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Home My WebLink About01-09-13 (2)~ REV-1500Ex(010) 1505610143 ~' OFFICIAL USE ONLY PA Department of Revenue Pennsylvania County Code Vear File Number Bureau of Individual Taxes °E'.A,Mr"'°raE°ENOE Po Box.zaosot INHERITANCE TAX RETURN 21 12 0 0 4 6 2 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 579 62 0692 04 10 2012 11 07 1919 Decedent's Last Name Suffix Decedent's First Name MI JOHNSON DAGMAR (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ® 1, Original Return ^ 2. Supplemental Return ^ a. Limited Estate ^ qa. Future Interest Compromise (date of death after 12-12-82) ® g Decedent Died Testate ® T (Attach Copy Hof Trust)a Living Trus[ (Attach Capy of W Iq ^ 9. Litigation Proceeds Received ^ 1p. Spousal Poverty Credit (date of death between 12-31-91 and i-1-95) ^ 3, Remainder Return (date of death prior to 12-13-82) ^ 5. Federal Estate Tax Return Required O 8. Total Number of Safe Deposit Boxes ^ ~ t,Election to tax under Sec. 9113(A) (Attach Sch. 0) ~c.--~- ;%7 A ~ rn CORRESPONDENT • THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TA~r~§ftMATIONLSHOUL~ Name Dayt,~e~lephonl~umbg~ ;;..:a THOMAS P GACKI 71~' ~~9 6000~-~ 'I First line of address 213 MARKET STREET Second line of address 8TH FLOOR City or Post Office State ZIP Code HARRISBURG PA 17101 Correspondent'se-mail address: tgaCki@eCkertSeamanB.COm i~iSTeR~~F WILLS US~~ OTiI(LY " r..~ ~,• ~ ~ , " 7 ~. : F~ _.. . s "- r''1 .~.a rv -rt i:n DATE FILED TO: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative Is based on all information of which preparer has any knowledge. SIGNATU OF PERSON RESPONSI E FOR FILING RETURN +~ DATE ~i, , , ,,, P~,,, m ~~, ~ J Karen Yeager ~~,~/7-/~ 20 Sunfire Avenuev a ill, PA 17011-1020 SIGNATU EPARER R T REP~ENTATIVE DATE ' - ,/,;,• Thomas P Gacki ~ Z ~ 7 ~ ~ ~_ ADDRESS 213 Market Street, Harrisburg, PA 17101 1505610143 Side 1 1505610143 J ~~~ 1505610243 REV-1500 EX oacedenrs Name: JOHNSON , D A G M A R RECAPITULATION 1. Real Estate (Schedule A) ................................................................................... ....... 1. 2. Stocks and Bonds (Schedule B) ........................................................................ ....... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)...... .... 3. 4. Mortgages & Notes Receivable (Schedule D) .................................................... ...... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............ .... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .......... ... 6. 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested .......... ... 7, 8. Total Gross Assets (total Lines 1-7) ................................................................. ...... g, 9. Funeral Expenses & Administrative Costs (Schedule H) .................................... ..... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ........................... ..... 10. 11. Total Deductions (total Lines 9 & 10) ............................................................... .......11. 12. Net Value of Estate (Line 8 minus Line 11) ....................................................... ......12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............................................ ..... 13. 14. Net Value Subject to Tax (Line i2 minus Line 13) ............................................ ..... 14. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 15. 16. Amount of Line 14 taxable at lineal rate X .045 4 8 0, 6 0 1. 0 0 16. 17. Amount of Line 14 taxable at sibling rate X 12 17. 18. Amount of Line 14 taxable at collateral rate X .15 1 0, 0 0 0. 0 0 18. 19. Tax Due ............................................................................................................. ......19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Decedent's Social Security Number 579 62 0692 178,000.00 242,862.67 7,949.95 27,303.48 73,496.80 529,612.90 34,251.16 4,760.74 39,011.90 990,601.00 490,601.00 21,627.05 1,500.00 23,127.05 Side 2 1505610243 1505610243 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 - 12 - 00462 Johnson, Dagmar - ---- STREET ADDRESS 9 Roundhill Road CITY ;STATE Camp Hill ' PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments 21 ,400.00 __ .._ B. Discount 1,126.32 3. Interest Total Credits (A + B) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (1) 23,127.05 (2) 22,526.32 (3) 0.00 (4) (5) 600.73 Make Check Payable to: REGISTER OF WILLS, AGENT. i i ~ PF; §~ ~) ~a~ii~ i ~ ~a ~ ~~ ( d,Q aY .~, ~ ~ ~ s v r'' {~p9;~}W" Bugs . ~,; I~Lg3~' Z a~~i ~, ,uN a . .. ,' ,~ i . , ~° ti,~l) i a .I~{~ `. ,~".: R~. :~ ,¢~~„~ ,.5}~~ ~. ~~~ v i 6ti~i .G,1~-~. ~~~s.~b., d3llir .. ~e149i'!I q . Aga .' a £~' , ~, ~ ; PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No p p Y ............................................................. . rx l b. retain then ht to desi Hate who shall use the ro ert transferred or its income :................................ c. retainahrevesonary Merest or.ro ert transfPmp.'...y ......................................................~.................... ~ X d. receive the romise for life of either a ments, benefits or care .............._............................................... ~ x p p y ~ h without ~~] ~-] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of deaf receiving adequate consideration? ..........................................................................._.........................................._ ',Lx' 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... ~ x 4 Donta ns a benefic ary designatl'oR?irement Account, annuity, or other non-probate property which { X I_ i IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MU gSee~~T COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETUR ~i" °' q~ ~ £ Ii ~ i .£. t ~~W:`e ~.acM ~a~r"~l4tau .9~~~~uii.: s,~,Ii~i~~ii~„~i"~~~d ~~~~~I ~. 't li i~i,ea d?;CmCt i~{iii ~68 (~ia~~l i~ ,;~,$i~i~"-: w 1.. ~~~ °ry 1~! ~.~, r~~ilf;. 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 January 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)]. 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 1,2 percent [72 P.S. §9116 (a) (1.3)1. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. COMMONWEALTH OF PENNSYLVANIA SCHEDULE A REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ',, - FILE NUMBER ESTATE OF Johnson, Dagmar X21 - 12 - 00462 _ -- - All real property owned sole)yy or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be excYtanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. Attach a copy of the settlement sheet if the property has been sold. Include a copy of the deed showing decedent's interest if owned as tenant in common. - - _ - ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH _- 1 9 Round Hill Road, Camp Hill, PA--see settlement sheet attached 178,000.00 __ _._ TOTAL (Also enter on Line 1, Recapitulation) 178,000.00 I SCHEDppULE NB LOMMONVVEAL7H OF PENNSYLVANIA i STOCKS -" BO- "DS i INHERITANCE TAX RETDRN RESIDENT DECEDENT ESTATE OF Johnson, Dagmar 'FILE NUMBER 21 - 12 - 00462 All property jointly-owned with right of survivorship must t>e disclosed on Schedule F. ITEM DESCRIPTION UNIT VALUE ~ VALUE AT DATE OF NUMBER DEATH 1 Walnut Street Securities Portfolio--see statement attached ~ 242,862.67 i i ~~ ~ TOTAL (Also enter on line 2, Recapitulation) I 242,862.67 SCHEDULE E CASH, BANK DEPOSITS, 8~ MISC. cDMMONWEALTH DF PENNSV~VANIA PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT - - FILE NUMBER ESTATE OF ,Johnson, Dagmar 21 - 12 - 00462 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION NUMBER - -- - - - 1 Township/County Taxes reimbursed at settlement 2 Township/County Taxes reimbursed at settlement 3 Sewer reimbursed at settlement 4 Buick Century--sale price 5 Household Furniture--sale price 6 Miscellaneous Household furnishings 7 Patriot News Refund 8 Car Insurance Refund 9 AAA Refund 10 Estimated Refund of 2012 income taxes per accountant _ _ -- - -. VALUE AT DATE OF DEATH -- -- -- -_ 283.18 1, 952.20 114.00 3,000.00 880.00 500.00 172.83 285.99 11.75 750.00 - - -- - __ - _ _ TOTAL (Also enter on Line 5, Recapitulation) 7,949.95 I SCHEDULEF i °DMM°NWEA~T"Dr PE"NSVLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT __ _,_.. .-___-- ---~-- ---- -- -- ESTATE OF ~ FILE NUMBER Johnson, Dagmar 21 - 12 - 00462 __ __ _ _ - _ _ - If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. __ __ SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT - - __ Karen E. Yeager 20 Sunfire Avenue Daughter A Camp Hill, PA 17011-1020 Y OWNED PROPERTY: -- - __ _- _ LETTER ~ ITEM DATE _ __ I gESCRIPTIOry pF PROPERTY rpATE OF DEATH Include name of financial Instltu~tlon and bank account numb % OF ~ DECD'S DnrE of DEATH vA~ue of FOR JOINT NUMBER MADE 'or similar identifying number Attach deed for jointly-held reap VALUE OF ASSET (I NTEREST oeceDENrs INTEREST TENANT JOINT estate. , _ 1 A _ - 08/13/2008 _ I 22,249.30 Wells Fargo CD 24702073709487 0% 1,124.65 2 A 1 04/14/2009 !, Citizens Bank Checking a,359,9s I 50% 2,179.98 3 A 2009 Citizens Bank CD 2~ss7ss i ~~ 50% 13,998.85 ~I L _~- __, _ 1- - I _ --- __ TOTAL (Also enter on line 6, Recapitulation) 27,303.48 SCHEDULE G COMMONWEALTH OF PENNSYLVANIA ~ INTER-VIVOS TRANSFERS & INHERITANCE TAX RETURN '~ RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY __ ESTATE OF Johnson, Dagmar FILE NUMBER 21 - 12 - 00462 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. ITEM ~ DnTE of DEATH 4 EXCLUSION I TAXABLE VALUE andlthe date of trans e e tAHa ff h atop yo the deed for~eal esdtatel. ~~ VALUE OF ASSET ~ I E oEST ~(IF APPLICABLE) ~- 73,496.80 NUMBE ; I RIVerSOUI'Ce AnnUlty--See Statement attached--Karen 73,496.80 I 1 Yeager Death Beneficiary I I I '~ I ii I - I -- ~!- - ! _ _~ TOTAL (Also enter on line 7, Recapitulation) 73,496.80 SCF~DULE H FUNERAL D(PONSES 8~ COMMONWEALTH OF PENNSYLVANIA ~w ~ ~ i INHERITANCE TAX RETURN IIVC RESIDENT DECEDENT i __.. __ ___.. _-.I____ _.-.. _ __ _ ~I _____ --.__- ___ _. I FILE NUMBER ESTATE OF Johnson, Dagmar 21 - 12 - 00462 __ __ Debts of decedent must be re orted on Schedule I. _ ITEM NUMBER DESCRIPTION AMOUNT FUNERAL EXPENSES: A. 1 I Wegmans--Food for Funeral lunch 328.54 2 Sound Board rental 50.00 3 Funeral Home and Pastor Honorarium 10,246.20 4 Organist 125.00 5 Cemetery/Monument Engraving 875.00 B. ~ ADMINISTRATIVE COSTS: ~, Personal Representative's Commissions Name of Personal Representative(s) Street Address I~ City State Zip Year(s) Commission paid 2. Attorney's Fees Eckert Seamans 3,500.00 3_ Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant I Street Address City State Zip Relationship of Claimant to Decedent a. i Probate Fees Initial Probate/Death Certificates 5. Accountant's Fees 6. Tax Return Preparer's Fees Bergdoll and Company 7, Other Administrative Costs 1 ,Broker fee paid at settlement 508.50 2,000.00 10.680.00 __ _ _ __ _ _ I _ _ _ _ - - -- TOTAL (Also enter on line 9, Recapitulation) 34,251.16 Schedule H Funeral Experl~es & COMMONWEALTH OF PENNSYLVANIA A~:NN^~ ~~Yy.N. ~ INHERITANCE TAX RETURN /'N~ 1 Y' IL7Y G11Y6 ~+1101.71.U1 ~Y1 MRA RESIDENT DECEDENT ___ _ _ __ - __ i. _ ___ _ FILE NUMBER ESTATE OF Johnson, Dagmar 21 - 12 - 00462 -- -- 2 Transfer tax paid at settlement 3 School taxes paid at settlement 4 Sewer paid at settlement 5 Notary fee at settlement 6 I Duplicate Car title 7 Lawn Care 8 I Mazland and Garrick--account set up fee i 9 PPL 10 Water 11 Lawn Care II 12 PPL 13 Water 14 House Cleaning and lawn care ~I 15 Checks 16 i Final Electric 17 ,Final Water 18 j Stanley Steamer for carpet cleaning 19 True Value hardware for rugs and soil 1, 780.00 2, 041.70 138.00 15.00 64.50 175.00 50.00 27.39 25.27 145.00 34.03 21.62 255.00 35.75 32.85 13.07 274.54 46.59 Page 2 of Schedule H Schedule H Funeral Exper~es & COMMONWEALTH OF PENNSYLVANIA A~In~M^~~M.~ INHERITANCE TAX RETURN hM.a 11 IbYS7YYC liW{D 'IlJC4 RESIDENT DECEDENT FILE NUMBER ESTATE OF Johnson, Dagmar 21 - 12 - 00462 20 .Highland Gardens- plants 26.25 21 Lowes--plants and bushes 105.56 22 True Value--trash bags and weed killer 24.75 23 True Value--Mulch 12.60 24 ~ Homeowner's Insurance ~~ 154.75 25 Fuel Oil ', 230.60 26 Lawn Treatments 70.10 27 Sewer/Trash 138.00 Page 3 of Schedule H SCHEDULEI DEBTS OF DECEDENT, MORTGAGE COM NORERITANDE TAx RETURN ANIA LIABILITIES, & LIENS RESIDENT DECEDENT j FILE NUMBER ESTATE OF Johnson, Dagmar 121 - 12 - 00462 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. __ ITEM _ __ -_ - NUMBER -- 1 - --- Amerigas 2 Messiah Village Home Care 3 Griswold (Medical Care) 4 Melissa Spitzer (Medical Care) 5 Sylvia Deppen (Medical Care) 6 Gwen Bryant (Medical Care) 7 Linda Maireccino (Medical Care) 8 PPL 9 Water Bill 10 Phone Bill 11 Messiah Village Home Care 12 2012 Taxes 13 Credit Card Balance DESCRIPTION AMOUNT 219.57 1, 219.24 166.00 162.00 12.00 132.00 192.00 95.49 49.01 28.20 798.97 616.93 1,069.33 TOTAL (Also enter on Line 10, Recapitulation) 4,760.74 REV•1513 EX+ (11-08) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Johnson, Dagmar SCHEDULE) BENEFICIARIES FILE NUMBER 21 - 12 - 00462 -- - T RELATIONSHIP TO SHARE OF ESTATE ', AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) - ' ($$$) RECEIVING PROPERTY Do Not list Trusteels) l~ TAXABLE DISTRIBUTIONS[include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 ;Steven Omvik Other--Godson 10,000.00 3409 Almar Drive Vestal, NY 13850 ', I 2 Karen Yeager 20 Sunfire Drive Camp Hill, PA 17011 Daughter j 100% Residue Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet, as appropriate. II. NON-TAXABLE DISTRIBUTIONS' A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN I B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEaT 0.00 FIRST CODICIL TO WILL OF DAGMAR JOHNSON I, Dagmar Johnson, presently of Cumberland County, Pennsylvania, declare this to be a First Codicil to my Will of January 9, 1998: I hereby delete Paragraph 2 of my Will in its entirety, and replace it with the following Paragraph 2: 2. Cash Bequest: I give the sum of Ten Thousand Dollars ($10,000) to my Godson, Steven Omvik, of 3409 Almaz Drive, Vestal, New York, 13850, if he survives me. 2. I hereby delete Paragraph 9 of my Will in its entirety, and replace it with the following Paragraph 9: 9. Fiduciaries: I appoint as Executor hereunder my daughter, Kazen Hollinger. If Karen is unable or unwilling to serve or to continue serving, then Stephanie Kleinfelter, shall serve as Executor hereunder. My fiduciaries shall serve as guardian of the property of any minor beneficiaries hereunder, under any instrument of trust executed by me, under any policies of insurance on my life, and in any other situation in which the power to make such appointment exists under the laws of Pennsylvania. No individual fiduciary shall be liable of the acts, omissions or defaults of any agent appointed and retained with due care or of any co-fiduciary. No fiduciary named herein shall be required to furnish bond or other security for the proper performance of their duties hereunder. 3. In all other respects, my Will of January 9, 1998, shall remain in full force and effect. IN WITNESS WHEREOF, I, Dagmaz Johnson, set my hand to this First Codicil to my last Will, typed on two (2) sheets of paper, including the self-proving attestation clause and signature of witnesses, this 30~, day of November, 1999. !"~=~,~Z~,~li~~ /'~~Cr~~~2i' (SEAL) ~'Dagmaz Johnson, Testatrix residing at !~;, ,~ ., ./~ .~ 1~' residing at S -1- TT T'i _J COMMONWEALTH OF PENNSYLVANIA COT_TNTY OF DAUPHIN ss: Dagmar Johnson, (the testatrix), SfePhcrrr;e ~/e;~{~ /~~ and ~ ; ,, cQ~ m . ~s h e/n-, a ~~ (the witnesses), whose names are signed to the foregoing instrument, being first duly sworn, each hereby declares to the undersigned authority that the testatrix signed and executed the instrument as her First Codicil to her Will dated January 9, 1998, in the presence of the witnesses and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the codicil as witness and that to the best of his or her knowledge the testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. TESTATRIX: ,~' ~' D~GMAR JO SON Subscribed, sworn to and acknowledged before me by Dagmar Johnson, the testatrix, and subscribed and sworn to before me by Sfe~Lig~i ~/e~~ ~/{er and /~;,,~~ y-r1. ~s~elmu~ ,the witnesses, this 30~' day of November, 1999. NOTARIAL SEAL Notary Public ~3LA(dCA I. itRIS11CH, Notary Public Harrisburg, PA Dauphin County !~y Commislon E~iras Feb. 3, 2f30~ (SEAL) -2- WITNESS: _. WILL OF DAGMAR JOHNSON I, DAGMAR JOHNSON, presently of Cumberland County, Pennsylvania, declare this to be my will and hereby revoke all prior wills and codicils made by me. 1. Personalty. 2 bequeath such items of my tangible personal property as are specifically itemized on the list, if any, in my handwriting, signed and dated by me at the end thereof, and attached to this, my will, to the persons named thereon to receive such items. I bequeath all of my remaining tangible personal property not used in business or for the production of income, including without limitation, furniture, furnishings, clothing, objects of art and decoration, and the like, and any motor vehicles which I own, together with the insurance thereon, to my husband, Karl E. Johnson, if he survives me. If my husband does not survive me, I bequeath all such remaining property, together with the insurance thereon, to my daughter, Karen Hollinger, or, if my said daughter does not survive me, to those of my grandchildren who survive me, to be divided as they may agree. If said grandchildren are not all competent adults, or if they cannot agree on the division, then my executor(s) shall make the division, into shares that are as equal as practicable in the judgment of my executor(s), raving due regard fcr the stated personal preferences of said grandchildren, and/or may sell any or all items passing hereunder and distribute the proceeds. 2. Residence. If my husband survives me, and at my death our usual principal residence is owned in a manner which will not result in passage of full title to him by operation of law, then I devise to him my entire interest in said residence, together with all insurance thereon. 3. Residue. I bequeath, devise, and appoint all the rest of my property, of whatever nature and wherever situated, including property over which I hold a power of appointment, except that I do not exercise any power of appointment given to me by my husband, to my husband, Karl E. Johnson, and my daughter, Karen Hollinger, or the survivor(s) or successor(s) of the foregoing, as Trustee(s) under an Agreement of Trust executed by me on January 9, 1998, to be held by said Trustee(s) and added to and administered as part of the trust established by said Agreement. Said trust is in existence as of the date of execution of this will, and it is my intention, if necessary to validate the foregoing gift to the Trustee(s), to incorporate herein by reference its terms and any amendments thereto. No debts, administration expenses or death taxes shall be charged to or reduce any marital share under said Agreement of Trust and all administration expenses and debts of my estate shall be computed and accounted for before computing the shares of such Trust. 4. Survival. If any beneficiary should die within sixty (60) days after me, then he or she shall be deemed to have predeceased me for all purposes of this will. 5. Spendthrift Clause. No interest (whether in income or principal, whether or not a remainder interest, and whether vested or contingent) of any beneficiary hereunder shall be subject to anticipation, pledge, assignment, sale or transfer in any manner, nor shall any beneficiary have power in any manner to charge or encumber his or her said interest, nor shall the said interest of any beneficiary be liable or subject in any manner while in the possession of my fiduciaries for any liability of such beneficiary, whether such liability arises from his or her debts, contracts, torts, or other engagements of any type. - 2 - 6. Facility of Payment for Minors or Incapacitated Persons. Any amounts or assets which are payable or distributable to a minor or incapacitated person hereunder may, at the discretion of my fiduciaries, be paid or distributed to the parent or guardian of such minor or incapacitated person, to the person with whom such minor or incapacitated person resides, to a trust existing primarily or exclusively for the benefit of such minor or incapacitated person, or directly to such minor or incapacitated person, or may be applied for the use or benefit of such minor or incapacitated person. 7. Powers. In addition to such other powers and duties as may be granted elsewhere herein or which may be granted by law, my fiduciaries hereunder shall have the following powers and duties, without the necessity of notice to or consent of any court, but subject to any applicable requirements of ordinary due care: (a) To retain all or any part of my property, real or personal, in the form in which it may be held at the time of its receipt, including any closely held business in which I have an interest and the stock of any corporate fiduciary hereunder, if ever any, as long as in the exercise of their discretion it may be advisable so to do, notwithstanding that said property may not be of a character authorized by law. (b) To invest and reinvest any funds held hereunder in any property, real or personal, including, but not by way of limitation, bonds, preferred stocks, common stocks and other securities of domestic or foreign corporations or investment trusts, mortgages or mortgage participations, mutual funds with or without sales or redemption charges, and common trust funds, even though such property would not be considered appropriate or legal for a fiduciary apart from this provision. (c) To sell, convey, exchange, partition, give options to buy or lease upon, or otherwise dispose of any property, real or personal, at the time held by them, at public or private sale or otherwise, for cash or other consideration or on credit, and upon such terms and for such price as they may determine, and to convey such property free of all trusts. (d) To borrow money from any person, including any fiduciary hereunder, for any purpose in connection with the administration hereof, to execute promissory notes or other obligations for amounts so borrowed, to secure the payments of such amounts by mortgages or pledges of any property, real or personal, which may be held hereunder, and to receive property - 3 - encumbered by debts and mortgages and to take subject to and/or assume same. (e) To make secured loans (or unsecured. loans if to my husband, his estate, any trust established by either of us, or if to a descendant of mine), in such amounts, upon such terms, at such rates of interest, and to such persons, firms, or corporations as they may deem advisable. (f) To renew or extend the time for payment of any obligation, secured or unsecured, payable to or by them as fiduciaries, for as long a period or periods of time and on such terms, as they may determine, and to adjust, settle, and arbitrate claims or demands in favor of or against them. (g) In dividing or distributing any property, real or personal, included herein, to divide or distribute in cash, in kind, or partly in cash and partly in kind. (h) Without limitation of powers elsewhere granted herein, to hold, manage and develop any real estate which may be held by them at any time, to mortgage any such property in such amounts and on such terms as they may deem advisable, to lease any such property for such term or terms and upon such conditions and rentals as they may deem advisable, whether or not the term of any such lease shall exceed the period permitted by law or the probable period of retention under this instrument; to make repairs, replacements and improvements, structural or otherwise, in connection with any such property, to abandon any such property which they may deem to be worthless or not of sufficient value to warrant keeping or protecting, and to permit any such property to be lost by tax sale or any other proceedings. (i) To employ such brokers, banks, custodians, investment counsel, attorneys, accountants and other agents, and to delegate to them such duties, rights and powers as they may determine, and for such periods as they think fit. (j) To register any securities at any time in their own names, in their names as fiduciary, or in the names of nominees, indicating the trust character of the securities so registered. (k) With respect to any securities forming a part of my estate, to vote upon any proposition or election at any meeting of the corporation issuing such securities, and to grant proxies, discretionary or otherwise., to vote at any such meeting; to join or become a party to any reorganization, readjustment, merger, voting trust, consolidation or exchange, and to deposit any such securities with any committee, depository, trustee or otherwise, and to pay out of the assets held hereunder, any fees, expenses and assessments incurred in connection therewith, to exercise conversion, subscription or other rights, and to receive or hold any new securities issued as a result of any such reorganization, readjustment, merger, voting trust, consolidation, exchange or exercise of conversion, subscription or other rights and generally to take all action with respect to any such securities as could be taken by the absolute owner thereof. (1) To engage in sales, leases, loans, and other transactions with the estate of my husband or any trust - 4 - established by either of us, even if they are fiduciaries or beneficiaries thereof. (m) To exercise all elections which they may have with respect to income, gift, estate, inheritance and other taxes, including without limitation execution of joint income tax returns, election to deduct expenses in computing one tax or another, election to split gifts, and election to pay or to defer payment of any tax, in all events without their being bound to require contribution from any other person. (n) To operate, own, or develop any business or property held hereunder in any form, including without limitation sole proprietorship, limited or general partnership, corporation, association, tenancy in common, condominium, or any other, whether or not they have restricted or no management rights, as they in their discretion think best. S. Taxes. I direct that all estate, inheritance, and succession taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, other than generation-skipping taxes, shall be paid out of the principal of my general estate to the same effect as if said taxes were expenses of administration, except that any such additional taxes (and interest and penalties thereon) imposed on account of my interest in or power over any trust established by my husband shall be paid out of the property held in such trust, and all other property includable in my taxable estate for federal or state tax purposes, whether or not passing under this will, shall be free and clear thereof; provided, however, that my executor(s) may in the discretion of my executor(s) request that any portion or all of said taxes (i.e., any or all taxes to be paid out of the principal of my general estate) shall instead be paid out of the principal of any trust established by me, to the extent expressly authorized under the terms of said trust. 9. Fiduciaries. I appoint as Executor hereunder my husband, Karl E. Johnson. If my husband is unable or unwilling to serve or to complete the administration of my estate, then my daughter, Karen Hollinger, shall serve in his place, or if my said daughter should be unable or unwilling to serve or to - 5 - complete the administration of my estate, then my son-in-law, Brad Hollinger, shall serve as Executor hereunder. My fiduciaries shall serve as guardian of the property of any minor beneficiaries hereunder, under any instrument of trust executed by me, under any policies of insurance on my life, and in any other situation in which the power to make such appointment exists under the laws of Pennsylvania. No individual fiduciary shall be liable for the acts, omissions or defaults of any agent appointed and retained with due care or of any co-fiduciary. No fiduciary named herein shall be required to furnish bond or other security for the proper performance of their duties hereunder. 10. Interpretation. Unless the context indicates otherwise, any use of the masculine gender herein shall also include the feminine and neuter genders, and vice versa, and the singular shall include the plural and the plural the singular. IN WITNESS WHEREOF, 2, DAGMAR JOHNSON, herewith set my hand to this, my last Will, typewritten on seven (7) sheets of paper including the self-proving n attestation clause and signatures of witnesses, this day of January, 1998. "/`~iC~-j- t'~tz~/~l ( SEAL ) D JOHNSON witnessed: ~~ `~-y~~~~'1 ~~ ~~ ~ ~ residing at ~/ ~22La~'~~-~ / ~~ ... ~7/d O ~~~ ~cc v ~~ ,~~~ ~ residing at C,~"~~ ~/,~ • /~~/j - 6 - COI~II'~IONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN SS: DAGMAR JOHNSON, (the testatrix), SHARON R. PAXTON and CLAYTON P. ARNOL D (the witnesses), whose names are signed to the foregoing instrument, being first duly sworn, each hereby declares to the undersigned authority that the testator signed and executed the instrument as her last will in the presence of the witnesses and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and 'nearing of the testatrix, signed the will as witness and that to the best of his knowledge the testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. WITNESS: TESTATRIX: <%~'C~GC~J ~<~'c~~ DAB' JOHNSON WITNESS: Subscribed and sworn to before me by DAGMAR JOHNSON, the testatrix, and subscribed and sworn before me by SHARON R. PAXTON and CLAYTON P. ARNOLD the witnesses, this 9th day of January, 1998. ,YJ! r..n ~' k~ a~c~~.- ~ ;l ~ . ~l .cam ;,. ~5.~ Notary Public (SEAL) NOTARIAL SEAL MARLENE A. RHINE, Notary Public ~ _ Harrisburg, PA Dauphin County My Commission Expires July 28,1999 FIRST AMENDMENT TO THE DAGMAR JOHNSON AGREEMENT OF TRUST DATED JANUARY 9, 1998 I, Dagmar Johnson, presently of Cumberland County, Pennsylvania, declare this to be a First Amendment to my Agreement of Trust dated January 9, 1998 ("Trust"): 1. I hereby delete Subparagraph 4(g) of my Trust in its entirety, and replace it with the following Subparagraph 4(g): (g) Alternative Distribution. Any property held in trust hereunder when no issue of Settlor are then living, which is not effectively disposed of elsewhere herein, shall be distributed equally to Sloan Kettering Institute (Hospital) for Cancer Research, located at 68"' York Street, New York, New York, and the Childrens Inn at Nih T.C.L, Bethesda, Maryland (affiliated with the National Institute of Health), or its successors. If such organization(s), or its successor(s), is not in existence at the time of distribution, then my Trustee shall select and distribute the respective share hereunder to one or more exempt organizations within the meaning of Section 501(c)(3) of the Internal Revenue Code of 1986, as amended from time to time, or any corresponding section of any future federal tax code. 2. I hereby delete Paragraph 8 of my Trust in its entirety, and replace it with the following Paragraph 8: 8. Trustees. If Settlor's husband is unable or unwilling to serve or to complete the administration of any trust hereunder, no successor shall be appointed to serve in his place. If Settlor's daughter is unable or unwilling to serve or to complete the administration of any trust hereunder, then Stephanie Kleinfelter shall serve in her place. The then surviving Trustee(s) of any trust hereunder may at any time, acting unanimously by written instrument, appoint -1- one or more individual(s) and/or a corporation with fiduciary powers to serve as Trustee(s) hereunder if and when all Trustee(s) named above are unable or unwilling to serve or to continue serving, and/or so appoint an individual and/or a corporation with fiduciary powers as a special, limited or full co-trustee at any time. In addition, the individual Trustee(s) then serving may so remove any corporate trustee then serving hereunder and/or replace any such corporate trustee with another independent corporate trustee. Notwithstanding the above, no then current income beneficiary shall serve as the sole Trustee of a trust created hereunder for his or her benefit, and no beneficiary shall participate as a Co- Trustee in any decision if the power to do so would constitute a general power of appointment for federal estate tax purposes. A trustee may resign at any time upon giving not less than thirty (30) days' written notice to the other Trustee(s) (or, if none, to the then current income beneficiary(ies) of the specific trust), provided that the resignation of a Trustee may not take effect until a successor Trustee, if required hereunder, is able and willing to begin acting as such. Successor Trustee(s) shall have the same rights and powers hereunder as the initial Trustee(s). No successor Trustee shall be charged with any default occurring prior to their becoming a Trustee hereunder. No fiduciary hereunder shall be required to furnish bond or other security for the proper performance of their duties hereunder. The Trustee(s) shall serve as guardian of the property of any minor beneficiary hereunder, as necessary. No individual fiduciary shall be liable for the acts, omissions or defaults of any agent appointed and retained with due care or of any co-fiduciary. Karen Hollinger and any other individual Trustee(s) who are beneficiaries of any trust established hereunder shall serve as such without compensation for their services hereunder. All other individual Trustee(s), if ever any, shall be entitled to reasonable compensation for their services hereunder. The compensation of any corporate Trustee, if ever any, shall be in accordance with its normal fee schedule in effect for like trusts when services are rendered hereunder. Notwithstanding the foregoing, all Trustee(s) hereunder shall be entitled to reimbursement for any and all costs and expenses actually and reasonably incurred by them in serving as Trustee(s). 3. In all other respects, my Trust of January 9, 1998, shall remain in full force and effect. -2- IN WITNESS WHEREOF, I, Dagmar Johnson, set my hand to this First Amendment to my Agreement of Trust dated January 9, 1998, typed on four (4) sheets of paper, including the self-proving attestation clause and signature of witnesses, this 30`'' ,day of November, 1999. SETTLOR: ,- ~ «/,-'; ~~~ {, ; ~ ~ s'~~~~ (SEAL) Dagrri"ar JohnsonC~-' Witnessed: at ~~1,< < , •~ ~ /~ at S r TRUSTEE: ~- ~l~l,~~..,Cr ~-(SEAL) Kasen Hollinger / l; -3- COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN ss: Dagmar Johnson, (Settlor), Sf~phar~ie ~/e~~~~/,fir and ~;rir~o` i~'l . ~s/~ /,r,G,-, (the witnesses), whose names are signed to the foregoing instrument, being first duly sworn, each hereby declares to the undersigned authority that the Settlor signed and executed the instrument as her First Amendment to her (revocable) Agreement of Trust dated January 9, 1998, in the presence of the witnesses aild that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Settlor, signed the First Amendment as witness and that to the best of his or her knowledge the Settlor was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. WITNESS: ~ -.~ ! .~ Settlor: i DAGMAR JOHNSON Subscribed, sworn to and acknowledged before me by Dagmar Johnson, the Settlor, and subscribed and sworn to before me by S!-ePhQ~%e ~,~~~ and /,:,,c(~ n i, fs~~/.~,u~ , the witnesses, this 30"' day of November, 1999. iVOTARIAt. SEAL ~ ' OC (, ji/L c~ p,{~~O 22~~iL /~ Bt~,r~cA i. r~isncH, Notary Public Notary Public Hamsburg, PA Dauphin Courtly ~, F' Ny Commission Euplres Fatr. 8, 283 ~.-_,-~.~.w..m,_.,= - -~,....~,.,..._..,_,.~ (SEAL) -4- AGREEMENT OF TRUST BY THIS AGREEMENT, executed on January 9, 1998, DAGMAR JOHNSON, of Cumberland County, Pennsylvania, as Settlor, hereby establishes a trust, and Settlor~s husband, KARL E. JOHNSON, and Settlor's daughter, KAREN HOLLINGER, as Co-Trustee(s), hereby agree to hold the initial trust principal, and such additional property as may be placed in trust hereunder (whether during lifetime or by testamentary act) by Settlor or (with the consent of the Trustee(s)) any other person, in trust subject to the terms and conditions set forth below. 1. Initial Trust Property. The Settlor has this date contributed to this trust the funds and/or assets listed in Appendix A hereto, the receipt whereof is hereby acknowledged by Trustee(s). Said assets form the initial principal of the trust. 2. During Settlor's Lifetime. During the lifetime of the Settlor, the relationship between her and the Trustee(s) shall be as follows: (a) The trust may be revoked by the Settlor at any time by written notice to the Trustee(s), and in case of such revocation, all property then held in trust shall be given over to her. (b) The trust may be modified, altered or amended by written agreement between the Settlor and the Trustee(s). (c) The net income, if any, generated from trust assets in Settlor's lifetime shall be the property of the Settlor and shall be paid to or for the benefit of the Settlor at least quarterly. (d) The Trustee(s) shall from time to time pay from the principal of the trust such sums, including any or all of the principal, that the Settlor may request in writing. In addition, the principal of the trust may be distributed to or for the benefit of Settlor from time to time as needed, in the discretion of the Trustee(s), for her health care, maintenance and support, and/or to maintain the standard of living now maintained by her, and any property held in trust hereunder may be made available for use and/or possession by Settlor. (e) All incidents of ownership in any life insurance policies in which the Trust has an interest as a designated beneficiary, including but not limited to the right to change beneficiaries, shall at all times be held by the Settlor. The Settlor shall at all times retain the right to possess and use said policies without limitation, including but not limited to the right to sell, pledge, assign, receive cash value or otherwise dispose of, any or all of said policies without liability to account for the proceeds of any such disposition or action. All premiums on the policies shall be paid by the Settlor, and the Trustee(s) shall not in any way be liable for the failure to make such payments or for any loss in value of the policies which may result from such failure. Settlor does not in any way obligate herself to make any premium payments, and no such payments may be enforced by the Trustee(s) or any beneficiary hereof. 3. Allocation of Assets. The primary purpose for the establishment of this trust is to provide for Settlor's husband and descendants in the event of her decease. The Settlor anticipates that a significant portion of her estate may be distributed and/or administered hereunder as a result of bequests to the Trustee(s) contained in her will. Upon Settlor's death, if Settlor's husband, Karl E. Johnson, survives her, the assets held or received by the Trustee(s) shall be distributed, held and administered as follows: (a) There shall be distributed outright to Settlor's husband, Karl E. Johnson, the amount, if any, equal to the greater of (i) (A) the maximum amount that could be sheltered from Federal - 2 - Estate Tax by Settlor's husband at the time of Settlor's death through utilization of him then remaining unified credit or applicable credit amount less (B) the aggregate fair market value of all assets and property owned outright by him immediately after Settlor's death, including without limitation all property passing to him by right of survivorship, all proceeds of life insurance on Settlor's life, and so forth (other than assets passing hereunder), with any such assets which were included in part or in whole in Settlor's taxable estate for federal or state death tax purposes being valued at the final value as determined for such death tax purposes, and with the Trustee(s) accepting and relying upon the reasonable written statement of Settlor's husband (or his personal representative) as to the value of his remaining assets, and (ii) (A) the minimum amount, after taking into account all deductions other than the marital deduction and applying all available credits, which is necessary as the marital deduction to reduce to the lowest possible amount the federal estate tax payable by reason of Settlor's death and any federal generation- skipping tax on any transfer with respect to which Settlor is the deemed transferor, minus (B) the value of all other assets included in Settlor's gross estate for federal estate tax purposes which qualify for the marital deduction and which pass, have passed or will pass to Settlor's husband under Settlor's Will, by operation of law, survivorship or otherwise, including without limitation life insurance proceeds on Settlor's life if included in Settlor's gross estate for federal estate tax purposes. It is Settlor's intention that all property passing to her husband under this subparagraph shall qualify for the marital deduction for - 3 - federal estate and gift tax purposes, and any provision herein or in Settlor's Will which may appear to conflict with or in any way defeat such intention for the full amount passing to Settlor's husband shall be construed or applied to accomplish that intention. In addition, Settlor directs that debts and expenses of administration be paid or accounted for out of Settlor's general estate before computation of shares hereunder and that, notwithstanding anything contained herein to the contrary, no debts, administration expenses or death taxes shall be paid out of any share allocable to Settlor's husband under this subparagraph. (b) The remainder of the property held and received hereunder (or, if Settlor's husband does not survive her, all of such property) shall be allocated to and held in the Family Trust (Paragraph 4 below). 4. Family Trust. Any and all assets allocated to the Family Trust shall be held, administered and distributed as follows: (a) Income. The net income shall be paid at least quarterly to or for the benefit of Settlor's husband, Karl E. Johnson, for life. Thereafter, if Settlor's daughter, Karen Hollinger, does not survive the survivor of Settlor and her husband, the Trustee(s) shall from time to time pay any or all of said income to or for the benefit of any or all of Settlor's issue, in such proportions or amounts as in the sole discretion of the Trustee(s) seem necessary to provide for their support, maintenance, health care, and education ("education" includes elementary, secondary, preparatory, vocational, undergraduate and graduate levels for all trust(s) established under this Agreement), taking into account the other sources of income, - 4 - support and estate available to them. Without intending to create any legal rights, Settlor would approve distribution of income to those beneficiaries in lower tax brackets, even if that would require invasion of principal for other beneficiaries. Any net income not paid or distributed to Settlor's issue, as aforesaid, shall be accumulated and added to principal at the end of each taxable year. Settlor's husband shall not participate as a Co- Trustee in any decision with respect to the application of this subparagraph (a). (b) Principal. During the lifetime of Settlor's husband, the Trustee(s) shall from time to time pay such sums from the principal of the Family Trust to or for the benefit of Settlor's husband alone as may in the discretion of the Trustee(s) seem necessary for his support, maintenance and health care, or for the maintenance by Settlor's husband of the standard of living maintained by him during Settlor's lifetime. Thereafter, if Settlor's daughter, Karen Hollinger, does not survive the survivor of Settlor and her husband, the Trustee(s) shall from time to time pay such sums from the principal of the Family Trust to or for the benefit of any or all of Settlor's issue as may in the discretion of the Trustee(s) seem necessary for their support, maintenance, health care and education. For all distributions hereunder to Settlor's issue, the Trustee(s) shall take into account the other sources of income, support and estate available to the distributee and the needs and resources of all the beneficiaries. Any of the foregoing distributions to or for the benefit of Settlor's issue shall be based on their needs, rather than a desire to maintain absolute equality of payments among them. Settlor's husband shall - 5 - not participate as a Co-Trustee in any decision with respect to the application of this subparagraph (b). (c) Legal Support Obligation. No payment shall be made under subparagraphs (a) or (b) above which would discharge to any extent the legal obligation of any person for the support of the recipient of such payment. (d) Husband's Rights of Withdrawal. In addition to the foregoing, during any calendar year Settlor's husband shall have the unqualified right in his sole discretion to demand in one or more writings delivered by him to the Trustee(s) that he be paid from the principal an amount not in excess of the greater of Five Thousand Dollars ($5,000.00) or five percent (5 e) of the aggregate market value of the assets in the trust as of December 31 of the calendar year during which such demand is made. The right permitted Settlor's husband under this subparagraph (d) must be exercised by him as herein provided on or before December 31 of the calendar year to which applicable, and any amount as to which such right is not exercised for any given calendar year shall lapse and shall not accumulate or carry over to any future calendar year. If this right is exercised for an amount in excess of $5,000.00 prior to December 31, the withdrawal shall be at the discretion of the Trustee(s) (other than Settlor's husband) and., if permitted, shall be based on an estimated value and shall be adjusted as necessary on December 31 of that year. (e) After Husband's Lifetime: Limited Power of Appointment by Husband. Upon the death of the survivor of Settlor and her husband, if he survives her, the Trustee(s) shall pay the balance held in trust, outright or in trust, in such amounts or - 6 - proportions as Settlor's husband may direct in his last valid Will making specific reference to this Family Trust, but only among any or all of Settlor's issue and/or their spouses. (f) Distribution. To the extent Settlor's husband fails to exercise effectively his limited power of appointment, or if he predeceases Settlor, then upon the death of the survivor of Settlor and her husband, the Trustee(s) shall distribute the remaining balance then held in the Family Trust outright to Settlor's daughter, Karen Hollinger. If Settlor's said daughter does not survive the survivor of Settlor and her husband, then, until Settlor's daughter's youngest living child reaches the age of twenty-five (25) years, the Trustee(s) shall retain the assets in the Family Trust and pay such sums from the income and/or remaining principal to or for the benefit of Settlor's issue for the purposes and subject to the considerations and other terms set forth in subparagraphs (a), (b) and (c) above; and when Settlor's daughter's youngest living child has reached the age of twenty- five (25) years, the Trustee(s) shall distribute the remaining balance in the Family Trust per stirpes to those of Settlor's issue who are then living; provided, however, that if any such issue is then under the age of thirty (30) years, his or her share shall be held for him or her in a separate trust hereunder under the terms of Paragraph 5 below. If no issue of Settlor are then living, the remaining balance shall be distributed as provided in subparagraph (g) below. (g) Alternate Distribution. Any property held in trust hereunder when no issue of Settlor are then living, which is not effectively disposed of elsewhere herein, shall be distributed to - 7 - Settlor's son-in-law, Brad Hollinger, or, if he is not then living, in equal shares (per capita) to those nieces and nephews of Settlor's daughter, Karen Hollinger, and her husband, Brad Hollinger, who are then living. 5. Separate Trusts. The income and principal of a separate trust in which a share is to be held for a beneficiary under the terms of this Paragraph 5 shall be held, administered and distributed as follows: (a) Income. Until the beneficiary reaches the age of eighteen (18) years, the Trustee(s) shall from time to time pay such sums from the income of the separate trust to or for the benefit of the beneficiary, as may in the discretion of the Trustee(s) seem necessary for his or her support, maintenance, health care and education, taking into account the beneficiary's other sources of income, support and estate and his or her income tax bracket. Any net income which is not expended as set forth above shall, at the end of each taxable year, be added to the principal of the separate trust. For all quarters ending after the beneficiary's eighteenth birthday, the Trustee(s) shall pay all of the net income at least quarterly to or for the benefit of the beneficiary. Notwithstanding the foregoing, no payment shall be made under this subparagraph (a) which would discharge to any extent the legal obligation of any person for the support of the beneficiary. (b) Principal. The Trustee(s) shall from time to time pay such sums from the principal of the separate trust to or for the benefit of the beneficiary as may in the discretion of the Trustee(s) seem necessary for his or her support, maintenance, health care and education, and such additional sums as in the sole - 8 - discretion of the Trustee(s) seem proper to help establish him or her in a business or profession and/or to acquire and/or furnish and/or remodel a home for him or her, taking into account the other sources of income, support and estate available to the beneficiary, his or her income and estate tax brackets, the desirability of the transaction (if any), and the possible application of any generation-skipping tax. No payment shall be made under this subparagraph (b) which would discharge to any extent the legal obligation of any person for the support of the beneficiary. (c) Distribution of Separate Trusts. (i) When the beneficiary has reached the age of twenty-five (25) years, the Trustee(s) shall distribute to him or her at his or her written request one-half (1/2) of the remaining principal balance then held in his or her separate trust; and when the beneficiary has reached the age of thirty (30) years, the Trustee(s) shall distribute to him or her at his or her written request the entire balance then held in his or her separate trust. (ii) If the beneficiary should die before final distribution of all assets held in his or her separate trust hereunder, the remaining balance then held in such separate trust shall at his 'or her death be distributed per stirpes to his or her issue, or, if no such issue survive. him or her, per stirpes to the issue of his or her parent who was a child or more remote descendant of Settlor, or, if no such issue - 9 - survive him or her, per stirpes to those of Settlor's issue who survive him or her, with the share of any of such issue for whom property is then held in or payable to a separate trust under this Paragraph being added to and administered with the other assets of such separate trust. If no issue of Settlor are then living, the remaining balance in the separate trust shall be distributed as provided in Paragraph 4(g) above. (d) Disposition Upon Application of Rule Against Perpetuities. Notwithstanding the foregoing, if during the lifetime of a person for whom a separate trust under this Paragraph was established the interest of such person therein becomes void under the applicable rule against perpetuities, then the balance in such separate trust shall then be distributed outright to such person. 6. Survival Clause. If any beneficiary hereunder should die within sixty (60) days after Settlor, or within sixty (60) days after any other person the survival of whom determines his or her rights hereunder, then such beneficiary shall be deemed to have predeceased Settlor or such other person for all purposes hereunder. 7. Powers. In addition to such other powers and duties as may be granted elsewhere herein or which may be granted by law, the fiduciaries hereunder shall have the following powers and duties, without the necessity of notice to or consent by any Court, but subject to any applicable requirements of ordinary due care: (a) To retain all or any part of the property of Settlor, real or personal, in the form in which it may be held at the time of its receipt, including any closely held business in which the Settlor has an interest and the stock of any corporate fiduciary, if ever any, as long as in the exercise of their discretion it may - 10 - be advisable so to do, notwithstanding that said property may not be of a character authorized by law. (b) To invest and reinvest any funds held hereunder in any property, real or personal, including, but not by way of limitation, bonds, preferred stocks, common stocks, and other securities of domestic or foreign corporations or investment trusts, mortgages or mortgage participations, and common trust funds, even though such property would not be considered appropriate or legal for a fiduciary apart from this provision. (c) To sell, convey, exchange, partition, give options to buy or lease upon, or otherwise dispose of any property, real or personal, at any time held by them, with or without order of court at their option, at public or private sale or otherwise, for cash or other consideration or for such credit terms as they think proper, and upon such terms and for such prices as they may determine, and to convey such property free of all trusts. (d) To borrow money from any person, including any fiduciary hereunder, for any purpose in connection with the administration hereof, to execute promissory notes or other obligations for amounts so borrowed, and to secure the payments of such amounts by mortgages or pledges of any property, real or personal, which may be held hereunder, and to receive property encumbered by debts and mortgages and to take subject to and/or assume same. (e) To make secured loans, or unsecured loans if to Settlor's husband, his estate, a trust created by either Settlor or her husband, or if to a descendant of Settlor, in such amounts, upon such terms, at such rates of interest, and to such persons, firms or corporations as they may deem advisable. (f) To renew or extend the time for payment of any obligation, secured or unsecured, payable to or by them, for as long a period of time and on such terms, as they may determine, and to adjust, settle and arbitrate claims or demands in favor of or against them. (g) In dividing or distributing any property, real or personal, included herein, to divide or distribute in cash, in kind, or partly in cash and partly in kind. (h) To hold, manage, and develop any real estate which may be held by them at any time, to mortgage any such property in such amounts and on such terms as they may deem advisable, to lease any such property for such term or terms, and upon such conditions and rentals as they may deem advisable, whether or not the term of any such lease shall exceed the period permitted by law or the probable period of retention under this instrument; to make repairs, replacements, improvements, structural and otherwise, in connection with any such property, to abandon any such property which they may deem to be worthless or not of sufficient value to warrant keeping or protecting, and to permit any such property to be lost by tax sale or any other proceedings. (i) To employ such brokers, banks, custodians, investment counsel, attorneys, accountants and other agents, and to delegate to them such duties, rights and powers as they may determine, and for such periods as they think fit. - 11 - (j) To register any securities at any time in their names as fiduciary, or in the names of nominees, indicating the trust character of the securities so registered. (k) With respect to any securities held hereunder, to vote upon any proposition or election at any meeting of the person or entity issuing such securities, and to grant proxies, discretionary or otherwise, to vote at any such meeting; to join or become a party to any reorganization, readjustment, merger, voting trust, consolidation or exchange, and to deposit any such securities with any committee, depository, trustee or otherwise, and to pay out of the trust created herein, any fees, expenses, and assessments incurred in connection therewith; to exercise conversion, subscription or other rights, and to receive or hold any new securities issued as a result of any such reorganization, readjustment, merger, voting trust, consolidation, exchange or exercise of conversion, subscription or other rights and generally to take all action with respect to any such securities as could be taken by the absolute owner thereof. (1) To engage in sales, leases, loans, and other transactions with the estate of Settlor, the estate of her husband, or any trust established by either of them, even if they are also fiduciaries or beneficiaries thereof. (m) To make all necessary proofs of death under the insurance policies (if any) of which they are the beneficiary, to execute any receipts for the proceeds and to institute any action to collect said proceeds and to make adjustments of any claim thereunder; provided, however, that they need not institute any action unless they shall have been indemnified against all expenses and liabilities to which they may become subject as a result thereof. If, however, they desire to institute such action without indemnification, they are hereby authorized to be reimbursed for all expenses and liabilities incurred as a result thereof from any amounts which may be held in trust hereunder then or thereafter. (n) To operate, own, or develop any business or property held hereunder in any form, including without limitation sole proprietorship, limited or general partnership, corporation, association, tenancy in common, condominium, or any other, whether or not they have restricted or no management rights, as they in their discretion think best. (o) To make any and all elections available to the Trustee(s) for purposes of any or all income, estate, inheritance, gift and/or succession taxes. (p) If the Trustee(s) are serving as Trustee(s) of another trust with terms and provisions substantially similar to any trust established herein, the Trustee(s) are empowered, in their sole discretion reasonably exercised, to consolidate the trust(s) herein created with such other trust(s), insofar as it is practicable, not in substantial conflict with the terms of this trust or of such other trust, and not in derogation of any tax- saving provision of any applicable state or federal law. Provisions of a trust established herein and of such other trust or multiple trusts shall be considered substantially similar even if there are minor variations as to the management and distribution of the trusts. The determination by the Trustee(s) as to any consolidations hereunder shall be final and conclusive upon all parties. - 12 - (q) If the Trustee(s) are acting as Trustee(s) of a trust established hereunder (other than the Family Trust) which is of a size or amount which they reasonably conclude no longer justifies the continuation of such trust, the Trustee (s} are hereby authorized to terminate such trust and distribute all amounts held in such trust to the then current income beneficiary thereof, without a court accounting. If there is more than one income beneficiary, the Trustee(s) shall make the distribution to the income beneficiaries in the proportion in which they are to receive the principal upon distribution of the trust. 8. Trustees. If Settlor's husband is unable or unwilling to serve or to complete the administration of any trust hereunder, no successor shall be appointed to serve in his place. If Settlor's daughter is unable or unwilling to serve or to complete the administration of any trust hereunder, then Settlor's son-in-law, Brad Hollinger, shall serve in her place. The then serving Trustee(s) of any trust hereunder may at any time, acting unanimously by written instrument, appoint one or more individual(s) and/or a corporation with fiduciary powers to serve as Trustee(s) hereunder if and when all Trustee(s) named above are unable or unwilling to serve or to continue serving, and/or so appoint an individual and/or a corporation with fiduciary powers as a special, limited or full co-trustee at any time. In addition, the individual Trustee(s) then serving may so remove any corporate trustee then serving hereunder and/or replace any such corporate trustee with another independent corporate trustee. Notwithstanding the above, no then current income beneficiary shall serve as the sole Trustee of a trust created hereunder for his or her benefit, and no beneficiary shall participate as a Co-Trustee in any decision if the power to do so would constitute a general power of appointment for federal estate tax purposes. A Trustee may ,resign at any time upon giving not less than thirty (30) days' written notice to the other Trustee(s) (or, if none, to the then current income beneficiary(ies) of the specific trust), provided that the resignation of a Trustee may not take effect until a successor Trustee, if required hereunder, is able and willing to begin acting as such. Successor Trustee(s) - 13 - shall have the same rights and powers hereunder as the initial Trustee(s). No successor Trustee shall be charged with any default occurring prior to their becoming a Trustee hereunder. No fiduciary hereunder shall be required to furnish bond or other security for the proper performance of their duties hereunder. The Trustee(s) shall serve as guardian of the property of any minor beneficiary hereunder, as necessary. No individual fiduciary shall be liable for the acts, omissions or defaults of any agent appointed and retained with due care or of any co-fiduciary. Karen and Brad Hollinger and any other individual Trustee(s) who are beneficiaries of any trust established hereunder shall serve as such without compensation for their services hereunder. All other individual Trustee(s), if ever any, shall be entitled to reasonable compensation for their services hereunder. The compensation of any corporate Trustee, if ever any, shall be in accordance with its normal fee schedule in effect for like trusts when services are rendered hereunder. Notwithstanding the foregoing,- all Trustee(s) hereunder shall be entitled to reimbursement for any and all costs and expenses actually and reasonably incurred by them in serving as Trustee(s). 9. Accounting and Taxes. The Trustee(s) shall keep accurate books of account with respect to all trust(s) established hereunder and shall render an account of the administration thereof as and when required by law or more frequently as determined by the Trustee(s). Trustee(s) shall also cause to be prepared and sent to the applicable beneficiaries, annually, all information necessary to enable such beneficiaries to prepare and file federal and state income tax returns on a timely basis. The accounts of the Trustee(s) may be settled and the Trustee(s), their successors and assigns, fully discharged from all liability to the Settlor and other persons, including all beneficiaries, whether or not now in being, who have or claim to have any - 14 - beneficial interest in the income or principal, by the joint written action of the Trustee(s) and all of such persons who are beneficiaries and who are then competent to act. The Trustee(s) may rely upon the authenticity and accuracy of any document, instrument or signature presented to them, provided such reliance is in good faith, and the Trustee(s) shall have no obligation to investigate the application or use of any funds paid by them in accordance with this Agreement. With respect to any distribution pursuant to the exercise of any power of appointment arising under this Agreement, if any, the Trustee(s) shall be fully protected in relying upon any instrument admitted to probate in any jurisdiction as the last will and testament of the party holding such power or in acting upon the assumption that the party died intestate in case the Trustee(s) have no notice of the existence of a probated will within six (6) months after the date of the person's death. 10. Spendthrift Clause. No interest (whether in income or principal, whether or not a remainder interest, and whether vested or contingent) of any beneficiary hereunder shall be subject to anticipation, pledge, assignment, sale or transfer in any manner, nor shall any beneficiary have power in any manner to charge or encumber his or her said interest, nor shall the said interest of any beneficiary be liable or subject in any manner while in the possession of the fiduciaries for any liability of any such beneficiary, whether such liability arises from his or her debts, contracts, torts, or other engagements of any type. 11. Facility of Payment for Minors or Incapacitated P rsons. Any amounts which are payable or distributable hereunder to a minor or incapacitated person may, at the discretion of the fiduciaries, be paid or distributed to the parent or guardian of such minor or incapacitated person, to the person with whom such minor or incapacitated person resides, to a trust existing primarily or exclusively for the benefit of such minor or - 15 - incapacitated person, or directly to such minor or incapacitated person, or may be applied for the use or benefit of such minor or incapacitated person. 12. Death Taxes. Estate, inheritance and succession taxes that may have been assessed in consequence of Settlor's death, of whatever nature and by whatever jurisdiction imposed, whether or not on account of property passing hereunder, other than generation-skipping taxes, may on request of Settlor's personal representative(s) and consent of the Trustee(s) be paid out of the principal held hereunder, as if said taxes were expenses of administration hereof; provided, however, that no such taxes shall be paid out of assets that are not includible in the federal gross estate of Settlor. 13. Interpretation. Unless the context indicates otherwise, any use of the masculine gender herein shall also include the feminine and neuter genders, and vice versa, and the singular shall include the plural and the plural the singular. 14. Law Governing. This Trust shall be administered and interpreted in accordance with the laws of the Commonwealth of Pennsylvania (excluding conflicts of laws). Jurisdiction and venue for the resolution of any and all disputes arising hereunder, and/or for interpretations hereof, shall lie only with the Common Pleas Court for Cumberland County, Pennsylvania, and/or the United States District Court for the Middle District of Pennsylvania. The - 16 - situs of this trust shall be in Cumberland County, Pennsylvania, by agreement of the parties hereto, to the fullest extent permitted by law. IN WITNESS WHEREOF, and intending to be legally bound hereby, the Settlor and the Trustee(s) have hereunto set their hands and seals on the date first mentioned above. WITNESS: SETTLOR: f ,.. ~~./Q` c<'C~-,+ ~/''.7%'/.z (SEAL) DAGMAR JOHNSON- TRUSTEE (S) ~ ' ~ ~ - 17 - SEAL) SEAL) APPENDIX A One Dollar ($1.00) - Attached below I, the undersigned DAGMAR JOHNSON, this 9th day of January, 1998, do hereby acknowledge that in my capacity as Settlor of the accompanying Agreement of Trust I have paid to Karl E. Johnson and Karen Hollinger as Trustees thereof One Dollar ($1.00) in cash, such payment representing the initial funding of such Trust. DAG~ JOHNSON - 18 - COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN SS: On this, the ~ day of January, 1998 before me, a Notary Public, the undersigned officer, personally appeared DAGMAR JOHNSON, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged to me that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ~q,f Notary Public (SEAL) NOTARIAL SEAL MARLENE A. RHINE, Notary Public Harrisburg, PA Dauphin County My Commission Expires July 28,1999 - 19 - OMB Approval No. 2502-02fi5 'is1~u'<> A. Settlement Statement (HUD-1) 1. ~ FHA 2.0. RHS 3. XQ Conv. Unins. 6. File Number: 12-436 7. Loan Number: 6205112110 8. Mortgage Insurance Case Number. 4.~VA 5.^Conv. Ins. C. Note: This form is furnished to give you a statement d actual settlement costs. Amounts paid to and by the settlement agents xe shown Items marked "(p.o. c)" were paid outside the closing; they are shown here tor informational purposes and are not inGuded in the totals. D. Name & Address of Borrower. E. Name 8 Address of Seller. F. Name & Address of Lender: ROBERT W. MALICK, JR, JOAN C. MAUCK THE ESTATE OF DAGMAR JOHNSON NORTHWEST SAVINGS BANK 186fi Harrisburg Ave., Mount Joy, PA 17552 9 Round Hill Road, Camp Hi9, PA 17011 100 Liberty Street, P.O. BOX 1793, WARREN, PA 16365 G. Property Location: H. Settlement Agent I. Settlement Date: 07/17/2012 9 ROUND HILL ROAD, EAST.PENNSBORO Homesale Settbment Servbes Disbursement Date: 07/17/2012 TOWNSHIP 4309 Unglestown Road, 717-671-9876 Faz 717$71-9676, CAMP HILL, PA 17011 Harisburg, PA 17112 East Pennshoro Township Place of Settlement: TitleE~ress _ 4309 Linglestown Road, 71771-9876 Fax 717-671-9676, Printed 07/132012 at 12:51 pm Hanisbu , PA 17112 by SH 100. Gross Amount Due from Borrower 400. Gross Amount Due to Seller 101. Contract sales price 178,000.00 401. ntract sales price 179,000.00 102. Personal property 402 Personalpmperry 103. Settlement charges to borrower (line 1400) 8,584.51 403. 104. 404. - 105. 405. Ad'ustmants for items aid b seller inadvance - Ad'ustments for Items aid b seller In advance 106. CityMwn taxes to 406. City/town taxes to 107. County taxes 0 7 /1 71201 2 to 12/31!2012 283.18 407. County taxes 07/17/2012 to 12/31/2012 283.18 108. Assessments 0 711 7 2 01 2 to 06/302013 1,95220 408. Assessments 07!172012 to 06/3012013 1,952.20 109. Sewer 07 /1 7120 1 2 to 09/3012012 114.00 409. Sewer 07!172012 fo 09/3012012 114.00 110. 410. 111. 411. 112 412. 120• Gross Amount Due from Borrtaver 188,933.89 420. Gross Amount Due In Seller 180,349.38 200. Amounts Paid b or in Behalf d Borrower 500. Reductions In Amount Due to Seller 201. Deposit oreamest money 2,000.00 501. Excess deposit (see instructions) 202. Pdncipal amount of new ban(s) 115,000.00 502. Settlement charges to seller pine 1400) 14,654.70 203. Exis6n IoaMs taken sub"ecl to 503. Ezistln loans taken sub'ect to 204. Origination Fee Credit 50.00 504. PayoR of first mortgage ban 205. 505. PayoR of second mortgage ban 206. 506. 207. 507. 206. 508. 209. 509. Ad)ustments for items unpaid b seller Ad'ustments for items unpaid b seller 210. Cirynown texas to 510. Cirynown taxes to 211. County taxes to 511. County taxes to 212, Assessmems tc 512 Assessments to 213. 513. 214. 514. 215: - 515. 216. 516. 217. 517. 218. 518. 219. 519. 220• Tohl Paid h Ror Borrower 117,050.00 520. Total Reductlon Amount Due Seller 1d,854.70 300. Cash at Settlement fromlto Borrower 600. Cash at SeWement tdfrom Seller - 301. Gross amcunl due from borrower (line 120) 188,933.89 5p1, Gross amount due to seller pine 420) 180,349.38 302. Less amounts paid bynor borrower pine 220) 117,050.00 602 less reductions in amount tlue seller (line 520) 14,654.70 303. Cash QX From ~ To Borrower uxa„~`,.r°.°°. new,.... ~.,.,w-uiaie-mw,..a,:, u..,..%w:.w~ Y 71,863.89 `~n~s..w.~...~'°,..u"'..;°4 :,. 603. Cash QX To ~ From Seller °p..°..'°..--r.......'r"`,r "`r e~m ..-.__.~__~' w~.,.,o ,.w:-- 165,694.66 .` Previous edltlons are obsolete Page 1 of 4 ~ HUD-1 700. Total Real Estate Broker Fees $10,905.00 Paid From Pdld FrDm Division of commission(line 700) as follows: Borrower's Seller's 01. $5,340.00 to n[ury 21 Realty Funds at Funds at 702• $5,565.00 to Prudential Homesale Services Group 703. Commission paid at settlement Settlement 225.00 Settlement 10,680.00 800. Items Pa ahle in Conneetlon with Loan 801. Our origination charge (Includes Origination Point 0.000%or $0.00) $400.00 (from GFE#1) 002. Your credit orcharge (points) for the speck interest rate chosen $3,450.00 (from GFE #2) 803. Your adjusted odgination charges (from GFE A) 3,850.00 804. Appreisaffee to NORTHWEST SAVINGS B $375.00 P.O.C. B` (from GFE #3) 805. Credit report to NORTHWEST SAVINGS B $19.10 P.O.C. B' (from GFE #3) 806. Tax service Io NORTHWEST SAVINGS BANK (from GFE#3) 807. Fbod certification to NORTHWEST SAVINGS B $7.00 P.O.C. B' (from GFE #3) 808. to 84.00 900. kerns Re aired b Lender to be Paid in Advance 901. Daily interest charges from from 0 7 /1 712 01 2 to 0 8 /0112 01 2 ~ $11.1806/day (from GFE #10) 167.71 902 Mort a insurance remium months to from GFE #3 903. Homeowners insurance for 1 ears to Nationwide $601.00 P.O.C. 8` (tram GFE #11) 904. months to from GFE #11 1000. Reserves De osited with Lender - 1001.Initial deposit foryourescrow account (from GFE#9) 535.80 7002. Homeowner's insurance 3 months $ 50.09/month $150.27 1003. Mort a insurance months $ !month 1004. Propert taxes months $ (month 1005. County taxes 7 months $ 51.41/month $359.87 1006. Assessments 2 months $ 166.42/month $332.84 1007. Aggregate Adjustment $-307.18 1100. Title Char es 1101. Title services and lenders title insuance from GFE#4 1,3 8.00 1102. Settlement or closing fee to $ 1103. Owners title insurance (from GFE#5) 444.00 1104. Lenders title insurance $975.00 1105. Lenders title policy limit $115,000.00 Lenders Policy 1106. Owners title policy limit $178,000.00 Owners Policy 1107. Agents portion of the total Olle insurance premium $1,262.91 1108. Underwdters portion of the total title insurance premium $156.09 1109. 1200. Government Recordin and Transfer Char es 1201. Government recording charges $ ~ (from GFE #7) 170.00 1202. Deed $66.00 Mort age $104.00 Release $ 1203. Transfer taxes $ (fmm GFE#8) 1,780.00 1204. CirylCounrytax/stamps Deed $1,780.00 Mort $ 1205. State Taz/stamps Deed $1,780.00 Marta $ 1,780.00 1206. Deed $ Mort $ 1207. $ 1300. Additlonal Settlement Char es 1301. Required services that you can shop for (from GFE #6) 1302. to 1303. to 1304. 2012 School Taxes to Dehbie Lupold Treasurer 1305. Sewer /1112 to 9/30112 fo East Pennshoro Townshi Authodry 2,041.7 138 00 1306. Notary Fee to Connie Zi an . 15 0 1307. Property Inspections to Inspection Company $ $500.00 P.O.C.(B') _ r r . r ' _ r ' 8,584.51 . 14,654.70 ui crosmg oy (olorrower, (s)erer, (gentler, (I)nvestor, Bro(K)er. °Credk by lender shown on page 1. "'Credit by seller shown on page 1. Previous editions are obsolete Page 2 of 4 HUD-1 Cam orison of Good Faith Estimate GF and HU0.1 Char es Char es Thal Cannot Increase HUD1 Line Number Our origination charge # 801 Your credit or charge (points) for the spechic interest rate chosen # 802 Your adjusted originaton charges # 803 Transfertaxes # 1203 Char es That in Total Cannot Increase More Than 10% Govemmentre~ardingcharges # 1201 Appraisal Fee #804 Credit report #805 Tax service #806 Food certifcation # 807 Wire Out # 1304 r Cha es That Can Chan e Initial deposes for yourescrow account # 1001 Daily interest chages from g 901 $11.18061d Homeowners insurance #903 Title services and lenders this insurance # 1101 Owners thk insuance # 1703 Property lnspec6ons # 1307 Loan Terms Goad Faith Estimate HUD•1 400.00 400.00 3,450.00 3,450.00 3,850.00 3,850.00 3,560.00 1,780.00 Good Faith Estimate HUD-1 189.00 170.00 375.00 375.00 19.10 19.10 84.00 64,00 7.00 7.00 0.00 0.00 674.10 655.10 $ -19.00 or -28186°~ Good Faith Estimate HU0.1 2,399.96 535.80 167.71 167.71 444.96 601.00 1,878.75 1,328.00 315.00 444.00 500.00 500.00 Your initial loan amount is $115,000.00 Your loan term is 30. years Your initial interest rate is ~ 3.5000% Your initial montBly amount owed for principal, interest, and any modgage $516.40 includes insurance is QX Principal QX Interest Modgage Insurance Can your interest rate rise? ^X No. ~ Yes, it can dse to a maximum of %. The frst change will be on / I and can change again every years after / ( .Every change date, your interest rate can increase or decrease by °k. Overthe life of the loan, your interest 2fe is gua2nteed to never be lower than %or higher than °k. Even it you make payments on time, can your loan balance dse? ^X No. ~ Yes, h can dse to a maximum of $ Even d you make payments on time, can your monthly amount owed for ~X No. ~ Yes, the first increase can be on / I and the monthly principal, interest, and mortgage insurance rise? amount owed can dse to $ The maximum it can ever rise to is $ Does your loan have a prepayment penalty? ^X No. ~ Yes, your maximum prepayment penalty is $ Does your ban have a baloon payment? Q No. ~ Yes, you have a balloon payment of $ due in years on I I Total monthly amount owed including escrow account payments ~ You do not have a monthy escrow payment for hems, such as property taxes and homeowners insurance. You must pay these items directly yourseB. ^X You have an addhional mouthy escmw payment of $267.92 that results in a total initial monthly amount owed of $784.32. This includes pdncipal, interest, an mortgage insurance and any items checked below: QX Property taxes 0 Homeowners insurance Fbod insurance School taxes Note: It you have any questions about the Settlement Charges and Loan Terms listed on this form, please contad your lender. Previous editions are obsolete Page 3 of 4 HUD-1 HUD CERTIFICATION OF BUYER AND SELLER I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement d all receipts and disbursements made on my account w by me in this transaction 1 further certify that I have received a copy of [he HUD-1 Settlement Statement. ROBERT W. MALICK, JR. JOAN C. MALICK THE ESTATE OF DAGMAR JOHNSON The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this transaction. 1 have cause] or will cause Me funds to be disbursed in accordance with [his statement SETTLEMENTAGENT DATE WARNING: R IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE TITLE 18: U.S. CODE SECTION 1001 AND SECTION 1070. Previous editions are obsolete Page 4 of 4 HUD-1 Name of 8onower. ROBERT W. MALICK, JR JOAN C. MA LICK Name of Seller. THE ESTATE OF DAGMAR JOHNSON File Number. 12-436 Prepared 07/132012 at 12:51 pm Note: This page displays an itemization of the charges shown on line 1101 of the HU0.1 Settlement Statement This page accompanies but is not a part ofthe HU0.1 Settlement Statement If a discrepancy exists, the information on the HU0.1 Settlement Statement applies. 1100. Title Charges Totll Charge Borrower Seller 1101. Title services and lendefs title insurance to Notary Fee to Nota Public $ 45.00 45.00 Wire In to Homesale Settlement Services, I$ 15.00 15.00 Internet Doc Prep to Homesale Settlement Services, I$ 50.00 50,00 Express Handling to Homesale Settlement Services, I$ 18.00 1g,pp End 1 0011 0 0 0 0 to Old Re ublic TKIe $ 50.00 50,00 300/30000 to Old Republic Tdle $ 50.00 50,00 900181000 to Old Republic Title $ 50.00 50.00 CbsmgSvcLtrlCSL td Old Re ublic Title $ 75.00 75.00 1102. Settlement or closing fee to $ 0.00 , 1104. lsndefs title insurance to Old ReDUblic Title $ 975.00 975.00 Totals: 1,328.00 0.00 1,328.00 0.00 SellerlLender credits shown on page 1 POC =Paid Outside Closine CR = t.endar tr.,tu Previous editions are obsolete Page 1 of 1 HUD-1 e ' 0 0 V C ~ ~ N i V1 O1 •~ V Ol V1 Y G1 ~ c ~' a V1 o T o ~ N ~ C ~ o _ W _ d ~ ~i a T a ° _ a v m e P ~ d' ~ N ~ o r ui T N n r o O r O d d Q L rn Q a `° o N •n tl) O R c ° U i ~ ~ u o ~ . m ~ o c .a ~+ d N m ~ m _ t H o . 0 ~ C. N -~ Q ~ Q o C r C ~ d _ Q V U c L E rn 0 rn m ~{ O X E d Z O C - d x U H ~ n M ~ o ~`+ M E $ a -- V C y H )( ,p M M r P ~ X 4 ,. o: 4 E m ri v d O T ~ W r ry y j X X Y aA'~ .Wrr W V U U ~ a w m "IEEE 9 Tt O D ~ v ee~e n O+ O V Q+ c~ 7 N 4 O ._ d a 7 1D jp N > 10 m a 9 N C N W ~ ~ a A > L O Y V ~-' ~ .~ O p h O G W O o ~ w ~ L O v m C' ~ ' \° e w 1 ~ d N ~ C O d' a d F 7 1D jp N > fD ~ 00 C N v C ' N W 7 ~ 1D c 'a R N y t ~ Y V .y.. O tl! b O C 10 O O ~ N :.. aL C U~ d o e e o 0 O n lh N f0 O r t~ th C O Q i i 4 Q O [7 f7 O N O W f0 O ~ O ~ V ~ m O L V l7 (D O1 Q r ~ ~ h O (O ~ V) » i C .r, . » Y O O O < r ~ d 0 0 o co c~ m G ~ ~ ~ to f9 N N 00 n ~ er~ O fA fA fA V .... .J C .~ G d O O O O O O 7 0 ~ ~ ~ ~ u 9 ~ O O N L F- Z ~ ~ a a ~ C7 N p ~ h m m C 7 T C 7 ', r ~ O V ~ a0 rn C W a , C R' CO r ~ O ~ ( O a f/J c > c > ~ r ~ n ~n ~ ~ co n a ~ a °' v ~ ~ n ~ ~ ~ ° "' d m m N fA fA r fA N N W a m cam ~ o a o 0 0 0 , c o rn n n co m N O O ~ 01 n n O O O O~ F1 LL3 (D O O ' N O a •- a ' ~ 0 2 W _ ~ r ~ p lL N ' N ~ ~ O ~o _o o n r p, ~ . ~ r2 XM X~ t D 2 f- ~ ~ 7+ Q = N = O U O ~ Q N m U O Ur Uo mo Z ~' ~ p p m N ~ N - r = ua N ~ m ~~ > ?~ ~~ ~ ~ d)H; ~' a U ~lL W ~lL ~lL W 10 c O 2 (~ ~ W E ° ~ c p ~ ~j U C m > 9 ~ _ U Q m c 4 c '~ y m ti B ~ = E ~ ~ d ~ m ~, . n ~ ~ U U U E S m m ~ C QC W C ~ h O w C ~ d $ c ~ 7 7 = ~ LL a ° m „ ' a o 3 0 ~ o n r r ~ ~ ~ o R ~ a 7 n d h ~ E r r r .~ m~ a o n a G Ol r ~ ~ ~ U U N N Q ~ a ~ ~ C C pp U N o O O ~ . .. m V L ~ rn N U ~ ~ 7 pp m ~ ' w a /0 t [N e ~~ v v o U o U ~ z a® BUREAU OF INDIVIDUAL TAXES PO BOX 288601 HARRISBURG PA 17128-0601 Pennsylvania DEPAfl7MENT DF REVENUE REV-I SLa EY ~FP (OS-11J PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE NO. 21 AND ACN 12129170 TAXPAYER RESPONSE DATE 05-02-2012 KAREN E YEAGER 20 SUNFIRE AVE CAMP HILL PA 17011-1020 EST. OF DAGMAR JOHNSON SSN 579-62-0692 DATE OF AEATH 04-10-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST ® CERTIF. WELLS FARGO provided the department with the information below, which was used in calculating the inheritance tax due. Records indicate that at the death of the above-named decedent, you were a ,joint owner/beneficiary of this account. If you are the SpOUSe of the deceased and any amount other than zero is reflected below on the Potential Tax Due line. note no tax may be due, but you must notify the department of your relationship to the deceased by checking Box C in PART 1 below and writing "spouse" in PART 2. If you believe the information is incorrect, please obtain written correction from the financial institution. attach a copy to this form and return it to the above address. Please call 717.787-8327 with ouesti ons. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 2474 0 2 07370 9487 Date 08-13-2008 To ensure proper credit to the account, two Established copies of this notice ^ust accompany Account Balance 2 2 24 9. 3 0 payment to the Register of Wills. Make check ~` a payable to "Register of Wills. Agent". Percent Taxable X 50.000 NOTE: If tax Dayments are made within three Amount Subject to Tax $ 11 , 124.65 months of the decedent's data of death. TaX Rate X , lrj deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent Potential Tax Due $ 1,668.70 nine months aft¢r the date of death. P~T TAXPAYER RESPONSE 1 ~ ~., ~ ~ x . s. A. ^ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain a discount pr avoid interest, or return this notice to the Register of Wills and C H E C K an official assessment will be issuetl by the PA Department of Revenue. ONE BLOCK B. ~ The above asset has been or will be r¢ported and tax paid with the Pennsylvania inheritance tax return 0 N L Y filed by the estate representative. C. ~ The above inf orma ion is incorrect and/or debts and deductions were paid. Complete PART ~2 and/or PART 3~ below. ppg7 If indicating a different tax rate, please state -~u ~tf~:a sxr.4,~~,in+iw~~r{r~;~~,~+Ir~~°~:~ya~: ~ ~ 1 relationship to decedent: ~~ ~~+~~ X 1 t + ~~~ TAX RE TURN - CALCULATION OF ~_+ ~i ~ ~~~ ~~ TAX DN JOINT/TRUST ACCOUNTS ~°~~~ LINE 1. Date Established 1 ~ ~-~ 2. Account Balance 2 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 +~' ~' 5. Debts and Deductions 5 ~ ~~ 6. Amount Taxable 6 $ ~ ~~ 7. Tax Rate 7 X 8. Tax Due 8 $ - ~ - ~. ,. .. r. ., ,. ...... PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I reported above are true, correct and complete to the best of my knowledge and belief. HOME C ~ woRK t ~ TAXPAYER SIGNATURE TELEPHONE NUMBER DATE GENERAL INFORMATION I. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on information submitted by the financial institution. 2. Inheritance tax becomes delinquent nine months after the decedent's date of death. 3. A joint account is taxable even when the decedent's name was added as a natter of convenience. 4. Accounts (including those held between husband and wife) the decedent Dut in joint names within one Year prior to death are fully taxable. 5. Accounts established jointly between husband and wife Wore than one year prior to death are not taxable. 6. Accounts held by a decedent "in trust for" another or others are fully taxable. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE I. BLOCK A - If the information and calculation in the notice are correct and deductions are not being claimed, place an "X" in Block A of Part 1 of the "Taxpayer Response" section. Sign two copies and submit them with a check for the amount of tax to the register of wills pf the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-1548 EX) upon receipt of the return frpw the register of wills. 2. BLOCK B - If the asset soecif Ted on this notice has been or will be reported and tax paid with the Pennsylvania inheritance tax return filed by the estate's representative, Di.ace an "X" in Block B of Part 1 of the "Taxpayer Response" section. Sign two copies and return to the register of wills of the county indicated. 3. BLOCK C - If the notice information is incorrect and/or deductions are being claimed, check Block C and complete Parts 2 and 3 according to the instructions below. Sign two copies and submit them with Your check for the amount of tax pay able to the register of wills of the coup tY indicated. The PA Department of Revenue will issue an official assessment (Form REV-1548 IX) upon receipt of the return from the register of wills. TAX RETURN - PART 2 - TAX CALCULATION LIRE 1. Enter the date the accpunt originally was established or titled in the manner existing at date of death. NOTE: For a decedent who died after l2/12/82, accounts the decedent put in joint names within one year of death are fully taxable. However, there is an exclusion not to exceed E3.000 per transferee, regardless of the value of the account or the number of accounts held. If a double asterisk (.•) appears before Your first nave in the address portion of this notice, the E3,000 exclusion was deducted iron the account balance as reported by the financial institution. 2. Enter the total balance of the account including interest accrued to the date of death. 3. The percentage of the account that is taxable to each survivor is dete rm inetl as fallous: A. The percentage taxable of ]Dint assets established more than one year prior to the decedent's death: 1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF MULTIPLIED BY 100 = PERCENT TAXABLE JOINT OWNERS SURY IVING JOINT OWNERS Example: A joint asset registered in tfie name of the decedent and two other persons: 1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) _ .167 X 100 = 16.7 percent (TAXABLE TD EACH SURVIVOR) B. The percentage taxable for assets created within one Year of the decedent's death or accounts owned by the decedent but held in trust for another individual(s) (trust beneficiaries): 1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT MULTIPLIED BY 100 = PERCENT TAXABLE OWNERS DR TRUST BENEFICIARIES Example: Joint account registered in the name of the decedent and two other persons and established within one Year of death by the decedent. 1 DIVIDED BV 2 (SURVIVORS) _ .50 X ]OD 50 percent (TAXABLE FOR EACH SURVIVOR) 4. The amount subject to tax (Line 4) is determined by multiplying the account balance (Line 2) by the percent taxable Cline 3). 5. Enter the total of the debts and deductions listed in Part 3. 6. The amount taxable (Line 6) is determined by subtracting the debts and deductions (Line 5) from the amount subject t0 tax (Line 4). 7. Enter the appropriate tax rate CL ine 7) as determined below. Date of Death Spouse Lineal Sibling Collateral 07/01/94 to 12/31/44 3 percent 6 percent 15 percent 15 Percent 01/01/95 to 06/30/00 0 percent 6 percent 15 percent 15 percent 07/01/00 to present 0 percent 4.5 percent a 12 percent 15 pereen t~ 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 ^arent, an adoptive parent or a stepparent of the child is 0 percent. The lineal class of heirs includes grandparents, Darents, children and other lineal descendents. "Children" includes natural children whether or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the natural parents and their descendents, whether or not they have been adopted by others; adopted descendents and their descendants; and step-descendants. "Siblings" are defined as individuals who have at least one parent in common with the decedent, whether by blood or adoption. The Collateral class of heirs includes all-other beneficiaries. CLAIMED DEDUCTIONS - PART 3 - DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: A. You are legally responsible for payment. or the estate subject to administration by a personal representative is insufficient to pay the deductible items. B. You actually paid the debts after the death of the decedent and can furnish proof of payment. C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, use 8 1J2" x 11" sheet of paper. Proof of payment nay be requested by the PA Department of Revenue. ~ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES FILE ND. 21 PD BDx 2Bg6g1 enns lvania AND HARRISBURG PA 17128-8601 ~ y ACN 121279$7 oeaARTNI[NT OF neyenuE TAXPAYER RESPONSE DATE 04-26-2012 REV-3543 EA AFP (a5-11) KAREN E YEAGER 9 ROUND HILL RD CAMP HILL PA 17011-2636 EST. OF DAGMAR JOHNSON SSN ~ 579-62-0692 DATE OF' DEATH 04-10-2012 COUNTY. CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. CITIZENS BANK OF PENNSYLVANIA provided the department with the information below, which was used in calculating the inheritance tax due. Records indicate that at the death of the above-named decedent, you were a joint ownerlbeneficiary of this account. If yoU are the SpOUSe of the deceased and any amount other than zero is reflected below on the Potential Taic Due line, note no tax may be due, but you must notify the department of your relationship to the eceased by checking Box C in PART 1 below and writing "spouse" in PART 2. If you believe the fnformation is incorrect. please obtaintwritten correction from the financial institution, attach a coDY to this form and return it to Lhe above address. Please call 717-787-8327 with pues ti ons. COMPLETE PART I BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 6224556494 Date 04-14-2009 To ensure proper cretlit to the account, two Established copies of this notice must accompany Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due PART 0 CHECK C ONE BLOCK ONLY $ 4,359.96 X 50.000 $ 2,179.48 X .is $ ~ 327.00 TAXPAYER RESPON paYnent to the Register of Wills. Make check payable to "Register of Wills, Agent". NOTE: If tax payments are made within three months of the decedent's tlate of death, tleduct a 5 percent discount on the tax due. AnY inheritance tax due will become delinquent nine months aft¢r the date of death. A. O The above information a~d tax due is correct. Remit pavnent to the Register of Wills with two conies of this notice to obtain a discount or avoitl interest, or return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. i B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return filed by the estate repr•e sentative. - DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I reported above are true, correct and complete to the best of my knowledge and belief. HOME ( ) WORK C ~ TAXPAYER SIGNATURE TELEPHONE NUMBER DATE GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on information submitted by the financial institution. 2. Inheritance taz becomes delinquent nine months after the decedent's date of death. - 3. A joint account is taxable even when the decedent's name was added as a natter of convenience. 4. Accounts (including those held between husband and wife) the decedent out in joint names within one year prior to death are fully taxable. 5. Accounts established jointly between husband and wife Wore than one year prior to death are not taxable. 6. Accounts held by a decedent "in trust for" another pr others are fully taxable. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. BLOCK A - If the inf ors ation and calculation in the notice are. correct and deductions are not being claimed, place an "X" in Block A of Part 1 of the "Taxpayer Response" section. Sign two copies and submit them with a check for the amount of tax to the register of wills of the county indicated. The PA Department of Revenue will issue an official rise ssnent CFo rn REV-1548 IX) upon receipt of the return from the register of wills. 2. BLDCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania inheritance taz return filed by the estate's representative, place an "X" in Block B of Part 1 of the "Taxpayer Response" section. Sign two copies and return to the register of wills of the county indicated. 3. BLOCK C - If the notice information is incorrect and/or deductions are being claimed, check block C and complete Parts 2 and 3 according to the instructions below. Sign twq copies and submit them with your check for the amount of tax payable to the register of wills of the county indicated. The PA Department of Revenue will issue an official assessment (Porn REV-1548 IX) upon receipt of the return from the register of wills. TAX RETURN - PART 2 - TAX CALCULATION LINE I. Enter the date the account originally was established or titled in the manner existing at date of death. NOTE: For a decedent who died of ter l2/12/82, accounts the decedent put in joins names within one year of death are fully taxable. However, there is an ex clusign not to exceed 53,000 per transferee, regardless of the value of the account or the number of accounts held. If a double asterisk Cris) appears before your first name in the address portion of this notice, the 13,000 exclusion was deducted from the account balance as reported 6y the Financial institution. 2. Enter the total balance of the account including interest accrued to the date of death. 3. The percentage of the account that is taxable to each survivor is determined as follows: A. The percentage taxable of joint assets established more than one year prior to the decedent's death: 1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF MULTIPLIED BY 100 = PERCENT TAXABLE JDINT OWNERS SURVIVING JOINT DWNERS Example: A joint asset registered in the name of the decedent and two other persons: 1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (BURN IYORS) _ .167 X 100 = 16.7 percent (TAXABLE TO EACH SURVIVOR) B. The percentage taxable for assets created within one year of the decedent's death or accounts owned by the decedent but held in trust for another individual(s) (trust beneficiaries): 1 DIVIDED BV TOTAL NUMBER OF SURVIVING JOINT MULTIPLIED BV 100 = PERCENT TAXABLE OWNERS OR TRUST BENEFICIARIES Example: Joint account registered in the name of the decedent and two other Dersons and established within one year of death by the decedent. 1 DIVIDED BY 2 (SURVIVORS) _ .50 X 100 = !i0 ve rcent (TAXABLE FOR EACH SURVIVOR) 4. The amount subject to tax (Line 4) is determined by multi plying the account balance Qine 2) by the percent taxable (Line 3). 5. Enter the total of the debts and deductions listed in Part 3. 6. The amount taxable (Line 6) is determined by subtracting the debts and deductions CLine 5) from the amount subs ect to tax (Line 4). 7. Enter the appropriate tax rate (Line 7) as deters fined below. Date of Death Spouse Lineal Sibling Collateral 07/01/94 to 12/31/94 3 percent 6 percent 15 percent 15 percent 01/01/95 to 06/30/00 0 percent 6 percent 15 percent 15 percent 07/01/00 to present 0 percent 4.5 percent + 12 percent 15 percent ..._ __.. . ___ _...-____ _.. ...~ ,.... ...~,.~ ... „ o„~, ~, ~ , , ,,,,, a ue~eeonw unuu a years or 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 Dercent. The lineal class of heirs includes grandparents. parents, children and other lineal descendents. "Children" includes natural children whether or mat they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the natural parents and their descendents, whether or not they have been adopted by others; atlooted descendents and their descendants; and step-descendants. "Siblings" are defined as individuals who have at least one parent in common with the decedent, whether by blood or adoption. The Collateral class of heirs includes all other beneficiaries. CLAIMED DEDUCTIONS - PART 3 - DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are dete rn fined as follows: A. You are legal lv responsible for payment, or the estate subject to administration by a personal representative is insufficient to pay the deductible items. B. You actually paid the debts after the death of the decedent and can furnish proof of payment. C. Debts being claimed oust be itemized fully in Part 3. If additional space is needed, use 8 1/2" x 11" sheet of paver. Proof of payment may be requested by the PA Department of Revenue. Eckert Seamans Cherin & Mellott, LLC "R7_ 717 237 6000 213 Market Street FqX 717 237 601 9 ~~~~ ~ 8'h Floor wtiwv.eckertseamans.com Harrisburg, PA 17101 ATTORNEYS AT LAW Thomas P. Gacki 717237.6093 tgacki@eckertseamans.com January 8, 2013 n ~-~ ~ ~ ~ ~...> m ~~ c_ ~ n m ~' ~~ <n Glenda Farner Strasbaugh, Register of ~ ~ ~ '" ~ r p n"! " Wills & Clerk of the Orphans' Court ~ ny ~ cn ~° ; 1 ~~ ~~ Cumberland County Courthouse ~ ~ c:, ,-., -c -,, ~, One Courthouse Square °~' ``' '' `~ Carlisle, PA 17013-3387 ~ ~` ~-~.a =~ ~"" r~~t ~~-- _~ CD 7y Re: Estate of Dagmar Johnson No. 21-12-00462 Dear Ms. Strasbaugh: Enclosed for filing please find the original and two (2) copies of the Inheritance Tax Return in the above-referenced matter, along with check No. 523 made payable to "Register of Wills, Agent" in the amount of Six Hundred and 73/100 Dollars ($600.73) representing the tax due on this estate. Also enclosed is our check in the amount of Fifteen and 00/100 Dollars ($15.00) to cover the cost of filing same. Please date-stamp and return one copy of the Return to me in the enclosed self-addressed, stamped envelope. Thank you for your courtesy and cooperation in this matter. Please do not hesitate to contact us if you have any questions. Yours truly, /s/Tlior~uzs P. yac~ii Thomas P. Gacki TPG:kmo Enclosures cc: Karen E. 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