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Home My WebLink About07-26-12~ \. r• a TRUST f7 `~~ ~? ~; ~~' "' tii. -~ ' COURT OF COMMON PLEAS OF ~ {, -- ~ ~ =-7 Cumberland COUNTY PENNSYLVANIA _ ~' `=' ' ' ~~ = ~ ~ ~ ` ~' _r, ~ - , ORPHANS' COURT DIVISION --; ' f -1 ; ~ ~ ~~~ t., 4.• NAME OF TRUST (TRUST UNDER WILL OF or TRUST CINDER DEED OF Peter J. Chomyn Family Trust DATED 11-3-1997 ~ No. 21-10-1220 PETITION FOR ADJUDICATION / STATEMENT OF PROPOSED DISTRIBUTION PURSUANT TO Pa. O.C. Rule 6.9 This form may be used in all cases involving the Audit of Trust Accounts. If space is irisu~cient, riders may be attached. INCLUDEATTACHMENTSAT THE BACK OF THIS FORM. Name of Counsel: Robert W. King, Esquire Supreme Court I.D. No.: 25820 Name of Law Firm: ~8 & Guiddy Address: 114 North Maple Avenue, Greensburg, PA 15601 Telephone: 724-836-1500 Fax: 724-836-1668 Form OC-02 rev /0.13.06 Page 1 of 10 Name of Trust: Peter J. Chomyn Family Trust dated November 3, 1997 1. Name(s). and address(es) of Petitioner(s): Petitioner: Petitioner: Name. Peter J. Chomyn, III Address: 2536 Shellburne Drive Wexford, PA 15090 2. Check if any of the following issues are involved in this case: A. Appointment of Trustee ........................................... B. Interpretation ................................................... C. Discharge of Trustee ............................................. D. Transfer of Situs ................................................. E. Appointment of Ad Litem .......................................... F. Minor, Unborn or Unascertained Beneficiary(ies) ......... G. Principal Distribution ............................................. H. Partial/Full Termination of Trust .................................... I. Missing Beneficiary(ies) .....................................:.... J. Cy Pres ........................................................ K. Williamson Issue* ........................................... .... L. Other Issues .................................................... List: Please note: A detailed explanation of issues checked should be set forth at item 13 below. * See Williamson Estate, 368 Pa. 343, 82 A.2d 49 (1951), if Trustee was also Executor of the settlor/decedent's estate and received commissions in such capacity. Form oc-o2 rev 10.13.06 Page 2 of 10 Name of Trust: Peter J. Chomyn Family Trust dated November 3, 1997 3. Testamentary Trnst: Decedent's date of death: Date of Decedent's Will: Date(s) of Codicil(s): Date of probate: or Inier Vivos Trust: Date of Trust: November 3, 1997 Date(s) of Amendment(s): August 18, 2009 and December 23, 2009 4. A. If any other Court has taken jurisdiction of any matter relating to this Trust, explain: N/A B. Identify all prior accountings and provide dates of adjudication. N/A 5. A. State how each Trustee was appointed: Peter J. Chomyn was the Settlor and Trustee. Peter J. Chomyn died November 18, 2010, pursuant to Artilce VIII (A) Settlor appointed his son Peter J. Chomyn, Jr. as successor Trustee and upon his death, Settlor appointed his grandson Peter J. Chomyn, II as alternate successor Trustee. Peter J. Chomyn, Jr. died August 2, 2009 B. If a Petitioner is not a Trustee, explain: N/A Fon,+ oc-oz r~ ~o.is.o6 Page 3 of 10 Name of Trust: _ Peter J. Chomvn Family Trust dated November 3 1997 6. State how and when the present fund was awarded to Trustee(s): The Trust was created and funded in 1997 by Settlor and administered by Settlor without any accounting prepared for or given to the Petitioner as alternate successor Trustee so that the Petitioner was not accountable for funds and transactions before his appointment on November 18, 2010. Accounting for the Trust as conducted by prior Trustee is excused under Article VII Section A of the Trust Instrument. 7. Period covered by accounting: 11-18-2010 to 4-17-2012 8. Current fair market value of the Trust principal is _$593.149.89. lsee page 2-6 of Account. ) 9. State concisely the dispositive provisions of the Trust: Article V Section (B) specific devise of the cash sum $10,000.00 to my wife Bertha May Stuckey Chomyn; amended to the' cash sum of $110,000.00 by First Amendment to the Peter J. Chomyn Family Trust dated August 18, 2009; as further amended to the cash sum • of $235,000.00 by Second Amendment to Peter J. Chomyn Family Trust dated December 23, 2009. Article V Section (C) 1. One Third (1/3) to Settlor's son Peter J. Chomyn, Jr. and his wife Pamela Chomyn, or to survivor thereof (the said Peter J. Chomyn predeceased decedent on August 2, 2009). Article V Section (C) 2. One Third (1/3) to Settlor's granddaughter, Holly Chomyn. Article V Section (C) 3. One Third (1/3) to Settlor's grandson, Peter J. Chomyn, III. 10. Explain the reason for filing this Account (if filed because of the death of a party, state name of person, relationship to Trust and date of death): Pursuant to Article V of the Peter J. Chomyn Family Trust "Upon the death of Settlor, the trust shall terminate and the Trustee shall distribute the trust estate, including any property received under the Settlor's Will or otherwise. The said Peter J. Chomyn, Settlor/Trustee died November 18, 2010. Form OC-02 rev 10.13.06 Page 4 of 10 Name of Trust: Peter J. Chomyn Family Trust dated November 3, 1997 11. State why a Petition for Guardian/Trustee Ad Litem has or has not been filed for this Audit see Pa. O.C. Rule 12.4): 12. A. State the amount of Pennsylvania Transfer Inheritance Tax and Pennsylvania Estate Tax paid (including postponed tax on remainder interests), the dates of payment and the interests upon which such amounts were paid: Date February 12, 2011 October 2, 2011 ***See Notation Below Payment Interest 12,278.37 None 4,324.83 None B. If any such taxes remain unpaid or are in dispute, explain: ***Trust assets were listed on Schedule "G" on Inheritance Tax Return filed by Peter J. Chomyn, III, Executor of the Estate of Peter J. Chomyn, deceased Settlor and tax paid by estate funds*** 13. Describe any questions requiring Adjudication and state the position of Petitioner(s) and give details of any issues identified in item 2: This account is to conclude the trust as required by the terms of the attached trust instrument with full distribution of all net income and principal to the beneficiaries followed by discharge of the trustee. Form OC-02 rev 10.73.06 Page 5 of 10 d Name of Trust: Peter J. Chomyn Family Trust dated November 3, 1997 14. Written notice of the Audit as required by Pa. O.C. Rules 6.3, 6.7 and 6.8 has been or will be given to all parties in interest listed in item 15 below. In addition, notice of any questions requiring Adjudication as discussed in item 13 above has been or will be given to all persons affected thereby. A. If Notice has been given, attach a copy of the Notice as well as a list of the names and addresses of the parties receiving such notice. B. If Notice is yet to be given, a copy of the Notice as well as a list of the names and addresses of the parties receiving such Notice shall be submitted at the Audit together with a statement executed by Petitioner(s) or counsel certifying that such Notice has been given. C. If any such party in interest is not sui juris (e.g., minors or incapacitated persons), Notice of the Audit has been or will be given to the appropriate representative on such party's behalf as required by Pa. O.C. Rule 5.2. D. If any charitable interest is involved, Notice of the Audit has been or will also be given to the Attorney General as required under Pa. O.C. Rule 5.5. In addition, the Attorney General's clearance certificate (or proof of service of Notice and a copy of such Notice) must be submitted herewith or at the Audit. 15. List all parties of whom Petitioner(s) has/have notice or knowledge, having or claiming any interest in the Trust, whether such interest is vested or contingent, charitable or non-charitable. This list shall: A. State each party's relationship to the Settlor/Decedent and the nature of each party's interest(s); Name and Address of Each Party in Interest ~ Relationshiv and Bertha May Stuckey Chomyn Wife $235,000.00 9 Keswick Drive Mechanicsburg, PA 17050 Pamela Chomyn 212 Ingrid Place Carnegie, PA 15106 Daughter-in-law ~ 1/3 residue Trust Form oc-oa rev 10.13.06 Page 6 of 10 Name of Trust: Peter J. Chomyn Family Trust dated November 3, 1997 Name !n Interest ~ Relationshia and Interest Holly Chomyn Grandaughter 1/3 residue Trust 785B Meadowland Drive Naples, FL 34108 Peter J. Chomyn, III Grandson 2536 Shellburne Drive Wexford, PA 15090 1/3 residue Trust B. Identify each party who is not sui juris (e.g., minors or incapacitated persons). For each such party, give date of birth, the name of each Guardian and how each Guardian was appointed. If no Guazdian has been appointed, identify the next of kin of such party, giving the name, address and relationship of each; and N/A C. If distribution is to be made to the personal representative of a deceased party, state date of death, date and place of grant of Letters and type of Letters granted. N/A 16. If Petitioner(s) has/have knowledge that a Trust share has been assigned or attached, provide a copy of the assignment or attachment, together with any relevant supporting documentation. 17. If a trustee's principal commission is claimed: A. If based on a written agreement, attach a copy thereof. Forn oc-oz rev J0.13.Oti Page 7 of 10 Name of Trust: Peter J. Chomyn Family Trust dated November 3, 1997 B. If a principal commission is claimed, state amount. N/A C. If a principal commission is claimed, state the amounts and dates of any principal commissions previously paid in prior accounting periods. Amount Date Paid 18. If a reserve is requested, state amount and purpose. Amount: Purpose: If a reserve is requested for counsel fees, has notice of the amount of fees to be paid from the reserve been given to the parties in interest? ........................................ ®Yes ®No If so, attach a copy of the notice. 19. Is the Court being asked to direct the filing of a Schedule of Distribution? .......................... ®Yes ®No Fora, oco2 rev /0.13.06 Page 8 of 10 Name of Trust: Peter J. Chomyn Family Trust Dated November 3, 1997 Wherefore, your Petitioner(s) ask(s) that distribution be awarded to the parties entitled and suggest(s) that the distributive shares of income and principal (residuary shares being stated in proportions, not amounts) are as follows: A. Income: Proposed Distributee(sJ Amount/Proportion Pamela Chomyn One third residue Estate Holly Chomyn One third residue Estate Peter J. Chomyn, III One third residue Estate B. Principal: Proposed Distributee(s) Amount/Proportion Pamela Chomyn One third residue Estate Holly Chomyn One third residue Estate Peter J. Chomyn One third residue Estate Submitted By: (All petitioners must sign. Add additional lines if necessary): w ..u.. Name of Pe 'loner: peter J. Chomyn, III Name of Petitioner: Form oc-oa rev to.ts.o6 Page 9 of 10 r PETER J. CHOMYN FAMI Y TRUST j This Trust Agreement made this~day of ~~J , 1997, by and between 1 PETER J. CHOMYN of Bonita Springs, Lee County, Florida, hereinafter called the 1 Settlor, and ~ ,~ PETER J. CHOMYN, or his successors, hereinafter called the Trustee. WHEREAS, the Settlor hereby revokes all prior Trust Agreements and Amendments to such Trust Agreements; (Whenever the words "Trustee" and "Settlor" are found, they shall include the ' singular and plural and all genders.) '` NAME OF TR SST This trust shall, for convenience, be known as the PETER J. CHOMYN FAM/,CY TRUST, dated 1997, and it shall be sufficient that it be referred to as such in any deed, assignment, bequest or devise. ARTICLE II DESCRIPTION OF PROP RTY TRAN~FFRR~n The Settlor has paid over, assigned, granted, conveyed, transferred and delivered, and by this Agreement does hereby pay over, assign, grant, convey, transfer PETER J. CHOMYN FAMILY TRUST Page 1 -~,.:.. and deliver unto the Trustee the property described in Schedule A, annexed hereto and made a part hereof, and any other property that may be received or which has been received by the Trustee hereunder, as invested and reinvested (hereinafter referred to f as the "trust estate"), which shall be held, administered and distributed by the Trustee I I as hereinafter set forth. ARTICLE III ADMINISTRATION DURING LIFE OF SETTLOR (A) DISPOSITION OF INCOME AND CORPUS `~ The Trustee shall hold, manage, invest and reinvest the trust estate (if any requires such management and investment) and shall collect the income, if any, therefrom and shall dispose of the net income and principal as follows: (1) During the lifetime of the Settlor, the Trustee shall pay to or apply for the benefit of the Settlor, or to such person or persons and in such proportions as he may, from time to time direct, all the net income from this trust. (2) During the lifetime of the Settlor, the Trustee may pay to or apply for the benefit of the Settlor such sums from the principal of this trust (even to the point of completely exhausting the same) as in his sole discretion shall be necessary or advisable from time to time for the health, support, and maintenance of the Settlor, f taking into consideration to the extent the Trustee deems advisable, any other income or resources of the Settlor known to the Trustee. (B) RIGHT TO ADD TO CORPUS Either the Settlor or any other person may, at any time and from time to time add property, acceptable to the Trustee, to the trust estate, including without limitation, the proceeds of life insurance made payable to the Trustee. (C) RIGHT TO REVOKE AND AMEND The Settlor reserves the right during his lifetime, except during any period when PETER J. CHOMYN FAMILY TRUST Page 2 4 he is certified incapacitated by two doctors as set forth in ARTICLE IV, at any time and from time to time, and intended to take effect in his lifetime, by an instrument in writing, signed and acknowledged by Settlor and delivered to the Trustee: ~ (1) To revoke this instrument entirely and to receive from the Trustee all trust property remaining after making payment or provision for payment of all expenses connected with the administration of this trust; (2) From time to time to alter or amend this instrument in any and every particular; (3) From time to time to change the identity or number, or both, of the Trustee; and (4) From time to time to withdraw from the operation of this trust any or all of the trust property. (D) TANGIBLE PERSONAL PROPERTY ,, µ Settlor's household and personal effects, furniture, furnishing and equipment, articles of personal, domestic or household use or ornament, jewelry, sporting equipment, and items of a like or similar nature which may have been transferred to i and owned by Trustee shall remain in the care, custody and control of Settlor so long 1, as he shall live and is not disabled; and Trustee shall have no responsibility or liability with respect to such property during that time. (E) RIGHTS TO INSURAN -F PO ir•iFs The Settlor retains during his lifetime all rights under insurance policies payable ,-- to the Trustee, including the right to change the beneficiaries, and to assign any policies to any lender as security for any loan. The rights of the assignee of any policy shall be superior to the rights of the Trustee. If any policy is changed, this trust shall be revoked with respect to it. During the lifetime of the Settlor, the Trustee shall have no responsibility with respect to any policies for the payment of premiums or otherwise. (F) DISPOSITIVE PROVI ION D RING Il^Y L IFF In addition, for my lifetime, I shall be entitled to full use and possession of any PETER J. CHOMYN FAMILY TRUST Page 3 .. ~ __ non-income producing real estate owned by the Trust, specifically including my residence. ARTICLE IV INCAPACITY AND REHABILITATION ' If the Settlor, Trustee or his successors, is under a legal disability or by reason of illness, or mental or physical disability is, in the written opinion of two doctors currently practicing medicine, unable to properly manage his affairs, he shall be deemed incapacitated for the purposes of this Trust Agreement. The Settlor, Trustee I- or his successors, deemed incapacitated under this Article, shall be deemed rehabilitated when he is no longer under a legal disability or when, in the written ,. opinion of any two doctors currently practicing medicine, _he is able to properly ~ manage his affairs. Upon rehabilitation, that individual shall resume the duties and powers he had prior to incapacity and his successors shall relinquish all powers and be relieved of all duties. All physician's statements should be in writing, notarized and ~ .~ attached to this original trust instrument. Third parties are protected in relying upon such statements without any further act or notice; and no further act on the part of the parties hereto or of any court shall be necessary to vest in a successor Trustee the fiduciary powers and duties in the administration of this trust. ARTICLE V ADMINISTRATION AFTER DEATH OF SETTLOR Upon the death of the Settlor, the trust s~iall terminate and the Trustee shall " distribute the trust estate, including any property received under Settlor's Will or otherwise, as follows: A. From time to time the Settlor may attach to this trust a signed and dated document which will indicate the distribution of certain tangible personal PETER J. CHOMYN FAMILY TRUST Page 4 i property and said document is incorporated herein by reference thereto. B. At the time of the execution of this the PETER J. CHOMYN FAMILY TRUST, I am married to BERTHA MAY STUCKEY CHOMYN. Prior to our marriage we entered into that certain Antenuptial Agreement concerning our respective properties. In connection with said Agreement the home residence therein referred to was sold and its replacements is the home we are residing in on the execution of this Will. •~ • ~~•~ ••~~~..... ..., Additionally, I ratify and confirm other portions of the Agreement whereby we have purchased properties in our joint names with rights of survivorship and that all other provisions of said Antenuptial Agreement shall continue unabated and unchanged unless hereafter amended by agreement between ourselves, and not withstanding any other provisions thereof, I, in addition to the terms of said Agreement, hereby devise the cash sum of TEN THOUSAND AND NO/100 DOLLARS ($10,000.00) to my wife, BERTHA MAY STUCKEY CHOMYN, if she survives me. C. All of the rest, residue and remainder of the Trust assets shall be distributed in equal shares, share and share alike in the following manner; 1. ONE THIRD (1/3) to my son, PETER J. CHOMYN, JR., and his wife, PAMELA CHOMYN, or the survivor thereof. 2. ONE THIRD (1/3) to my granddaughter, HOLLY CHOMYN, if surviving, and if not surviving, then this share shall lapse and be distributed in equal shares, share and share alike among the remaining. residual heirs. 3. ONE THIRD (1/3) to my grandson, PETER J. CHOMYN, III, if surviving, and if not surviving, then this share shall lapse and be distributed in equal shares, share and share alike among the remaining residual heirs. PETER J. CHOMYN FAMILY TRUST ~.: ~`.. i P'~ Y r Page 5 ~:. D. No beneficiary shall have the power voluntarily or involuntarily to sell, alienate, convey, assign, transfer, mortgage, pledge or otherwise dispose of or encumber any interest in his or her share until physical distribution ~LLl or payment is made to his or her creditors or to judgment, levy, execution, sequestration, garnishment, attachment, bankruptcy or other insolvency proceedings, or any, other legal or equitable process. ~• ~. Prior to the distribution of property under ARTICLE IV of this Trust Agreement, the Trustee may, in his sole and absolute discretion, pay to the estate of the Settlor ~ from the principal of the trust estate, such amounts as may be needed to pay all or any part of the Settlor's legally enforceable debts, funeral expenses, administration expenses of the Settlor's estate, together with all estate or other death taxes, ~ ~: I_ including any penalties thereof. (A) SUCCESSOR TRUSTEE If PETER J. CHOMYN dies, resigns, refuses or is at any time unable to act, then Settlor's son, PETER J. CHOMYN, JR. shall be successor Trustee and shall have all the powers and discretion of the Trustee. If Settlor's son, PETER J. CHONFYN, JR., dies, resigns, refuses, or is at any time unable to act, then Settlor's grandson, PETER J. CHOMYN, 111 shall be the alternate successor Trustee and shall have all the powers and discretion of the Trustee. No successor Trustee shall be responsible for acts or omissions of prior Trustees and shall be under no obligation to inquire into the acts or PETER J. CHOMYN FAMILY TRUST Page 6 to examine the accounts of anyone who was a Trustee prior to the qualification of such successor Trustee. (B) SUBSTITUTE TRUSTEE As often as the Trustee shall deem such action to be advantageous to the trusts or to any beneficiary, the Trustee may, by written instrument, resign and appoint as substitute Trustee with respect to all or any part of the trust principal, including property as to which the Trustee cannot act, any person, or any bank or trust 4 company, within or outside the State of Florida. The substitute Trustee shall have all of the title, powers and same under the supervision of the resigning Trustee, who shall act as adviser to the substitute Trustee. The adviser may at any time remove the substitute Trustee by written instrument delivered to the substitute Trustee. Upon the - removal or resignation of the substitute Trustee, the adviser may resume the office of Trustee or may continue to act as adviser and appoint another substitute Trustee. Any adviser may receive reasonable compensation for services as an adviser. (Cl APPOINTMENT OF OTHER SUCCESSOR TRUSTEES That should all of the named Trustees resign, die or become incapacitated, or should a Trustee be dissolved or in some manner cease to legally exist, a new Trustee shall immediately be appointed by a majority of the beneficiaries (in interest not in number), or beneficiary, or guardian of same; should a majority of the beneficiaries not agree to the appointment of any successor Trustee, any beneficiary may apply to the Circuit Court of any county in the State of Florida, wherein the Judge, to whom this case is assigned, shall appoint a successor Trustee to this trust for as many times as is necessary; any Trustee, to resign, shall give any remaining Trustee thirty (30) days notice, in writing, of his or her intention; if there are no remaining Trustees, this notice shall be given to at least one beneficiary. (D) COMPENSATION OF TRUSTEE As compensation for services hereunder, the Trustee may, at his option, receive PETER J. CHOMYN FAMILY TRUST Page 7 .~ r` reasonable fees for his services; in the case of a corporate Trustee, it may charge fees according to the schedule of fees it then has in existence for trusts of comparable size. Such commissions may be charged currently or deferred in the discretion of the Trustee. The Trustee shall have the right to make a reasonable charge each year for his services in preparing income and other tax returns for the trust estate. Such charge may be made to the corpus of the trust estate or to the income thereof or partly to one and partly to the other in the discretion of the Trustee. (E) BOND AND QUALIFICATION No bond shall be required of my Trustee or any successor Trustee hereunder. The Trustee and successor Trustee shall not be required to qualify in any court and are ,- relieved of the filing of any document and accounting to any court. ARTICLE VIII TRUSTEES' POWERS The Trustee shall have the continuing, absolute, discretionary power to deal with any property, real or personal, as freely as I might in the handling of my own affairs, including the general power to sell any trust assets, whether real or personal, for such price and upon such terms as the Trustee sees fit, without any court order. The Trustee's powers may be exercised independently and without the prior or subsequent approval of any court of judicial authority and no person dealing with the Trustee shall be required to inquire into the propriety of the Trustee's actions. The Trustee and his successors and parties serving in their stead, shall have the power and authority conferred by Florida Statutes Section 737.402 as amended from time to time. In addition and not in limitation of any common law or statutory authority, and without application to any court, he and his successors and parties PETER J. CHOMYN FAMILY TRUST Page 8 ~._ serving in his stead shall have the powers and responsibilities described below, to be exercised in their sole discretion. (A) RETAIN TRUST ESTATE To retain any property transferred to the Trustee, regardless of any lack of diversification, risk, non-productivity, or under-productivity. (B) BFI I .EXCHANGE INVEST AND REINVEST ' To hold, convey, exchange, or acquire any interest in the trust property, real, personal or mixed, and any reinvestment thereof, and to invest and reinvest in any real estate, stocks, bonds, notes, other securities, including shares or interests in investment trusts or common trust funds, shares of stock of any corporate trustee or its affiliates. The Trustee shall have as wide a latitude in the selection and making of ' any investments as one holding property free of any trust and shall not be restricted to the investments for Trustees as fixed by the statutes or laws of the State of Florida or of any other jurisdiction. (C1 INSURE To carry any insurance deemed advisable with any insurer against any hazards, ' including public liability, and to use insurance proceeds to repair or replace the asset insured. (D) BORROW To borrow money from any lender, including the Trustee or an affiliate of the Trustee, and to pledge any property in the Trust. (E) DISTRIBUTION IN CASH OR IN KIND To make any division or distribution at fair market value in cash or in kind ar both, and to allocate different kinds or disproportionate shares of property or undivided interests in property among the beneficiaries. (F) TERMINATION OF TRUST To terminate the trust at any time the Trustee shall consider it impracticable to continue the trust by reason of costs, or other reasonable cause in light of Settlor's intentions for creating this trust. (G) FINANCIAL INSTITUTIONS To sign checks, orders to withdraw or to make deposits on accounts at any financial institution. Also, to place stop payment orders on checks or on any assets owned by this trust. And included is the right to obtain certificates of deposit, money market, other accounts or investments and the right to withdraw early certificates of deposit regardless of any penalty involved or to borrow against certificates of deposit or other accounts. PETER J. CHOMYN FAMILY TRUST P~ae 9 -~ r e,RTICLE IX THIRD PARTIES AND TRUSTEE'S s!rN_ATURE (A) Banking institutions, savings and loan associations, insurance companies, stock brokerage firms as well as stock transfer agents and all other third parties are authorized to rely on the provisions of this trust instrument and are exonerated from any loss, claim or liability in relying on said instrument and its provisions. Parties dealing with the Trustee and successor Trustees named hereunder are not required to investigate or to see to the proper exercise of powers or to follow the disposition of money and/or property delivered to the Trustee hereunder. (B) The Trustee shall have the power and authority to designate the authorized signature on accounts with banks and brokerage houses and any other institution whether such signatories be Trustees or not, and all institutions relying on such authorized signatures are exonerated from any loss, claim or liability. Accordingly, one of two or more Trustees, as well. as non-fiduciary parties may be authorized signatories. (C) The certificate of the Trustee that he is acting according to the terms of this instrument shall fully protect all persons dealing with the Trustee. PROHIBITION OF ALIENATION No income or principal beneficiary of any trust created hereunder shall have any right or power to anticipate, pledge, assign, sell, transfer, alienate or encumber his or her interest in the trust, in any way; nor shall any such interest in any manner be liable for or subject to the debts, liabilities or obligations of such beneficiary or claims of any sort against such beneficiary. PETER J. CHOMYN FAMILY TRUST Page 10 !~ ARTICLE XI FLORIDA LAW This Agreement shall be construed and regulated in all respects by the laws of the State of Florida. St1RVIVORSHIP This Agreement shall be binding upon the heirs, personal representatives, successors and assigns of the parties hereto. ARTICLE Xlll INVALIDITY In the event this Trust Agreement is found not to be a valid Inter Vivos Trust and the Settlor cannot or chooses not to amend in order to revalidate same, then this instrument shall be deemed to be a part of Settlor's Last Will and Testament (or the sole Will should the Settlor not have a Will in existence) and incorporated therein by reference and enforced and carried out despite technical matters. IN WITNESS WHEREOF, PETER J. CHOMYN, has signed this instrument as Settlor, and PETER J. CHOMYN, has signed this instrument as Trustee, to evidence his acceptance of the Trust Agreement. Signed, sealed and delivered in the presence of: Witness' / ~ c ,- /1; // ` ~, 1. ~ (Y iV V ~ ~ ~. Witness ,,, ETER J~ HOMYN, Se for PETER J. CHOMYN FAMILY TRUST Page 11 4 ~~~ , The undersigned hereby accepts the trust imposed by the foregoing trust instru nt an agrees~to serve as Trustee upon the ter2ms and conditions set forth. fitness PETER J. OMYN, Tr tee 9 Witness L.J STATE OF FLORIDA COUNTY OF LEE We, PETER J. CHOMYN, +,AFiI S. S1MtTf; l and L CONINAY .are the Settlor and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned officer that the Settlor individually and as Trustee signed the instrument as his Revocable Trust Agreement, and accepted same as Trustee, that he signed, and that each of the witnesses, in the presence of the Settlor, at his request, and in the presence of each other, signed the trust as a witness. PETER . CH IYN Witness ~.c~-c~ Witness The foregoing instrument was acknowledged before me this'" -d day of , 1997 by PETER J. CHOMYN, the Settlor, who ( is personally known to me, ( )has produced ~,i;R15. S111i11i~I as identification, and and U ~'~;'~ ~'ON1iYAY ,the witnesses, who are personally known to me and who did not take an ~oat~h~.~ ,~ ~~ ~~ ~~ ~~ Q Notary Public My commission expires: piFIClAL NOTARY SEAL DSON aY P~' e. PETER J. CHOMYN FAMILY TRUST o`P RALPNARICNAR 2 ~~a n 1~,j~, < cower Nur.En CC56664! Page 12 9iF ~ My co~ssbNExriREs o Op F~ JULY 1 2000 /~ ,.. SCHEDULE A This Schedule is to be attached to the PETER J. CHOMYN FAMILY TRUST dated 1997 by and between PETER J CHOMYN, as Settlor and PETER J. CHOMYN, as Trustee. The following property was delivered to the Trustee by the Settlor: 1. i 2. 3. PETER J. CHOMYN FAMILY TRUST Page ] 3 ~~ FIRST AMENDMENT TO THE PETER J. CHQMYN FAMILY TRUST PETER J. CHOMYN, as Settlor, made, executed and delivered a certain Trust Agreement dated November 3, 1997, in favor of PETER J. CHOMYN, Trustee; and WHEREAS, the Settlor reserved the right at any time to amend or revoke the Trust Agreement in whole or in part; and WHEREAS, PETER 3. CHOMYN now desires to amend said Trust Agreement as set forth herein and to retain in trust all of the assets held therein; and WHEREAS, PETER J. CHOMYN, JR. has died and Settlor wishes to amend the Trust to reflect alternate distribution. NOW, THEREFORE, KNOW ALL MEN BY THESE PRESENTS, that for and in consideration of the premises and intending to be legally bound, the Settlor hereby amends the PETER J. CHOMYN FAMILY TRUST thereto, as follows: 1. The Settlor hereby deletes that portion of Article V, Section (B) "...hereby devise the• cash sum of TEN THOUSAND AND NO/100 DOLLARS ($10,000.00)..." and inserts in lieu thereof ONE HUNDRED TEN THOUSAND AND NO/100 DOLLARS ($110,000.001. 2. The Settlor hereby modifies Article V, Section (C) (1) to add, "If PAMELA CHOMYN should not survive, then her share shall lapse and be distributed in eaual shares, share and share alike. among the remainine residuary heirs " 3. The Settlor hereby modifies Article VII, Section (A), and inserts the following: If PETER J. CHOMYNt III dies, resigns, refuses or is at any time unable to act, then Settlor's ~randdaushter, HOLLY CHOMYN, shall be the alternate successor Trustee and shall have all the powers and discretion of the Trustee. In all other respects, the Settlor republishes and reconfirms THE PETER J. CHOMYN FAMILY TRUST dated November 3, 1997. IN WITNESS WHEREOF, PETER J. CHOMYN has signed this Amendment this ~ 2009. 1 4Sy day of _ ~t~..~t,~ S ~ , G~'~"-'~?~-r'~t ETER J. C OMYN ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss. I, PETER J. CHOMYN, Settlor, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my FIRST AMENDMENT TO THE PETER J. CHOMYN FAMILY TRUST; that I signed it as my free and voluntary act for the purposes therein expressed. P J. OMYN Sworn or affirmed to and acknowledged before me by Peter J. Chomyn, Settlor, this l ~ day of -~ , 2009. otary a~ke•-~--~------ NC~TARIAI SEAL DIANE M SMITH Notary Public MECHANICSBURG BORO, CUMBERIANDCNrF' My Commission Expires Jun 22, 2012 /~ AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss. We, and , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw. Settlor sign and execute the instrument as his AMENDMENT TO THE PETER J. CHOMYN FAMILY TRUST, that PETER J. CHOMYN signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Settlor signed the AMENDMENT TO THE PETER M. CHOMYN FAMILY TRUST as witnesses; and that to the best of our knowledge, the Settlor was at the time 18 years of age or more, of sound mind d der no constraint or undue influence. ,. Sworn or affirmed to and acknowledged b re me this day of , 2009. Notary Public SECOND AMENDMENT TO THE PETER J. CHOMYN FAMILY TRUST PETER J. GHOMYN, as Settlor, made, executed and delivered a certain Trust Agreement dated November 3, 1997, in favor of PETER J. CHOMYN, Trustee; and WHEREAS, the Settlor reserved the right at any time to amend or revoke the Trust Agreement in whole or in part; and WHEREAS, PETER J. CHOMYN now desires to amend said Trust Agreement as set forth herein and to retain in trust all of the assets held therein; and WHEREAS, PETER J. CHOMYN, JR. has died and Settlor wishes to amend the Trust to reflect alternate distribution. WHEREAS a First Amendment to the Trust was executed on August 18, 2009 and Settlor desires to modify Paragraph #1 of that First Amendment and confirmed Paragraph #2 and Paragraph #3. NOW, THEREFORE, KNOW ALL MEN BY THESE PRESENTS, that for and in consideration of the premises and intending to be legally bound, the Settlor hereby amends the PETER J. CHOMYN FAMILY TRUST thereto, as follows: 1. The Settlor hereby deletes that portion of Article V, Section (B) "...hereby devise the cash sum of TEN THOUSAND AND NO/100 DOLLARS ($10,000.00)..." and inserts in lieu thereof TWO HUNDRED THIRTY-FIVE THOUSAND AND NO/100 DOLLARS ($235,000.00). 2. The Settlor hereby modiSes Article V, Section (C) (1) to add, "If PAMELA CHOMYN should not survive then her share shall la se and be distributed in a ual shares, share and share alike, among the remaining residuary heirs " ~. , ~ ~ ''~ , ~ 3. The Settlor hereby modifies Article VII, Section (A), and inserts the following: If PETER J. CHONIYN, III dies, resins, refuses or is at anv time unable to act, then Settlor's ~randdau2hter, HOLLY CHOMYN, shall be the alternate successor Trustee and shall have all the powers and discretion of the Trustee. In all other respects, the Settlor republishes and reconfirms THE PETER J. CHOMYN FAMILY TRUST dated November 3, 1997. IN WITNESS WHEREOF, PETER J. CHOMYN has signed this Second Amendment this 23rd day of December, 2009. PETER J. CHOMYN ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss. I, PETER J. CHOMYN, Settlor, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my SECOND AMENDMENT TO THE PETER J. CHOMYN FAMILY TRUST; that I signed it as my free and voluntary act for the purposes therein expressed. y~ FETER J. HOMYN Sworn or affirmed to and acknowledged before me by Peter J. Chomyn, Settlor, this 23rd day of December, 2009. 1 ~~ ~ _ ~~~~.t~ Notary Public NOTARIAL SEAT. DIANE M SMITH Notary Pubifc MECFIANICSBURG 90R0, CUAABERl.AND CNN My Commission Expires Jun 22, 2012 /,. i AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss. We, ~(/~~c'L-L 2 . (,J,~ c~r~ r ~ and ~OS ~. rn q,2, ~~ ~1 C~~ the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Settlor sign and execute the instrument as his SECOND AMENDMENT TO THE PETER J. CHOMYN FAMILY TRUST, that PETER J. CHOMYN signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Settlo .~ signed the SECOND AMENDMENT TO THE PETER M. CHOMYN FAMILY TRUST as/ 'tresses; and that to the best of our knowledge, the Settlor was at the time 18 years o~,~geor mo , of sound mind and under no constraint or undue influence. / /" ~~ _~ Sworn or affirmed to and acknowledged before me this day of Ll e ~.P~fn-/~-v~ , 2009. cc~u-~.- ~'Y1= ~ Notary Public I NOiAR1A~ SEAL _~ p-ANE M SMITH Notary Public MECHAN-CggURG BORO, CUMBERLgNp CNi 11'-Y Commission Expires Jun 22, 2012 AFFIDAVIT OF SERVICE COMMONWEALTH OF PENNSYLVANIA ) )SS: COUNTY OF WESTMORELAND ) I, Robert W. King, Attorney for Peter J. Chomyn, III, Trustee of the Peter J. Chomyn Family Trust, dated November 3, 1997, do hereby certify that an actual copy of the First and Final Account, and Petition for Adjudication /Statement of Proposed Distribution and a written notice of the Audit was hand delivered to Peter J. Chomyn, III on the 25t'' day of April, 2012 as evidenced by the attached Receipt, and an actual copy of the First and Final Account, and Petition for Adjudication /Statement of Proposed Distribution and a written notice of the Audit was hand delivered to Pamela Chomyn and Bertha May Stuckey Chomyn on the 4`" day of May, 2012 as evidenced by the attached Receipt and an actual copy of the First and Final Account, and Petition for Adjudication /Statement of Proposed Distribution and a written notice of the Audit was hand delivered to Holly Chomyn on the 9`'' day of May, 2012 as evidenced by the attached Receipt. KING & G By: ~.,... ~~ ... Robert W. King, Esquir Attorney for Peter J. Chomyn, SWORN TO and subscribed before me this 2 ~iay of Ju ;~2 2. '~~,/ Notary Public My Commission Expires: corHMONw~TM of Penaas~rw~wra Notarial Seal Diane K. Menham, Notary Public ~Y ~ Greensburg, Westrnoreland County I'tY CamMasbn ExPkes Oct. 16, 2015 Mtn, PFJMISVLVANU ASSOQATION t)F NOTARIt3 e i . h ~ . ~`' ~. w. 1" ~ ~ J •t + r`• 1 /.~' .. . h ~ ~. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: ) PETER J. CHOMYN FAMILY TRUST ) No. 21-10-1220 RECEIPT I, Peter J. Chomyn, III, a beneficiary of the above Trust, do depose and say that I have received and reviewed the First and Final Account and Petition for Adjudication /Statement of Proposed Distribution and a written notice of the Audit, and consent to and join in for approval of the First and Final Account and the Petition for Adjudication /Statement of Proposed Distribution, for myself, my heirs and assigns. IN WITNESS WHEREOF, I set my hand and seal this 7sa'' day of .; , 2012, intending to be legally bound hereby. WITNESS: l (SEAL) Peter J. omyn, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: ) PETER J. CHOMYN FAMILY TRUST ) No. 21-10-1220 RECEIPT I, Holly Chomyn, a beneficiary of the above Trust, do depose and say that I have received and reviewed the First and Final Account and Petition for Adjudication /Statement of Proposed Distribution and a written notice of the Audit, and consent to and join in for approval of the First and Final Account and the Petition for Adjudication /Statement of Proposed Distribution, for myself, my heirs and assigns. IN WITNESS WHEREOF, I set my hand and seal this ~~'~` day of ~ ~ , 2012, intending to be legally bound hereby. WITNESS: 'Zc~vtc~ (SEAL) Holly Chom IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: ) PETER J. CHOMYN FAMILY TRUST ) No. 21-10-1220 RECEIPT I, Pamela Chomyn, a beneficiary of the above Trust, do depose and say that I have received and reviewed the First and Final Account and Petition for Adjudication /Statement of Proposed Distribution and a written notice of the Audit, and consent to and join in for approval of the First and Final Account and the Petition for Adjudication /Statement of Proposed Distribution, for myself, my heirs and assigns. IN WITNESS WHEREOF, I set my hand and seal this ~ day of , 2012, intending to be legally bound hereby. WITNESS: J (SEAL) Pamela Chomyn IN THE COURT OF COMMON PLEA5 OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: ) PETER J. CHOMYN FAMILY TRUST ) No. 21-10-1220 RECEIPT I, Bert'sa May Stuckey Choffiya, a ben.^,ficiary of the ubcve Trust, do depose and say That I have received and reviewed the First and Final Account and Petition for Adjudication /Statement of Proposed Distribution and a written notice of the Audit, and consent to and join in for approval of the First and Final Account and the Petition for Adjudication /Statement of Proposed Distribution, for myself, my heirs and assigns. . IN WITNESS WHEREOF, I set my hand and seal this _~~day of -~ 2012, intending to be legally bound hereby. WITNESS: (SEAL) Bertha May tuckey omyn IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: ) PETER J. CHOMYN FAMILY ) TRUST ) No. 21-10-1220 ELECTION TO TAKE IN KIND TO THE HONORABLE, THE JUDGES OF SAID COURT: BERTHA MAY STUCKEY CHOMYN, being beneficially interested in the above- captioned trust, does hereby elect to receive in kind the hereinafter described assets as part of her distributive share of the trust and does hereby authorize PETER J. CHOMYN, III, Trustee, to charge and reduce her share in the total amount stated herein, see Exhibit "A" attached hereto and made apart hereof. BERTHA MAY STUCKEY CHOMYN does hereby acknowledge that the assets distributed pursuant to this Election shall be valued as of July 12, 2011, the date of distribution and that the Trustee is hereby relieved from any and all liability which may result from a change in value of said assets from the date of distribution to the date of final distribution. In witness whereof, I set my hand and seal this _~~''~ day of ~~ , 2012. WITNESS: BERTHA MA TUC CHOM EXHIBIT "A" Bertha May Stuckey Chomyn Election to Take in Kind Common Stocks 1. AT&T (T) 892 Shares $ 27,446.84 Trust Death Value $ 25,265.90 Increase in Value on Date of Distribution $ 2,180.94 2. American Electric Power Co Inc (AEP) 400 Shares $ 15,264.00 Trust Death Value $ 14,358.00 Increase in Value on Date of Distribution $ 906.00 3. Comcast Corp (CMCSA) 217 Shares $ 5,342.54 Trust Death Value $ 4,470.20 Increase in Value on Date of Distribution $ 872.34 4. Ericsson L M Tel Co (ERIC) 320 Shares $ 4,323.20 Trust Death Value $ 3,331.20 Increase in Value on Date of Distribution $ 992.00 5. FirstEnergy Corp (FE) 200 Shares $ 8,780,00 Trust Death Value $ 7,186.60 Increase in Value on Date of Distribution $ 1,593.40 6. General Electric Co (GE) 600 Shares $ 11,028.00 Trust Death Value $ 9,660.00 Increase in Value on Date of Distribution $ ~ 1,368.00 . 7. Hospitality PPTYS Trust SBI (HPT) 100 Shares $ 2,488,00 Trust Death Value $ 2,200.50 Increase in Value on Date of Distribution $ 287.50 8. Merck & Co Inc New (MRK) 800 Shares $ 28,508.00 - Trust Death Value $ 28,076.00 Increase in Value on Date of Distribution $ 432.00 9. Nextera Energy Inc (NEE) 400 Shares $ 22, 916.00 Trust Death Value $ 20,942.40 Increase in Value on Date of Distribution $ 1,973.60 10. PPL Corp (PPL) 888 Shares $ 24,828.48 Trust Death Value $ 22,990.32 Increase in Value on Date of Distribution $ 1,838.16 11. Pfizer Inc. (PFE) 420 Shares $ 8,400,00 Trust Death Value $ 7,022.40 Increase in Value on Date of Distribution $ 1,377.60 12. Piedmont Natural Gas (PNY) 400 Shares $ 12,216.00 Trust Death Value $ 11,524.80 Increase in Value on Date of Distribution $ 691.20 13. Progress Energy Inc. (PGN) 200 Shares $ 9,618.00 Trust Death Value $ 8,802.00 Increase in Value on Date of Distribution $ 816.00 Total Common Stocks $ 181,159.06 Mutual Funds 14. Templeton Global Opportunities Fund (TEGOX) s 11.412 Shares $ 9,358.83 Trust Death Value $ 8,990.56 Increase in Value on Date of Distribution $ 368.27 Total Mutual Funds: $ 9,358.83 Bonds: 15. Montgomery Co PA HGHR ED&HLTH AUTH REV (613603RA9) 20,000 $ 19,405.20 Trust Death Value $ 18,501.20 Increase in Value on Date of Distribution $ 904.00 16. JEA FLA WTR&SWR SYS REF REV SERB (46613PEA0) 5,000 $ 5,000.40 Trust Death Value $ 4,860.45 Increase in Value on Date of Distribution $ 139.95 17. Miami-Dade CNTY FLA AVIATION REV SER C (59333PBT4) 10,000 $ 9,751.30 Trust Death Value $ 9,200.10 Increase in Value on Date of Distribution $ 551.20 18. Tampa FLA REV HLTH SYS Catholic HLTH-A-3-MBIA (875231FT4) 10,000 $ 4,822.15 Trust Death Value $ 4,585.75 Increase in Value on Date of Distribution $ 236.40 Total Bond Distributions $ 38,979.05 TOTAL Value of Election to Take In Kind b Bertha May Stuckey Chom $ 229,496.94 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA ORPHANS' COURT DIVISION In Re: ) Peter J. Chomyn Family Trust ) No. 21-10-1220 RECEIPT I, the undersigned, BERTHA MAY S'~UCKEY CHOMYN, one of the beneficiaries of the above Trust, do hereby acknowledge receipt of distribution in full of cash in the amount of $5,503.06 and of trust assets pursuant to my Election to Take in Kind having a value on July 12, 2011, the date of distribution, of $229,496.94, from Peter J. Chomyn, III, Trustee of the Trust. In consideration of this advancement being made prior to the filing and audit of the Final Account, I hereby agree to refund on demand, all or any part of this advancement which may be determined to have been improperly made. IN WITNESS WHEREOF, I set my hand and seal this yam' day of 1!~~~ , 2012, intending to be legally bound hereby. WITNESS: (SEAL) BERTHA M STUC Y CHO YN IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: ) PETER J. CHOMYN FAMILY TRUST ) No. 21-10-1220 ELECTION TO TAKE IN KIND TO THE HONORABLE, THE JUDGES OF SAID COURT: HOLLY CHOMYN, being beneficially interested in the above-captioned trust, does hereby elect to receive in kind the hereinafter described assets as part of her distributive share of the trust and does hereby authorize PETER J. CHOMYN, III, Trustee, to charge and reduce her share in the total amount stated herein, see Exhibit "A" attached hereto and made apart hereof. HOLLY CHOMYN does hereby acknowledge that the assets distributed pursuant to this Election shall be valued as of September 7, 2011, the date of distribution, and that the Trustee is hereby relieved from any and all liability which may result from a change in value of said assets from the date of distribution to the date of final distribution. In witness whereof, I set my hand and seal this ~ + ~ da of Cu. Y , 2012. WITNESS: H LY C MYN EXHIBIT "A" Holly Chomyn Election to Take in Kind Bonds: 1. Florida HSG FIN CORP M/F REV MTG- Sumerset HSG Apts Ser S-1 AMT (34073JMS) 5,000 $ 5,057.35 Trust Death Value $ 4,923.65 Increase in Value on Date of Distribution $ 133.70 2. Miami-Dade CNTY FLA SPL OBLIG SERB (59333NCX9) 5,000 $ 5,000.85 Trust Death Value $ 4,664.25 Increase in Value on Date of Distribution $ 336.60 3. Miami-Dade CNTY FLA Aviation REV SERA (59333PEE4) 5,000 $ 4,901.70 Trust Death Value $ 4,658.20 Increase in Value on Date of Distribution $ 243.50 4. Philadelphia PA Gas WKS (717823Y44) 10,000 $ 10,150.90 Trust Death Value $ 9,084.30 Increase in Value on Date of Distribution $ 1,066.60 TOTAL Value of Election to Take in Kind b Holl Chom $ 25,110.80 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA ORPHANS' COURT DIVISION In Re: ) Peter J. Chomyn Family Trust ) No. 21-10-1220 RECEIPT I, the undersigned, HOLLY CHOMYN, one of the beneficiaries of the above Trust, do hereby acknowledge receipt of partial distribution of trust assets, being cash in the amount of $100,000.00 and bonds, pursuant to my Election to Take in Kind, having a value on July 12, 2011, the date of distribution, of $25,110.80 from Peter J. Chomyn, III, Trustee of the Trust. In consideration of this advancement being made prior to the filing and audit of the Final Account, I hereby agree to refund on demand, all or any part of this advancement which may be determined to have been improperly made. IN WITNESS WHEREOF, I set my hand and seal this ~~ day of.~ 2012, intending to be legally bound hereby. WITNESS: (SEAL) HOLLY C OMYN IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA ORPHANS' COURT DNISION In Re: ) Peter J. Chomyn Family Trust ) No. 21-10-1220 RECEIPT I, the undersigned, PAMELA CHOMYN, one of the beneficiaries of the above Trust, do hereby acknowledge receipt of partial distribution of trust assets being cash in the amount of $125,000.00 from Peter J. Chomyn, III, Trustee. In consideration of this advancement being made prior to the filing and audit of the Final Account, I hereby agree to refund on demand, all or any part of this advancement which may be determined to have been improperly made. IN WITNESS WHEREOF, I set my hand and seal this ~ day of , 2012, intending to be legally bound hereby. WITNESS: ~ C~~ (SEAL) PAMELA CHOMYN ,. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA ORPHANS' COURT DIVISION In Re: ) Peter J. Chomyn Family Trust ) No. 21-10-1220 RECEIPT I, the undersigned., PETER J. CHOMYN, III, one of the beneficiaries of the above Trust, do hereby acknowledge receipt of partial distribution of trust assets being cash in the amount of $125,000.00 from Peter J. Chomyn, III, Trustee. In consideration of this advancement being made prior to the filing and audit. of the Final Account, I hereby agree to refund on demand, all or any part of this advancement which may be determined to have been improperly made. IN WITNESS WHEREOF, I set my hand and seal this ~~'' day of ~~.~ 1' , 2012, intending to be legally bound hereby. WITNESS: (SEAL) PETER . CHO ,III Name of Trust: Peter J. Chomyn Family Trust dated November 3, 1997 Verification of Petitioner (Verification must be by at least one petitioner.) The undersigned hereby verifies * [that hers~e he is tare Trustee of the above-named name ojcorpormmn_ Peter J. Chomyn Family Trust and] that the facts set forth in the foregoing Petition for Adjudication /Statement of Proposed Distribution which are within the personal knowledge of the Petitioner are true, and as to facts based on the information of others, the Petitioner, after diligent inquiry, believes them to be true; and that any false statements herein are made subject to the penalties of 18 Pa. C.S. § 4904 (relating to unsworn falsification to authorities). ~~~~~~~~ Signature Petitioner - * Corporate petitioners must complete bracketed information. Certification of Counsel The undersigned counsel hereby certifies that the foregoing Petition for Adjudication / Statement of Proposed Distribution is a true and accurate repr uction of he ~ o etition authorized by the Supreme Court, and that no changes to the f have been m eyond the responses herein. Signature of Counsel fob Petitioner Form OG02 rev 1 D.13.06 Page 10 of 10 SCHEDULE OF DISTRIBUTION Balance as shown by account $447.74 Additional Assets not shown by account: 0.00 Total corrected balance $447.74 Additional disbursements not shown by account: 0.00 Corrected net balance for distribution: $447.74 Personal Estate Fund - $447.74 Distribution Pursuant to the Peter J. Chomyn Family Trust dated November 1,1997,Article V. Section (C) Paragraph 1: TO: Pamela Chomyn Cash $ 186.18 Distribution Pursuant to the Peter J. Chomyn Family Trust dated November 1, 1997, Article V . Section (C) Paragraph 2: TO: Holly Chomyn Cash $ 75.38 Distribution Pursuant to the Peter J. Chomyn Family Trust dated November 1, 1997, Article V. Section (C) Paragraph 3: TO: Peter J. Chomyn, III Cash $ 186.18 TOTAL DISTRIBUTION TO BENEFICIARIES $ 447.74 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION In Re: Peter J. Chomyn Family Trust, dated November 3, 1997 Deceased. No.: 21-10-1220 FIRST AND FINAL ACCOUNT OF Peter J. Chomyn. III. Trustee Date of Trust: November 3, 1997 ~,.., Q ' ~ c__ rz-t ' ~: rn~ ~- <::,~ c~ ~.-i _, ,._-~ r e.- ~ ~ .Ti ~ 1J ~r Y _ M -- - •:?C~ ~ . , ~ J~ _ > _ _~ ,~,~ -~ ~: _ Accounting for the Period: November 18, 2010 thru April 16, 2012 Gross Trust: $607,077.55 Peter J. Chomyn, III, Trustee offers thitis Account to acquaint interested parties with the transactions that have occurred during his administration. It is important that the Account be carefully examined. Requests for additional information or questions or objections can be discussed with: Robert W. King, Esquire KING & GUIDDY 114 North Maple Avenue Greensburg, PA 15601 (724) 836-1500 SLTMNIARY OF ACCOUNT Peter J. Chomyn Family Trust Page Fiduciary Acquisition Yalue PRINCIPAL Receipts 2-5 $ 580,562.90 Other Receipts 6 $12,586.99 Net Gain (or Loss) on Sales or Other Dispositions 10-13 $ (1,131.75) Total $ 592,018.14 Increase in Basis of Stocks and Bonds on Date of Distributions of Elections to Take in Kind $ 19,308.96 Total Principal $ 611,327.10 LESS DISBURSEMENTS: Administration Expenses 14 $ 824.85 Fees and Commissions 14 $ 15,001.12 Taxes 15 $ 2.00 Total Disbursements 15 $ 15,827.97 Principal Balance before Distributions $ 595,499.13 INCOME Receipts 7-9 $ 15,059.41 Less Disbursements 9 $ 0.00 Income Balance before Distributions 9 $ 15,059.41 Principal and Income Balance before Distributions $ 610,558.54 Distributions to Beneficiaries 15-19 $ 610,110.80 COMBINED BALANCE ON HAND $ 447.74 -1- RECEIPTS OF PRINCIPAL ASSETS LISTED IN INVENTORY (Valued as of date of death) Fiduciary Acquisition value CASH: Morgan Stanley Smith Barney Account Number xxx-xxxxx-17255 1. Cash $ 95,527.83 2. Wachovia Bank Certificate of Deposit Account Number 9557 $ 27,481.70 3. Wachovia Bank Certificate of Deposit Account Number 9559 $ 42,798.95 4. Wachovia Bank Certificate of Deposit Account Number 1149 $ 37,559.16 Common Stocks 1. AT&T (T) 892 Shares $ 25,265.90 2. American Electric Power Co Inc (AEP) 400 Shares $ 14 358.00 ' 3. Comcast Corp (CMCSA) 217 Shares $ 4,470.20 4. Commonwealth Reit (CWH) 75 Shares $ 1, 867.12 S. Ericsson L M Tel Co (ERIC) 320 Shares $ 3,331.20 6. FirstEnergy Corp (FE) 200 Shares $ 7,186.60 7. Five Star Quality Care Inc. (FVE) 6 Shares $ 36.60 8. General Electric Co (GE) 600 Shares $ 9,660.00 9. Hospitality PPTYS Trust SBI (HPT) 100 Shares $ 2,200.50 10. Medco Health Solutions Inc. (MHS) 192 Shares $ 11,569.92 -2- 11. Merck & Co Inc New (MRK) 800 Shazes $ 28,076.00 12. Nextera Energy Inc (NEE) 400 Shazes $ 20, 942.40 13. PPL Corp (PPL) 888 Shazes $ 22,990.32 14. Pfizer Inc. (PPE) 420 Shazes $ 7,022.40 15. Piedmont Natural Gas (PNY) 400 Shazes $ 11,524.80 16. Progress Energy Inc. (PGN) 200 Shares $ g~802.00 17. Senior Housing PPTYS TR SIB (SNH) 30 Shazes $ 686.40 18. Travel Centers of America LLC (TA) 10 Shazes $ 33.40 TOTAL COMMON STOCKS $ 180,023.76 Preferred Stocks 1 • RBS Capital Funding TR VII (RBSPRG) 300 Shares $ 4,653.00 Total Preferred Stocks $ 4,653.00 Mutual Funds 1. Invesco Tax-Exempt Securities Fund Class Y (TAXDX) 4,620.765 Shazes, Merger 6/01/2011 to Invesco Van Kampen Municipal Inc FD Cl Y 3,816.997 Shazes $ 48,748.91 2. Columbia High Yield Municipal Fund B (CHMBX) 896.057 Shazes $ 8,611.10 3. Franklin Federal Tax Free Income FD (FKTIX) 856.898 Shazes $ 9,880.03 4. Oppenheimer Rochester National Municipals Fund (ORNAX) 991.251 Shazes $ 6,780.02 5. Templeton Global Opportunities Fund (TEGOX) 511.412 Shares $ 8,990.56 -3- TOTAL MUTUAL FUNDS $ 83,010.62 Corporate Bonds 1. General MTRS Accep Corp Smartnotes Book Entry (3704AOWG3) 10,000 $ 8,738.51 Municipal Bonds 1. Eaton Vance Municipal Bund Fund (EIM) 333 $ 4 017.64 ' 2. Nuveen Preen INCM MUN Fund 2 Inc (NPM) 389 $ 5,239.83 3. Florida ST BRD ED CAP OUTLAY SER 99-E (341422Y64) 10,000 $ 10,344.40 4. Miami-Dade CNTY FLA HLTH FACS AU HOSP REV RFDG-Miami Children (59334NAU6) 10,000.00 $ 1x,445.70 5. Florida HSG FIN CORP M/F REV MTG- Somerset HSG Apts Ser S-1 AMT (34073JMS) 5,000 $ 4,923.65 6. Florida ST BRD ED CAP OUTLAY RFDG-PUB ED-SERE (3414223W1) 10,000 $ 10,243.90 7. Montgomery Co PA HGHR ED&HLTH AUTH REV (613603RA9) 20,000 $ 18,501.20 8. JEA FLA WTR&SWR SYS REF REV SERB (46613PEA0) 5,000 $ 4,860.45 9. Miami-Dade CNTY FLA AVIATION REV SER C (59333PBT4) 10,000 $ 9,200.10 10. Tampa FLA REV HLTH SYS Catholic HLTH-A-3-MBIA (875231FT4) 10,000 $ 4,585.75 11. Philadelphia PA Gas WKS (717823Y44) 10,000 $ 9 084.30 ' 12. Miami-Dade CNTY FLA Aviation REV SERA (59333PEE4) 5,000 $ 4,658.20 -4- 13. Miami-Dade CNTY FLA SPL OBLIG SERB (59333NCX9) 5,000 TOTAL BONDS $ 4,664.25 $ 109,507.881 ~~ TOTAL INVENTORY ~ $ 580,562.90 -5- RECEIPTS SUBSEQUENT TO INVENTORY Fiduciary Acquisition (Valued when received) Yalue 1. Distribution from the Estate of Peter J. $ 9,985.99 Chomyn, pursuant to Article II of the Last Will and Testament of Peter J. Chomyn 2. United States Treasury -Tax Refund $ 2,601 00 $ 12,586.99 TOTAL RECEIPTS OF PRINCIPAL $ 593,149.89 -6- RECEIPTS OF INCOME DIVIDENDS: 1. Ericsson L M Tel Co (ERIC) $ 100 27 2. Senior Housing PPTYS TR SIB (SNH) $ 33.30 3. Progress Energy Inc. (PGN) $ 372 00 4. AT&T (T) $ 1,150.68 5. Comcast Corp (CMCSA) $ 69.33 6. General Electric Co (GE) $ 258 00 7. Piedmont Natural Gas (PNY) $ 344 (~ 8. Merck & Co Inc New (MRK) $ 912.00 9. PPL Corp (PPL) $ 932.40 10. RBS Capital Funding TR VII (RBSPRG) $ 228 00 11. Templeton Glabal Opportunities Fund (TEGOX) $ 102.79 12. Franklin Federal Tax Free Income FD (FKTIX) $ 360.32 13. Nuveen Prem INCM MUN FD 2 Inc (NPM) $ 294.49 14. Columbia High Yield Municipal Fund B (CHMBX) $ 371.98 15. Invesco Tax-Exempt Securities Fund Class Y (TAXDX) $ 2,139.69 16. Nextera Energy Inc (NEE) $ 640 ~ 17. American Electric Power Co Inc (AEP) $ 552.00 18. Pfizer Inc. (PFE) $ 243.60 19. FirstEnergy Corp (FE) $ 355.42 20. Eaton Vance Municipal Bund Fund (EIM) $ 22g 78 -7- 21. Oppenheimer Rochester National Municipals Fund (ORNAX) $ 480.75 22. Hospitality PPTYS Trust SBI (HPT) $ 180.00 23. Commonwealth Reit (CWH) $ 150.00 Total Dividends $ 10,499.80 INTEREST: 1. Morgan Stanley Smith Barney -Money Market $ 73.52 2. Wachovia Bank Certificate of Deposit XXXX9557 $ 107.54 3. Wachovia Bank Certificate of Deposit XXXX9559 $ 167.49 4. Wachovia Bank -Decedents Checking Account $ 406.27 5. Wachovia Bank -Decedents Savings Account $ 36.80 Total Interest: $ 791.62 BOND INTEREST: 6. Tampa FLA REV HLTH SYS Catholic HLTH-A-3-MBIA (875231FT4) $ 118.75 7. Florida HSG FIN CORP M/F REV MTG- Somerset HSG Apts Ser S-1 AMT (34073JMS) $ 237.50 8. BRD ED CAP OUTLAY SER 99-E (Florida ST 341422y64) $ 500 ~ 9. Florida ST BRD ED CAP OUTLAY RFDG-PUB ED-SERE (3414223W1) $ 556.94 -8- 10. Miami-Dade CNTY FLA HLTH FACS AU HOSP REV RFDG-Miami Children (59334NAU6) $ 512.50 11. Philadelphia PA Gas WKS (717823Y44) $ 250.00 12. Montgomery Co PA HGHR ED&HLTH RUTH REV (613603RA9) $ 500 00 13. Miami-Dade CNTY FLA AVIATION REV SER C (59333PBT4) $ 375.00 14. Miami-Dade CNTY FLA SPL OBLIG SERB (59333NCX9) $ 125.00 15. JEA FLA WTR&SWR SYS REF REV SERB (46613PEA0) $ 115.63 16. General MTRS Accep Corp Smartnotes Book Entry (3704AOWG3) $ 476.67 Total Bond Interest $ 3,767.99 TOTAL INCOME OF DIVIDENDS AND INTEREST $ 15,059.41 DISBURSEMENTS OF INCOME None TOTAL DISBURSEMENTS OF INCOME INCOME BALANCE ON HAND $ 0.00 $ 0.00 $ 15,059.41 -9- GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS Liquidation of Morgan Stanley Smith Barney Assets: COMMON STOCKS: 1. Commonwealth Reit (CWH) 75 Shares Fiduciary Acquisition Value $ 1,867.12 Amount Received $ 1,407.47 Loss on Liquidation $ (459.65) 2. Five Star Quality Care Inc. (EVE) 6 Shares Fiduciary Acquisition Value $ 36.60 Amount Received $ 16.35 Loss on Liquidation $ (20.25) 3. Medco Health Solutions Inc. (MHS) 192 Shares Fiduciary Acquisition Value $ 11,569.92 Amount Received $ 10,250.28 Loss on Liquidation $ (1 319 64) , . 4. Senior Housing PPTYS TR SIB (SNH) 30 Shares Fiduciary Acquisition Value $ 686.40 Amount Received $ 624.70 Loss on Liquidation $ (61 70) . -10- S. Travel Centers of America LLC (TA) 10 Shares Fiduciary Acquisition Value $ 33.40 Amount Received $ 31.34 Loss on Liquidation $ (2 ~) PREFERRED STOCK: 6. RBS Capital Funding TR VII (RBSPRG) 300 Shares Fiduciary Acquisition Value $ 4,653.00 Amount Received $ 2,897.94 Loss on Liquidation $ 1 7 ( , 55.06) MUTUAL FUNDS 7. Columbia High Yield Municipal Fund B (CHMBX) 896.057 Shares Fiduciary Acquisition Value $ 8,661.10 Amount Received $ 8,822.40 Gain on Liquidation $ 1 61.30 8. Invesco Van Kampen Municipal Inc FD Cl Y 3,816.997 Shares, formerly Invesco Tax-Exempt Securities Fund Class Y (TAXDX) 4,620.765 Shares Fiduciary Acquisition Value $ 48,748.91 Amount Received $ 50,079.00 Gain on Liquidation $ 1,330.09 -11- 9. Franklin Federal Tax Free Income FD (FKTIX) 856.898 Shares Fiduciary Acquisition Value $ 9,880.03 Amount Received $ 10,282.78 Gain on Liquidation $ 402.75 10. Oppenheimer Rochester National Municipals Fund (ORNAX) 991.251 Shares Fiduciary Acquisition Value $ 6,780.02 Amount Received $ 6,829.72 Gain Liquidation $ 49.70 BONDS 11. Eaton Vance Municipal Bund Fund (EIM) 333 Fiduciary Acquisition Value $ 4,017.64 Amount Received $ 3,906.80 Loss on Liquidation $ (110.84) 12. Florida St BRD ED CAP OUTLAY SER 99-E (Florida ST 341422Y64) Fiduciary Acquisition Value $ 10,344.40 Amount Received $ 10,100.00 Loss on Liquidation $ 244 ( .40) 13. Florida ST BRD ED CAP OUTLAY RFDG-PUB ED-SERE (3414223W1) Fiduciary Acquisition Value $ 10,243.90 -12- Amount Received Loss on Liquidation 14. Miami-Dade CNTY FLA HLTH FACS AU HOSP REV RFDG-Miami Children (59334NAU6) Fiduciary Acquisition Value Amount Received Loss on Liquidation 15. Nuveen Prem INCM MUN Fund 2 Inc (NPM) 389 Fiduciary Acquisition Value Amount Received Gain on Liquidation 16. General MTRS Accep Corp Smartnotes Book Entry (3704AOWG3) 10,000 Fiduciary Acquisition Value Amount Received Gain Liquidation TOTAL GAINS AND LOSSES $ $ $ 10,100.00 $ 10,445.70 10,100.00 $ (143.90) (345.70) $ 5,239.83 $ 5,365.95 $ 126.12 $ 8,738.51 $ 10,000.00 $ 1,261.49 $ (1,131.75 -13- DISBURSEMENTS OF PRINCIPAL ADMINISTRATION EXPENSES PRINCIPAL 1. Register of Wills (a) Fee to file Trust Account $ 50.00 (c) Fee to Advertise Trust Account $ 80 ~ 2. King &Guiddy -Preparation of 2011 $ 400 ~ Trust Fiduciary Tax Returns 3. Dollar Bank -Trust Checking Account $ 10 00 Service Fee . 4. King &Guiddy -Postage, Photo Copies $ 284.85 and Certificate of Mailings TOTAL ADMINISTRATION EXPENSES - PRINCIPAL $ 824.85 ADMINISTRATION EXPENSES -REALTY None $ 0 ~ TOTAL ADMINISTRATION EXPENSES - REALTY $ ~.~ TOTAL ADMINISTRATION EXPENSES $ 824.85 FEES AND COMMISSIONS 1 • Morgan Stanley Smith Barney $ Administration Fee -Ericsson Class B 1.12 2. King &Guiddy -Attorney Fee $ 15,000.00 TOTAL FEES AND COMMISSIONS $ 15,001.12 -14- TAXF,S 1. PA Department of Revenue - PA41 Tax $ 200 due for tax year 2011 TOTAL TAXES $ 2 ~ TOTAL DISBURSEMENTS OF PRINCIPAL $ 15,827.97 DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES Pursuant to the Peter J. Chomyn Family Trust dated November 1, 1997, Article V. Section (B), as amended on December 23, 2009 under paragraph 1. of the Second Amendment to the Peter J. Chomyn Family Trust: TO: Bertha May Stuckey Chomyn Cash $ 5,503.06 Common Stocks 1. AT&T (T) 892 Shares $ 27,446.84 Trust Death Value $ 25,265.90 Increase in Value on Date of Distribution $ 2,180.94 2. American Electric Power Co Inc (AEP) $ 15 264.00 400 Shares ' Trust Death Value $ 14,358.00 Increase in Value on Date of Distribution $ 906.00 3. Comcast Corp (CMCSA) 217 Shares $ 5,342.54 Trust Death Value $ 4,470.20 Increase in Value on Date of Distribution $ 872.34 4. Ericsson L M Tel Co (ERIC) 320 Shares $ 4,323.20 Trust Death Value $ 3,331.20 -15- Increase in Value on Date of Distribution $ 992,00 5. FirstEnergy Corp (FE) 200 Shares Trust Death Value $ 7,186.60 Increase in Value on Date of Distribution $ 1,593.40 6. General Electric Co (GE) 600 Shazes Trust Death Value $ 9,660.00 Increase in Value on Date of Distribution $ 1,368.00 7. Hospitality PPTYS Trust SBI (HPT) 100 Shares Trust Death Value $ 2,200.50 Increase in Value on Date of Distribution $ 287.50 8. Merck & Co Inc New (MRK) 800 Shazes Trust Death Value $ 28,076.00 Increase in Value on Date of Distribution $ 432.00 9. Nextera Energy Inc (NEE) 400 Shazes Trust Death Value $ 20,942.40 Increase in Value on Date of Distribution $ 1,973.60 10. PPL Corp (PPL) 888 Shazes Trust Death Value $ 22,990.32 Increase in Value on Date of Distribution $ 1,838.16 11. Pfizer Inc. (PFE) 420 Shares Trust Death Value $ 7,022.40 Increase in Value on Date of Distribution $ 1,377.60 12. Piedmont Natural Gas (PNY) 400 Shazes Trust Death Value $ 11,524.80 13. Increase in Value on Date of Distribution Progress Energy Inc. (PGN) 200 Shazes $ 691.20 ~ $ 8,780.00 ~ ~~ $ 11,028.00 ~ ~~ $ 2,488.00 $ 28,508.00 $ 22,916.00 $ 24,828.48 $ 8,400.00 $ 12,216.00 $ 9,618.00 -16- Trust Death Value $ 8,802 00 Increase in Value on Date of Distribution $ 816.00 Total Common Stocks $ 181,159.06 Mutual Funds: 14. Templeton Global Opportunities Fund $ 9,358.83 (TEGOX) 511.412 Shares Trust Death Value $ 8,990.56 Increase in Value on Date of Distribution $ 368.27 Total Mutual Funds: $ 9,358.83 Bonds: 15. Montgomery Co PA HGHR ED&HLTH $ 19 405.20 AUTH REV (613603RA9) 20,000 , Trust Death Value $ 18,501.20 Increase in Value on Date of Distribution $ 904.00 16. JEA FLA WTR&SWR SYS REF REV $ 5 000 40 SERB (46613PEA0) 5,000 , . Trust Death Value $ 4,860.45 Increase in Value on Date of Distribution $ 139.95 17. Miami-Dade CNTY FLA AVIATION $ 9 751 30 REV SER C (59333PBT4) 10,000 , . Trust Death Value $ 9,200.10 Increase in Value on Date of Distribution $ 551.20 18. Tampa FLA REV HLTH SYS Catholic $ 4 822 15 HLTH-A-3-MBIA (875231FT4) 10,000 , . Trust Death Value $ 4,585.75 Increase in Value on Date of Distribution $ 236.40 Total Bond Distributions $ 38,979.05 TOTAL DISTRIBUTION to Bertha Chomyn: $ 235,000.00 -17- Partial Distribution Pursuant to the Peter J. Chomyn Family Trust dated November 1, 1997, Article V. Section (C) Paragraph 1: TO: Pamela Chomyn Cash $ 125,000.00 Partial Distribution Pursuant to the Peter J. Chom 1, 1997, Article V. Section (C) Paragraph 2: TO: Holly Chomyn yn Family Trust dated November Cash $ 100 000 00 , . Bonds: 1. Florida HSG FIN CORD M/F REV MTG- Somerset HSG Apts Ser S-1 AMT (34073JMS) 5,000 $ 5,057.35 Trust Death Value $ 4,923.65 Increase in Value on Date of Distribution $ 133.70 2. Miami-Dade CNTY FLA SPL OBLIG SERB (59333NCX9) 5,000 $ 5,000.85 Trust Death Value $ 4,664.25 Increase in Value on Date of Distribution $ 336.60 3. Miami-Dade CNTY FLA Aviation REV SERA (59333PEE4) 5,000 $ 4,901.70 Trust Death Value $ 4,658.20 Increase in Value on Date of Distribution $ 243.50 4. Philadelphia PA Gas WKS (717823Y44) 10,000 $ 10,150.90 Trust Death Value $ 9,084.30 Increase in Value on Date of Distribution $ 1,066.60 Total Bond Distributions $ 25,110.80 -18- Total Partial Distribution to Holly Chomyn Partial Distribution Pursuant to the Peter J. Chomyn Family Trust dated November 1, 1997, Article V . Section (C) Paragraph 3 TO: Peter J. Chomyn, III Cash I~ TOTAL DISTRIBUTIONS TO BENEFICIARIFS $ 125,110.80 $ 125,000.00 $ 610,110.80 -19- BALANCE ON HAND 1. Cash Total ~~ BALANCE ON HAND ~ $ 447.74 $ 447.74 $447.74 -20- PROPOSED DISTRIBUTION TO BENEFICIARIES BALANCE FOR DISTRIBUTION Cash withheld for payment of final expenses Specific bequest RESIDUARY BALANCE $ 447.74 $ 0.00 $ 0.00 $ 447.74 DISTRIBUTIONS CASH WITHHELD I Distribution Pursuant to the Peter J. Chomyn Family Trust dated November 1, 1997, Article V. Section (C) Paragraph 1: TO: Pamela Chomyn Cash 0.00 Distribution Pursuant to the Peter J. Chomyn Family Trust dated November 1, 1997, Article V. Section (C) Paragraph 2: TO: Holly Chomyn Cash Distribution Pursuant to the Peter J. Chomyn Family Trust dated November 1, 1997, Article V. Section (C) Paragraph 3: TO: Peter J. Chomyn, III Cash TOTAL DISTRIBUTION TO BENEFICIARIES $ 186.18 $ 75.38 $ 186.18 $ 447.74 -21- AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF WESTMORELAND ) ~: Before me, the undersigned authority in and for said Commonwealth and County, personally appeared PETER J. CHOMYN, III, who, being duly sworn according to law, deposes and says that he is the Trustee of the Peter J. Chomyn Family Trust dated November 3, 1997, that the disbursements shown in the account have been made to the parties entitled thereto and that the Account, as stated, is true and correct as he verily believes. PETER J. HOMYN, III, Trustee SWORN TO and subscribed before me thisJ~2~ day of /f 12. (Seal) `~ NOTARY PUBLIC My Commission Expires: ~MOIVWEALTH OF PENNSYLVA(Viq Diane K. ~n~al Seal ply ~ ~~~ W NobrY Publk esimon.Mand County MEN ExWres OCt 16.2015 ~socrnnoH of Harm REQUEST FOR APPROVAL Accountant requests that the approval be determined by the Court in accordance with the Petition for Approval of Account to be offered in evidence at the audit of this Account. PETER . CHO , m, Trustee