedent own an "in trust fof or payable upon death bank account or security at his or her death?......... 4 Did tl d . ece ent own an Individual Retirement Recount, annuity, or other non-probate property which contains a beneficiary designation? ................................. ^ ........................ IF THE ANSWER TO ANY OF THE ABOVE QUESTION3 IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under paMMbe or p?rl~ry, I deUere Ihet I have examined this velum. meiwm,..,..,.,,..,.......:~ _-._...~__ __ ~ _... SIGNATURE OF PERSON RETURN 1, and complete. ]7090 DATE lad 13 ~aao5 1x113 I~-DOs Susan E. Lederer 4811 Jonestown Rd. Suite 226 Harrisburg, PA 17109 ___._.._.._..~_.....~.,..m,,,, u~ ~ x ~' For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statutedoes not exemota transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0°~ [72 P.S. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal benericiaries is 4.5%, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 72% [72 P.S. §9116 (a) (1.3)). A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMCNNFAL,H OF FENNBYLVAN~A PERSONAL PROPERTY INHERITANCE TA%RETURN REBIDEN! CECECEM ESTATE OF -- --_ Mabius, Charles L i FILE NUMBER -- _ 21 - 04 - 0885_ Include the proceeds of litigation and the date the proceeds were received by the estate. All property joinUyowned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF __ DEATH I Litigation proceeds, Thomas Mabius, Personal Representative of the Estate of Larry C. Mabius v. Celotex 1,412.00 Corporation (asbestos claim), check received August, 24, 2005 TOTAL (Also enter on Line 5, Recapitula0on) I 1 412.00 , • ~SC~FIED~ILE H COMMONrVEALTH OF PENNBYLVgN1A -" INHERITANCE TAX RETURN Ary~~~~~~~ RESIDENT OECEDENi ~'tirrt~~g7 r rW _ _ --_ _ ESTATE OF - -~ Mabius, Chazles L ~ FILE NUMBER -- 21-04-0885 Debts of decedent must be reported on Schedule I. ITEM ! - NUMBER I DESCRIPTION AMOUNT A. F-UN-ERAL EXPENSES: ~- B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. i Other Administrative Costs 1 I Law Offices of Peter G. Angelos (Attorney's fees for asbestos litigation) 2 Filing Fee for Supplemental Inheritance Tax Return Total of Continuation Schedule(s) 470.67 15.00 15.00 TOTAL (Also enter on line 9, Recapitulation) ~ 500.67 ' Schedule H pp COMMONN£ALTH OP PENNSYLVANIA ~ p{ INHERITANCE TA% RETURN i.....L'..~ RESIDENT DECEDENT ESTATE OF - --- -- _ - _ Mabius, Charles L j FILE NUMBER ----- ---- 21 - 04 - 0885 Additional Probate Fees --T- i 15.00 Page 2 of Schedule H LOMMONKFALTII OF PENN8V~VANIq INHERRgNLE Tq%RETURN RE810ENT DECEDENT ESTATE OF Mabius, Chazles L SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 2t _ na _ ncuc Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION Balogh Becker, Ltd. (New Century Financial Services, Inc.) (debt is unpaid and in dispute) AMOUNT 431.25 TOTAL (Also enter on Line 10, Recapitulation) 431.25 REV, 751~E%+19-0UI , COMMONWEALTH OF PENNSVLVANVI INHERITANCE TAX RETURN _- RESIDENT DECEDENT SCHEDULE) BENEFICIARIES ESTATE OF -~ ~ -- - - --- __ Mabius, Chazles L FILE NUMBER -- --.-- _ _ _- 21 - 04 - 0885 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT AMOUNT OR SHARE T----- _ OF ESTATE I~ TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 i Amy A. LeBazd Sister 1/4 of estate Box 138 i Mt. Holly Springs, PA 17065 2 Wilhelm Mabius 107 Valley Street Brother 1/4 of estate Summerdale, PA 17093 3 ~ Mazgazet M. Wilbert ~ 1730 Palmer Avenue Sister 1/4 of estate Wyomissing, PA 19610 4 Thomas Mabius i 738 Pisgah Road i Brother 1/4 of estate Shermansdale, PA 17090 (Enter dollar amounts for distributions shown above on lines 15 through 18, as appropd te, on Rev 1500 rover she II. NON TAXABLE DISTRIBUTIONS. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN BEING MADE ELECTION TO TAX IS NOT B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE _- ._-. --- . _ .. LAW OFFICES OF PETER G. ANGELOS 171.26.4267 C O ^~ / SETTLEMENT AND DISTRIBUTION SHEET PA54679 r Y 100% E THOMAS MABIUS ,Personal Representative of The Estate of LARRY C. Check No.: 667940 MABIUS v. Celotex Corporation 2nd Payment SETTLEMENT: Celotex Corporation 2nd Payment TOTAL: ATTORNEY'S FEE: MEDICAL BILLS: TOTAL: CASE EXPENSES: TOTAL: TOTAL DEDUCTIONS: (33.33% of Settlement) 470.67 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $- 0.00 $ n nn $ 470.67 BALANCE TO: THOMAS MABIUS Personal Re resentative of The Estate of LARRY C. MABIUS $ 941.33 I understand and acknowledge that the funds being paid to me in regard to this settlement have been maintained in a trust account in a financial institution located outside of the Commonwealth of Pennsylvania, and that settlement monies payable to me from a settling party in any future settlement, and / or monies payable to me as a result of any verdict or judgement in my case, upon receipt by the LAW OFFICES OF PETER G. ANGELOS, P.C., will be placed into such a trust account and, less attorneys' fees and expenses, will be paid thereafter to me as expeditiously as circumstances allow. I hereby give my consent to this in regard to this present settlement and in regard to all monies payable to me as a result of any future settlements, verdicts, or judgements. lox 253 - ... sQah Road ~ airsdale, PA~~ ~C79D $ 1,412.00 $_ $ t 412.00 $_, 1 412.00 $ 04-17-2006 MABIUS 09-16-2004 21 04-0885 CUMBERLAND 101 APPEAL DATE: 06-16-2006 (See reverse side under Objections) Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +-- REv:is47-Ex-AFP-io3:osj-NoTIcE-OF-INHERITANCE-TAX-APPRAIsEMENT:-ALLowANCE-OR--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX CHARLES L FILE NO. 21 04-0885 ACN 101 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION ~o BOX 280601 ~ARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX SUSAN E LEDERER S E LEDERER LAW OFFC 4811 JONESTOWN RD 226 HBG PA 17109 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN ESTATE OF MABIUS REV-1547 EX AFP (06-05) CHARLES L DATE 04-17-2006 TAX RETURN WAS: ( ) ACCEPTED AS FILED x) CHANGED SEE ATTACHED NOTICE NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: .00 X 00 = .00 .00 X 045 = .00 .00 X 12 = .00 .00 X 15 = .00 (19)= .00 AMOUNT PAID RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN NO. 02 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Mortgages/Notes Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets .00 .00 .00 .00 65.16 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax 36.72 .00 (11) (12) (13) (14) (9) nO) + DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 65.16 36 72 28.44 .00 8,094.03- .00 .00 .00 .00 IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE .6. 1l1=J:'IINn <:'1=1= DI=UI=D<:.I= c::.Tnl= nl= TUT<:. !l:'nDM I=nD TY~TDII"'TTn"l~ "\ ~EV-1470 EX (6-88) INHERITANCE TAX EXPLANATION OF CHANGES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME Charles L. Mabius REVIEWED BY Sheila Megonnell ITEM SCHEDULE NO. EXPLANATION OF CHANGES Applied excess deductions from prior return(s). ROW FILE NUMBER ACN 2104-0885 101 Paqe 1 Cumberland County - Register or Wl~~S One Courthouse Square Carlisle/ PA 17013 phone: (717) 240-6345 Date: 7/27/2006 LEDERER SUSAN E 4811 JONESTOWN ROAD SUITE 226 HARRISBURG/ PA 17109 RE: Estate of MABIUS CHARLES LARRY File Number: 2004-00885 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES/ NO. 103 SUPREME COURT RULES DOCKET NO. 1/ for decedents dying on or after July I, 1992/ the personal representative or his counsel/ within two (2) years of the decedent's death/ shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 9/16/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely/ & L/ L1- I j} AP/~~ L~:t.'U..UJ.ttZ/Mu~~ (~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register or Wl~~S One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 7/27/2006 MABIUS THOMAS 738 PISGAH ROAD SHERMANSDALE, PA 17090 RE: Estate of MABIUS CHARLES LARRY File Number: 2004-00885 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing lS due by: 9/16/2006 please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, d' ('''",,~,rI IJ /t- . '-.-" . '. Li", ,-C0M'L utVfA"'tV'_) '/f 'MCa v Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel STATUS REPORT UNDER RULE 6.12 Name of Decedent: Charles Larrv Mabius Date of Death: 9/16/2004 Will No. Admin. No. 2'004-00885 Pursuant to Rule 6. 12 of the Supreme Court Orphans' Court Rules, I report tile following with respect to completion of the administration of the above-captioned estate: 1 . State whether administration of the estate IS complete: Yes No X 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: UN KNCI:vN 3 . If the answer to No. 1 is Yes, state the following: a. account with the Court? Did the personal representative file a final Yes No b. The separate Orphans I Court No. (if any) for the personal representative's account is: c . Did the personal representative state an account informally to the parties in interest? Yes No __ d . Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans I Court and may be attached to this report. Date: "7 J 2-g 10 \.0 / I ~~- \;;, -C. Signature sL~'~A --~ Susan E. Lederer. Esq. Name (Please type or print) 4811 Jonestown Road Suite 226 Harrisburg PA 17109 Address C:_J (717 ) 652- 7:\23 Tel. No . '- . Capacity : Personal Representative X Counsel for personal representative ) ~' L Susan E. Lederer July 28, 2006 Register of Wills Cumberland County Courthouse I Courthouse Square Carlisle, P A 17013 RE: CHARLES L. MABIUS Date of Death: 9/1612004 Admin File No.: 2004-0885 Dear Register of Wills: Enclosed please find one (1) original and one (1) photocopy of the Status Report Under Rule 6.12 for the Estate of Charles L. Mabius, File No. 2004-0885. Upon filing the original, please time/date stamp the photocopy and return it to my office using the envelope provided. Thank you for your assistance. If you need further information in this matter, please contact me. Very truly yours, ~'. ~~~/\-^-~ Susan E. Lederer Enclosures 4811 ]onesto\Vn Road. Suite 226 . Harrisburg. P/\ 17109 . Phone 717.652.7323 . Fax 717.652.7340 . susanCclledererla\v.c()fTI \V\Vw.ledererla \V.com STATUS REPORT UNDER RULE 6.12 Name of Decedent: Charles Larry Mabius Date of Death: 9/16/2004 Will No. Admin. No. 2004-00885 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1 . State whether administration of the estate IS complete: Yes No X 2 . If the answer is No, state when the personal representative reasonably believes that the administration will be complete: unknown 3. If the answer to No. 1 is Yes, state the following: a. account with the Court? Did the personal representative file a final Yes No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: t 19 / O} ~~.~ Signature Susan E. Lederer. Esa. Name (Please type or print) 4811 Jonestown Road Suite 226 Harrisbura PA 17109 Address ( 717 ) 652- 7323 Tel. No. Capacity: Personal Representative JrlJ <daD X Counsel for personal representative OS:ZIHd II Lnl? UiJv J STATUS REPORT UNDER RULE 6.12 Name of Decedent: Charles Larrv Mabius Date of Death: 9/16/2004 Will No. Admin. No. 2004-00885 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1 . State whether administration of the estate IS complete: Yes No X 2 . If the answer is No, state when the personal representative reasonably believes that the administration will be complete: unknown 3. If the answer to No. 1 is Yes, state the following: a. account with the Court? Did the personal representative file a final Yes No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: ~ ~~-<-~ Signature O.A ~_ Susan E. Lederer Eso. Name (Please type or print) 4811 Jonestown Road Suite 226 Harrisbura PA 17109 Address (717 ) 652-7323 Tel. No. Capacity: Personal Representative x Counsel for personal representative ,-, : ; i' 1'_1 n J i ;. 'wi ~ Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: Charles L Mabius Date of Death: 09/1612004 File Number: 21-04-0885 Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: unknown 3. If the answer to No. 1 is YES, state the following: a. Did the personal representative file a final account with the Court? b. The separate Orphans' Court No. (if any) for the personal representative's account is: ^ Yes ^Q No ^ Yes ^ No c. Did the personal representative state an account informally to the parties in interest? ^ Yes ^ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphans' Court and may be attached to this report. Date ~ ~ ~ v l~~ ~ , ~~~~~~r-~~~C? Form RW-1 U Rev: fo-ysaoos ~' Sigriature of Person Filing this Form Capacity: ^ Personal Representative ~ Counsel Susan E. Lederer Name of Person Filing this Form 4811 Jonestown Rd. Suite 226 Address Harrisburg, PA 17109 City, State, Zip 717/652-7323 Telephone Copyright (c) 2006 form software only The Lackner Group, Inc. ~~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 171 2B-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 01 1 145 MABIUS THOMAS 738 PISGAH ROAD SHERMANSDALE, PA 17090 ACN ASSESSMENT AMOUNT CONTROL NUMBER fold ESTATE INFORMATION: ssrv: ~~i-2S-42x7 FILE NUMBER: 2104-0885 DECEDENT NAME: MABIUS CHARLES LARRY DATE OF PAYMENT: 04/22/2009 POSTMARK DATE: 04/21 /2009 COUNTY: CUMBERLAND DATE OF DEATH: 09/ 1 6/2004 REMARKS: RECEIPT TO ATTY SEAL CHECK# 101 101 ~ S 1, 302.43 TOTAL AMOUNT PAID: INITIALS: CJ RECEIVED BY: S 1, 302.43 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS 1505607.120 REV-1500 Ez ~~) OFFK:GhL USE ONLY PA Department of Reverute Burreu of Individual Taxes c«.+r Cod. veer Fee Neancer PO Box.2sa601 INHERITANCE TAX RETURN 21 0 4 0 8 8 5 Harrisburg, PA 77128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Securely Number Date of Death Data of Birth 171 28 4267 09 16 2004 09 13 1936 Decedents Last Name suffix Decedents Fret Narrre MI MABIUS CBARLSS I, pf Applicable) Enbsr Strrvtvittg Spouse's Irrfomratlon Below Spouse's Last Name Suffbc Spouse's First Name MI Spouse's Sor~ai Serxuity Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL INAPPROPRIATE OVALS BELOW ^ 1. Origetal Redsre 0 2 Suppleerrarkal Rehm ^ 4. Lhref6ed Eabtle ^ ,b, FduA wMereet Cempmmiae (date d Qaee~ seer 12-12-02) ^ g, DsaedarM Died Teahae ~, DaoedarR AAeitaiMd a 1.wiV Trust (Altedr Copy d V11n ^ (AfCach Copy dTnrsU 3. Rerresireder fietttm (date of death prior b 12-1382) 5. Federal Esfale Tear Rehm Requirod 8. Tdal Number of Sa1fe Deposit Bootee 9. l.il~ior- Prooeeda Reoeiexei ^ 10. 121 skid i-1~'-e5jr ~' ~ 11. EbcfiOn b hex under Sec. 9113(A) Wmcn Selo. o> - TFIIS SEG7iON 1tADST BE COIPLf?7'ED. ALL ~tiCE At!O CONFIDENnAL TAX II~ORMATiON SFi0t1LD 8E DRECTED TO: Name Daythna Telepitorte Number SUSAN $. LSDSRSR 717 652 7323 Firm Name (If Applicable) LA9t OFFICES OF SUSAN S. LSDLRSR First Hne of address 5011 LOCUST LANE Second Hne of addross 3UIT3 226 City or Post Office HARRISBURG Stste ZIP Code PA 17109 n ~, REGISTER CI~~USE~ILY +'. 3 ,r-~ ~'~.,-, N -_. '.C7 (~ :,~~ _ ``~~ IV DATE FlLED ~4 _i Corrssporrdart'se~laddrsss: SUSan~iedererlBW.COm Under paneMiee of perjesy, I de~iere that i hews exatrrreed Ibis rehm, incked'uip auoompen in8 sateeduf~ and s7rlemenls, and b the beet d my ~torMsdpe end bdlef, k is bus, oonect and aonpeb. Dedmalton or prsperar alher then the petsort~ relxest y is based m ab lydbrnutlon of wf~ich preperer bee anl+ 1stoMAedOe- SIONA [L-TE Thomas Nablus 'Y ~ ~ o ~onrsESS _. R.D. 1, Ba T~8 -Pissl~ali Road Shernta~dale. PA 17090 TtlNE OF PriEPARER OTFEJi 7FMN REPRESBiTATNE q~-~ _ ~. 1 ., ,D _ Susan E. Lederer ~ i I _. I _ 5011 Locust Lane, Harrisburg, PA 17109 Side 1 1505607320 1505607120 J 1505607220 REV-1500 EX Decedent's Name: C h a r l e s L M a b i u s RECAPITULATION 1. Real Estate (Schedule A) ...................................................................................... 1. 2. Stocks and Bonds (Schedule B) .............................._.......................................... 2. 3. Closely Held Corporation, Partnership orSole-Proprietorship (Schedule C).......... 3. 4. Mortgages 8~ Notes Receivable (Schedule D) ............................._........................ 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 6. Jointly Owned Property (Schedule F) [] Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7, 8. Total Gross Assets (total Lines 1-7) ................................................................ 8. 9. Funeral Expenses & 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 and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .............................................. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) .............................................. 14. Decedent's Social Security Number 171 28 4267 30,345.32 30,345.32 11,397.34 11,397.34 18,947.98 18,947.98 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable 0 . 0 0 at lineal rate X .045 16. 0 . 0 0 17. Amount of Line 14 taxable at sibling rate x .12 18 , 9 4 7. 9 8 17. 2, 2 7 3. 7 6 18. Amount of Line 14 taxable at collateral rate X .15 0 0 0 18. 0. 0 0 19. Tax Due ............................................................_ . 19. 2, 2 7 3. 7 6 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 1505607220 1505607220 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-04-0885 DECEDENT'S NAME Charles L Mabius STREET ADDRESS CITY Carlisle STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 2,273.76 3. InterestlPenalty if applicable Total Credits (A + B + C) (2) p. Interest E. Penalty Total lnteresUPenalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theDVERPAYMENT. (4) 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 theTAX DUE (5) 2 273.76 A, Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (56) 2, 2 ] 3 , 7 s Make Check Payable to: REGISTER OF WILLS, AGENT ~~ PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :............................................................................ x b. retain the right to designate who shall use the property transferred or its income :................................ x c. retain a reversionary interest; or .............................._............................................................................ ^ d. receive the promise for life of either payments, benefits or care? ........................................................... ^ ^x 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................................................................................................. ^ 3. Did decedent own an "in trust for« or payable upon death bank account or security at his or her death?......... [] Ox 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? :............................................................................................................... ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. _, . ,, For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)], The statutedoes not exemata transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half {4.5) percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rsv-1508 EX* (6.98) SCHEDULE E CASH, BANK DEPOSITS, 8t MISC. PERSONAL PROPERTY COMMONWEALTN OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Mabius , Charles L 21-04-0885 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 i» disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of 320.00 Larry C. Mabius v. National Gypsum Corporation ERC, check received April 28, 2006 2 Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of 236.00 Larry C. Mabius v. National Gypsum Corporation, check received October 26, 2006 3 Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of 500.00 Larry C. Mabius v. Uniroyal, check received August 8, 2007 4 I Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of I 1.007.70 Larry C. Mabius v. Babcock 8< Wilcox, check received January 4, 2008 5 f Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of I 3,400.00 I Larry C. Mabius v. Babcock and Wilcox, check received January 4, 2008 I 6 ~ Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of I 1,250.00 Larry C. Mabius v. The Manvil{e Trust, check received June 3, 2008 7 I Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of ~ 3,735.00 Lany C. Mabius v. U.S. Gypsum Company, check received July 23, 2008 Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of I 2,875.00 Larry C. Mabius v. Owens Corning/Fibreboard, check received September 12, 2008 9 ~ Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of I 614.40 Larry C. Mabius v. Owens Corning/Fibreboard, check received September 12, 2008 10 I Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of I 435.81 Larry C. Mabius v. AC8tS, check received October 13, 2008 Total of Continuation Schedule See attached page TOTAL (Also enter on Line 5, Recapitulation) 30.345.32 (tt more space is needed, additional pages of the same size) Copyright (c) 2002 form software onty The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rsv-1508 EX* (8.98) SCHEDULE E CASH, BANK DEPOSITS, 8~ MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN continue RESIDENT DECEDENT ESTATE OF FILE NUMBER Mabius , Charles L 21-04-0885 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 11 Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of 9.291.84 Larry C. Mabius v. Owens CorningtFibreboard, check received January 23, 2009 12 Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of 750.00 Larry C. Mabius v. Westinghouse Electric Corp., check received February 6, 2009 13 Litigation proceeds -Thomas Mabius, Persona{ Representative of the Estate of 2,655.13 Larry C. Mabius v. Armstrong World Industries, check received March 13, 2009 14 Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of 706.63 Larry C. Mabius v. United States Gypsum Company, check received Apri11, 2009 15 Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of 2,567.81 Larry C. Mabius v. the Kaiser Trust, check received April 9, 2009 TOTAL (Also enter on Line 5, Recapitulation) ~ 30.345.32 Copyright (c) 2002 form software on{y The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98j REV-1151 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Mabius , Charles L 21-04-0885 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER q, FUNERAL EXPENSES: B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees Law Offices of Susan E. Lederer 3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. I Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 700.00 7. Other Administrative Costs 10,697.34 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation} 11,397.34 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-7500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF Mabius ,Charles L LE NUMBER 21-04-0885 ITEM NUMBER DESCRIPTION AMOUNT Other Administrative Costs 1 Law Offices of Peter G. Angelos - (attorney's fees for asbestos litigation proceeds 106.67 received on Aprii 28, 2006) 2 Law Offices of Peter G. Angelos - (attorney's fees for asbestos litigation proceeds 855.94 received on April 9, 2009) 3 Law Offices of Peter G. Angelos - (attorney's fees for asbestos litigation proceeds 235.54 received on April 1, 2009) 4 Law Offices of Peter G. Angelos - (attorney's fees for asbestos litigation proceeds 78.67 received on October 26, 2006) 5 Law Offices of Peter G. Angelos - (attorney's fees for asbestos litigation proceeds 166.67 received on August 8, 2007) 6 Law Offices of Peter G. Angelos - (expert fees for asbestos litigation proceeds 133.00 received on August 8, 2007) 7 Law Offices of Peter G. Angelos - (attorney's fees for asbestos litigation proceeds 335.90 received on January 4, 2008) 8 Law Offices of Peter G. Angelos - (attorney's fees for asbestos litigation proceeds 1.133.33 received on January 4, 2008) 9 Law Offices of Peter G. Angelos - (expert fees for asbestos litigation proceeds 465.65 received on January 4, 2008) 10 Law Offices of Peter G. Angelos - (attorney's fees for asbestos litigation proceeds 312.50 received on June 3, 2008) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Mabius , Charles L 21-04-0885 ITEM NUMBER DESCRIPTION AMOUNT 11 Law Offices of Peter G. Angelos - (attorney's fees for asbestos litigation proceeds 1,245.00 received on July 23, 2008) 12 Law Offices of Peter G. Angelos - (attorney's fees for asbestos litigation proceeds 958.33 received on September 12, 2008) 13 Law Offices of Peter G. Angelos - (attorney's fees for asbestos litigation proceeds 204.80 received on September 12, 2008) 14 Law Offices of Peter G. Angelos - (attorney's fees for asbestos litigation proceeds 145.27 received on October 13, 2008) 15 Law Offices of Peter G. Angelos - (attorney's fees for asbestos litigation proceeds 3.097.28 received on January 23, 2009) 16 Law Offices of Peter G. Angelos - (attorney's fees for asbestos litigation proceeds 250.00 received on February 6, 2009) 17 Law Offices of Peter G. Angelos - (attorney's fees for asbestos litigation proceeds 885.04 received on March 13, 2009) 18 Cumberland County Register of Wills - (Filing fee -Supplemental Inheritance Tax 15.00 Return) 19 Cumberland County Register of Wills - (Filing fee -Supplemental Inventory) 15.00 20 MSiT Bank - (fee for new checks) 12.75 21 Cumberland County Register of Wills - (additional probate fees) 45.00 H-B7 subtotal 10,697.34 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) REV•151~ E7(+ (9-00) SCHEDULE J COM 1NHE~R/IETANCE TAX RETURN CIA BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER n~av~ua , vuq~ICS L Z1-04-08 85 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE Do Not List Trustes s (Words) ($$$) I~ TAXABLE DISTRIBUTIONS (include outright spousal distributions and transfers under Sec. ~116(a)(1.2)] 1 Amy A. LeBard Sister 1/4 of estate 4,737.00 Box 138 Mount Holly Springs, PA 17065 2 Thomas Mabius Brother 114 of estate 4,736.99 738 Pisgah Road Shermans Dale, PA 17090 3 Wilhelm Mabius Brother 1/4 of estate 4,736.99 107 Valley Street Summerdale, PA 17093 4 Margaret M. Wilbert Sister 1/4 of estate 4,737.00 1730 Palmer Avenue Reading, PA 19610 5 The estate requests an abatement of interest from 9 months after the decedent's date of death until the dates of each payment received. Total 18,947.98 Enter dollar amounts for distributions shown above on lines 15 through 18, as approp riate, on Rev 1500 cov er sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0 00 Copyright (c) 2002 form software ony The Lackner Group, Inc. Form PA-1500 Schedule) (Rev. 6-98) LAW OFFICES PETER G. ANGELOS A PROFESSIONAL CORPORATION GOVERNOR'S PLAZA SOUTH BUILDING 3, SUITE 330 2001 N. FRONT STREET HARRISBURG, PA 17102 (717) 232-1886 FAX (717) 232-4189 (800) 283-9240 PETER G. ANGELOS <MD.D.c.,TN.NYI THEODORE M. FLERLAGE, JR. cMD,D.c.I PAUL M. MATHENY <MDI FREDERIC C. HEYMAN IMDI SEAN D. BURNS <MDI H. RUSSELL SMOUSE IMOI JOSEPH L. JOHNSON IMDI LOUIS F. ANGELOS (MDI EVE E. PRIETZ <MD,iw JOHN KOTSATOS cMD,NJ,pAI M. ALBERT FIGINSKI (MDI ROGER A. DOUMAR <MDI KEITH E. HAYNES (MD,D.c.I CRAIG BOAS aDl KARA A. HAGER roEl THOMAS MINKIN IMD,D.C.,TNI WILLIAM D. POLAND, JR. (PhWV,MD,NT) MARY V. KOCH cMDI GLENN E. MINTZER cMD,FL,w AMY H. BAC KENSTOSE lphNJl EDWARD P. MONAGHAN <MO,PAI CHARLES A. CANDON (MD,D.c.,rN,NVI MICHAEL W. REED (MDI CRAIG A. THOMPSON (MDI KARYN S. BERGMANN (MDI GARY J. IGNATOWSKI IMD,o.c..rN,Nr/ JOHN A. PICA, JR. (MDI VASILIKI P. SZCZESNY <MD,D.c.I ANTHONY J. COVACEVICH (MDI CHRISTOPHER M. McNALLY (MD R. BRUCE McELHONE cMD,PhD.c.,NTI JAMES T. FITZGERALD <phNJl MICHAEL B. GILLAND cMDI JAMES S. ZAVAKOS (MDI SHANI DINOVITZ (MDI ARMAND J. VOLTA, JR. IMD.D.c.,Nn STEVEN W. SMITH (MD,D.c.l GREGORY N. BUNITSKY (PA,NJI JENNIFER R. FRANKOVICH <MD,oN,o.c.l SHANNON D. HUGHES cMw GEORGE A. WEBER, III (MD.D.c.,rN,PA,NTI THOMAS P. KELLY IMO,D.c.l MARY CINA CHALAWSKY cMDI CAROL A. HASTINGS (MDI DAVID L. PALMER (MO,o.c.,Nn RONALD E. RICHARDSON <MO,D.c.,Nn MARLA A. MACEY (phNJl PENNY ALAFASSOS (Mw EDWARD J. LILLY (MDI KATHLEEN D. HADLEY IDE/ BRIAN J. TAYLOR (PhNYI LAMONT G. McCLURE, JR. cpAl PATRICIA J. KASPUTYS (MD,D.c./ BESSIE S. DEMOS (MD,D.c.l WILLIAM G. MINKIN (MD,D.c.l ROBERT S. PATTERSON lTN) BRUCE C. HILL cMDI RICHARD E. WALDT (MD> MARK A. KOWIT (pAl RICHARD T. WILSON fDEI ANDREW M. CANTOR (MO,D.c.l SCOTT D. SHELLENBERGER (MD,D.c.l JEFFREY J. UTERMOHLE cMD,D.c.l KATHLEEN M. BROWN (MDI FREDRICK H. DURST cMD,D.c.l GREGORY R. SMOUSE IMDI MARLO A. TROTTA (MDI JUAN CARLOS RADZINSCHI cD.c.l THOMAS C. SUMMERS (MD,D.C.1 STEPHEN J. HOLM ES (MDI HELLEN P. HARLSTON cMD,NCI JENNIFER LILLY (MDI COUNSEL PHILADELPHIA, PENNSYLVANIA KNOXVILLE, TENNESSEE FANNIE ANGELOS (MO,D.c.l BETHLEHEM, PENNSYLVANIA WILMINGTON, DELAWARE NORMAN R. STONE, JR. (Mw GEORGE L. RUSSELL, JR., P. A. cMDI THOMAS V. FRIEDMAN f 1929-I 997 ) JULIUS W. LIGHTER April 28 2006 (1934-2001) , Thomas Mabius, Personal Representative of the Estate of Larry C. Mabius RD 1, Box 253 738 Pisgah Road Shermansdale, PA 17090 RE: Settlement Payment by National Gypsum (NGC) bankruptcy Trust Estate of Larry C. Mabius, a/k/a Charles L. Mabius Dear Mr. Mabius: You will recall that within the past few months we wrote to you, on behalf of your brother's estate, about a very small settlement offer to his estate from the bankruptcy trust of the former National Gypsum Company (NGC), in connection with the late Mr. Mabius' asbestos litigation in Dauphin County. You accepted the offer upon our recommendation. The NGC Trust now has issued payment of the settlement monies to this office and, as a result, we are writing to send to you -- on behalf of the estate -- the net proceeds of that payment. Thus, enclosed please find the Estate's check, attached to your copy of a Settlement And Distribution Sheet. Also enclosed, as usual, are (1) the original of the Settlement Sheet and (2) a postage- prepaid return envelope. Please sign the original Settlement Sheet at the red X; then please mail back the signed paper in the envelope provided. ONE CHARLES CENTER UNION PARK CENTER 111 5. GEORGE STREET 100 N. CHARLES STREET 5905 HARFORO ROAD UNIT 2 BALTIMORE, MD 21201.36oa BALTIMORE, MD 21214.1548 CUMBERLAND, MD 21502 410.849-L000 4Ip-426-3200 301-759-2700 fe00) 252-6622 (6001 492.3240 FAX 301-759-2703 FAX 410.659-1760,81,52 FAX 41 0126-1 2 69 •~6 LAW OFFICES PETER G. ANGELOS Thomas Mabius April 28, 2006 Page Two RE: Estate of Larry/ Charles Mabius NGC Trust payment Thank you, as always, for your cooperation. As before, if there are any questions, please feel free to contact us at any time. The toll-free number for our Harrisburg office is 1-800-283- 9240. Sincerely, William D. Poland Jr. Enclosures Copy: Susan E. Lederer, Esquire _ LAW OFFICES OF PETER G. ANGELOS 171-28-4267 ` SETTLEMENT AND DISTRIBUTION SHEET PA54679 100% E Check No.: 697200 THOMAS MABIUS ,Personal Representative of The Estate of LARRY C. v. National Gypsum Corporation ERC MABIUS SETTLEMENT: National Gypsum Corporation ERC TOTAL: ATTORNEY'S FEE: (33.33% of Settlement) MEDICAL BILLS: TOTAL: CASE EXPENSES: TOTAL: TOTAL DEDUCTIONS: $ 320.00 $ $ 320.00 $ 320.00 $ 106.67 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 106.67 BALANCE TO: THOMAS MABIUS .Personal Representative of The Estate of LARRY C MABIUS $_ 213.33 I understand and acknowledge that the funds being paid to me in regard to this settlement have been maintained in a trust account in a financial institution located outside of the Commonwealth of Pennsylvania, and that settlement monies payable to me from a settling party in any future settlement, and / or monies payable to me as a result of any verdict or judgement in my case, upon receipt by the LAW OFFICES OF PETER G. ANGELOS, P.C., will be placed into such a trust account and, less attorneys' fees and expenses, will be paid thereafter to me as expeditiously as circumstances allow. I hereby give my consent to this in regard to this present settlement and in regard to all monies payable to me as a result of any future settlements, verdicts, or judgements. AND NOW, this day of I / We do hereby declare that this Settlement and Distribution Sheet has been read and is understood and approved and that the deductions for expenses and other items shown hereon are true and correct and receipt of a copy of this Settlement and Distribution Sheet is acknowledged. WITNESS THOMAS MABIUS, Personal Representative of The Estate of LARRY C. MABIUS WITNESS WITNESS WITNESS WITNESS LAW OFFICES PETER G. ANGELOS A PROFESSIONAL CORPORATION GOVERNOR'S PLAZA SOUTH BUILDING 3, SUITE 330 2001 N. FRONT STREET HARRISBURG, PA 17102 (717) 232-1886 FAX (717)232-4189 (8001 283-9240 S~~ c~ c ~--~,-~ ~ PETER G. ANGELOS fMD.o.c.,rN,Nn THEODORE M. FLERLAGE, JR. fMD,D.c.1 PAUL M. MATHENY fMDI FREDERIC C. HEYMAN fMD) SEAN D. BURNS fMO) H. RUSSELL SMOUSE fMD1 JOSEPH L. JOHNSON fwD1 LOUIS F. ANGELOS fMO1 EVE E. PRIETZ <MD,AZ1 JOHN KOTSATOS fMO,N~,PA1 M. ALBERT FtGINSKI fMDI ROGER A. DOUMAR fMO) KEITH E. HAYNES fMD,D.c.1 CRAIG BOAS fMD) KARA A. HAGER fDE> THOMAS MINKIN fMD.D.C.,TNI WILLIAM D. POLAND, JR. fPA,WV,MD,NrI MARY V. KOCH <MDI GLENN E. MINTZER (MD,FL,W AMY H. BACKENSTOSE fPA,NJ1 EDWARD P. MONAGHAN IM D,PAI CHARLES A. CANDON IMD,D.C.,TN.NrI MICHAEL W. REED fMD) CRAIG A. THOMPSON fMD) KARYN S. BERGMANN fMD) GARY J. IGNATOWSKI (MD,D.C.,TN,NVI JOHN A. PICA, JR. fMD) VASI LI Kt P. SZCZESNY fMO.o.c.l ANTHONY J. COVACEVICH fMD) CHRISTOPHER M. McNALLY fMD R. BRUCE McELHONE fmo.PA,D.c..Nrl JAMES T. FITZGERALD fPA.N~I MICHAEL 8. GILLAND fMD) JAMES S. ZAVAKOS fMOI SHANI DINOVITZ fMD) ARMAND J. VOLTA, JR. fMD,o.c.Nrl STEVEN W. SMITH fMD,D.c.1 GREGORY N. BUNITSKY fPA,NJ1 JENNIFER R. FRANKOVICH fMD,oH,o.c.1 SHANNON D. HUGHES flwDl GEORGE A. WEBER, III fMD,D.c.,rN,PA,Nr1 THOMAS P. KELLY fMD.o.c.1 MARY CINA CHALAWSKY fMD1 CAROL A. HASTINGS «.lol DAVID L. PALMER fMD,D.c..Nr1 RONALD E. RICHARDSON fMD,o.c.,Nr1 MARLA A. MACEY <PA.NJ1 PENNY ALAFASSOS fMD) EDWARD J. LILLY fMO1 KATHLEEN D. HADLEY fDE1 BRIAN J. TAYLOR fPA,Nr1 LAMONT G. McCLU RE, JR. fPAI PATRiCIA J. KASPUTYS fMD,D.C.I BESSIE S. DEMOS fMD,D.c.l WILLIAM G. MINKIN fMD.D.c.> ROBERT 5. PATTERSON frN) BRUCE C. HILL fMD) RICHARD E. WALDT tMDI MARK A. KOWIT fPAI RICHARD T. WILSON fDE) ANDREW M. CANTOR 1MD,D.C.1 SCOTT D. SHELLEN BERGER fMD,D.c.1 JEFFREY J. UTERMOHLE <MD,D.c .) KATHLEEN M. BROWN IMDI FREDRICK H. DURST fMD,D.c.l GREGORY R. SMOUSE fMD) MARLO A. TROTTA fMD) JUAN CARLOS RAD2INSCHI ro.C.1 THOMAS C. SUMMERS IMD,D,C.) STEPHEN J. HOLM ES fMO> HELLEN P. HARLSTON IM D,NCI JENNIFER LILLY fMD) COUNSEL PHILADELPHIA, PENNSYLVANIA KNOXVILLE, TENNESSEE FANNIE ANGELOS fMD,D.C.I BETHLEHEM, PENNSYLVANIA WILMINGTON, DELAWARE NORMAN R. STONE, JR. fMD) GEORGE L. RUSSELL, JR., P. A. fMD1 THOMAS V. FRIEDMAN (1929-1997 ) JULIUS W. LIGHTER October 26 2006 (1934-2001) ~ Thomas Mabius RD 1, Box 253 739 Pisgah Road Shermansdale, PA 17090 RE: Supplemental Payment by National Gypsum Trust bankruptcy Estate of Larry C. Mabius, a/k/a Charles L. Mabius Dear Mr. Mabius: You will recall that in late April this year, we distributed to you, as the Personal Representative of your late brother's estate, a small settlement payment from the bankruptcy trust of the former National Gypsum Company (NGC). That payment by the NGC Trust was based upon a calculation of 32% of the approved "evaluation" of the claim submitted on behalf of Charles L. Mabius (known to us as Larry). Recently, the Trustees for the National Gypsum Trust determined that it has funds sufficient to raise the payment percentage from 32% to 55.6%. Under the terms of the Trust Distribution Procedures, the Trustees determined that this increase in the payment percentage will be retroactive and, therefore, that it wnuld provide supplemental payments to those who previously settled their claims. This office has now received the Estate's supplemental payment, and as a result, we are writing to enclose to you as Personal Representative, acheck for the net proceeds, which is attached to your copy of the Settlement and Distribution Sheet. Also enclosed are (1) the original of the Settlement and Distribution Sheet and (2) apostage-prepaid return envelope. ONE CHARLES CENTER UNION PARK CENTER I I I S. GEORGE STREET loo N. CHARLES STREET 5905 HARFORD ROAD UNIT 2 BALTIMORE, MD 21201-3804 BALTIMORE, MD 21214-1846 CUMBERLAND, MD 21502 410-649.2000 410-42E3200 301-1gg-2]00 (8001 252-6622 16001 492-3240 FAX 301-]59-2103 FAX 410.639-1780,61,62 FAX 41Q426-1269 •rpj LAW OFFICES PETER G. ANGELOS r Thomas Mabius October 26, 2006 Page Two RE: National Gypsum bankruptcy -supplemental payment Please have the original of the Settlement Sheet signed at the red X, and then please snail the signed page back to us in the envelope provided. Thank you for your cooperation. Very truly yours, Linda M. Wise Legal Assistant Enclosures Copy: Susan E. Lederer, Esquire _ _ LA.W OFFICES OF PETER G. ANGELOS SETTLEMENT AND DISTRIBUTION SHEET THOMAS MABIUS ,Personal Representative of The Estate of LARRY C. MABIUS SETTLEMENT: National Gypsum Corporation TOTAL: ATTORNEY'S FEE: (33.33% of Settlement) MEDICAL BILLS: TOTAL: CASE EXPENSES: TOTAL: TOTAL DEDUCTIONS: 171-28-4267 PA54679 100% E Check No.: 711148 v. National Gypsum Corporatlon $ 236.00 $ 236.00 $ 236.00 $ 78.67 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 78.67 BALANCE TO: THOMAS MABIUS .Personal Representative of The Estate of LARRY C MABIUS $ 157.33 I understand and acknowledge that the funds being paid to me in regard to this settlement have been maintained in a trust account in a financial institution located outside of the Commonwealth of Pennsylvania, and that settlement monies payable to me from a settling party in any future settlement, and / or monies payable to me as a result of any verdict or judgement in my case, upon receipt by the LAW OFFICES OF PETER G. ANGELOS, P.C., will be placed into such a trust account and, less attorneys' fees and expenses, will be paid thereafter to me as expeditiously as circumstances allow. I hereby give my consent to this in regard to this present settlement and in regard to all monies payable to me as a result of any future settlements, verdicts, or judgements. AND NOW, this day of I / We do hereby declare that this Settlement and Distribution Sheet has been read and is understood and approved and that the deductions for expenses and other items shown hereon are true and correct and receipt of a copy of this Settlement and Distribution Sheet is acknowledged. WITNESS WITNESS WITNESS WITNESS THOMAS MABIUS, Personal Representative of The Estate of LARRY C. MABIUS WITNESS LAW OFFICES PETER G. ANGELOS A PROFESSIONAL CORPORATION l~ 3 PETER G. ANGELOS rMD. D.C.,TN,NYI THEODORE M. FLERLAGE, JR. rMD.o.cJ LOUIS F. ANGELOS IMDI FREDERIC C. HEYMAN wol SEAN D. BURNS rMDI H. RUSSELL SMOUSE rMDI ROGER A. DOUMAR IMDr KEITH E. HAYNES IMD,o.c.r EVE E. PRIETZ IMD,AZr JOHN KOTSATOS IMD.NJ,PAr M. ALBERT FIGINSKI IMDI WILLIAM D. POLAND, JR. rPA,wv,MO,Nn MARY V. KOCH rMDI CRAIG BOAS rMDr KARA A. HAGER IDEI THOMAS MINKIN IMD. D.C..TNI CHARLES A. CANDON IMD.D.c.,TN.NrI MICHAEL W. REED rMDI GLENN E. MINTIER rMD,FL.L.AI AMY H. BACKENSTOSE raa.NJl EDWARD P. MONAGHAN IMD,PAI JOHN A. PICA. JR. rMDI VASILI KI P. SZCZESNY rMO.D.C.r SHARON L. HOUSTON IMO,NJ.D.C.I KARYN S. BERGMANN IMDI GARY J. IGNATOWSKI rMD.O.C..TN.NrI JAMES T. FITZGERALD IPA,NJr MICHAEL B. GILLAND rMDI ANTHONY J. COVACEVICH rMDI SHANI DINOVITZ rMDI R. BRUCE McELHONE rMD.PA.o.c..Nn STEVEN W. SMITH rMD.D.c.r GREGORY N. BUNITSKY rPA.NJI JAMES S. ZAVAKOS rMDI STANFORD L KIMMEL, III IMDI ARMAND J. VOLTA, JR. rMD,D.c..NTI THOMAS P. KELLY rMD.o.c.l MARY CINA CHALAWSKY rMD.O.C.I JENNIFER R. FRAN KOVICH IMD.OM, D. C.I CRAIG M. SILVERMAN IMDI GEORGE A. WEBER. III rMO.D.C..TN,PA.NVr RONALD E. RICHARDSON rMD.D.c.,Nrr TWILA C. DRIGGINS rMDI CAROL A. HASTINGS IMOr JAMES R. COX rMSI DAVID L. PALMER IMD.D.C.,NYI KATHLEEN D. HADLEY rDEI MARLA A. MACEY rPA.NJr PENNY ALAFASSOS IMm JESSICA E. HAY rMDI EDWARD J. LILLY IMDI BESSIE 5. OEMOS rMD.D.c.l BRIAN J. TAYLOR IPA,NYI LAMONT G. McC LURE, JR. rPAI PATRICIA J. KASPUTYS rMO,O.C.I RICHARD E. WALDT rMDI WILLIAM G. MINKIN rMD.D.C.I ROBERT S. PATTERSON rTNr BRUCE C- HILL rMDI SCOTT D. SHELLENBERGER rMD,D.C.r MARK A. KOWIT rrnl RICHARD T. WILSON rDEr ANDREW M. CANTOR rMD.D.c.l GREGORY R. SMOUSE rMDI JEFFREY J. UTERMOHLE rMD,D.c.r KATHLEEN M. BROWN IMDI FREDRICK H. DURST rMD.D.c.r STEPHEN J. HOLMES rMDI MARLO A. TROTTA rMDr JUAN CARLOS RADZINSCHI rD.C.I THOMAS C. SUMMERS rM D,D.C.I PAUL M. MATHENY <MDI HELLEN P. HARLSTON IMD,NCI JENNIFER LILLY rMDI COUNSEL PHILADELPHIA, PENNSYLVANIA KNOXVILLE, TENNESSEE FANNIE ANGELOS rMD.D.c.l BETHLEHEM, PENNSYLVANIA WILMINGTON, DELAWARE NORMAN R. STONE, JR. rMDI GEORGE L. RUSSELL, JR., P. A. rMDr THOMAS V. FRIEDMAN A p ^7 U USt 8 2OO 11 9 2 9-199 7 1 g , / JULIUS W. LIGHTER (1 9 34-2 0011 Thomas Mabius, Personal Representative of the Estate of Charles L. Mabius RD 1, Box 253 738 Pisgah Road Shermans Dale, PA 17090 RE: Uniroyal settlement payment Estate of Charles L. Mabius /Larry C. Mabius Dauphin County Court asbestos litigation Dear Mr. Mabius: You may recall that sometime ago this office mailed to you a Release for a minimal settlement with Uniroyal Inc. in your Iate brother's asbestos litigation. After much delay (obviously), Uniroyal finally has completed the processing of the settlement and has issued payment to this office. As a result, we are writing to enclose the payment to you as the personal representative of your brother's Estate. Please find enclosed the following: (1) the check (payable to the Estate), attached to your copy of a Settlement and Distribution Sheet; (2) the original of the Settlement Sheet; and (3) apostage-prepaid return envelope. GOVERNOR'S PLAZA SOUTH BUILDING 3, SUITE 330 2001 N. FRONT STREET HARRISBURG, PA 17102 (7171 232-1886 FAX (7171 232-4189 (6001 283-9240 S~a~~ E We ask that you please sign the original Settlement Sheet (at the red X) as this office's receipt for having provided this check to you. Then please mail back the signed paper in the ONE CHARLES CENTER loo N. CHARLES STREET BALTIMORE, MO 21201.3504 410-649-2000 150012528622 FAX 410E59.1750,81,52 UNION PARK CENTER 5905 HARFORD ROAD BALTIMORE, MD 2 1 2 14-1 546 41 O<26-3200 ISDDr 492-3240 FAX 410126-1269 III 5. GEORGE STREET UNIT 2 CUMBERLAND, MD 21502-306] 301-759-2]00 FAX 301-]59-2103 •® LAW OFFICES PETER G. ANGELOS Thomas Mabius August 8, 2007 Page Two RE: Estate of Charles L. Mabius /Larry C. Mabius -Uniroyal settlement payment envelope provided. If you have any questions, though, please call. Thank you for your cooperation. Sincerely, Linda M. Wise Legal Assistant Enclosures Copy: Susan E. Lederer, Esquire LAW OFFICES OF PETER G. ANGELOS COPY SETTLEMENT AND DISTRIBUTION SHEET THOMAS MABIUS ,Personal Representative of The Estate of LARRY C. v. UNIROYAL MABIUS SETTLEMENT: UNIROYAL TOTAL: ATTORNEY'S FEE: MEDICAL BILLS: TOTAL: CASE EXPENSES: TOTAL: TOTAL DEDUCTIONS: 171-28-4267 PA54679 100% E Cnecl< No.: 735203 $ 500.00 $ 500.00 $ 500.00 $ 166.67 $ 0.00 (33.33% of Settlement) See Below $ 0..00 $ 0.00 $ 133.00 See Attached Sheet $ 133.00 $ 133.00 $ 299.67 BALANCE TO: THOMAS MABIUS .Personal Representative of The Estate of LARRY C MABIUS $ 200.33 I understand and acknowledge that the funds being paid to me in regard to this settlement have been maintained in a trust account in a financial institution located outside of the Commonwealth of Pennsylvania, and that settlement monies payable to me from a settling party in any future settlement, and / or monies payable to me as a result of any verdict or judgement in my case, upon receipt by the LAW OFFICES OF PETER G. ANGELOS, P.C., will be placed into such a trust account and, less attorneys' fees and expenses, will be paid thereafter to me as expeditiously as circumstances allow. I hereby give my consent to this in regard to this present settlement and in regard to all monies payable to me as a result of any future settlements, verdicts, or judgements. AND NOW, this day of I / We do hereby declare that this Settlement and Distribution Sheet has been read and is understood and approved and that the deductions for expenses and other items shown hereon are true and correct and receipt of a copy of this Settlement and Distribution Sheet is acknowledged. WITNESS THOMAS MABIUS, Personal Representative of The Estate of LARRY C. MABIUS WITNESS WITNESS WITNESS WITNESS LAW OFFICES OF PETER G. ANGELOS Page 1 SETTLEMENT DEDUCTIONS FOR LARRY C. MABIUS - PA54679 07/31 /2007 171-28-4267 " Category Description Date "EXPERT FEE RICHARD C. BERNSTEIN, M.D (Inv. #PAH04 )REPORT & B-READING " Subtotal " COPY Check# Total Amount 05/20/2007 179420 133.00 133.00 " Grand Total " 133.00 s . ~,~~~ ;. Jr', is ±_:~ ~~L~l~1R C ~. !`~NGLLUS .. ~~IL;)Fi_1S!il~N,i_. (. ~l?]'.I";..._. ij~?.:-.I. GrVERiJ Dk'S PLAZA SC,UTH B U3LL]IIJG 3, S~C'93E 330 POOI hJ. FRONT SaR_ET HARRiSSUkG, PA d 7 302 f717! r^32-1886 FAX. t7f7J 232-8139 JBUUJ 283-9240 PCTCR G. qWC,°_!.OS ,I;pr. C..Tx r, :: ~ HLL UORE F4. FI.ERLAGC. JrZ. I+nu. i..i-. : LUUIS F. ANf+EI US ,lac' FREDEF.IL C. HEYM A.N 'rnLO, SERN iJ. BL+RNS non' H. RiJS=E_LL Srt000C "r+: • ROGEFi A P_GUMA.R :v~• h:.Et7H F.. HAYN CS ,snL._%.c:: ='JC G. faR!ETZ. ,tor ;,', JOi~dN KOTSATUS :•~,r:.,r-,;~ ~. A.LCiCRT RGJN$iil 'Nri: 'J.". i. L3AM G. 9~0LANI'i, JN. ,. s; a•:.mp.nri F4AP'?Y V. KOCH <r.. :, CRA3G BOAS ,MO, K.ARA A. d•'AvCR ,DE: T•iG1dA5 M1IJKJJV :v,p.ac. Trr Cl1AP.LEE~ ?." GANUCiN ,t-0Ct:U.C..~l:a MY~ F•11CHAEL YJ. F7EED +InD: GLEN19 L. MJt•JTZF.R •.r/^..rl,u: P.MY H. 6ACKENSTf]SE :I~arda C'A'A.HU V, t.10NAu HAN •M;a.NA: J:J•, Tl A. PICA, JR. +~n171 VASI'J K! P. S2CZESNY rht?.r,.. , SHARON l.. HUUSTGIJ Imcr:.l.a.r..1 HA.RYte S. F.EHGI.7A,r**! rr.,, GARY J. iGtJATCri+JSKI ~•.th ;: c :nJ.ra•• J.AhiiS T. FITZGERALD :vA.rJ~I t1tG iACL B. G!i. i.A.t:!7 ,~n~, AIJTHJFJY J. CUVACE VtCH •w.c• SHAF-0I L'1 FdOV1T2 !'~_ R. FdR1.3C? lJ.I:F:1 HUFJC •t.•~.I=a.[?c vn STEVEN VJ S•d!TH ;!no.c.r'.: GREGGRY svl. 3UNIT5K" ,wr. ia.?. JAMES 5. ZAVAKUS nno_ STAhiFGP.D L_ klMld-L, :!I n.ro, Az h'AtJD .;. VUITN. JT?. ~:r.•::.r c ,ev: THq".1AS Y. KELLY nnu.[.. c., MARY CL3VA CHALAV.•'SKY mtn ^.c., JEAJIJlFFh' R. FRAN KOVICH wG.Dt• .G C.• CRAG t.1. _iL'dERt.7AN •.lac. f_C'?GE A. 'PJcBEJ:', ct ~o-•_.c'.: ,na,Nn,ur RONALD E. TIC HARDSON IMIi.::>1=.tJY:• TWILA 4 DR:GG~~hfS Inc" CLROL A. HASTINGS ,MCA .JAMCS R. COX m• , UAVIG L. ?ALt.1ECi •.Mri,n •:. tr; I KATHLEEN D. HAJLEY .:n-. MAHLA A. MACEY :1-A.tJ.a i'ENtJI' A.LAFAS505 nn'n JESSICA E. HAY nnc~ =Ctk'ARD J Lq t.r I~,o' BLS_IE 5. DEed OS,tefi.c•c.' 6R7A:d J. TAYI.UR :Pa,rJ r, :.HNONT G. h1~ CLUHF, _J P.. ,„t., • '~b_J~ J. Ki.jPtJT'i5 'v^D ':c: RICH AR6 k. "ri'ALD3 :M.t:~• V')iJ_lA."d G.. {,~JFJ KIN •ut+. t?% • R'JBER7 S +~A77LSi5flN ,tra idHULC C. HILL 'Into SCi>1'1 G. B.HEL:.EN R= RGER IHC~.u c.+ h1 AviK A. KO'JJIT r n, RIC HARD T. L•JIISG2J •uE' AIJflR^^.:4 M. CAh: 7~ON ~^nG -,.c i (=kEGGRv R. Sh90USE :mn, JC FFf,'EY J. UiF.RM G3iLE ~Ni1.LK:' KA7JiLCC1J M. BRG'JJIJ 'MCr =RFtiRiC it H. !~UkST wu_t~r~ : =TE;'"•-.EF: J. ."i t~Lid ES :m::• M.~.RLO A. 1R[:7TTA. 'mc•' JUAN C.ARL.GS RADLINSCHI r !: • SHUJ.tAS C. SUt-q htERS 'at:;n:: ~ F,A!.3 td. MATHENY ~.u... n_:E L=\ P. HARI S7 CN I~nu.tac• JFNNIF ER LiLU''In~' C. t7UN ShL PHILA.DELPHSA. ?Eti`b:~YLVANIA I(NOXVILLE. TENNEt"iGC. FAhfiJIC AN~PL:73 ,rtoD [.'' BETH!..ti.HLM. FCJVNSYLVANIA i'J71MIhdG7UN. DCLAWARz. IJORMAt: +t. 5'.ONE. J~~. 'Mr„ 3,_. _...'uE L. RIi55Fl_:-. JR.. ='. A_'fu.. 1 Hf?`dA~ V. ^7ZIEDMA.N January 4 2008 1329.15971 , JULi U:: 't+i. L3C4TFR Tho3nas Mabius RD 1, Qox 253, 738 Pisgah Road Shcrmansdale, PA 17090 RE: Babcock & Wilcox bankruptcy Trust settlement payment Estate of Larry C. Mabius Dear Mr. Mabius: Babcock & Wilcox (BW} is an asbestos manufacturingldistributing company which chiefly made large commercial/industrial boilers. Due to mounting asbestos-related personal injury claims, BW filed for bankruptcy protection in February of 2000. However, prior to BW's peeking bankruptcy protection, BW had agreed to settle and pay your late brother's claim against them. As you may recall, your brother previously signed a Release for a settlement with BW but, until now, no payment has been made by I3W an that claim. The Law Offices of Feter G. Angelos, p.C., in conjunction with a select group of other law firms, participated in the bankruptcy process on behalf of asbestos personal injury victims ~;rith outstanding settlement agreements. W c are pleased to announce that our efforts have yielded positive results for our clients with pending settlement agreements. As a result, enclosed please find a check in partial pay2nent of your outstanding settlement, along with a separate (second) check for an interest payment from the date BW filed for bankruptcy. The amount you are recei~ring is 34% of the settlement agreement value, plus 34% of the interest due on the settlement as mentioned above. C,I.11 L^NI<LE:. rEtJTrp :-1IJIC!IJfAeil'. .'L':1 L~, i't S. GEOFuc. ,•TPI't1 i0~~'a C1yAFrt.:; :~IIiEET !: y;?_ HAq- JFC, AfsAf? ',11JI't 2 E".~_TIIn CJF'L. Mt CI?liv--3+?:)-: HALI'IMt?F.', 1!CI :•I:'Ia~tU4G .'.-11Mf1t itLn::U. M;?215n:. +In> nt.E.a n. +r):);) 4:c)4~L..3_C~r: 3,,,->S`3 r:)^~~ ,HC:[. ..~Ci.l~~_ :JJC~~<n2--f~a[_. f'A.Y.~'3UI fin. c,.~-~p_ rA,:. .alc.cs?-n er.Ware ,: fA?'<i~y~ [, 1=C0 LAVb OFFICES PETER G. ANGELOS Thomas Mabius January 4, 2008 Page Two RE: Babcock & Wilcox bankruptcy Trust settlement payment The Law Offices of Peter G. Angelos, P.C. is continuing our efforts to recover the full value of your settlement and the remaining interest due on your claim. As events unfold, we will inform you of our progress to recover the remaining portion of your settlement and interest. Please note that the portion of your payment designated as interest is subject to income taxation. The BW Asbestos Settlement Trust will report this payment to the Internal Revenue Service (IRS) and issue an individual IRS Form-1099 so that you may account for this payment next year on your income tax form for calendar year 2007. Our office will forward your Form-1099 to you upon receipt from the BW Asbestos Settlement Trust. Please further note that the portion of your interest payment retained as attorney fees may be listed as a deduction on an itemized income tax return. You are strongly urged to consult with your tax adviser concerning the proper reporting requirements for this interest payment. Your two 2 checks are enclosed and attached to your co ies of separate Settlement and Distribution Sheets. Also enclosed are the originals of the hvo Settlements Sheets and a postage-prepaid return envelope. Please sign the original Settlement Sheets (at the red Xs) aid then mail back both of the signed papers in the envelope provided. Should you have any other questions, please do not hesitate to contact our Status Departnle~.t in Baltimore at 1-804-252-6522, or oar Harrisburb office at 1-R00-2S3-9210. Thank you for your cooperation. Sincerely, t~~ ~f1 U ~ -'` ~v~v ~y ~`~ Pctcr G. Angelos ~'~ PGAJImw Enclosures PETER G. ANGELOS TRUSTEE ACCOUNT ~ wac,~o«~ 7 ~ 2 100 N. CHARLES S T. 0"5-32Qj`550-96715 BALTIMORE, MD 21.201 ~2S?-PA54679 FILE hJ: B~~+TRlISi-ER :;,,.,. 01.1 One 1~housand Eight Hundred One and G2?1i70 Dollars DATE A1~10UNT 12/1812007 ], 801.0? ;~'FR TH0~~1AS ~~iAB(US, Personal Representative of The Estate of WRRY C. r~~ABlUS RO l Box ?53 . i3d Pisgah t~oana n t:.+ .. _... -. J(1~rrP,3llSdiiie, t"~ ~ I179~ `-~~AUTHORtZL•JSisrii~TUraf' -~ 1t`752663t-° ~:055Q0320~~.2D4~,0033990L5tt° ~. ----- PETER G. AIVGEL4S TRUSTEE ACCOUNT u 100 N. CHARLES ST. - wac~;o--ra -] 5 r] ~ ~ .~ SALTr~.5pr3E, fulD 21201 55-3201550-56715 (~3 L. ~i25'-?A5~6i9 EJEE AtO: 81't+TRUST-ittiT 7 Six N~~ndred Sevent} One and 8011U0 Doi(ars THOP9AS iliiABIUS, Pcrsor:al RcPresentative of The Estate of ll~BRY O. Mgg!!JS RU 1 Box 253 73E Pisrlah Road Sherr~~arsdalc, PA 3 7Dfl0 DATE AftpUi~T 12/19/20D7 _ 671.817 ~._.-~ AUTHOFttZE~ 51CNI47URE', .~ --~ -- ~ - J.4 -. ._ .._._.z-~--.r:_r..,:.~._ _. ----- =~--~T. _.~-. 1t~ g - ---->~:.~ . ~ 5 2 9 b 3 ~t j e 0 5 5 0 0 3 2 0~~ 0 2 .~...~,~,«zT... 04~.DD33940b5tt° -~~ LAW OFFICES OF PETER G. ANGELOS 171-28-4267 SETTLEMENT AND DISTRIBUTION SHEET PA54679 ~ a PY 100~,o E Check No.: 7~2~~ 3 THOMAS MABIUS ,Personal Representative of The Estate of LARRY C. v. BW TRUST -BANKRUPTCY INTEREST MABIUS SETTLEMENT: BW TRUST -BANKRUPTCY INTEREST TOTAL: ATTORNEY'S FEE: MEDICAL BILLS: TOTAL: CASE EXPENSES: 'TOTAL: TOTAL DEDUCTIONS: (33.33% of Settlement) $ 1,007.70 $ 1.007.70 $ __ 1.007.70 $ 335.90 $ 0.00 $ _ 0.00 $ 0.00 $ 0.00 S $ 0.00 $ 0.00 $ 335.90 BALANCE TO: THOMAS MABIUS ,Personal Representative of The Estate of LARRY C MABIUS $ B71 80 I understand and acknowledge that the funds being paid to me in regard to this settlement have been maintained in a trust account in a financial institution located outside of the Commonwealth of Pennsylvania, and That settlement monies payable to me from a settling party in any future settlement, and / or monies payable to me as a result of any verdict or judgement in my case, upon receipt by the LAW OFFICES OF PETER~G. ANGELOS, P.C., will be placed into such a trust account and, less attorneys' fees and expenses, will be paid thereafter to me as expeditiously as circumstances ai?ow. I hereby give my consent to this in regard to this present settlement and in regard to all monies payable to me as a result of any future settlements, verdicts, or judgements. AND NOw, this day of I / We do hereby declare that this Settlement and Distribution Sheet has been read and is understood and approved and that the deductions for expenses and other items shown hereon are true and correct and receipt of a copy of this Settlement and Distribution Sheet is acknowledged. WITNESS WITNESS WITNESS WITNESS THOMAS MABIUS, Personal Representative of The Estate of LARRY C. MABIUS WITNESS COPY LAW OFFICES OF PETER G. ANGELOS SETTLEMENT AND DISTRIBUTION SHEET HOMAS MABIUS ,Personal Representative of The Estate of LARRY C ABlUS ETTLEMENT BW TRUST -EXPEDITED REVIEW OTAL: ATTORNEY'S FEE' (33.33% of Settlement) MEDICAL BILLS: OTAL- SASE EXPENSES: TOTAL: TOTAL DEDUCTIONS: See Below See Attached Sheet 171-28-4267 PA54679 1 oo°i° E Check No.: 752663 v. BW TRUST -EXPEDITED REVIEW $ 3,400.00 $ $ $_ $ $ 3.400.00 $ 3,400.00 $ 1.,133.33 $ o.oa $ _ 0.00 $_ 0.00 $ 465.65 $ $ 465.65 $ 465.65 $ 1,598.98 BALANCE TO: THOMAS MABIUS ,Personal Representative of The Estate of LARRY C. MABIUS $ 1.801.02 I understand and acknowledge that the funds being paid to me in regard to this settlement have been maintained in a trust account in a financial institution Located outside of the Commonwealth of Pennsylvania, and that settlement monies payable to me from a settling party in any future settlement, and / or monies payable to me as a result of any verdict or judgement in my case, upon receipt by the UAW OFFICES OF PETER G. ANGELOS, P.C., will be placed into such a trust account and, less attorneys' fees and expenses, wilt be paid thereafter to me as expeditiously as circumstances allow. I hereby give my consent to this in regard to this present settlement and in regard to all monies payable to me as a result of any future settlements, verdicts, or judgements. AND NOW, this day of , I ! We do hereby deGare that this Settlement and Distribution Sheet has been read and is understood and approved and that the deductions for expenses and other items shown hereon are true and correct and receipt of a copy of this Settlement and Distribution Sheet is acknowledged, WITNESS WITNESS WITNESS WITNESS THOMAS MABIUS, Personal Representative of The Estate of LARRY C. MABIUS 1A1f7hIFS~ 1.A~V OFFICES PETER G. ANGELOS r~ PROFESSIONAL CORPORATION GOVERNOR'S PLAZA SOUTH BUILDING 3. SUITE 330 - 2001 N. FRONT STREET HARRISBURG, PA 17102 t7!7! 232-1886 FAX (7171 232-4189 tB00! 263.9240 ANGELOS tMD.D.C.,TN.NY1 PETER G THEOCORE '•..-_ERis,GE. JR. IMD.e.c.l KEITH E. HAYNES (MD,D.C.1 SHARON L. HOUSTON (MD,N,!i KARYN 5. BERGMANN IMa . RUSSELL SMOUSE IMn! H ROGcR A. ,~":-,i.L+:R.;va~- MARY V. KOCH 1M01 ANTHONY J. COVACEVICH IMDI SHANI DINOVITZ WDI . ALBERT FIGINSKI (MDr M WILLIAM C. POLO^:]; JR. IPA,w~:.MD.Nn MICHAEL W. REED IMDI JAMES S. ZAVAKOS IMDI CRAIG M. SILVERMAN IMD) . TNi THOMAS MINKIN !MD. D.C. CHARLES -. --:.~i1C^A: Ctn. D.C.JN,NY:~ VASIUKI P. SZCZESNY 1MD, D.C.1 JENNIFER R. FRANKOViCH iMD.OH,D.CJ JAMES R. COX iMSI , MONAGHAN (MD.PAI EDWARD P JOHN A. ='rG~. J=.~'~= MICHAEL B. GILLAND IMa CAROL A. HASTINGS (MD) JESSICA E. HAY !MDi . GARY J. IGNATOWSKI IMD.D.C.,TN,NYI JAMES T. Ft-ZGERALC -.=-s.n.;~ GREGORY N. BUNITSKY (PA,NJI LAMONT G. MCCLURE, JR, caal JIMMY C. CHONG lDE?A.N.LD.c.) R. BRUCE McELHONE 1MD.Pa.D.C..Nn STEVEN 'd!. S"'?~ri ^'-...c. MARY CINA CHALAWSKY cMD.D.o.! ROBERT 5. PATTERSON /TN) ARMAND J. VOLTA. JR. IMD.D.c..Nn THOMAS ?. tiELLY Mme.... _.. BRIAN J. TAYLOR rpA,NYi RICHARD T. WILSON IOEI GEORGE A. WEBER. 411 IMD,D.C.,TN.PA, NY, RONALD E RICriAR6-SON +=.~.C_vY! WILLIAM G. MINKIN IMD.D.c.) KATHLEEN M. BROWN IMDI DAVID L. PALMER IMD,O.C..NYI KATHLEEN C. H=.1LEY'.DE~. JEFFREY J. UTERMOHLE cnlD.D.c.1 JUAN CARLOS RADZINSCHI co.c.l EDWARD J. LILLY (MDi BESSIE S. ~=b?CS ~_._. _. ^ MARLO A. TROTTA IMDI JENNIFER LILLY IMD) PATRICIA J. KASPUTYS 1MD, D.C.I RICHARD E. t;ALCT IMO~ HELLEN P. HARLSTON tMD.NCI SEAN D. BURNS IMDI ° BRUCE C. HILL tMDI GREGORY R. St ~OUS_ ~..,. FREDERIC C. HEYMAN IMD) JOHN KOTSATOS 1MD.NJ,PAi ANDREW M_ CANTOR (MD,D.e.l STEPHEN J. HOLMES "e D: EVE E. PRIETZ <MD,AZI PAUL O. RABCHKE (MD,DC,PA! FREDRtCK H. DURST IMD.D.c.l PAUL M. MATHENY '~D~ CRAIG BOAS IMDI KARA A. HAGER tDEI RS o , LOUIS F ANG~LOS I.MC1 GLENN E. MINTZER (MDFL.u, AMY H. BACKENSTOSE (PA,NJI THOMAS C. SUMME wD. .c.. - COUNSEL BETHLEHEM,.PENDsSYLVANIA WILMINGTON. DELAWARE FANNIE ANGELOS (MO.D.c., KNOXVILLE. TENNESSEE NORMAN R. STONE, JR. (MDr GEORGE L. RUSSELL, JR., P. A. IMw THOMAS V. FRIEDMAN June 3, 2008 1929-19971 JULIUS W. LIC HTER (I 934-2001) Thomas Mabius RD 1 Box 253 738 Pisgah Road Shetmansdale, PA 17090 RE: Sunnlemental Settlement payment by Manville bankruptcy 't'rust Estate of Larry C. Mabius Dear Mr. Mabius: You may recall that several years ago your late brother accepted -and was issued payment for - a small settlement with The Manville Trust, the bankruptcy-court-created cntit~.• which oversees and manages the bankruptcy of the former Johns Manville Corporat.i~n. :4t tF;e time of the previous settlement and payment, the U.S. Bankruptcy Court (in New Yor-Ic) had approved a Pian by which settlements were Wald at live perc::nt +;~ %) of the `'e~~aluated•' ~~all_,e of a claim. [As an example, a claim approved at an evaluation of $25>000 was paid at 5~I of that amount, or $1,250.] As background, when the Manville Trust was first created in the late 1980s, this, money available in the trust fund was sufficient to pay settlements at 10/0 of the evaluations. B~c~-use of a marked increase in the number of claims against the Trust, however, the payment figure later was reduced to the 5% level at which you were paid. Now, as an update, the trust fund for the Manville Trust has improved its financial status and, as a result, the Bankruptcy Court has approved a Plan Modification which now pays claims at 7.5% of the settlement evaluation. Further, as a consequence of that increase, settlement ONE CHARLES CENTER UNION PARK CENTER I, I S. GEORGE STREET 100 N. CHARLES STREET 6905 HARFORO ROAD UNIT 2 BALTIMORE, MD 21201-3604 BALTIMORE. MD 2121a-1946 CUMBERLAND. MD 2 1 60 2-306 7 410-649.2000 410-426-3200 301.76fl-2700 fbO0i 25E~66EP IBU014fl2-3240 FA%301.739-2703 FAX 410.669-I760.B 1,6E FAX 410-426-1265 LAW OFFICES PETER G. ANGELOS June 3, 2008 Page Two RE: Si~lenzerttal Manville settlement payment claims which previously had been paid at the Solo Level (such as your husband's) are ttow being issued sacpplemerital pavmerats of an additional 2.5 °lo. This office recently received the 2.5% supplemental payment in your/the ESUIt~'S c!ai~n and, thus, we are now writing to enclose to you the net proceeds from that additional l.~aymt~ni. :i:;cJidingly, ~;l:,ase ft.:d eno:Ic?sed ;`~?r_-./the Estate's Ch;'c:!, f,~t~ the ~ISTTr14'Crlfnt:r I~ I~ Ins ni. Your/the Estate's check, as usual, is attached to your conv of a Settlement And Distribution Sheet which shows the total amount of the Manville Trust payment and any deductions} -- ,~it~h as the attorneys fee -which was/were subtracted from the total. Also enclosed are ' 1 `~ the original of the Settlement Sheet and (2) apostage-prepaid return envelope. Please have the original of the Settlement Sheet signed at the red X(s} as this offi;:e's receipt for having distributed this check to you; then please mail the signed page back to us in the envelope provided. Thank you for your continuing cooperation. Sincerely, ,, _, ,a ,. !~ l~~f ILA.; *-.. ~ .~~' ~,u-~ ,. yr1 ~ F' ~-. ~1 William D. Poland Jr. W llYlamv Enclosures LAW ©FFICES OF PETER G. AtU^vELOS SETTLEMENT Anti) B4STRtBt1T34N S~iEET THOhRAS MABfUS , ?ersona# Representatnre of The Estate of LARRY C. v. Jonas Manvitte ~11A$fUS SETTLE';."=hT: Johns Manvi3ie TOTAL: ATTORNEY'S FEE: (25.0°~~ of Set#iemzntRfter Expenses) t.~iEDtCAL BILLS: TOTAL. CASE. EXPEiVSES: T~CTAL: 171-28-4267 PA54B73 100°!4 E Chick No.: 77439 S t,2~0.~0 S S fi 6 1.254.00 ~ 1,250.00 S 3 i 2.50 ~ 0.00 S ~ - - -- O.GO S 0.00 w 13.00 5 S s ~_c~ s c.~ TOT~.L DEDUCTiO#VS: ~ 312 50 V BALANCE TO: THOMAS MA8#tJS Personal Representative of The Estate of LARRY C MA8#US S 937 50 l understand and actrnoe<riedga that the funds being paid to me in regard to this settlemen# have been maintained i:~ a trust account in a tinancia! institution #ocafed outside of ih8 ^ommonwealth of Pennsylvania, and that settlement monies payable to me from a settling pG,~ty in arty ~~rture setilerr~ent, aced f or monies payable fo me as a resul# of any verdict or judgement in my case, upon receipt by the LA1,r;r OFFICES OF PETER G. RNGEL.OS, P.C., vailt be placed into such a trust account and, less attorneys' fees and expenses, r.~lill Le pai+~ thereafter to me as expeditiously as circumstances ailow. thereby give my consent to #his in regard to this present setflement and in regard io alt monies payable to me as a result of any future settlements; ~.erdicts, ar judgements. ANl? NOW: this !s day of . ~ t7~ %z`c` ~'~ l ! 4Ve do hereby declare that this Settlement and Distribution Sheet has been read and is understood and approved and that the deductions for expenses and other iierr~s shown hereon are true and correci and receipt of a copy of this Settlement and Distrib~or~Sheet is aLl:nowiedged. :'4~1T#~CSv b+llT~'~ESS 1N}TNESS Representative of The Estate of LARRY C. 1VlA$lUS ~J1rfTNESS LAW OFFICES PETER G. ANGELOS A F'ROFFSSIONAL CORPORATION GOVERNOR'S PLAZA SOUTH BUILDING #3, SUITE 330 2001 N. FRONT STREET HARRISBURG, PENNSYLVANIA 17102 (717) 232-1886 FAX (717) 232-4189 ~c~.e~.ul~ C--, /-f ~„-, ~ (BOO) 283-9240 PETER G. ANGELOS IMD, D.C., TN, Nvl H. RUSSELL SMOUSE IMDI M. ALBERT FIGINSKI IMDI THOMAS MINKIN IMD, D.C., TNI EDWARD P. MONAGHAN IMO. Pwl GARY J. IGNATOWSKI IMO. D.C.. TN, Nn R. BRUCE MCELHONE IMD. Pw. D.c.. NYI ARMAND J. VOLTA, JR. IMO. D.C.. NrI GEORGE A. WEBER, III IMD. D.c., TN, Pw. Nvl DAVID L. PALMER IMD, D.c., Nvl EDWARD J. LILLY IMD> PATRICIA J. KASPUTYS IMD. D.C.) BRUCE C. HILL IMw ANDREW M. CANTOR IMO, D.C.I FREDRICK N. DURST IMD, D.C.> THOMAS C. SUMMERS IMD, aC.l THEODORE M. FLERIAGE, JR. IMD, D.c.l ROGER A. DOUMAR IMDI WILLIAM D. POLAND, JR. IPA, Wv, MD. NvI CHARLES A. CANDON IMD, D.c.. TN, Nvl JOHN A. PICA, JR. IMDI JAMES T. FITZGERALD IPw, NJI STEVEN W. SMITH IMD, D.c.l THOMAS P. KELLY IND, D.c.l RONALD E. RICHARDSON IND, D.c., NvI BESSIE 5. DEMOS IND• D.c.l PAUL D. RASCHKE IMD. D.c., PwI GREGORY R. SMOUSE IMDI STEPHEN J. HOLMES IMDI PAUL M. MATHENY INDI LOUIS F. ANGELOS IMw KEITH E. HAYNES IMO, D.C.) MARY V. KOCH IMw VASILIKI P. SZCZESNY IMD, D.C.I MICHAEL B. GILLAND IMDI GREGORY N. BUNITSKY IPw, NJI MARY CINA CHALAWSKY IMD, D.C.I BRIAN J. TAYLOR IPA. NY) WILLIAM G. MINKIN IMD. D.C.I JEFFREY J. UTERMOHLE IMO, o.c.> MARLO A. TROTTA IMDI HELLEN P. HARLSTON IMO, NDI FREDERIC C. HEYMAN IMw GLENN E. MINTZER IMO, FL, Lal SHARON L. HOUSTON IMD, NJI ANTHONY J. COVACEVICH IMw JAMES S. ZAVAKOS IMw CAROL A. HASTINGS IMw COUNSEL FANNIE ANGELOS IMD. O.C.I NORMAN R. STONE. JR. IMDI GEORGE L. RUSSELL, JR., P.A. IMw KATHLEEN D. HADLEV IoEI BALTIMORE, MARYLAND BETHLEHEM, PENNSYLVANIA TOWSON, MARYLAND PHILADELPHIA, PENNSYLVANIA CUMBERLAND, MARYLAND WILMINGTON, DELAWARE KNOXVILLE, TENNESSEE THOMAS V. FRIEDMAN "929-'997 July 23, 2008 JULIUS W. LIGHTER 11934-2001) Thomas Mabius, Personal Representative of the Estate of Larry C. Mabius RD 1, Box 253 738 Pisgah Road Shermansdale, PA 17090 LAMONT G. MCCLURE, JR IPwI ROBERT 5. PATTERSON <TNI RICHARD T. WILSON IDEI TIMOTHY MANUELIDES IMDI KATHLEEN M. BROWN IMD) JUAN CARLOS RADZINSCHI ID.C.I JENNIFER LILLY IMD> SEAN D. BURNS IMDI JOHN KOTSATOS IMD, NJ. PAI KARA A. HAGER IDEI AMY N. BACKE NSTOSE IPw, NJI CRAIG M. SILVERMAN IMw JESSICA E. HAY IMDI RAYMON A. ARREOLA IPw. NJI CHRISTOPHER D. WRIGHT IMDI DANIEL P. CONNELL IMDI ERIC M. ROSENFELD IMw RE: United States Gypsum (USG) Asbestos Personal Injury Trust Pre-Bankruptcy Settlement Payment Estate of Larry C. Mabius, aka Charles L. Mabius Dear Mr. Mabius: Another one of the former asbestos product manufacturers which this office sued, or attempted to sue, in your/the estate's asbestos personal injury case is/was the United States Gypsum Company, also known as U.S. Gypsum andlor USG. The suit against USG was stayed, however, because U.S. Gypsum -like numerous other companies -filed for bankruptcy protection. Now the U.S. Bankruptcy Court has approved a plan for USG to make payments in claims (such as yours/the estate's) which had been submitted to U.S. Gypsum for settlement prior to the bankruptcy filing. According to the plan approved by the Bankruptcy Court, your/the Estate's pre-bankruptcy settlement with USG will be paid at the current payment percentage of 45%. ONE CHARLES CENTER 100 N. CHARLES STREET 22ND FLOOR BALTIMORE, MD 21201-3804 1410) 649-2000 • (8001 252-6622 FAX 14101 659.1780, 61, 62 COURT TOWERS 210 W. PENNSYLVANIA AVENUE • SUITE ISO • TOWSON, MD 21204-5324 1a 101 821-1000 • FAX (al0> 426-1269 111 5. GEORGE STREET UNIT 2 CUMBERLAND, MD 21501-3067 1301) 759.2700 • FAX (3011 759-2703 .~. LAW OFFICES PETER G. ANGELOS Thomas Mabius July 23, 2008 Page Two RE: U.S. Gypsum Co. bankruptcy payment for Estate of Larry C. Mabius Therefore, enclosed please find a check in payment of your/the Estate's outstanding settlement. As usual, your/the Estate's settlement check is attached to your copy of a Settlement And Distribution Sheet. Also enclosed are (1) the original of the Settlement Sheet and (2) a postage-prepaid return envelope. We ask that you please sign the original of Settlement Sheets at the red X(s); then please mail back the signed paper in the envelope provided. Should you have any questions, though, please do not hesitate to call. Thank you for your cooperation. Sincerely, ~~ ~` ~~~~`CU Paul M. Matheny PMM/amrh Enclosures COPY: Susan E. Lederer, Esquire •- .,~ ` ~ 4 ,~ LAW OFFICES OF PETER G. ANGELOS 171-28-4267 ~`" '` ~~ ~~~` ~ ~ % ` `°``~~ SETTLEMENT AND DISTRIBUTION SHEET PA54679 ~ ~ r ~~~'` ~ ~~ 100% E 4 ...~ f `' Check No.: 787407 THOMAS MABIUS ,Personal Representative of The Estate of LARRY C. MABIUS SETTLEMENT: U.S. GYPSUM CO. BANKRUPTCY SETTLEMENT TOTAL: ATTORNEY'S FEE: (33.33% of Settlement) MEDICAL BILLS: TOTAL: CASE EXPENSES: v. U.S. GYPSUM CO. BANKRUPTCY SETTLEMENT $ 3,735.00 $ $ 3,735.00 $ 3,735.00 $ 1,245.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 TOTAL: $ 0.00 $ 0.00 TOTAL DEDUCTIONS: $ 1,245.00 BALANCE TO: THOMAS MABIUS ,Personal Representative of The Estate of LARRY C. MABIUS $ 2,490.00 I understand and acknowledge that the funds being paid to me in regard to this settlement have been maintained in a trust account in a financial institution located outside of the Commonwealth of Pennsylvania, and that settlement monies payable to me from a settling party in any future settlement, and / or monies payable to me as a result of any verdict or judgement in my case, upon receipt by the LAW OFFICES OF PETER G. ANGELOS, P.C., will be placed into such a trust accounl and, less attorneys' fees and expenses, will be paid thereafter to me as expeditiously as circumstances allow. I hereby give my consent to this in regard to this present settlement and in regard to all monies payable to me as a result of any future settlements, verdicts, or judgements. AND NOW, this day of I / We do hereby declare that this Settlement and Distribution Sheet has been read and is understood and approved and that the deductions for expenses and other items shown hereon are true and correct and receipt of a copy of this Settlement and Distribution Sheet is acknowledged. WITNESS WITNESS WITNESS WITNESS THOMAS MABIUS, Personal Representative of The Estate of LARRY C. MABIUS ~; _ ., '. 7, 1 WITNESS LAW OFFICES ~~~~ ~ ~ ' ~S ~_ / PETER G. ANGELOS A PROFESSIONAL CORPORATION GOVERNOR'S PLAZA SOUTH BUILDING #3, SUITE 330 2001 N. FRONT STREET HARRISBURG. PENNSYLVANIA 17102 (717) 232-1886 FAX (717) 232-4189 1800) 283-9240 PETER G. ANGELOS IMD, D.C_ TN, Nn H. RUSSELL SMOUSE IMOt M. ALBERT FIGINSKI IMDI THOMAS MINKIN IMD. D.C.. TNI EDWARD P. MONAGHAN IMD. PAI GARY J. IG NATOWSKI IMD. D.C.. TN. NYt R. BRUCE MCELHONE IMD, PA, D.C.. NYr ARMAND J. VOLTA, JR. IMD. D.C.. NYI GEORGE A. WEBER, III IMD, D.C.. TN, PA, NYI DAVID L. PALMER IMD. D.C.. NYI EDWARD J. LILLY IMm PATRIC IA J. KASPUTYS IMD, p.CJ BRUCE C- HILL .Mm ANDREW M. CANTOR IMD, D.C.I FREDRICK H. DURST IMD. D.c.1 THOMAS C SUMMERS IMD. D.c.l THEODORE M. FLERLAGE. JR. IMp. D-c.l ROGER A. DOUMAR IMDI WILLIAM D. POLAND, JR. IPA, wv. MD. Nv/ CHARLES A. CANDON IMD. D.C.. TN, NVl JOHN A. PICA, JR. IMDr JAMES T. FITZGERALD IPA. NJr STEVEN W. SMITH IMD. D.C.r THOMAS P. KELLY IMD. D.C.r RONALD E. RICHARDSON IMD, D.C.. Nvr BESSIE S. DEMOS IMD. D.[.t PAUL D. RASCHKE IMD. p.c.. PAr GREGORY R. SMOUSE IMDI STEPHEN J. HOLMES IMD! PAUL M. MAT HE NY IMDI LOUIS F. ANGELOS IMD, KEITH E. HAYNES unD. D.C.I MARY V. KOCH IMp> VASILIKI P. SZCZESNY IMp. D.cJ MICHAEL B. GILLAND IMDI GREGORY N. BUNITSKY IPA, NJI MARY CINA CHALAWSKY IMD, D.CJ BRIAN J. TAYLOR IPA, Nv> WILLIAM G. MINKIN IMD. O.C.I JEFFREY J. UTERMOHLE IMD. O.C.1 MARLO A. TROTTA IMDI HELLEN P. HARLSTON IMO. NCI FREDERIC C. HEYMAN IMDI GLENN E. MINI2ER IMp. FL. LAI SHARON L. HOUSTON IMD. NJI ANTHONY J. COVACEVICH IMDI JAMES S. ZAVAKOS IMDI CAROL A. HASTINGS IMDr LAMONT G. McCLURE, JR IPAI R08ERT 5. PATTERSON rtw RICHARD T. WILSON IDEt TIMOTHY MAN UELIDES IMDI KATHLEEN M. BROWN IMDI JUAN CARLOS RAD2INSCHI ID.C./ JENNIFER LILLY IMOt SEAN D. BURNS IMDI JOHN KOTSATOS IMD. NJ. PAI KARA A. HAGER IDEI AMY N. BACKENSTOSE IPA, NJI CRAIG M. SILVERMAN IMDI JESSICA E. HAV IMDI RAVMON A. ARREOLA IPA. NJI CHRISTOPHER D. WRIGHT IMDI DANIEL P. CONNELL IMDI ERIC M. ROSENFELD IMDI COUNSEL BALTIMORE, MARYLAND BETHLEHEM, PENNSYLVANIA FANNIE ANGELOS IMD. D-c.l TOWSON, MARYLAND PHILADELPHIA, PENNSYLVANIA NORMAN R. STONE, JR. IMDI CUMBERLAND, MARYLAND WILMINGTON, DELAWARE GEORGE L. RUSSELL, JR., P.A. IMDr KNOXVILLE , TENNESSEE KATHLEEN D. HADLEY IDE> THOMAS V. FRIEDMAN 11929-1997) September 12, 2008 JULIUS W. LIGHTER ! 1934-2001) Thomas Mabius, Executor of the Estate of Larry C. Mabius RD 1, Box 253 738 Pisgah Road Shermansdale, PA 17090 RE: Owens Corning/Fibreboard Asbestos Personal Injury Trust Pre-Bankruptcy Settlement Payment Estate of Larry C. Mabius, a/k/a Charles L. Mabius Dear Mr. Mabius: On October 5, 2000, Owens Corning/Fibreboard (OC/FB) petitioned for bankruptcy relief in the United States Bankruptcy Court of the District of Delaware. Prior to OC/FB filing for bankruptcy they had agreed to settle the asbestos personal injury claim of Larry C. Mabius. Unfortunately, due to the bankruptcy, the claim on behalf of your late brother has remained unpaid. Last summer OC/FB emerged from bankruptcy with a confirmed Plan of Reorganization (the Plan). As a part of the Plan, OC/FB was required to form a settlement trust [the Owens Corning/Fibreboard Asbestos Trust (OC/FB Trust) ] to compensate the persons injured by exposure to asbestos products manufactured by Owens Corning and/or Fibreboard. Under the Trust Distribution Procedures of the Plan, claimants identified as having "pre-petition liquidated ONE CHARLES CENTER 100 N. CHARLES STREET 22ND FLOOR BALTIMORE. MD 21201-3804 - to 10) 649-2000 tB00) 252.6622 -FAX IalO) 659-1760, al, 82 COURT TOWERS 210 W. PENNSYLVANIA AVENUE SUITE 150 TOWSON, MD 21204-5324 la 101 621.1000 FAX to 101 4 26-12 69 111 S. GEORGE STREET UNIT 2 CUMBERLAND. MD 21501-3087 13011 759-27017 FAX 13011 7 59-2 703 . •s~.'~. LAW OFFICES PETER G. P.NGELOS Thomas Mabius September 12, 2008 Page Two RE: Fibreboard bankruptcy payment to Estate of Larry C. Mabius claims" (such as you and the Estate) may have their claims paid at the current payment percentage (40% for Owens Corning liability, and 25% for Fibreboard liability) without having to have their claims reevaluated by the OC/FB Trust. This will result in claimants, including your brother's Estate, receiving compensation much faster than claimants who are required to have their claims newly evaluated under the Trust Distribution Procedures. We are pleased to inform you that Lang/Charles Mabius' pre-bankruptcy settlement agreement with Fibreboard has been approved for payment. Therefore, enclosed please find a check in payment of his Estate's outstanding settlement, l~us a separate check to the Estate as an interest payment from the date that Fibreboard filed for bankruptcy. As mentioned above, the checks which the Estate is receiving represent 25% of the pre-bankruptcy settlement amount, plus the interest calculation. Please note that the portion of the payments designated as interest may be subject to income taxation. The Trustees for the OC/FB Trust are seeking a ruling from the IRS that the interest portion of the settlement is not income. Presently, the IRS has not yet issued a ruling on that matter. Should the IRS determine that this interest payment is income then the OC/FB Trust will report this payment to the Internal Revenue Service and issue an individual Internal Revenue Service Form 1099 so that you may account for the payments on your next federal income tax forms. The Estate's settlement check - as well as the separate check for interest -are attached to your copies of separate Settlement And Distribution Sheets. Also enclosed are (A) the originals of the two (2) separate Settlement Sheets and (B) apostage-prepaid return envelope. We ask that you please sign the originals of each of the two Settlement Sheets at the red Xs; then please mail back both of the signed papers in the envelope provided. Should you have any questions, though, please do not hesitate to call. Thank you. Lastly, Please Note that these monies for the estate must be properly accounted for, in accordance with Pennsylvania law. Further, please note that this money maybe subject to Pennsylvania state inheritance tax. Neither I nor this office is a tax attorney. Because of that, we advise that you consult with an accountant or tax attorney to determine whether inheritance tax is required and, if so, how to take care of that. It is also advisable, we think, to open a separate bank account in the name of the Estate. .. LAW OFFICES PETER G. ANGELOS Thomas Mabius September 12, 2008 Page Three RE: Fibreboard bankruptcy payment to Estate of Larry C. Mabius Thank you again for your cooperation. Sincerely, ,~f ' ~~~~ ~r Paul M. Matheny PMM/amrh Enclosures Copy: Susan E. Lederer, Esquire .. RAW OFFICES OF PETER G. ANGELOS 171-28-4267 -'SETTLEMENT AND Dt5TRIBUTION SHEET PA54679 __ 100% E - .._ Check No.: $~03$~ THOMAS MABIUS ,Personal Representative of The Estate of LARRY C. v. FIBREBOARD BANKRUPTCY SETTLEMENT MABIUS SETTLEMENT: TOTAL: FIBREBOARD BANKRUPTCY SETTLEMENT ATTORNEY'S FEE: (33.33% of Settlement) MEDICAL BILLS: TOTAL: CASE EXPENSES TOTAL: TOTAL DEDUCTIONS: $ 2,875.00 $ 2,875.00 $ 2,875.00 $ 958.33 $ 0.00 $ 0.00 $ Q 0.00 $ 0.00 $ 0.00 $ 958.33 BALANCE TO: THOMAS MABIUS ,Personal Representative of The Estate of LARRY C. MABIUS $ 1,916.67 I understand and acknowledge that the funds being paid to me in regard to this settlement have been maintained in a trust account in a financial institution located outside of the Commonwealth of Pennsylvania, and that settlement monies payable to me from a settling party in any future settlement, and / or monies payable to me as a result of any verdict or judgement in my case, upon receipt by the LAW OFFICES OF PETER G. ANGELOS, P.C., will be placed into such a trust account and, less attorneys' fees and expenses, will be paid thereafter to me as expeditiously as circumstances allow. I hereby give my consent to this in regard to this present settlement and in regard to all monies payable to me as a result of any future settlements, verdicts, or judgements. AND NOW, this day of I / We do hereby declare that this Settlement and Distribution Sheet has been read and is understood and approved and that the deductions for expenses and other items shown hereon are true and correct and receipt of a copy of this Settlement and Distribution Sheet is acknowledged. WITNESS WITNESS WITNESS WITNESS THOMAS MABIUS, Personal Representative of The Estate of LARRY C. MABIUS WITNESS _ _ LAW OFFICES OF PETER G. ANGELOS 171-28-4267 k '.. r t _ ~ ~` ,-SETTLEMENT AND DISTRIBU"PION SHEET PA54679 ~ ~ , ~ F~. ~ ' ' 100% E Check No.: 800439 THOMAS MABIUS ,Personal Representative of The Estate of LARRY C. v. FIBREBOARD BANKRUPTCY INTEREST MABIUS SETTLEMENT: FIBREBOARD BANKRUPTCY INTEREST TOTAL ATTORNEY'S FEE: (33.33% of Settlement) MEDICAL BILLS: TOTAL: CASE EXPENSES: TOTAL: TOTAL DEDUCTIONS: $ 614.40 $ 614.40 $ 614.40 $ 0.00 $ 0.00 $, $ 0.00 $ 0.00 $ 204.80 $ 204.80 BALANCE TO: THOMAS MABIUS ,Personal Representative of The Estate of LARRY C. MABIUS $ 409.60 I understand and acknowledge that the funds being paid to me in regard to this settlement have been maintained in a trust account in a financial institution located outside of the Commonwealth of Pennsylvania, and that settlement monies payable to me from a settling party in any future settlement, and / or monies payable to me as a result of any verdict or judgement in my case, upon receipt by the LAW OFFICES OF PETER G. ANGELOS, P.C., will be placed into such a trust account and, less attorneys' fees and expenses, will be paid thereafter to me as expeditiously as circumstances allow. I hereby give my consent to this in regard to this present settlement and in regard to all monies payable to me as a result of any future settlements, verdicts, or judgements. AND NOW, this day of I / We do hereby declare that this Settlement and Distribution Sheet has been read and is understood and approved and that the deductions for expenses and other items shown hereon are true and correct and receipt of a copy of this Settlement and Distribution Sheet is acknowledged. WITNESS WITNESS WITNESS WITNESS THOMAS MABIUS, Personal Representative of The Estate of LARRY C. MABIUS WITNESS LAW OFFICES DETER C.s. ANGELOS A PROFESSIONAL CORPORATION GOVERNOR'S PLAZA SOUTH BUILDING #3, SUITE 330 X001 N. FRONT STREET HARRISBURG, PENNSYLVANIA 17102 (717) 232-1886 FAX (717) 232-4189 (600) 283-9240 PETER G. ANGELOS rMD. D.c., rN. Nv) H. RUSSELL SMOUSE udDr M. ALBERT FIGINSKI renDl THOMAS MINKIN rMD. D.c.. TNJ EDWARD P, MONAGHAN IMD, PAr GARY J. IGNATOWSKI rMD, D.C.. TN, Nr; R, BRUCE MCELHONE IMD, PA. D.C- NYl ARMAND J. VOLTA, JR.:MD, e.c.. NY, GEORGE A. WEBER• 16 +MD. D.c., TN, pA. Nv, DAVID L. PALMER IMD. D.c.. Nn EDWARD J. LILLY tMD> PATRICIA J. KASPUTYS rMD. D.c.r BRUCE C. HILL IMD, ANDREW M. CANTOR IMD. D.C.r FREDRICK H. DURST IMD. D.C.r THOMAS C. SUMMERS rMD. O.C.! THEODORE M. FLERLAGE, JR. IMD. D.c., ROGER A. DOUMAR IMD> WILLIAM D. POLAND. JR. IPA. wv, MD. NYr CHARLES A. CANDON rMD- D.C.. TN. NYJ JOHN A. PICA, JR. rMm JAMES T- FITZGERALD rPA, NJr STEVEN W. SMITH rMD. D.C.r THOMAS P- KELLY rMD. D.C.J RONALD E. RICHAROSON rMD, D.c.. NY> BESSIE S. DEMOS <MD. D.c.1 PAUL D. RASCHKE rMD, D.c., PA> GREGORY R. SMOUSE IMD, STEPHEN J. HOLMES rMw PAUL M. MATHENY rMOr LOUIS F. ANGELOS rMD) KEITH E. HAYNES rMD, D.C., 5~,~„t~ ~, I~ , o MARY V. KOCH IMDI VASILIKI P. SZCZESNY rmD. D.c.r MICHAEL B. GILLANO rMDr GREGORY N. BUNITSKY <pA. NJ, MARY CINA CHALAWSKY rMD, D.C.1 BRIAN J. TAYLOR (pA. Nvr WILLIAM 6. MINKIN IMD. O.C., JEFFREY J. UTERMOHLE IMD, D.c., MARLO A. TROTTA rMm HELLEN P. HARLSTON IMD. NcJ FREDERIC C. HEYMAN IMD, GLENN c'. MINTZER IMD. FL. LAI SHARON L. HOUSTON rMD. NJ> ANTHONY J. COVACEVICH IMD, JAMES S. ZAVAKOS rMw CAROL A. HASTINGS IMD, COUNSEL BALTIMORE, MARYLAND BETHLEHEM•PENNSYLVANIA FANNIE ANGELOS rMD, D.C.1 TOWSON, MARYLAND PHILADELPHIA, PENNSYLVANIA NORMAN R. STONE. JR. +MDr CUMBERLAND, MARYLAND WILMINGTON, DELAWARE GEORGE L. RUSSELL, JR., P.A. +MDr KNOXV ILLE, TENNESSEE KATHLEEN D. HADLEY IDEr THUMAS V. FRIEDMAN I~929-1997J October 13, 2008 JULIUS W. LIGHTER 11934-2001) Thomas Mabius RD 1 Box 253 738 Pisgah Road Shermansdale, PA 17090 LAMONT G. McCLURE, JR IPA'r ROBERT S. PATTERSON rTN) RICHARD T, WILSON rOE) TIMOTHY MANUELIDES rMDr KATHLEEN M. BROWN rMD) JUAN CARLOS RADZINSCHI +D.C.1 JENNIFER LILLY rMbr SEAN D. BURNS rMDI JOHN KOTSATOS rrnD. NJ. pAr KARA A. HAGER mE) AMY N. BACKE NSTOSE rPA. NJ, CRAIG M. SILVERMAN rMDI JESSICA E. HAY rMD) RAYMON A. ARREOLA +PA. NJr CHRISTOPHER D. WRIGHT rMD) DANIEL P. CONNELL IMD) ERIC M. ROSENFELD cMOr RE: AC&S, Inc. Asbestos Trust -Pre-Bankruptcy Settlement Payment Estate of Larry C. Mabius Dear Mr. Mabius: ~"~nother one of file former asbestos product manufactiuer~ which this office sued in your; the Estate's asbestos personal injury case is/was AC&S, Inc., also known as ACandS and originally formed as Armstrong Contracting & Supply Co. The suit against AC&S was stayed, however, because ACandS -like numerous other companies -filed for bankruptcy protection. Now the U-S. Bankruptcy Court has approved a plan for AC&S to make payments in claims (such as yours/the Estate's} which had been submitted to ACandS for settlement prior to the bankruptcy filing. Attached to this letter is a 2-sided letter -from attorney Paul Matheny of this firm's main office in Baltimore -which further explains the AC&S bankruptcy and the calculation of your settlement payment. Please find enclosed a check in payment of yourlthe Estate's ACandS settlement. As usual, the settlement check is attached to your cony of a Settlement And Distribution Sheet. Also ONE CHARLES CENTER IDD N. CHARLES STREET 22ND FLOOR RAL TIMORE. MU 2(201-3604 (410! 649-2000 56001 252-6622 FAX (41Or 659~I760, 61.62 COURT TOWERS 210 W. PENNSYLVANIA AVENUE SUITE 150 TOWSON, MD 212045324 (4101 621-1000 FAX (4101 426-i269 III 5. GEORGE STREET UNIT 2 -CUMBERLAND, MD 21501.3087 (3011 758-2700 FAX 13011 i59-2703 ,... LAW OFFiC~= PETER G. ANGELOS October 13, 2008 Page Two RE: ACandS bankruptcy payment enclosed are (1) the original of the Settlement Sheet and (2) apostage-prepaid return envelope We ask that you please sign the original of Settlement Sheet at the red X; then please mail back the signed paper in the envelope provided. Should you have any questions, though, please do not hesitate to call. Thank you for your cooperation. I ,•,.~ , Kara A. Magaro- an Paralegal Attachment Enclosures Pr-rrx c7. _~~lc>vl~os ONE CHARLES CENTER 100 N. CHARLES STREET 22ND FLOOR BALTIMORE, MARYLAND 21201-3804 (410) 644-2000 (800) 252-b622 Pr~UL Vii. ~NATHFaIr ((U) DIRECT DIAL: (~IU) 6~9 ?OId FAX: 1-1 t0) 6~9-21 I I L-~•1AIL.: P'~lathcnu:i~ L:~~cPCi:~.tum he:.~C&S. lnc.'_~sbestos Settlement `1'rtlst. Settlement Pa~•lnent Dear Client: OTHER OFFICES: CUt•18ERLAND, MARYLAND TOWSON,MARYLAND HARRISBURG, PENNSYLVAtJI.A BETHLEHEM. PENNSYLVANIA ?HILADELPHIA, PENNSYLVANIA VdILh11NGTOtJ. DELAIYARE KNOXVILLE, TEPJNESSEE .\C&`, lnc. (.\(:&S) ~c•as an asbestos insulating contractor which recently under~vcut C:hal~ter I 1 banl:ruptcv reorganisation proceedings. Prior to .\t:~S seeking bankruptcy protection, mam- client. of the 1 ~I~y C)ftices elf 1'erer G.:\ngetos, I'.C. and other asbestos victims nation~~-ide had unpaid settlement agI"1O1.nOt1tS penclltlg ~~'itll =~C.~~.:~5 a part of the bankruptcy" procecdin7, .~CLZ~ is reyuirecl to pay their pencling settlement obligations. 1-irnvc~-er, due to ~C&S's exceedingly high asbestos liabilities, the funds available to campenslte these unpaid claims are ~-ery limited. In fact, thrcxlgh the course of the bankruptcy and through cstcnsit-e negotiations ~yith former insurers of .\(:&~, file Bankruptcy (~ourt and the _\C~:S :\sbestos Settlement ~l•rust ~1•nistce ha~-c deternuncd there arc only sufftcienr assets to pay 5.'b° o of the outstanding, unpaid asbestos Sf:ttIC1nC:11IJ. '1'hercfore, cnclosrd please ftnd settlement and distributicnT sheets and the settlement check in paylncnt of the .\C&S pre-l~anknlptc~" settlement for your case- Please sign the settlement and disrril)ution sheet, hate your si~manlre il-itnessed and return the signed original in the postage prepaid envelop pravidecl. The settlement and distribution sheet marked "copt•" Ittat• be retained for your records. •1'he amount v~u are receiving represents your former scttlctncnt value, plus a sequencing adjustment of 30°'0 of that ~-aloe:, times the pa~•ment percentage of ~.~8°. f,. Sec the reverse side of this letter for the formula etpressing the gross settlement for }-our :\C~~S claim. Should you have all\" C1LEe'titl(lIl~ C(>I1CCrIllllg tlll> settlement please do not hl.'S1C:ItC to call Ilte lianl-ruprcy Status I~epartmcnt or me at -11Q-G49-?0()(l. Very truly yours, _---- ,. ~;, _ Paul ~f. illatheuv 1';\1~\1 COURT TOWERS - _'lii \\ .PENNSYLVANIA AVENUE -SUITE li~~ TOWSUN, MD 212U~F-i32~(- (a10) S2l-lUOU -FAX (a 10) a2G-I?G9 111 5. GEORGE STREET - UNIT- CUMBERLAND, MD 2L501-3D~? - (301) 739-?700 -FAX (30q 7~9-?703 LAW OFFICES OF PETER G. ANGELOS SETTLEMENT AND DISTRIBUTION SHEET COPY THOMAS MABIUS ,Personal Representative of The Estate of LARRY C. v. AC&S MABIUS SETTLEMENT: AC&S TOTAL: ATTORNEY'S FEE: (33.33% of Settlement) MEDICAL BILLS: TOTAL: CASE EXPENSES: TOTAL: TOTAL DEDUCTIONS: 171-28-4267 PA54679 100% E Check No.: 811379 $ 435.81 $ $ 435.81 $ 435.81 $ 145.27 $ 0.00 $ 0.00 $ u.uo $ o.oa $ $ $ o.oo $ o.oo $ 145.27 BALANCE TO: THOMAS MABIUS Personal Representative of The Estate of LARRY C. MABIUS $ 290.54 I understand and acknowledge that the funds being paid to me in regard to this settlement have been maintained in a trust account in a financial institution located outside of the Commonwealth of Pennsytvan'sa, and that settlement monies payable to me from a settling party in any future settlement, and / or monies payable to me as a result of any verdict or judgement in my case, upon receipt by the LAW OFFICES OF PETER G. ANGELOS, P.C., will be placed into such a trust account and, less attorneys' fees and expenses, will be paid thereafter to me as expeditiously as circumstances allow. I hereby give my consent to this in regard to this present settlement and in regard to all monies payable to me as a result of any future settlements, verdiCis, or judgemen#s. AND NOW, this day of I ! We do hereby declare that this Settlement and Distribution Sheet has been read and is understood and approved and that the deductions for expenses and other items shown hereon are true and correct and receipt of a copy of this Settlement and Distribution Sheet is acknowledged. WITNESS THOMAS MABIUS, Personal Representative of The Estate of LARRY C. MABIUS WITNESS WITNESS WITNESS WITNESS i~A1~~: vFrICE_~ C?f= PETER ~. Af~~~LG~~_, r G. ~ ~~,~~~~:~ ~ ~ ~ ~ ~ ~x :'tr~.•~ ~.~~f1,~?1 I Qf~iL~~' ~'~*'.~.~~~. ~ t~'~~~it~. ~i~~ f ,; ~ti `~20.t55'J-~5'1rj ~r~ P3. C'riARt~S ST. "'` ~t~o tiunr~red ~iinet~t and 5l?Q~J ~nFiaE~ na=~ ,,~~~:~„ 1~~06r'20~8 29u:54 iG TI !y of°`~ iNQ~4~xS ~ti~~~EJS. P¢tsanal ~ec~ esentatr<re of fie.~s:ate'ai i_i~~KY C ;.FABIUS ~~ 1 Edx ?53 ::--- ~herrna;tsdaie. PA 11t~~i~ `--~ %~ t , `.j= ~.~~~--'-- ~-~-~: ,.~ _ ~:: .~ ~ h~ `L~-----____- ,~~~•z[n siGS.~,~ ~ ;;L~~ffi3?~ss~ ~v05500320~~~20~~~iu3~~40~5«~ LAW OFFICES PETER G. ANGELOS A PROFESSIONAL CORPORATION GOVERNOR'S PLAZA SOUTH BUILDING #3, SUITE 330 2001 N. FRONT STREET HARRISBURG, PENNSYLVANIA 17102 1717) 232-1886 FAX 1717) 232-4189 1800) 283-9240 PETER G. ANGELOS IMD. D.C_ TN. NV1 H. RUSSELL SMOUSE IMDI M. ALBERT FIGINSKI IMDI THOMAS MINKIN IMD. D.G. TNI EDWARD P. MONAGHAN IMD. PAI GARY J. IGNATOWSKI IMD. D.G. TN. NVl R. BRUCE MCELHONE IMD. PA. D.C.. NVr ARMAND J. VOLTA, JR. IMD. D.C.. Nn GEORGE A. WEBER, III IMD. C,G, TN. PA. Nv~ DAVID L. PALMER II-0D. D.C.. r:vl EDWARD J. LILLY IMD! PATRICIA J. KASP UTYS IMD. D.C! BRUCE C HILL IMDI ANDREW M. CANTOR.r-+r.. D.C.+ FREDRICK H. DURST .MC. D.c.l THOMAS C. SUMMERS IMD. D.c.~ THEODORE M. FLERLAGE. JR. IMD. D.C.1 ROGER A. DOUMAR IMDI WILLIAM D. POLAND. JR. IPA. wv. MD. Nr1 CHARLES A. CANDON IMD. D.c.. TN, Nn JOHN A. PICA. JR. IMD] JAMES T. FITZGERALD IPA. NJt STEVEN W. SMITH IMD. D.cJ THOMAS P. KELLY IMO.D.c.r RONALD E. RICHARDSON IMD. D.C.. NYI BESSIE S. DEMOS IMD. D.c.r PAUL D. RASCHKE IMD, D.C.. PAr GREGORY R. SMOUSE IMDI STEPHEN J. HOLMES IMO) PAUL M. MATHENY IMD+ LOUIS F. ANGELOS IMDI KEITH E. HAYNES IMD, D.C,r MARY V. KOCH IMDI VASILIKI P. SZCZESNY IMD. D.C.I MICHAEL B. GILLAND IMD) GREGORY N. BUNITSKV IPA. NJr MARY CINA CHALAWSKY IMD, D.C.1 BRIAN J. TAYLOR IPA. Nn WILLIAM G. MINKIN IMD. D.C.I JEFFREY J. UTERMOHLE IMD. D.C-1 MARLO A. TROTTA IMDI HELLEN P. HARLSTON IMD. NCI FREDERIC C. HEYMAN IMDr MATT R. BALLENGER IMDr GLENN E. MINTZER IMD. FL, LAI SHARON L HOUSTON IMD. D.C.. NJI ANTHONY J. COVACEVICH IMOI JAMES 5. ZAVAKOS IMDI CAROL A. HASTINGS IMDI LAMONT G. McCLURE, JR IPA, NYr ROBERT S. PATTERSON It NI COUNSEL BALTIMORE, MARYLAND BETHLEHEM, PENNSYLVANIA FANNIE ANGELOS IMO. o-c.r TOWSON, MARYLAND PHILADELPHIA, PENNSYLVANIA NORMAN R. STONE, JR. IMDI CUMBERLAND, MARYLAND WILMINGTON, DELAWARE GEORGE L. RUSSELL. JR.. F.A. IMO1 KNOXVILLE. TENNESSEE KATHLEEN D. HADLEV ~DEI THOMAS V. ERIE DMAN 11529-19971 January 23, 2009 JULIUS W. LIGHTER 11934-zOOn Thomas Mabius, Executor of the Estate of Larry C. Mabius RD 1, Box 253 738 Pisgah Road Shermansdale, PA 17090 RICHARD T. WILSON IDEI TIMOTHY MANUELIDES IMD+ KATHLEEN M. BROWN IMDI JUAN CARLOS RADZINSCHI ro.c.l JENNIFER L. LILLY IMD. Nb SEAN D. BURNS IMDI JOHN E. KOTSATOS IMD. NJ. PAI KARA A. HAGER IDE+ AMV H. BACKS NSTOSE IPA. NJI CRAIG M. SILVER MAN IND. CC.1 JESSICA E. HAY IMDI RAMON A. ARREOLA IPA. NJI CHRISTOPHER D. WRIGHT IMDI DANIEL P. CONNELL IMD+ ERIC M. ROSE NF ELD IMDI JOSHUA L. CAPLAN IMDI GE METRtO.Gi A. KARAS IMDI RE: Owens Corning/Fibreboard Asbestos Personal Injury Trust Pre-Bankruptcy Settlement Payment Estate of Larry C. Mabius, a/k/a Charles L. Mabius Dear Mr. Mabius: On October 5, 2000, Owens Corning/Fibreboard (OC/FB) petitioned for bankruptcy relief in the United States Bankruptcy Court of the District of Delaware. Prior to OC/FB filing for bankruptcy they had agreed to settle your and your late brother's asbestos personal injury claim. Unfortunately, due to the bankruptcy, the claim on behalf of your late brother's estate has remained unpaid. Last summer OC/FB emerged from bankruptcy with a confirmed Plan of Reorganization (the Plan). As a part of the Plan, OC/FB was required to form a settlement trust [the Owens Corning/Fibreboard Asbestos Trust (OC/FB Trust) J to compensate the persons injured by exposure to asbestos products manufactured by Owens Corning and/or Fibreboard. Under the Trust Distribution Procedures of the Plan, claimants identified as having "pre-petition liquidated ONE CHARLES CENTER 100 N. CHARLES STREET Z2ND FLOOR BALTIMORE. MD 21201.3804 1a 101649-2000 IBO01 252-6622 FAX (4101659-I]BO. 81. 62 COUFT TOWERS 2l0 W. PE NNSVLVANIA AVENUE SUITE ISD TOWSON. MD 2r20a-5324 (4101 821-1000 FAX (4101 4 26-1 269 III 5. GEORGE STREET • UNIT 2 CUMBERLAND. MD 21501-306'( 13011 759-2700 FAX 13011 759-203 LAW CiFF~CES f ETER G. ANGELOS Thomas Mabius January 23, 2009 Page T~vo RE: Owens Corning bankruptcy payment Estate of Larry C. Mabius claims" (such as you and the Estate) may have their claims paid at the current payment percentage (40% for Owens Corning liability, and 25% for Fibreboard liability) without having to have their claims reevaluated by the OC/FB Trust. This will result in claimants, including you and the Estate, receiving compensation much faster than claimants who are required to have their claims newly evaluated under the Trust Distribution Procedures. We are pleased to inform you that the Estate's pre-bankruptcy settlement agreement with Owens Corning has been approved for payment. Therefore, enclosed please find a check in payment of the Estate's outstanding settlement, which includes a calculation of interest from the date that Owens Corning filed for bankruptcy. As mentioned above, the checks which the Estate is receiving represent 40% of the pre-bankruptcy settlement amount. As usual, the Estate's settlement check is attached to your copy of a Settlement And Distribution Sheet. Also enclosed are (A) the original of the Settlement Sheet and (B) a postage-prepaid return envelope. We ask that you please sign the original of the Settlement Sheet at the red X; then please mail back the signed paper in the envelope provided. Should you have any questions, though, please do not hesitate to call. Thank you for your cooperation. Y, Paul M: M PMM/lmb Enclosures COPY: Susan E. Lederer, Esq. ~~r~~:. LAW OFFICES OF PETER G. ANGELOS 171-28-4267 COPY SETTLEMENT AND DISTRIBUTION SHEET PA54679 100% E Check No.: 843283 THOMAS MABIUS ,Personal Representative of The Estate of LARRY C. v. OWENS CORNING BANKRUPTCY SETTLEMENT MABIUS SETTLEMENT: OWENS CORNING BANKRUPTCY SETTLEMENT TOTAL: ATTORNEY'S FEE: MEDICAL BILLS: TOTAL: CASE EXPENSES: TOTAL: TOTAL DEDUCTIONS: (33.33% of Settlement) $ 9,291.84 $ 9,291.84 $ 9,291.84 $ 3,097.28 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 3.097.28 BALANCE TO: THOMAS MABIUS ,Personal Reeresentative of The Estate of LARRY C. MABIUS $ 6.194.56 I understand and acknowledge that the funds being paid to me in regard to this settlement have been maintained in a trust account in a financial institution located outside of the Commonwealth of Pennsylvania, and that settlement monies payable to me from a settling party in any future settlement, and / or monies payable to me as a result of any verdict or judgement in my case, upon receipt by the LAW OFFICES OF PETER G. ANGELOS, P.C., will be placed into such a trust account and, less attorneys' fees and expenses, wilt be paid thereafter to me as expeditiously as circumstances allow. I hereby give my consent to this in regard to this present settlement and in regard to all monies payable to me as a result of any future settlements, verdicts, or judgements. AND NOW, this day of I / We do hereby declare that this Settlement and Distribution Sheet has been read and is understood and approved and that the deductions for expenses and other items shown hereon are true and correct and receipt of a copy of this Settlement and Distribution Sheet is acknowledged. WITNESS WITNESS WITNESS WITNESS WITNESS THOMAS MABIUS, Personal Representative of The Estate of LARRY C. MABIUS LAW OFFICES PETER G. ANGELOS A PROFESSIONAL CORPORATION GOVERNOR'S PLAZA SOUTH BUILDING #3, SUITE 330 2001 N. FRONT STREET HARRISBURG, PENNSYLVANIA 17102 (717) 232-1886 FAX f7L7) 232-4189 (800) 283-9240 PETER G. ANGELOS IMD. D.C.. TN. NVI H. RUSSELL SMOUSE :MDI M. ALBERT FIGINSKI IMDI THOMAS MINKIN IMD, D.c.. TNI EDWARD P. MONAGHAN IMD. PA) GARY J. iGNATOWSKI IMD. D.C.. TN, NY) R. BRUCE MCELHONE IMD. PA. D.C.. NYl ARMAND J. VOLTA, JR. IMD. D.C.. Nn GEORGE A. WEBER, III IMD. D.C.. TN, PA, NY/ DAVID L. PALMER IMD. D.C.. NYI EDWARD J. LILLY IMDI PATRICIA J. KASPU7Y51MD. D.C.1 BRUCE C. HILL IMDI ANDREW M. CANTOR .MD. o.c.l FREDRICK H. DURST IMD. D.CJ THCMAS C. SUMMERS :eaD, D.e.l THEODORE M. FLERLAGE. JR. IMO, D.c.) COUNSEL FANNIE ANGELOS IMD. D.c.l NORMAN R. STONE, JR. IMDI GEORGE L. RUSSELL, JR., P.A. IMDI KATHLEEN D. HADLEY IDEI THOMAS V. FRIED MAN 11929-1997) JULIUS W. LIGHTER 1 1934-2001) Thomas Mabius RD 1, Box 253 738 Pisgah Road Shenmansdale, PA 17090 ROGER A. DOUMAR IMDI WILLIAM D. POLAND, JR. IPA, wv, MD. Nv, CHARLES A. CANDON :MD. D. C., TN. NYl JOHN A. PICA, JR.:MD, JAMES T. FITZGERALD IPA. NJ> STEVEN W. SMITH IMD. D.c.) THOMAS P. KELLY IMD. D.c.) RONALD E. RIC HARDSON IMD. D.C.. NVI BESSIE S. DEMOS IMD. o.c.l PAUL D. RASCHKE :Me. D.c.. PAI GREGORY R. SMOUSE :MO/ STEPHEN J. HOLMES IMDI PAUL M. MATHENY IMCI LOUIS F. ANGELOS:MC_I KEITH E. HAYNES IMD. D.C.I MARY V. KOCH IMDI VASILIKI P. SZCZESNY IMD. D.c.l MICHAEL B. GILLAND IMDI GREGORY N. BUNITSKY IPA, NJI MARY CINA CHALAWSKY IMD, D.C.I BRIAN J. TAYLOR IPA, Nvl WILLIAM G. MINKIN IMD. D.c.l JEFFREY J. UTERMOHLE IMD. D.C.1 MARLO A. TROTTA IMDI HELLEN P. HARLSTON IMD. NCl FREDERIC C. HEYMAN .Ma MATT R. BALLENGER IMD) GLENN E. MINTZER IMD, FL LAI SHARON L. HOUSTON :MD. D.C.. NJ) ANTHONY J. COVACEVICH IMD: JAMES S. ZAVAKOS IMDI CAROL A. HASTINGS IMDI LAMONT G. McCLURE. JR IPA, NYI ROBERT S. PATTERSON ITNI BALTIMORE, MARYLAND BETHLEHEM, PENNSYLVANIA TOWSON, MARYLAND PHILADELPHIA, PENNSYLVANIA CUMBERLAND, MARYLAND WILMINGTON, DELAWARE KNOXVILLE, TENNESSEE February 6, 2009 RE: Westinghouse Corp. Settlement Payment Estate of Larry C. Mabius, a/k/a Charles L. Mabius Dear Mr. Mabius: RICHARD T. WILSON IDEI TIMOTHY MAN UELIDES IMDI KATHLEEN M. BROWN IMD) JUAN CARLOS RADZINSCHI ID.cJ JENNIFER L. LILLY IMD. Ncl SEAN D. BURNS IMD) JOHN E. KOTSATOS IMD. NJ, PAI KARA A. HAGER IDEI AMY H. BACKE NSTOSE IPA. NJr CRAIG M. SILVERMAN IMD. D.C.1 JESSICA E. HAY IMDI RAMON A. ARREOLA IPA, NJI CHRISTOPHER D. WRIGHT IMDI DANIEL P. CON NELL IMD> ERIC M. ROSENFELD IMDI JOSHUA L. GAPLAN IMDI DEMETRIOS A. KARAS IMDI You will recall that, within the past few months, we sent you, as Personal Representative of your late brother's Estate, a Release for a settlement with the Westinghouse Electric Corp., now a subsidiary of CBS Corp. This office now has received the Estate's settlement payment from Westinghouse and, as a result, we are writing now to enclose to you the net proceeds. Please find enclosed the following: A check to you as Personal Representative of your late brother's Estate, attached to your cOpy of a Settlement and Distribution Sheet. 2. The original of the Settlement Sheet. 3. Apostage-prepaid return envelope. ONE CHARLES CENTER 100 N. CHARLES STREET 22ND FLOOR BALTIMORE, MD 21201-380a (a 101 649.2000 1800) 252-6622 FAX 14101 659-1780. Bi. B2 COURT TOWERS 210 W. PENNSYLVANIA AVENUE SUITE 150 TOWSON, MD 21204-5324 1410) 821-1000 FqX (a 101 426.1269 III 5. GEORGE STREET UNIT 2 CUMBERLAND, MD 21501-3087 (3011 759-2700 FAX 1301) 759-2703 LAW OFFICES PETER G. ANGELOS Thomas Mabius February 6, 2009 Page Two RE: Westinghouse settlement payment Please sign your name on the original Settlement Sheet at the red X; then please mail back the signed paper in the envelope provided. If you have any questions, though, please call our office at 232-1886 or use our toll-free number 1-800-283-9240. Thant: you, as always, for your cooperation. Sincerely, `~~~ " /' Andrea Rowe-Heddings Paralegal Enclosures Copy: Susan E. Lederer, Esquire ,... COPY THOMAS MABIUS ,Personal Representative of The Estate of LARRY C. MABIUS SETTLEMENT: Westinghouse TOTAL: ATTORNEY'S FEE: (33.33% of Settlement) MEDICAL BILLS: TOTAL: CASE EXPENSES: TOTAL: TOTAL DEDUCTIONS: LAW OFFICES OF PETER G. ANGELOS SETTLEMENT ANO DISTRIBUTION SHEET v. Westinghouse 171-2a-4267 PA54679 100% E Check No.: 844904 $ 750.00 $ 750.00 $ 750.00 $ 250.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 250.00 BALANCE TO: THOMAS MABIUS .Personal Representative of The Estate of LARRY C. MABIUS $ 500.00 I understand and acknowledge that the funds being paid to me in regard to this settlement have been maintained in a trust account in a financial institution located outside of the Commonwealth of Pennsylvania, and that settlement monies payable to me from a settling party in any future settlement, and / or monies payable to me as a result of any verdict or judgement in my case, upon receipt by the LAW OFFICES OF PETER G. ANGELOS, P.C., will be placed into such a trust account and, less attorneys' fees and expenses, will be paid thereafter to me as expeditiously as circumstances allow. I hereby give my consent to this in regard to this present settlement and in regard to all monies payable to me as a result of any future settlements, verdicts, or judgements. AND NOW, this day of I / We do hereby declare that this Settlement and Distribution Sheet has been read and is understood and approved and that the deductions for expenses and other items shown hereon are true and correct and receipt of a copy of this Settlement and Distribution Sheet is acknowledged. WITNESS WITNESS WITNESS WITNESS THOMAS MABIUS, Personal Representative of The Estate of LARRY C. MABIUS WITNESS LAW OFFICES PETER G. ANGELOS A PROFESSIONAL CORPORATION GOVERNOR'S PLAZA SOUTH BUILDING #3, SUITE 330 2001 N. FRONT STREET HARRISBURG, PENNSYLVANIA 17102 1717) 232-1886 FAX (717) 232-4189 (800) 283-9240 PETER G. ANGELOS IMD. D.C.. TN. NYr H. RUSSELL SMOUSE IMDI M. ALBERT FIGINSKI IMDI THOMAS MINKIN rMD. O.C.. Tw EDWARD P. MONAGHAN IMD. PA) GARY J. IGNATOWSKI IMD. D. C.. TN, NVI R. BRUCE MCELHONE IMD. PA. D.C.. NYI ARMAND J. VOLTA. JR. IMD. D.c.. Nn GEORGE A. WEBER, III IMD, D.C.. TN. PA. NYI DAVID L. PALMER IMD, D.C.. NY) EDWARD J. LILLY IMDr PATRICIA J. KASPUTYS rMD, D.C.r BRUCE C. HILL IMm ANDREW M. CANTOR IMO. D.C.~ FREDRICK H. DURST rMD. D.c.r THOMAS C. SUMMERS IMD. D.C.I THEODORE M. FLERLAGE, JR. IMD, D.C.1 COUNSEL FANNIE ANGELOS IMO, D.C.1 NORMAN R. STONE, JR. IMDI GEORGE L. RUSSELL, JR., P.A. IMDI KATHLEEN D. HADLEY roEr THOMAS V. FRIEDMAN 11929-19971 JULIUS W. UCHT ER 1 I g34-20C I ) Estate of Larry Mabius c/o 'Thomas Mabius RD 1, Box 253 738 Pisgah Road Shermansdale, PA 17090 ROGER A. DOUMAR IMD, WILLIAM D. POLAND, JR. IPA, wv. Mo. Nv1 CHARLES A. CANDON IMD. D.c., rN. Nn JOHN A. PICA, JR. rMD, JAMES T. FITZGERALD IPA. NJI STEVEN W. SMITH IMO. D.c.r THOMAS P. KELLY IMD. D.C.1 RONALD E. RICHARDSON IMD. D.C.. Nv> BESSIE 5. DEMOS IMD. D.c., PAUL D. RASCHKE IMD. D.C.. PAr GREGORY R. SMOUSE IMD) STEPHEN J. HOLMES rMD, PAUL M. MATHENY rMD, LOUIS F. ANGELOS IMDr KEITH E. HAYNES IMD. o.c.l MARY V. KOCH IMDr VASILIKI P. SZCZESNY IMD. D.CJ MICHAEL B. GILLAND IMDr GREGORY N. BUNITSKY IPA. NJ1 MARY CINA CHALAWSKY rMD. D.C.r BRIAN J. TAYLOR IPA, NY) WILLIAM G. MINKIN IMD. O.C., JEFFREY J. UTERMOHLE IMO. D.c.l MARLO A. TROTTA IMDI HELLEN P. HARLSTON IMD. NCI FREDERIC C. HEYMAN IMDr MATT R. BALLENGER IMDI GLENN E. MINTZER IMD. FL. Ur SHARON L, HOUSTON IMD. D.C., NJI ANTHONY J. COVACEVICH IMDI JAMES S. ZAVAKOS IMDr CAROL A. HASTINGS tMw LAMONT G. MCCLURE, JR IPA, Nn ROBERT 5. PATTERSON rtro BALTIMORE, MARYLAND BETHLEHEM, PENNSYLVANIA TOWSON, MARYLAND PHILADELPHIA, PENNSYLVANIA CUMBERLAND, MARYLAND WILMINGTON, DELAWARE KNOXVILLE, TENNESSEE March 13, 2009 RICHARD T. WILSON IDEI TIMOTHY MANUELIDES IMDI KATHLEEN M. BROWN IMDr JUAN CARLOS RADZINSCHI ID.C.1 JENNIFER L. LILLY IMD. NO SEAN D. BURNS IMDI JOHN E. KOTSATOS IMD. NJ. PAI KARA A. HAGER IDEI AMY H. BACKENSTOSE rPA. NJI CRAIG M. SILVERMAN IMD. D.C.1 JESSICA E. HAY IMDr RAMON A. ARREOLA IPA. NJr CHRISTOPHER D. WRIGHT rMDr DANIEL P. CONNELL IMDr ERIC M. ROSENFELD IMDr JOSHUA L. CAPLAN rMD1 DE METRIOS A. KARAS IMDr RE: Armstrong World Industries Asbestos Personal Injury Trust Pre-Bankruptcy Settlement Payment Estate of Larry C. Mabius, a/k/a Charles L. Mabius Dear Mr. Mabius: Another one of the former asbestos product manufacturers which this office sued, or attempted to sue, in your late brother's asbestos personal injury case is/was Armstrong World Industries, more commonly known simply as Armstrong. The suit against Armstrong was stayed, however, because Armstrong -like numerous other companies -filed for bankruptcy protection. Now the U.S. Bankruptcy Court (in Delaware) has approved a plan for Armstrong to make payments in claims (such as yours) which had been submitted to Armstrong for settlement prior to the bankruptcy filing. According to the plan approved by the Bankruptcy Court, your/the Estate's pre-bankruptcy settlement with Armstrong will be paid at the current payment percentage of 20%. Therefore, enclosed please find a check in payment of your or the Estate's outstanding CNE CHARLES CENTER 100 N. CHARLES STREET 22ND FLOOR BALTIMORE, MO 21201-3604 14101 649-2000 18001 252-6622 FAX 1410) 689-1760, BI, B2 COURT TOWERS 210 W. PENNSYLVANIA AVENUE SUITE i50 TOWSON, MD 21204-5324 14101 821-1000 FAX X4101 426.1269 I I 1 S. GEORGE STREET UNI? 2 CUMBERLAND, MD 21501-30x7 1301) X59-200 FAX 13011 759-2703 . _' LAW OFFICES PETER G. ANGELOS Thomas Mabius March 13, 2009 Page Two RE: Armstrong World Industries bankruptcy payment settlement. As usual, your settlement check is attached to your copy of a Settlement And Distribution Sheet. Also enclosed are (1) the original of the Settlement Sheet and (2) a postage-prepaid return envelope. We ask that you please sign the original of Settlement Sheets at the red X; then please mail back the signed paper in the envelope provided. Should you have any questions, though, please do not hesitate to call. Thank you for your cooperation. Sincerely, ~~ /~ J~ Paul M. Matheny PMM/km-I Enclosures Copy: Susan E Lederer, Esquire i~ ~~, . LAW OFFICES OF PETER G. ANGELOS 171-28-4267 SETTLEMENT AND DISTRIBUTION SHEET PA54679 100% E Check No.: 851438 THOMAS MABIUS ,Personal Representative of The Estate of LARRY C. v. ARMSTRONG WORLD INDUSTRIES MABIUS SETTLEMENT: ARMSTRONG WORLD INDUSTRIES TOTAL: ATTORNEY'S FEE: (33.33% of Settlement) MEDICAL BILLS: TOTAL: CASE EXPENSES TOTAL: TOTAL DEDUCTIONS: $ 2,655.13 $ 2.655.13 $ 2.655.13 $ 885.04 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 885.04 BALANCE TO: THOMAS MABIUS .Personal Representative of The Estate of LARRY C MABIUS $ 1,770.09 I understand and acknowledge that the funds being paid to me in regard to this settlement have been maintained in a trust account in a financial institution located outside of the Commonwealth of Pennsylvania, and that settlement monies payable to me from a settling party in any future settlement, and / or monies payable to me as a result of any verdict or judgement in my case, upon receipt by the LAW OFFICES OF PETER G. ANGELOS, P.C., will be placed into such a trust account and, less attorneys' fees and expenses, will be paid thereafter to me as expeditiously as circumstances allow. I hereby give my consent to this in regard to this present settlement and in regard to all monies payable to me as a result of any future settlements, verdicts, or judgements. AND NOW, this day of I / We do hereby declare that this Settlement and Distribution Sheet has been read and is understood and approved and that the deductions for expenses and other items shown hereon are true and correct and receipt of a copy of this Settlement and Distribution Sheet is acknowledged. WITNESS WITNESS WITNESS WITNESS THOMAS MABIUS, Personal Representative of The Estate of LARRY C. MABIUS WITNESS S~u~ ~ , ~-~. 1 z{ ^'"""'"~ LAW OFFICES PETER G. ANGELOS A F'LZOFESSLONAL CORI'ORATTON GOVERNOR'S PLAZA SOUTH BUILDING #3, SUITE 330 2001 N. FRONT STREET HARRISBURG. PENNSYLVANIA 17102 (717) 232-1886 FAX fJ 17) 232-4189 !800) 283-9280 PETER G. ANGELOS !MD. D.C..7N.NY1 ROGER A. DOUMAR IMD1 MICHAEL B. GILLANDIMDr RICHARD T. WILSON !DE. H. RUSSELL SMOUSE IMm WIILIAMD. POLAND, JR. !PA, wY. MD, Nn GREGORY N. BUNITSKY a>A. NJI TIMOTHY MANUELIDES rMOi M. ALBERT FIGINSKI <Nm CHARLES A. CANDON !MO, D.C..TN, N» MARY CINA.CHALAWSKY !MO.D.C.) KATHLEEN M. BROWN IMD1 THOMAS MINKIN !MD, O.c.. rw JOHN A. PICA, JR. am ~ BRIAN J. TAYLORIPA, Nn JUAN GARLOS RADZINSCHI Io.c.1 EDWARD P, MONAGHAN IMD, PA1 JAMES T. FiTZGERALD IPA. NJ) WILLIAM G. MINKIN IMO. D.CJ JENNIFEP. L. LILLY !ND. NG GARY J, IGNATOWSKI .MD. D.c.. TN, NvI STEVEN W. SMITH IMD. D.c7 JEFFREY J: UTERMOHIE-IMD.D.c:) SEAN D. BVRNS wm R. BRUCEMCELHONE !MD. PA, ac_Nn THOMAS P. KELLY !MO. D.C.r MARLO A. TRGTTA+Mm JOHN E. KOTSATOS!ND. NJ. PAI ARMAND J. VOLTA, .iR. Iraa. D.C.. NY) RONALD £. RICHAROSON IMD,-D-L., x+Yl: ~ H~LLEN P. HARLSTON MD: Nd KARA A. HAGER IGE1 G£ORG£ A. WEBER, 171 wD, D.c.. rN, Pw,N» BESSI£ S. DEMOS +MO. D.c.l FREOERlC C. HEYMAN +MD: AMY H. BACKENSTOSE rPA NJ) DAViD L. PALMEP IMD. o.c.. Nn PAUL D. RASCHKE 1MC,D.c.. PAI MATT R:'9AlLENGER <MOl CRAIG M. SIWERMAN :.!D. D c.: EDWARD J. LILLY IMm GREGORY R. SMOUSEtMm GLENN' E..MINTZER IMD. FL. w JESSICA{. HAY 1Mm PATRICIAJ. KASPUTYS rMO, O.C_1 STEPHEN J. HOLMES INm SHARON~L. HOUSTONtMgo.O„ NJ! RAMON A. ARREOLA iPA, NJ+ BRUCE C. HILL 1Mm PAUL M. MATNENY !Mm ANTHONY J. COVACEVICH IMm CHRISTOPHER D. WRIOHT !MD) ANDREY! M. CANTOR IMD. c.a) LOUIS F. ANGELOS 1Mm JAMES S. ZAVAKOS-1Mm DANIEL P. CONNELL IMO) FP=DP3CKFi, DURST tMD, D.:•.r KE:TH E. HAYNE5 wD. D.c.> CAROL A. HASTINGS IMm ERIC M. ROSENFELD tram -+C~>e: 5 C 5UrSe~ii5 vMD. D.C.r W.At7Y V. KOCH !ke, IAMANT G. MCCtURE, JP IPa, Nn JOSHUA L. CAPi_4N !Mm :;°:.!'Ji°~ v. = ih~j'£..~s. a5~fi.,2.=C ~ '.+A:SfL7He o. 5?.-ZES'd" ,M~-.. v:C.s RC•)S'fRT a:.3>A"TERSCN ,rN! D£METRIGS A. K:1RPS IMCt _. CGUNSEL BALTIMORE, MARYLAND BETHLEHEM, FENNSYI.VANIA FANNIE ANv£LOS IMD. D.E.1 TOWSON, MARYLAND PHILADELPHIA, PENNSYLVANIA NORMAN R. STONE, JR. uem CUMBERLAND, MARYLAND WILMINGTON,D£LAWARE GEORGE L. RUSSELL, JR., P.A. 1Mm KNOXVILLE, TENNESSEE KATHLEEN D. HADLEV !0E1 ! THOMAS V, FRIEDMAN 11929.1997) JL,LILIS W. LIGHTER April 1, 2009 1193a•200!7 e Thomas Mabius RD 1, Box 253 73:8 Pisgah Road Shermansdale, PA 1'7090 12E: United States Gypsum (LJSG} Asbestos Personal Injury Trust Inte rest Payment on previous receipt of settlement-money ( Estate of Larry C. Mabius ~ Dear Mr. Mabius: You will recall that within the past several months you/ the Estate received a check from us for a settlement with the`bankruptcy trust overseeing the bankruptcy of the former United States Gypsum Company, also known as i7:S. Gypsum and/or USG, in the asbestos litigation of the-above-referenced decedent. The U.S. Bankruptcy'Court also required the U.S. Gypsum to pay you/ the Estate the equivalent of "interest" from the'time the settlement had been approved until the time payment was issued. That payment - .called a "Sequencing Adjustment" but actually in the nature of "interest" - now has been issued 6y the U.S. Gypsum Trust. Therefore, enclosed'please find a check in payment of yourfthe Estate's outstanding "sequencing-adjustment." As usual, the settlement check is attached to your cony of a Settlement And Distribution Sheet. Also enclosed are {1) the original of fhe Settlement Sheet and (2} apostage-prepaid return envelope. 'ONE CHARLES CENTER • 100-N..CHARLES 6TREET • 22ND FLOOR • BALTIMORE. ND 21201J60a •'Ial O)'6a9-2000 • 1800) 232.662E • FAX 1410) 66D•171~0. 67,82 COURT TOWEgS• 210 W. PENNSYLVANIA AVENUE • SUITE 160 • TOW60N-,Mq 21201-332a 1a 101981.1000 • FAX fni0)426.1269 i.I r9.JGEORGE STREF_7 • UNIT 2 • CUMBERLAND: MD 21501-9067 •a30U769-27.00 • FAX.t30U 7692703 L4W OFFICES PETER G. ANGELOS April 1, 2009 Page Two ItE: U.S. Gypsum Co._ "Sequencing adjustment" payment As always, we ask that you please sign the original of Settlement Sheet at the red_X; then please mail back the signed paper in the envelope provided. Please Note that, because this payment is characterized as a "sequencing adjustment," there are no tax reporting ~ requirements. Should you have any questions, please do not hesitate to call. Thank you for your inn. ~. Sincerely, 4 Paul M: Matheny PMM/km-1 Enclosures. LAW OFFICES OF PETER G. ANGELOS 171-28-4267 SETTLEMENT AND DISTRIBUTION SHEET PA54679 JPY 1. ~fOMAS MABIUS ,Personal Representative of The Estate of LARRY C. ~NABIUS SETTLEMENT: U.S. GYPSUM CO. SEQUENCING ADJUSTMENT TOTAL: ATTORNEY'S FEE: (33:33% of Settlement) TOTAL: CASE EXPENSES: TOTAL: TOTAL DEDUCTIONS: 100% E check No.: 854248 v. U.S. GYPSUM CO. SEQUENCING ADJUSTMENT $ 706.63 $ $ 706.63 $ 706:63 $ 235.54 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ $ $ 0.00 $ 0.00 $ 235.54 BALANCE TO: THOMAS MABIUS Personal Reareaentatlve of The Estate of LARRY C MABIUS $ _ 471.D9 I understand and acknowledge that the funds being paid to me in regard to this settlement have been maintained in a trust account in a financial institution located outside ofthe-Commonwealth of Pennsylvania, and that°settlement monies payable to me from a settling party in any future settlement, and / or monies payable to me as a result ofany-verdict or judgement in my case, upon receipt by the LAW OFFICES OF PETER G. ANGELOS, P.C., will be placed into such a trust account and, less--attorneys' fees and expenses; will be paid thereafter to me as expeditiously as arcumstances allow. i hereby give my consent to this in regard 1o this present settlement ' and m regard 1o all monies .payable to me as a resultt of any future settlements, verdicts, or judgements. AND NOW, this day of I / We do hereby deGare that this Settlement and Distribution Sheet has been read°and is understood and approved and thanthe deductions for expenses and other items shown hereon are true and correct and receipt of a copy of this Settlement and Distribution !Sheet is acknowledged. WITNESS WITNESS THOMAS'MABIUS, Personal :Representative of The Estate of LARRY C. MABIUS WITNESS WITNESS WITNESS LAW OFFICES PETER G. ANGELOS A PROFESSIONAL CORPORATION GOVERNOR'S PLAZA SOUTH BUILDING #3, SUITE 330 2001 N. FRONT STREET HARRISBURG, PENNSYLVANIA 17102 (717) 232-1886 FAX (7171 232-4189 (8001 2 83-9 2 40 PETER G. ANGELOS IMD. o.c.. rN, Nvl H. RUSSELL SMOUSE IMDI M. ALBERT FIGINSKI IMDI THOMAS MINKIN IMO. D.C.. rNl EDWARD P. MONAGHAN IMD. PAI GARY J. IGNATOWSKI IMD, O.C., TN. Nn R. BRUCE MCELHONE IMD. PA. D.C.. NYI ARMAND J. VOLTA, JR. IMD. D.c.. Nvl GEORGE A. WEBER, III IMO. D.C.. rN. PA. Nvl DAVID L. PALMER IMD. D.C.. Nvl EDWARD J. LILLY IMDI PATRICIA J. KASPUTYS IMD. D.c.l BRUCE C. HILL IMDI ANDREW M. CANTOR IMD. D. C.I FREORICK H. DURST IMD. D.r_.I THOMAS C. SUMMERS IMD. D.c.l THEODORF_ M. FLERLAGE, JR. IMD. D.C.I COUNSEL FANNIE ANGE LOS <MD. U.C.I NORMAN R. STONE. JR. IMDI GEORGE L. RUSSELL. JR., P.A. IMDI KATHLEEN D. HADLEY IDEI THOMAS V. FRIEDMAN (1929-1997) JULIUS W. UCHTER f 1934.20011 Thomas Mabius RD 1, Box 253, 738 Pisgah Road Shermansdale, PA 17090 April 9, 2009 RE: Kaiser bankruptcy settlement payment Estate of Larry C. Mabius, a/k/a Charles L. Mabius Dear Mr. Mabius: RICHARD T. WILSON IoEI TIMOTHY MAN UELIDES IMDI KATHLEEN M. BROWN IMDI JUAN CARLOS RADZINSCHI ID.C.I JENNIFER L. LILLY IMD, NCI SEAN D. BURNS IMDI JOHN E. KOTSATOS IMD. NJ, PAI KARA A. HAGER IoEI AMY H. BACKENSTOSE IPA, NJI CRAIG M. SILVERMAN IMD, o.c.I JESSICA E. HAV IMDI RAMON A. ARREOLA IPA, NJI CHRISTOPHER D. WRIGHT IMDI DANIEL P. CON NELL IMDI ERIC M. ROSENFELO IMDI JOSHUA L. CAPLAN IMDI DEMETRIOS A. KARAS IMDI You may recall that during the past several months this firni's main office in Baltimore mailed to you a Release for a minimal settlement with the bankruptcy trust of the former Kaiser Company in connection with your late brother's asbestos litigation. The Kaiser Trust now has issued payment of the money to this office and, as a result, we are writing to send to you the net proceeds. Please find enclosed the Estate's check, attached to your copy of the usual Settlement And Distribution Sheet. Also enclosed are (1 } the original of the Settlement Sheet and (2) apostage-prepaid return envelope. Please sign the original Settlement Sheet at the red X; then please mail back the signed paper in the envelope provided. Of course, if you have any questions, please call. Sincerely, ENCLOSURES COPY: Susan E. Lederer, Esq. Andrea M. Rowe-Heddings Legal Assistant ONE CHARLES CENTER 100 N. CRARLES STREET .22ND FLOOR BALTIMORE. MD 21201-3804 fa101 6x9.2000 t600> 252-6622 FAX IaIOI 659-1780, BI, B2 COURT TOWERS 210 W. PENNSYLVANIA AVENUE SUITE 150 TOWSON, MO 2 1 204-5 3 2 4 Ia101 621-1000 FAX (4101 x26-1269 III 5. GEORGE STREET UNIT 2 CUMBERLAND. MD 21SOI.300~ (30l l 759-2700 FAX (301) 759-2703 ROGER A. DOUMAR IMDI WILLIAM D. POLAND, JR. IPA, VJV, MD, NYI CHARLES A. CANDON IMD. D.C., iN, NYI JOHN A. PICA, JR. IMDI JAMES T. FITZGERALD IPA. NJI STEVEN W. SMITH IMD. D.C.I THOMAS P. KELLY IMD. D.c.l RONALD E. RIC HARDSON IMD. D.C., NVI BESSIE 5. DEMOS IMD, D.c.I PAUL D. RASCH KE IMD, D.C.. PAI GREGORY R, SMOUSE IMDI STEPHEN J. HOLMES IMDI PAUL M. MATHENY IMDI LOUIS F. ANGELOS IMDI KEITH E. HAYNES IMD. D.C.I MARY V. KOCH IMDI VASILI KI P. SZCZESNY IMD. D.C.I MICHAEL B. GILLAND IMDI GREGORY N. BUNITSKY IPA, NJI MARY CINA CHALAWSKY IMD. D.C.I BRIAN J. TAYLOR IPA, Nn WILLIAM G. MINKIN IMD, D.C.I JEFFREY J. UTERMOHLE IMO. o.c.I MARLO A. TROTTA IMDI HELLEN P. HARLSTON IMD. NCI FREDERIC C. HEYMAN IMDI MATT R. BALLENGER IMDI GLENN E. MINTZER IMD, FL, ul SHARON L. HOUSTON IMD. O.C.. NJI ANTHONY J. COVACEVICH IMDI JAMES 5. ZAVAK05 IMD> CAROL A. HASTINGS IMDI LAMONT G. MCCLURE, JR IPA, NV1 ROBERT S. PATTERSON IrNI BALTIMORE, MARYLAND BETHLEHEM. PENNSYLVANIA TOWSON, MARYLAND PHILADELPHIA, PENNSYLVANIA CUMBERLAND, MARYLAND WILMINGTON. DELAWARE KNOXVILLE, TENNESSEE . ~'_ _ -- - ~ m E. ~ = r' 4 t c o G 1.- ~ ~ gv ~ _ tn-n l n.?NyS ~ i ! ' ~ ~ Il yt? N -+ -o ~ a . D s S~j{O ^a o -i ~1 1 ~ o ~ ~ ~ZO-p lf1 ~ ~ ~~ cD ~ o d a m Q n -~i1 ~ ; m D Z i r 11 ~ GD m o m -~ ~ 1 ~ ~ " N C/1 ~ ; i i ~ r! ~ ~ .. G ~ ~ !: j _ • • ~ ¢' C CD ~ ^ n~J lC7 o O O O m m a ~ -I~ w = ty N -~ O O ` , r ti ~ :. n.r ~ O` r o ~ o w ~ '. ~ ~ ° O o m °cn' . w ~ r =' i n o £ Lf1 p o ~ ~j o x •± `n -n ~ g r m ~ .a _ O N ~ .. ~ ~ v D =p m ~ i~ c ~ ~ ~ rn cn >:~o "~ D 1 0 i ~ '. - ~ ~ . ~ ~ v ~~~ ' S N .~ ' i -- _ _~ 8ecu~/ features. Details on back. - _ L LAW OFFICES OF PETER G. ANGELOS SETTLEMENT AND DISTRIBUTION SHEET THOMAS MABIUS ,Personal Representative of The Estate of LARRY C. v. Kaiser MABIUS 171-28-4267 PA54679 100% E Cnecl< No.: 855582 SETTLEMENT: Kaiser TOTAL: ATTORNEY'S FEE: (33.33% of Settlement) MEDICAL BILLS: TOTAL: CASE EXPENSES: TOTAL: TOTAL DEDUCTIONS: $ 2,567.81 $ 2,567.81 $ 2,567.81 $ 855.94 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 855.94 BALANCE TO: THOMAS MABIUS ,Personal Representative of The Estate of LARRY C. MABIUS $ 1,711.87 I understand and acknowledge that the funds being paid to me in regard to this settlement have been maintained in a trust account in a financial institution located outside of the Commonwealth of Pennsylvania, and that settlement monies payable to me from a settling party in any future settlement, and / or monies payable to me as a result of any verdict or judgement in my case, upon receipt by the LAW OFFICES OF PETER G. ANGELOS, P.C., will be placed into such a trust account and, less attorneys' fees and expenses, will be paid thereafter to me as expeditiously as circumstances allow. I hereby give my consent to this in regard to this present settlement and in regard to all monies payable to me as a result of any future settlements, verdicts, or judgements. AND NOW, this day of I / We do hereby declare that this Settlement and Distribution Sheet has been read and is understood and approved and that the deductions for expenses and other items shown hereon are true and correct and receipt of a copy of this Settlement and Distribution Sheet is acknowledged. .~ WITNESS WITNESS WITNESS WITNESS MABIUS, Personal Representative of The Estate of LARRY C. MABIUS WITNESS SUr~~,~~-~.l INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA coalrrloNwEni.Tl~+ of PeNNSnvnr~la } ~ ~N'n' ~ Cumberland } File Number X1-04-0885 Thanes Maaus R~B~ ~ ~ Estate of charfes L Maws deceased d(s) and ~y(s) that the items appearing in the n~ inventory include aN of the sl assets wherev ~ d o sit th t th l~ l id D d t w ~ " i o~ sa - ec~ en Pennsy s ! alt ofth~ n~al estsfe in the Corrxnonw~lth ot situate an ace ppo e rra on p a ~ item d said inventory re~preserrts its Lair value a6 of the date of the iNadenl's death. a that Decedent owned no real estate outside of the Commonwealti~ of Pennsylvarxa exr~pt that vrtrir~r apPeam in end of this Inventory. I verity that the staterrrerrts made in this htvert- ~ Cory are true and correct. I understand that false state- } Thomas Maa s --. C ~ mats herein arB made subject to the penalties of . ~ y. ~ } ~ ~ 18 Pa.C.S. §4904 relating to unsworn falsification to _ "-~ ~ ~?, BlJttlOluleB. ;) ,-. r" t`J ~T. ; , - ~ ~a ~*: ~ ~ - ~. 7 ~- ; t~ - 'C7 - ~{ ~~ ~ ~ -, ~ - f~1 Susan E. Lederer lS+ CorMt t$ ~-) 4$61 (~1 Law Offices o! Susan E. Lederer _ y ~'' ~~~ X11 Locust Lane, Harrisburg, PA 17108 (Te%phone) 717/652-7323 w-~ of oraTM u-sT nESr~r+cE o~a~rrs soc. sEC. ra. 09/16f2004 CarUsle, PA 17013 171 28.4267 FICaURE3 MUST BE TOTALED Personal Proterty Cash ............._.......»._..........._......,......,..................._.................... 30,345.32 Personal Property ..............................._........................................ Stoclcslt.isted..........„ ..............„..................................................... StocksJClosely Held ...................................................................... Bonds ............................................................................................. Partnerships and Sole Proprietorships ..................................... [Mortgages and Notes Receivable ................._...........---.............. All Other Property ......................................................................... Total Personal Property ........................_.....,......... 30,345.32 Total Real Property ................................................ Total Personal and Real Property ......................... Nom: ~ Memorand~.n of red ~ ouWda the carnw,warm or Por,n~ mery, ~ the election or tie personal rep~n~ inrhde the vaN~e of ead, ikrn, ord s~ tiprres ahaub not be exlarrded r~to tre wal ar Yre rrnrenlorr. (ses 20 Pa. c.s. ~ saalro» ~, RrY-0D,asy so-~~aooe INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } File Number 21-04-0885 DATE OF DEATH I LAST RESIDENCE DECEDENTS SOC. SEC. NO. 09/16/2004 Carlisle, PA 17013 171-28-4267 Cash Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of 320.00 Larry C. Mabius v. National Gypsum Corporation ERC, check received April 28, 2006 Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of 236.00 Larry C. Mabius v. National Gypsum Corporation, check received October 26, 2006 Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of 500.00 Larry C. Mabius v. Uniroyal, check received August 8, 2007 Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of 1,007.70 Larry C. Mabius v. Babcock 8- Wilcox, check received January 4, 2008 Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of 3,400.00 Larry C. Mabius v. Babcock and Wilcox, check received January 4, 2008 Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of 1,250.00 Larry C. Mabius v. The Manville Trust, check received June 3, 2008 Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of 3,735.00 Larry C. Mabius v. U.S. Gypsum Company, check received July 23, 2008 Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of 2,875.00 Larry C. Mabius v. Owens Corning/Fibreboard, check received September 12, 2008 Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of 614.40 Larry C. Mabius v. Owens Corning/Fibreboard, check received September 12, 2008 (Attach additional sheets if necessary) Total Personal Property and Real Estate 30,345.32 INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland File Number 21-04-0885 DATE OF DEATH LAST RESIDENCE DECEDENTS SOC. SEC. NO. 09/16/2004 Carlisle, PA 17013 171-28-4267 Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of 435.81 Larry C. Mabius v. ACS1S, check received October 13, 2008 Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of 9.291.84 Larry C. Mabius v. Owens Corning/Fibreboard, check received January 23, 2009 Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of 750.00 Larry C. Mabius v. Westinghouse Electric Corp., check received February 6, 2009 Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of 2,655.13 Larry C. Mabius v. Armstrong World Industries, check received March 13, 2009 Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of 706.63 Larry C. Mabius v. United States Gypsum Company, check received April 1, 2009 Litigation proceeds -Thomas Mabius, Personal Representative of the Estate of 2.567.81 Larry C. Mabius v. the Kaiser Trust, check received April 9, 2009 Total Cash 30,345.32 -2- Apri121, 2009 ~.. _ ~p .a ~'~~ ~ ~l, .:i -" ~ N :: i_ Register of Wills ~=~ ~-~ - 1 C.~~ ~ (. ,.? Cumberland County Courthouse ,:=~ ~ ~; ~ -~. 1 Courthouse Square `-~' ~ -_ _- Carlisle, PA 17013 ~ ~' ~ .:: T'~ y r rn RE: CHARLES L. MABIUS SOCIAL SECURITY NO. 171-28-4267 FILE NO.: 21-04-0885 Ladies and Gentlemen: Enclosed for filing with your office is one (1) completed Supplemental Pennsylvania Inheritance Tax Return, in duplicate, together with date of death valuations for the above decedent, and a check made payable to "Register of Wills, Agent" in the amount of $1,302.43 for PA Inheritance Tax due. Also enclosed is a check made payable to "Register of Wills" in the amount of $75.00 for additional probate fees and filing costs.. Also enclosed for filing with your office is one (1) original Supplemental Inventory for the above referenced Estate. Please advise if any additional fees or expenses are due with regard to this matter. One (1) additional photocopy of the front page of the completed Supplemental Pennsylvania Inheritance Tax Return and one (1) additional photocopy of the front page of the completed Supplemental Inventory for the Estate have been provided. Please time/date stamp these copies as received and return them to me in the envelope provided. If there are any questions or further requirements regarding this return, please do not hesitate to contact me. Sincerely, Susan E. Lederer Enclosures 5011 Locust Lane • Harrisburg, PA 17109 • Phone 717.652.7323 Fax 717.652.7340 • Susan@ledererlaw.com www.ledererlaw.com ;. nP~ ~ ~2008USPS 1 _ 4 _ .~ ~; a ~; } { ,- , <~ _ i -; ;,. ; d .' ~ t ~c g pp AAfsuse may{{he a ~ia/atian vffederal Jaw. This AackagTng is not for resale. 2Q04 APR c:2 ~',ifi ~2~ ~+~ ~ QRPH"~1'~ ~~)URT ~rr~ _ L? (.;f1 ~)1~ "~~~~ ~~ ti ~~ ~ ~- m ~~ o -- a === o i O ~~~ ~ O O r ~~ 0'" ~~ ~ ~~~ D N O C c d V W J O y _~ C E ~ ~, ~~~- 0 ~~ as U a~' O a~ ~~ °x LL 0 O ~' ~" ~~~' ~~~., 3U~ a~ b ~~~ an ~' o ~ U U O N O ~ ~ ~ ~ o ~ ~ ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BDX i!80601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA .. DEPARTMENT OF REVENUE LNHERITANCE TAX STATEMENT OF ACCOUNT " ~11 ts~xt ~- a~g pp I^_ r,. - .,~~ ;~~ ~~ IYr~- ~ ~ '!~~r .. - -~_ SUSAN E LEDERER S E LEDERER LAW OFFC 4811 JONESTOWN RD 226 HBG PA 17109 REV-1607 EX AFP Q 2-08) DATE 05-26-2009 ESTATE OF MABIUS CHARLES L DATE OF DEATH 09-16-2004 FILE NUMBER 21 04-0885 COUNTY CUMBERLAND ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ --------------------------------------------------------------------------- REV-1607 EX AFP (12-08) *** INHERITANCE TAX STATEMENT OF ACCOUNT ~~~ ESTATE OF MABIUS CHARLES L FILE N0. 21 04-0885 ACN 101 DATE 05-26-2009 THIS S1fATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE iDF LAST ASSESSMENT OR RECORD ADJUSTMENT: 04-10-2006 PRINCIPAL TAX DUE: PAYMENTS CTAX CREDITS): .00 PAV'MENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID 04-2:1-2009 CD011145 .00 1,302.43 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. ~ IF PAID AFTER THIS DATE, SEE REVERSE I TOTAL DUE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. C IF TOTAL DUE IS LESS THAN 51, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FoR TNCT RIIrTTnNC ~ 1,302.43 1,302.43CR .00 1,302.43CR Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: Charles L Mabius Date of Death: 08/1612004 Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: ^ Yes ~ No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: unknown 3. If the answer to No. 1 is YES, state the following: a. Did the personal representative file a final account with the Court? ~] Yes ^ No b. The separate Orphans' Court No. (if any) for the personal ', representative's account is: ', c. Did the personal representative state an account informally to the parties in interest? ~] Yes ^ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphans' Court and may be attached to this report. Dare ~ V ~ Aa /~ r ~ pY o ~ '. S~pnatura a/Pe,sorr Frlnp fNS Fomr 4"'~~- --~ C J < M f'7 ~ Capacity: ^ Personal Representative ® Counsel '. _ . ~ 1~,. ~ ~ ~ C ~ LL. I ~. ~. , .~$ o~,-_; Susan E. Lederer , Q1 ~ ~~ ~-~' Z Name o/Ferson Filirp this Form t., iu ~- _ w _.. ~¢c 5011 Locust Lane ~ ~ r` ~ f Ud , ~ ~ _ ~ ~~ .x . i..ii. ~~ Sulte226 ~~ : rn O~ atlGress N v Harrisburg PA 17109 , Gb, ware, z~p 717/852-7323 relephorro Form RW 1O Rev. 10. fAP006 Copyright (d 200G loan software only The Lxkner Group, Inc. File Number: 21-04-0885 ~np BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 ,~~^;~~~~'~'t~"ANCE TAX t ~ 1 ~` T~N~~i~ OF ACCOUNT Z~IOFEB-5 AMi~= 06 Ct~'K Cri 4RpNA~i~~ CO ~RTPP. ~, ,._ SUSAN E LEDERER LAW ~'~ ~`~~~~' '~" STE 226 5011 LOCUST LN HBG PA 17109 Pennsylvania ~ DEPARTMENT OF REVENUE REV-1607 EX AFP C12-09) DATE 02-01-2010 ESTATE OF MABIUS CHARLES L DATE OF DEATH 09-16-2004 FILE NUMBER 21 04-0885 COUNTY CUMBERLAND ACN 501 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment. ORDS ~ CUT ALONG THIS LINE REV-1607 EX AFP (12- RETAIN LOWER PORTION FOR YOUR REC *~* INHERITANCE TAX STATEMENT~OF~ACCOUNT~~*** .......... ESTATE OF:MABIUS CHARLES L FILE N0.:21 04-0885 ACN: 501 DATE: 02-01-2010 THIS STATEMENT PROVIDES ALRRPAYMENTS~,STHE CURRENTTBALANCEINANDE IFMAPPLICABLE,BALPROJECTED INTEREST FIGUREINCIPAL TAX DUE, A~~LIGATI~N •F DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 01-25-2010 1,302.47 PRINCIPAL TAX DUE: PAYMENTS CTAX CREDITS): PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID C-) CD011145 .00 04-21-2009 .00 01-25-2010 SBADJUST AMOUNT PAID 1,302.43 .04 TOTAL TAX PAYMENT 1,302.47 .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. TOTAL DUE ~ .00 * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCN). YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. BUREAU OF INDIVIDUAL TAXES INHERIT NOTICE OF INHERITANCE TAX enns ~~~~ OWANCE OR P Ylvania ANCE 7AX DIVISION PO BOX 280601 ~ DISALLOWANCE DF' $ r DEPARTMENT OF REVENUE ~Db.~X,~, AND ASSESSMENT HARRISBURG PA 17128-D601 OF TAX r t ~ ' ~,; t ',,! w_ ~..~ REV-1547 EX AFP (12-09) ~~~~~~$_~ ~~~~;0~ DATE 02-01-2010 ESTATE OF MABIUS CHARLES L ~~',~~~ DATE OF DEATH 09-16-2004 C~ . R~~~,~ r0~~~ FILE NUMBER 21 04-0885 LEDERER A NTY CUMBERLAND LAW 8,~-n' ,~.,j~ ~ ~ ~ STE 226 , , ACN t~ 5 O 1 5011 LOCUST LN APPEAL DATE: 04-02-2010 H B G (See reverse side under Ob i ject ons ) PA 17109 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT-ALONG THIS LINE - - ---- REV-1547 EX AFP C12-09~ ~-/--R_ETA_IN-LOWER POR_TION_ FOR YOUR RECORDS ~ ----- NOTICE OF INHERITANCE TAX APPRAISEM D ESTATE OF: MABIUS ENT, ALLOWANCE OR ISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX CHARLES LFILE N0.:2i 04-0885 ACN: 501 DATE : 02-01-2010 TAX RETURN WAS: c ) ACCEPTED AS FILED C X) CHANGED $EE ATTACHED APPRAISED VALUE OF RETURN BAS L 1 R 1 ED ON: NOTICE ITIGATION RETURN . ea Estate (Schedule A) 2. Stocks and Bonds cSchedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property cSchedule E) 6. Jointly Owned Property cSchedule F) 7. Transfers cSchedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses cSchedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; 14. Net Value of Estate Subject to Tax cl) .00 c2) . 00 c3) .00 c4) .00 c5) 30,345.32 cs) . 00 c7) .00 NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment. cB) 30 345.32 (9)- 11 ;97 ~L (10) $ 094 O~ Non-elected 9113 Trusts (Schedule J) NOTE: If a AMOUNT PAID n assessment was issued previously, lines 14, 15 and/or 16 3 95 reflect figures that include the total of ALL returns assessed~to7d to and 19 will ASSESSMENT OF TAX: 15 . Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Cla C15) .00 X 17. Amount of Line 14 at Sibling ss A rate rate C16) DD X 18. Amount of Line 14 taxable at Collateral/Cla 1 D 8 ~ 9 ~ X 19. Principal Tax Due ss B rate (1B) .00 X TAX CREDITS: DATE NUMBER 04-21-2009 CD011145 01-25-2010 SBADJUST INTEREST/PEN PAID (-) .00 .00 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. , JVL ..{J .04 c11) 19,491.37 cl2) 10,853.95 c13) 00 c14) 10 85 00 = .00 045 = .00 12 1,302 47 15 = .00 c19)- 1, 302 47 TOTAL TAX PAYMENT BALANCE OF TAX DUE 1,302.47 INTEREST AND PEN. •00 .00 TOTAL DUE .00 IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MA- y gE DUE n A REFUND. SEE REVERSE SIDE OF THIS FnoM cnn ..~.._-.._ REV•1470 Ex (8.88 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 Charles L Mabius SCHEDULE INHERITANCE TAX EXPLANATION OF CHANGES Shannon E. Baker 2104-0885 507 EXPLANATION OF CHANGES Applied excess deductions from prior return(s). ROW ~.,.... Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: Charles L Mabius ~I Date of Depth: 09/16/2004 File Number: 21-040885 Pursuant t Pa. O.C. Rule 6.12, I report the following with respect to completion of the administr0tion of the above~aptioned estate: 1. State whether administration of the estate is complete: ^ Yes ~ No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: unknown a 3. '' If the answer to No. 1 is YES, state the following: ', a. Did the personal representative file a final account with the Court? ^ Yes ^ No I, b. The separate Orphans' Court No. (if any) for the personal representative's account is: ', c. Did the personal representative state an account ', informally to the parties in interest? ^ Yes ^ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphans' Court and may be attached to this report. ~~ g ~ o ~~ w Person Fibre this Form Capacitor: ^ Personal Representative ® Counsel' O ~ s... ~ ~• ~ a ~- s ~ : _~_~ c ~ ~Cr .v " ~C u_ p ~--% ,r :_.~ co v~ . ~: ~... , , ~~_ st CC^= C? , _ zY~ _.c:: c C ~ . ;:.,Form RW-10-Aee 10-132006 Susan E. Lederer Name of Person Filing this Form 011 Locust Lane Suite 226 A~B35 Harrisburg, PA 17109 City, State, Zip ~ 717/652-7323 rere~no~e CopyripM (c) 2006 form software only The Lackner Group, Inc. Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: Charles L Mabius Date of Death: 09/16/2004 File Number: 21-04-0885 Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: ~ Yes ~] No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is YES, state the following: a. Did the personal representative file a final account with the Court? ^ Yes ® No b. The separate Orphans` Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? ~ Yes ^ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphans' Court and may be attached to this report. Date ~~~~i~~ z.~ L ~ ~ .. C`K ..~ ~~ ` L .: 5... ; ~ , ~ 4/ ~ ~_ 9 ;.:__~ --1 ~'= ~~ - c7 ... ~;; ~, ~ U~ca » .~_ ~- Signa ure of Person Filing this Form Capacity: ^ Personal Representative ® Counsel Susan E. Lederer Name of Person Filing this Form 5011 Locust Lane Address Harrisburg, PA 17109 City, State, Zip 717/652-7323 Telephone Form f2VV 1 ~ Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. l~