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Home My WebLink About06-11-12 (2)1505610140 REV-1500 EX (01-10) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN 1 2 0 3 6 7 PO BOX 280601 RESIDENT DECEDENT 2 1 Harrisbur PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date Of Birth MMDDYYYY 1 7 5 1 8 8 6 5 4 1 2 1 2 2 0 1 1 0 6 2 0 1 9 2 1 Decedent's Last Name Suffix Decedent's First Name MI B a l o g Mar g a r e t ~ (If Applicable) Enter Surviving Spouse's Information Below ' MI Spouse's Last Name s First Suffix Spouse Name Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW l Return i i 1 O ^ 2. Supplemental Return ^ 3. Remainder Return (date of death na r g . prior to 12-13-82) ^ 4. Limited Estate ^ 4a. Future Interest Compromise (date of ^ 5. Federal Estate Tax Return Required death after 12-12-82) 6. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) ^ 9. Litigation Proceeds Received ^ (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death ^ h Ounder Sec. 9113(A) 11 • E h S ) between 12-31-91 and 1-1-95) c Attac ( CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Daytime Telephone Number Name I w Es q 81 4 262 0~~64 Gar y L Cost o First line of address H i g h l a n d Second line of address 3 5 1 B u d f i City or Post Office J o h n s t own Co mmo n s e l d S t r e e t State P A ZIP Code REGISTER LS USE 17~Y - ~ r r 1 ~r ~D~~ 'r__ ~= , `' ~ ri .... - ~ ! ~' ~ ~~~ ~ .~ ~- v~ DATE FILED Cl` 1 5 9 0 4 Correspondent's a-mail address: IllgtCOStIOW@hOtmall COm i nder eecorrlect and clompletde.cDeclaration of preparer other than the persoing eproesentative Scbased on d Snfo maUOn of whiochhpreparerfhas any know edge belief, SIGNUR"OF PE,I~Sj N RESPONSIBLE FOR FILING RETURN ~~~ ~~ DA~ ~~/~ ~ ~~ ~ ~cDDR~~s // ~/ POBox 627 Charles Town WV 25414 P.O~: Box 79 St. Michael PA 15951 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY 1505610140 Side 1 1505610140 ~; ~I ~ 1; Continuation of Inventory Margaret L. Balog 21 12 0367 File Number Decedent Name Pa e 1 Description of Inventory Members 1st Federal Credit Union P.O. Box 40, Mehanicsburg, PA 17055 Certificate of Deposit Wells Fargo Advisors, LLC Three Lemoyne Drive, Lemoyne, PA 17043 Account No. 1302-9654 Alert Pharmacy Services, Inc. 219 North Baltimore Avenue, Mt. Holy Springs, PA 17065 Pharmacy Refund PNC Bank Bethany Village Branch, 325 Wesley Drive, Mechanicsburg, PA 17055 Refund from Safe Deposit Box State Employees' Retirement System 30 North Third Street, Suite 150, Harrisburg, PA 17101-1716 Retirement Check State Employee's Retirement System 30 North Third Street, Suite 150, Harrisburg, PA 17101-1716 Retirement Check Pennsylvania State Employees Credit Union P.O. Box 60713, Harrisburg, PA 1 71 06-701 3 Savings Account Department of the Treasury Refund of 2011 Income Tax Real Estate Jointly-Owned Property Inter-Vivos Transfers/Misc. Non-Probate Property First Commonwealth Bank P.O. Box 490, Indiana, PA 15701-0400 Burial Reserve Wells Fargo Advisors, LLC Three Lemoyne Drive, Lemoyne, PA 17043 IRA No. 1302-9624 5,793.39 1,312,442.24 42.92 27.50 941.03 538.33 3,773.26 3,472.00 12,186.30 4,789.47 Subtotal I $ 1,344,006.44 Grand Total I $ 1,410,705.85 1505610240 REV-1500 EX Decedent's Social Security Number 1 7 5 1 8 8 6 5 4 Margaret L Baloq Decedent s Name RECAPITULATION 1. ......................................... Real Estate (Schedule A) .. 1 2. .................................... Stocks and Bonds (Schedule B) 2. .. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. • 4. Mortgages and Notes Receivable (Schedule D) ........................ .. 4. • 1 3 9 3 7 3 0. 0 8 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ..... .. 6. 7. Inter-Vivos Transfers & Miscellaneous N-Probate Property 1 3 9 7 5 7 7 (Schedule G) ~ Separate Billing Requested ..... .. 7. • 1 4 0 7 7 0 5' 8 5 8. Total Gross Assets (total Lines 1 through 7) ......................... .. 8. 1 0 3 7 7 6 • 8 1 9. Funeral Expenses and Administrative Costs (Schedule H) ............ .... .. 9• 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ....... .... .. 10. • 1 0 3 7 7 6 ' $ 1 11. Total Deductions (total Lines 9 and 10) ........................ ..... .. 11. 12 1 3 0 3 9 2 9. 0 4 12. Net Value of Estate (Line 8 minus Line 11) ..................... ..... .. • 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 7 4 1 2 1 6 9 an election to tax has not been made (Schedule J) ............... ..... .. 13• 5 9 9 8 0 7 3 5 14. Net Value Subject to Tax (Line 12 minus Line 13) ............... ..... .. 14. TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 0 0 0 15. 0. 0 0 . (a)(1.2) x.o _ 16. Amount of Line 14 taxable ~ 0 0 16 ~ • at lineal rate X •0 . 17. Amount of Line 14 taxable 5 2 1 5 7 1 6 17. 6 2 5 8. 8 6 at sibling rate X .12 18. Amount of Line 14 taxable 5 4 7 6 5 0 1 8 18 8 2 1 4 7. 5 3 at collateral rate X .15 . 8 8 4 0 6• 3 9 19. ............................................... TAX DUE ..... ..19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 1505610240 1505610240 REV-1500 EX Page 3 nnnnrlnnt'c r_mm~llptp ~rl[~r'P_CS' File Number 21 12 0367 VVVVMV.• vv...'...--- - -~~-- ---- DECEDENT'S NAME Margaret L. Balog _ -- STREET ADDRESS 100 Mount Allen Drive - _- - - - - - __ CITYSTATE ZIP Mechanicsbur PA 17055 Tax Payments and Credits: ~. Tax Due (Page 2, Line 19) 2. CreditslPayments A. Prior Payments - B. Discount _ 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (1) 88,406.39 Total Credits (A + B) (2) 0.00 (3) (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 88,406.39 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 0 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; .......................... ..... ^ c. retain a reversionary interest; or ........................................................................................... ..... ^ 0 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? ............................................................................................ ...... 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)j. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §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 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1508 EX+ (11-10) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Mar aret L. Balo 21 12 0367 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. VALUE AT DATE ITEM NUMBER DESCRIPTION OF DEATH 1. PNC Bank, N.A. 29,251.30 Bethany Village Branch, 325 Wesley Drive, Mechanicsburg, PA 17055 Checking Account No. 5140199181 2. PNC Bank, N.A. 35,108.37 Bethany Village Branch, 325 Wesley Drive, Mechanicsburg, PA 17055 Savings Account No. 5006277169 3. Genworth Life Insurance Company 2,339.74 Long Term Care Insurance Division, P.O. Box 40007, Lynchburg, VA 24506-9939 Refund for Long Term Insurance 793.39 5 4. Members 1st Federal Credit Union , P.O. Box 40, Mehanicsburg, PA 17055 Certificate of Deposit 442.24 312 1 5. Wells Fargo Advisors, LLC , , Three Lemoyne Drive, Lemoyne, PA 17043 Account No. 1302-9654 42 92 6. Alert Pharmacy Services, Inc. . 219 North Baltimore Avenue, Mt. Holy Springs, PA 17065 Pharmacy Refund 27 50 7. PNC Bank . Bethany Village Branch, 325 Wesley Drive, Mechanicsburg, PA 17055 Refund from Safe Deposit Box 8. State Employees' Retirement System 941.03 30 North Third Street, Suite 150, Harrisburg, PA 17101-1716 Retirement Check 33 538 9. State Employee's Retirement System . 30 North Third Street, Suite 150, Harrisburg, PA 17101-1716 Retirement Check 26 773 3 10. Pennsylvania State Employees Credit Union . , P.O. Box 60713, Harrisburg, PA 17106-7013 Savings Account 472.00 3 11. Department of the Treasury , Refund of 2011 Income Tax TOTAL (Also enter on Line 5, Recapitulation) I $ 1,393,730.08 If more space is needed, insert additional sheets of paper of the same size REV-1510 EX+ (08-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Mar aret L. Balo 21 12 0367 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1. First Commonwealth Bank 12,186.30 100.00 3,000.00 9,186.30 P.O. Box 490, Indiana, PA 15701-0400 Burial Reserve 2. Wells Fargo Advisors, LLC 4,789.47 100.00 4,789.47 Three Lemoyne Drive, Lemoyne, PA 17043 IRA No. 1302-9624 TOTAL (Also enter on Line 7 Recapitulation) ~ S 13,975.77 If more space is needed, use additional sheets of paper of the same size. REV.-1511 EX+ (10-09) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Mar aret L. Balo 21 12 0367 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. William Kisiel Funeral Home 9,218.95 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Phyllis Slonac Gregory Burch 40,875.00 Street Address P.O. Box 79 P.O. Box 627 c;ry St. Michael PA 15951 Charles Town .state WV zIP 25414 Year(s) Commission Paid: .2012 p. Attorney Fees: Gary L. Costlow, Esquire 40,875.00 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 173.50 4. Probate Fees: 5 Accountant Fees: 6. Tax Return Preparer Fees: 7. Messiah Village -Nursing Home 12,348.58 8. Cumberland County Legal Journal -Legal Advertising 75.00 g, The Sentinel -Legal Advertising 210.78 TOTAL (Also enter on Line 9, Recapitulation) I $ 103,776.81 If more space is needed, use additional sheets of paper of the same size. REV-'513 EX+ (01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Mar aret L. Balo 21 12 0367 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. Gregory Burch Collateral 259,110.89 P.O. Box 627 Charles Town, WV 25414 2. Phyllis Slonac Collateral 129,555.45 P.O. Box 79 St. Michael, PA 15951 3. Helen Burch Sibling 51,822.18 P.O. Box 627 Charles Town, WV 25414 4. Georgina Dickson Collateral 25,911.09 15 Meadowbrook Drive Kingston, NY 12401 5. Kailey Verbicky Collateral 38,866.63 424 Naugle Drive Johnstown, PA 15904 6. Elsie Bernadini Collateral 38,866.63 923 Keene Street East Syracuse, NY 13057 7. Nicholas Slonac Collateral 38,866.63 2122 Canterbury Drive Mechanicsburg, PA 17055 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: St. Peter & Paul Orthodox Church 141 Hoffman Farm Road Windber, PA 15963 St. Peter & Paul Orthodox Church 141 Hoffman Farm Road Windber, PA 15963 Christ the Savior Orthodox Church 225 Chandler Avenue Johnstown, PA 15906 194,333.16 2 3 25,911.09 129,555.44 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I $ 699,599.38 If more space is needed, use additional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent Margaret L. Balog Decedent's Name Page 1 21 12 0367 File Number Schedule J -Beneficiaries - 1 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 8. Nichoals Gantner Collateral 13,039.29 1522 Lucas Avenue Ext. Cotterkill, NY 12419 REV-!513 EX+ (Ot-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Mar aret L. Balo 21 12 0367 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. Gregory Burch Collateral 260,785.80 P.O. Box 627 Charles Town, WV 25414 2. Phyllis Slonac Collateral 130,392.90 P.O. Box 79 St. Michael, PA 15951 3. Helen Burch Sibling 52,157.16 P.O. Box 627 Charles Town, WV 25414 4. Georgina Dickson Collateral 26,078.58 15 Meadowbrook Drive Kingston, NY 12401 5. Kailey Verbicky Collateral 39,117.87 424 Naugle Drive Johnstown, PA 15904 6. Elsie Bernadini Collateral 39,117.87 923 Keene Street East Syracuse, NY 13057 7. Nicholas Slonac Collateral 39,117.87 2122 Canterbury Drive Mechanicsburg, PA 17055 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. St. Peter & Paul Orthodox Church 195,589.35 141 Hoffman Farm Road Windber, PA 15963 2. St. Peter & Paul Orthodox Church 26,078.58 141 Hoffman Farm Road Windber, PA 15963 3. Christ the Savior Orthodox Church 130,392.90 225 Chandler Avenue Johnstown, PA 15906 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 704 121.69 If more space is needed, use additional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent Margaret L. Balog 21 12 0367 Decedent's Name Page 2 File Number Schedule J -Beneficiaries - 2B II. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 4. Holy Apostles Orthodox Mission 5006 E. Trendle Road, Suite 101 Mechanicsburg, PA 17050 5. Christ the Savior Orthodox Church 5501 Locust Lane Harrisburg, PA 17109 6. Windber Library 1909 Graham Avenue Windber, PA 15963 7. Community Nursing Program University of Pittsburgh, 3500 Victoria Street Pittsburgh, PA 15261 8. University of Pittsburgh at Johnstown 450 Schoolhouse Road Johnstown, PA 15904 9. Orthodox Monastery of Transfiguration 321 Monastery Lane Ellwood City, PA 16117 91,275.06 52,157.16 65,196.45 65,196.45 65,196.45 13,039.29 SUBTOTAL SCHEDULE J-2B ~ 352,060.86 L~~~r~T YiL ~~~ L"11VJL/I rr ~I~/TII ~LY/l _'-I J~~i V11 ~lARCARIJI' LOUISL I3ALOG 1, I~lARCA1~IJT LOUlSL 13ALOG, of Camp hill, Cumberland County, Pennsylvania, being of sound ~u1d disposinb mind, memory and understanding, do make, publish and declare this to be my Last Will and Testament, hereby revoking and making void all previous Wills and Coclieils herctoCore made by ma. rliis r 1llLN'1'1~1'1' OF'1'LS'1'A'1'Rl`~'S FA1~11LY 1 declare that 1 and not now married. 1 have nu children. SLCONll PROYLRTY 131J1NG ll1SPOS1Jll It is my intention by this Will to dispose of all the properly which 1 may own. 1'11IRll BURIAL 1NSTUCTIONS It is my desire that a funeral and burial consistent ~.vith my economic status in life. be conducted as soon as may be practicable following my death and that my remains be buried at the SS. Peter and Paul Orthodox Church Cemetery in Windber, Pennsylvania, in the 13alog 1~u~1i1y plot. In n1y distribuliotl, I have included ~~ percentage bequest to the church for perpetual nl~iintenance of the Balog gave site. It is my desire shat my personal representatives ensure that Page 1 of 10 ~ ~~ --u 1 %~~~~~-~ any special needs to my family headstones and plot, including, but clot limited to, repair of sinking, erosion, topsoil replacement and the like, shall be performed as a continuing condition to the acceptance of the bequest by the church. I further direct my personal representatives to contact the William Kisiel Funeral Home presently located at 1015 Graham Avenue, Windber, Pennsylvania, as 1 have previously made arrangements with that funeral biome for my burial. FO Ult'I'I I llISYOS1T10N OF i:STA'1,L+; Pay~»~nt uI' Obli~;atio~~s 1 direcC thaC my executor pay the cost ol~ my luueral services and all debts which I am legally obligated to pay whether owing at the time of my death or pursuant to m}' final medical dire.. I f~ur[her direct my executors Cu pay the costs for purchase and erection of a suitable grave monui7lent with inscription thereon told a burial plot with perpetual care as a final resting place for me if same shall not already been purchased. Disposition 1 give, devise and bequeath the following property wit11 all insurance proceeds thereon as follows: 1. To my nephew, Gregory Burch, I give and bequeath the. following: a) Orient~il art and lamps he gave me as gifts; b) China and silverware and other arC work: Egyptian; Mexican; Greelc, and Chinese; c) Furniture of his choice; d) Crystal fron7 Czechoslovakia; e) Music bones; f) German Tankards; ~) Hummel and Llardo figurines; h) Crystal art works and linens. %s~7~~ Page ? of 10 ?. To my niece, Phyllis (131a~osl.yj Slonac, I give and becjueath the second choice of itcnls not selected by Gregory 13ureh. ~. lb the Windber Library, Wincfber, Penwylvania: aj Choice of any art boola in my personal library; b) Selection of piny boot, in my personal library. ~. ~7y articles that the aforem~ntioncd do not want shall be first offered to any o1 tl~,e other beneficiaries. Airy articles that shall remain shall be sold and the proceeds thereof added to my residual estate. hi fhe went that 1 do not possess piny of the above-referenced property at the Buie of my death, my estate shall not be obligated to obtain these items and those bequests shall lapse. 1Zesidu;,l Estate I give, devise and bequeath the rest, residue and remainder of i,7y estate, together wi(.h all insurance procwds thereon of whatsoever nature and wheresoever situate as follows: N A1~~1 ~ 1. Llelen (Balogj Burch (Sister] Charles Town, West Virginia ?. Gregory Burch (Nephew] Charles Town, Nest Virginia 3. Georgina (Gautwr j Dickson (Niece) Kingston, New York ~. Nicholas Gartner (Nephew] Cotterkill, New Yorl: ~. Phyllis (Blazosl:yj Slonac (Niece) St. Michael, Pennsylvania ~. Kailey Verbicl.y (Great-grand niece) Jollnstowti, Pennsylvania Page 3 of 10 PERCENT Four (~%) Percent l wenly (2U°'u j Percen t Two (2~%j Percent One (1 °o j Percent ten (1U°,~oj Percent Three (3°ioj Percent ` /.r~ ~~~ ~~N 7. L;lsie (Chinchar) 13ernadini (Niece) "Three (3%) Percent Syracuse, New Yorl: ~. I~licholas Slonac ~G1'l;at-grand nepl~iewj Three (3°i~) 1'ercenl Mechanicsburg, Pennsylvania y. St. Peter ~u~d Paul OrCliodox Chw~ch hifleen (15%) Percent 1~~1 lloflh~ati 1~ru~iu Road Windber, Yeiuisylvania (Note: 7'o be paid in lirsl 3 yearly increments) lU. Sl. Peter quid Paul Ortlwdox Cemetery "Two (2%) Percent 1 ~l 1 I-1o11h1~ui harm Koad Wlndbel', Pt;rlllSylVallla (Note: lur il~e perpetual care; oP the 13alog l~uui ly ploC) 1 1. Christ llie Savior Urlhodox Senrinaiy Ten (10%) Perceiil Jolulslown, Peiuisylv~ulia 12. holy Apostles Orthodox Mission Seven (7%) Percent Mechanicsburg, Pennsylvania 13. Cln~ist the Savior Orthodox Church huur (4%) Percent 1-hu~risb~u~g, Pennsylv~uiia gq. Wiudber Libr~uy hive (5°io) Percent Windber, Pennsylvania 15. Conuniuiily N~u~sing Program Dive (5%) Percent School of Nursing ot~ the University of Pittsburgh Pitlsb~u~gh, Peiulsylvauia 16. University uTPittsburgh at Jolulslown Dive (5%) PerceiiC Johnstown, Peiulsylvauia 17. The Orthodox Nlonaslery of lr~ulsllg~uation Oise (1%j Percent Ellwood City, Pennsylvania 1 hereby direct my Executors to sell or. liquidate all of my personal property irol bequeathed iii Paragraph Fo~u•th herein adding; the proceeds io my residuary estate, to be disposed according to Paragraph hiFttr herein. Page -1 oC 10 ~~~ (,1 1~,11~'1'FI In the uvcnt that my nephew, Crebory Burch, o(' Charles Town, Wcsl Virgiui,i, predi c~as~s mc:, ur dies on or bel~urc the ~hhirticth (~U'~') day lollowing my dealli, oiie-hall (1/?) ~~1 liis shore shall ~~,ass to 1~is mother, I-lclen Burch, and the olhcr one-hall (~/?) will bu disU~ibulc~l t~~ lh~~ surviving residual Heirs, on a pro-ra~%cl basis, <<ecording Lo each surviving residu~il heir's 1~~~~rcrn~agu of my residual estate. In the event that both Gregory Burch and his niothcr, Hclcn liurclr, predecease mc, ~I~c^ share that would have g~nc to Gregory Burch shall be distributed to thc~ surviving residu.d heirs un a pro-rated basis according to each surviving residual L~uir's prrcent~ige. ~~(' my residual estate. Should any o1 niy other bcncl~iciaries preduce•.asc rne, ur die on ur bclorc ll~c Thirtieth (~U`~') day lullowing nay death, that individual's purtiou oln~y eslatu shall pass per sttrpcs, Sll'I'll CL+;NLIZAL L;ffcrt u1' lu~~per~itiye, Invalid ur life~;til YE•uvisiun if any provision oP ibis will, or of ~u~y codicil thereto, is held to bu inoperative, invalid or illeg~il, it is my intention that all of the remaining provisions Chercol~, shall continur. to be lolly operative and cll'ecliv~ so I~u~ pis is possible and reasonable. llcadin~,s 'hhe headings ~~bove the various provisions of ibis will have. been included only in order t~~ i7i~~he it e<<sier to locale the subject covered by each provision and are not to be used in construitlg this will or i11 ascertaininb my intentions. Page s of lU ~- ~~r(~~1;~ ~, ~' SL~~L?N~1'I1 LO-LX1:CU'I'U1ZS ~1u~~ui>>fu~cut 1 appoint my niece, Phyllis Slonac, of St. I~lichael, Pennsylvania, and my nephew, Gregory Burch, 01 Charles shown, West Virginia, or the survivor of them, as Co-Lxeoutors oh [his, my Last Will and Testament. In tl~c event thaC either or bulb of them should predecease. mc, then 1 uon~inate anal appoint niy sister, 1-lclen (13alog) Burch ol~ Charles ~hown, WCSC Virginia, as nay Executrix in their place and stead. Lund No bond or other security shall bu recjuired oP any Executor appointed in this Will. I'uwers Nly Co-LxeCUl01's shall have, in addition to and nut in liuiitatiun ol, the powers given by l~iw or ~uiy other provisions ot~ ibis Will, the following powers wish respect to the settlement ul~ r7~y estate, to be exercised in each case from time to time in the discretion of my L,xecutor without further order or lieense of the Register of Wills or o1 any court: (a) to retain all property received including tl~ie stock of any corporate t~iduciru~y acting hereunder, provided such property remains productive. (b) To join in any corporation, partnership, recapitalization, 111ergel', reorgantzatii~n or voting frost plan; to d~le.g~ite authority with respect thereto; to deposit investments under agri emeirts and pay assessments; and generally to exercise all rights of investors, including; but not linlit~d lo, the voting of share-s. (c) To manage, operate, repair, improve, mortgage or lease on any terms any real estate held or owned by my ~st~tte, (d j To operate any business that I nlay own at my death. Page ~ of lU ~~~ ~ ~i (c') ~1,o inv~sl uny funds ol~irly eslale in any stocla, bunds, notes or other sccurili~~s o~ property, real or personal, witliu~il reg~u~d lu the principle ol~ diversi~ica(ion or any other slalutc+ ur ~~~ener~tl rule oC law iii their absolute disu~etion, it being my intuition to give nay pursunal represcutative~s the broadest investment powers possible, providing such investn~enls du nut unneccss~u~il}~ prevent lire prompt settlement of my estate. (t) ~1'o sell or otherwise. dispose of any property, real or personal, tangible ~~r iu~un~ibl~-, ul any ~inic l~orn~inb~i part oC my eslale iii any wanner rind oii such Leans ~mrl wudilions as my pu~sonal representatives shell see L~il in their ribsol.ule discretion. (g) To burrow muuey for t11e payment ol~ taxes or for any other proper purposes in lire administration of my estate, acid to nwrtgage or pledge estaCe: assets as security. (li) to coiilpromise claims without court approval including, but nut limited ~~, ~u~y controvcrsics with the United Spites of ~liirerica or the Conuliouwealtl~i ol~ Pulusyl~~ania cunceruing estate and inherit~uice taxes oir any interests that play pass under ibis niy LasC Will and ~l'estanlent. (i) to distribute in cash or in hind upon ally division or distribution ol~my eslale. (j) To ruldertal:e ~uiy and all acts deemed necessary and proper by my pu~sonal representatives for the proper, advantageous and proillpt nianagenieilt ol~ the settlullcnt o1 niy estate. (1.) In general, to exercise <<ll powers in the mauagemuit of my eslale which any in~lividu~il could exercise in the management of similar properly owned in his own right, upon such tt+rms and ~~onditions as to thu1~ may seem best and to execute and delivu~ all instruments and to do all acts which they deem necessary or proper to carry out the purposes of this, iriy Last Will <<n~l Teshuzleilt. ;~ Page 7 of lU -~-i,~~'~,~,. ~I v ~ ~~ F; t G ~ I'1'11 No interest of auy beneliciary of niy estate, either in income or in principal, shall be subject to anticipation or pledge, assignment, sale or transfer in any manner, nor shall any bencl~ici~u~y have the power in any manner to charge or encumber his or leer interest eitlie:r iu in~un~ie or principal, nor shill the interest of tiny beneficiary be liable or subject in any manner awhile in the possession of my personal representatives for the Liability oP such beneficiary. 1N `1'LS'1'1N10NY W1ILltli01~, 1, NIAlZCARl;'1' LOUlSi, 13ALOG, hereby set uiy hand to this, my L,asl Will and Teslarnent, each pale of which his been initialed by me, ou this 2Jth d~~y of Marcl~i,2U~5, nt Mechanicsburg, Pennsylvania. `~V1"1'NLSSES: `'1 ~~ N1A,~.ZGARET LOUISL I3ALOG `'~ Page 5 of 1U ~;!) ~AChNOti~'LI~UCI:(11LN'1' C(~iYlltilON~~'~'L;AL~1'1-1 Uh PL+;NNSYLVf~MA . ~~. COUN'T'Y O1~ CUM131:1ZLANll 1, I~lAKGARE'1' LOU15L 13ALC1G, the leslalrix whose Hanle is signed to the allached or iureguing instrunienC, hiving been cJuly qurrliliecl according to law, cfo hereby acknowledge tl~rat 1 sign~.d and clccutcd lyre instrunlcnt as nay Last Will ~rnd 1'cstanlenl; lhat l signed it ~~~, alrrl~,ly, turd tl~rat n signed it ri5 my lr~;e and votuurary acr l~or the purposes therein c,xpressed. 411i~,a ~/ ~ MARG~~ZL1' LOUISL 13AL00 Sworn or alt~irmed and acl.rlowledg~d belore nle by NIARGAIZLT LOUISE 13ALOG, the tcsCatrix this ~~~~~ ~ ~~day ot~ March, 2UU5. NOTA~~' PU13L1C NOTARIAL SEAL Stephanie M. Rider, Notary Public Carnp Hill Evora, Cumberland County N1y Commission expires Oct. 31, 200 Page ~) oP lU Y~-r AFFIllAti'I`I' CU~I~iON 1`"EALTII OF PENNSYL~"ANIA COUNTY OF CUiVIBERLAND WE, SS. 1 ~"~1 and .SI I\~ C'~ ~ t1 %~L' -1'-L" ,the witnesses whose names are attached to the foregoing document, being duly qualified according to law, do depose and say that we were present and saw MARGARET LOUISE BALOG sign and execute the instrument as her Last Will and Testament; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testatrix signed the Last Will and Testament as witnessed and that to the best of our knowledge the testatrix was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed and subscribed before me by L~i ~~'L~ Y+ ~ t.~U~"~~1~"-~~ and G~~~ r_~ -r CE? (; (~ -~ ~,~ ~ ~J this ~ ~ day of March, 2005. ~NOT~RY PUBLIC NOTARIAL SEAL Page 10 of 10 Stephanie M. Rider, Notary Public Camp Hill Boro, Gumberland County My Commission Expires Oct. 31, 2005 AFFIllAVIT COitiI~IO~~ ~ti"EALTH OF PENNSYL~"ANIA COUNTY OF CUMBERLAND W E, ,~. ~ ~~ t et a..._ ~ . ~ L ~ L SS. ~ ~'1 and .SiJ\~c~l% ( ~~~-~~~` ~-~,~ ,the witnesses whose names are attached to the foregoing document, being duly qualified according to law, do depose and say that we were present and saw MARGARET LOUISE BALOG sign and execute the instrument as her Last Will and Testament; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testatrix signed the Last Will and Testament as witnessed and that to the best of our knowledge the testatrix was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. ,_ ~~ ~ Sworn or affirmed and subscribed before me by L i r ~L( Y+': ~- ~ U'~~~-ra`-~'i( and ~~~~ J~' ; ~-E'.C~ ~. ^, ~;' ' '~~ this ~ ~ day of March, 2005. n, ~NOT~RY PUBLIC NOTARIAL SEAL Page 10 of 10 Stephanie M. Rider, Notary Public Camp Hill Boro, Cumberland County My Commission Expires Oct_31, 2005