The URL can be used to link to this page

Home My WebLink About01-23-13 (3)1505610143 REV-1500 txlaz"' PA Depenmenl of Revenue pennsylvanla Bureau of mdivaiuat Taxes °""`^°'°'°^~° Po Box.2eosot INHERITA Hatroburg, PA 17128.0801 RESIDI ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 147 18 3591 04 23 2012 Docotlent's Last Name SuBix PEDATI (1! Applkable) Enter Surv7ving Spouse's to/ortnatfon Below Spouse's Last Name SuNix Spouse's Socal Security Number OFFICIAL USE ONLY Caxny Coao Ycv Fdo NurLa 'AX RETURN 21 12 0576 ECEDENT Date of Binh O1 29 1926 Decedent's Firsl Name MI JOHN R Spouse's First Name MI THIS RETURN MUST 8E FILED IN OUPIICATE NIITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW i X ~ 1 Original Retum - 2 $apPlemalltal Ralwn 7 Remainder Rewm (Dale of Death - Prror W t2-1}623 a. timded Estate ' '' --- aa. Fuwotrcareflcomprwn~so 5 federal Eaute Tax Rewm Repuued tamvaaeom mlrr a-rzF27 ~. IXI s Deoraam DleaTnixto i ' ' IApaN tapyd Vaa) i_ i T. ~rlt ugonpn olmnpT~ ~ 8 Tppl NUmlMr ar SaM Deposa eoyea CWYM lrwll 9. lllgalan Proceeds Received ( ~, 10. eBOOn.~i~fi~~` w'>'~~1 r Damn : ! 11 Ekwtion b tax under Sec al l ](A) - (Attach SchadWe O) CORftESPO1vDENT - TM9 SECAOM MUST BE COMPLETEQ ALL CORRESPONDENCE ANO CONFIDENTIAL TAX INFORMATION SNOULD BE DIRECTED TO: Name DatflAtle Teleptrontrl~mber LINDA J OLSEN ESQ 4 7 ~ 0 4` 3'3 ry 2 r ~c ~; ~~p ,~g ~~g iL y ~ g W ~ fi r FlTSt Llrte of ATltlmss :;:n ~„r ..' ' ' iC 2000 LINGLESTOWN RD t:: J - (~ " "' c.~ =f - , -:~ _. ;a Second Line o/AdtNess -e7 '._., ~.~ ;;'S SUITE 202 ..-, , f:i c.1 tn0 ~J C{ly or Post OMce DAfGFILED 'rt State ZJP Code HARRISBURG PA 17110 Cortespondsnt's e-maN tWrUass: Delkt i/16 zooo Side t L 1505610143 1505610143 ](IlRCl3 11:38 AM P90M: Nazea Elder Lav Hazen Elder taW To: ?-540-B9i-D906 PAGE: 093 OF OOi PA Mnh~er"ttarnce Tax Return Signature of ~Idditinnat F9duciaiies [~Pec~-tf;.:iohn $8tph ~ ' ~~ ER S`1gaaEUre:#2 Z'd 2400-OYJ-EOL ~Coluol I REV-1500 EX Decetlent's Name'. PgdBtlr .jOilfl fZBijJrt Decedent's Social Security Number RECAPITULATION 1. Real Estate (Schedule A) ...................................................................................... . 1. 2. .Stocks and Bands (Schedule B) ............................................................................ . 2. 3 , 0 9 6.32 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)........ . 3. 4. Mortgages 8 Notes Receivable (Schedule D) ....................................................... . 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .............. . 5. 62 , 769.72 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 219 , 4 90.2 7 7. Inler-Vivos Transfers & Miscellaneous -Probate Property (Schedule G) ~ Separate Billing Requested............ 7. 1 , 012 , 825.07 6. Total Gross Assets (total Lines 1 through 7) ....................................................... . 8. 1 , 2 98 , 181.38 9. Funeral Expenses and Administrative Costs (Schedule H) ................................... . 9. 21 , 069.72 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule 1) ........................... . 10. 44 , 923.94 11. Total Deductions (total Lines 9 and 10) ............................................................... . 1 t. 65 , 993.66 12. Net Value of Estate (Line 8 minus Line 11) ......................................................... . 12. 1 , 232 , 187.72 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .............................................. . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) .............................................. . 14. 1 , 232 , 187.72 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amounl of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 15 0.00 (a)(1.2) X .00 . 16. Amount of Line 14 taxable 1 232 187.72 1s. 55 , 448.45 , , at lineal rate X .045 17. Amount of Line 14 taxable 0 00 17 0.00 . at sibling rate X .12 . 1 B. Amount of Line 14 taxable 0 00 18 0.00 . at collateral rate X .15 . 19. TAU DUE ............................................................................................................... . 1s. 55 , 448.45 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 1505610243 1505610243 J 1505610243 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-12-0576 DECEDENT'S NAME Pedati, John Ralph STREET ADDRESS 100 Mt. Allen Dr. CITY Mechanicsburg STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 52,000.00 2,736.84 (1) 55,448.45 Total Credits (A + g) (2) 54,738.84 3. Interest q, 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. (3) (4) (5) 711.61 Make Check Pa able to: REGISTER OF WILLS AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :............................................................................... ^ ^x b. retain the right to designate who shall use the property transferred or its income :.................................. [~ c. retain a reversionary interest; or ............................................................................................................... ^ ^x d. receive the promise for life of either payments, benefits or care? ............................................................ ^ ^x 2. If death occurred after Dec. 12, 1982, ditl decedent transfer property whhin one year of death without receiving adequate consideration? .................................................................................................................... ^ ^x 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?....... ^x ^ 4. Did decedent own an individual retirement account, annuity, or other non-probate property which contains a beneficiary designation? .................................................................................................................. ^x ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after 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 'rf 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 (a) (1)]. . The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116 (a) (1.3)]. 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. Rev~1503 EX~(8-99( SCHEDULE B STOCKS & BONDS COMMONWEALTHOF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT ~ELEOENT ESTATE OF FILE NUMBER Pedati, John Ralph 21-12-0576 All property jolntly~owned with dpht or eurvlvonhip must be tlisclcsed an Schetlule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 236 shares of Manulife Financial - 236 shares @ $13.12/sh. 13.12 3.096.32 TOTAL (Also enter on Line 2, Recapitulation) 3,096.32 (If more space is needetl, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-1505 EXi j11-10) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TA%RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Pedati, John Ralph 21-12-0576 Inclutle the proceeds of litigation end the tlata the proceetls were receivetl by the estate. All property jolntlyownad with Iha rtghl of aurvivonhip must De tliacloaed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 State Street Retiree Services 184.90 2 Wells Fargo cking. #1010054661549 866.89 3 Wells Fargo cking. #2504095502 100.03 4 Wells Fargo Savings #1010189 29,644.26 5 Refund - Highmark Ins. premium 372.97 6 Refund - Malpezzi Funeral Home (receipt of Veteran's benefit) 100.00 7 Refund - US Treasury Fed. Income tax for 2011 25.24 B Refund - Verizon monthly 12.60 9 Western National Life NQ Annuity Acct. #2FC51510 - Beneficiary is decedent's 2 daughters, 31,462.83 Cindy Bruno and Judith Hanley TOTAL (Also enter on Line 5, Recapitulation) I 62,769.72 (If more space is needed, addigonal pages M the same size) Copyright (c) 2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 11-10) Rev-1509 EX+ (01.101 SCHEDULE F COMMONWEALTH OFPENNSVLVANIA JOINTLY-OWNED PROPERTY INHERITANCE Tq%RETURN RESIDENT DECEDENT ESTATE OF NUMBER Man asset was matla joint within one year or Me tlecetlsnt's tlate of tleath, It must ba roportetl on achstlule G. SURVIVING JOINT TENANT(S) NAME A. Judith Ann Hanley B. Cynthia Mary Bruno C. JOINTLY OWNED PROPERTY: ADDRESS 1020 Windwood Coves Blvd. Mineral, VA 23117 3D Round Ridge Rd. Mechanicsburg, PA 17055 RELATIONSHIP TO DECEDENT Stepchild Stepchild ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR doINTLV-NEED REAL ESTATE. DATE OF DEATH VALUE OF ASSE % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST 1 A 10/18/2002 BBBT Investors Deposit Acct. 148,202.01 50.000°/a 74,101.01 #0005236092471 - -Jointw/decedent's daughter, Judith Hanley 2 A 10/18/2002 8B8T money market acct. #0005230017893 - 6,664.91 50.000% 3,332.46 -Jointw/ decedent's daughter, Judith Hanley 3 B 1998-1999 Savings Bonds -12 $5,000 IBonds -Held 130,352.00 50.000°/a 65,176.00 jointly with decedent's daughter, Cynthia Bruno 4 B 1993-1994 Savings Bonds - 33 $1,000 & $10,000 EE 67,400.80 50.000°/a 33,700.40 Bonds -Held jointly with decedent's daughter, Cynthia Bruno 5 A 1993-2005 Savings Bonds - 36 41,000 8 $10,000 EE 86,360.60 50.000% 43.180.40 bonds -Held jointly with decedent's daughter, Judith Hanley TOTAL (Also enter on Line 6, Recapitulation) I 219,490.27 (If more space is needed, additional pages of the same size) Copyright (c) 2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 01-10) Rav-1510 FJ[~ (09-09) SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TA%RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER This schetlule must ba completatl antl fletl d Iha answer t° any of questions 1 through 4 on pegs three of the REV-0500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY THELDATENOF TRANSFNAERNSATfACNTA COPY OF THE SEED ~OR REAL ESTA70E. DATE OF DEATH VALUE OF ASSET ~ of oeco~s INTEREST EXCLUSION pF APPLICABLE) TAXABLE VALUE 1 6B8T IRA #0005735810598 -Beneficiaries are 41,545.47 100.000% 41,545.47 decedent's children, Cindy Bruno and Judith Hanley 2 ING USA Annuity #066101/IRA - -Beneficiary is 16.931.34 100.000% 16,931.34 decedent's 2 daughters, Cindy Bruno and Judith Hanley 3 Merrill Lynch Wealth Mgmt Acct. #798-12488 - TOD - 466,544.04 100.000°h 466,544.04 decedent's 2 daughters, Cindy Bruno and Judith Hanley 4 Merrill Lynch Wealth Mgmt Acct. #798-13170 - TOD - 454,705.25 100.000% 454,705.25 decedent's 2 daughters, Cindy Bruno and Judith Hanley 5 SunAmerica -annuity #A0300008874 -Beneficiary is 24,269.53 100.000% 24,269.53 decedent's 2 daughters, Cindy Bruno and Judith Hanley 6 SunAmerica -annuity #A637090268A -Beneficiary is 8,829.44 100.000% 8,829.44 decedent's 2 daughters, Cindy Bruno and Judith Hanley TOTAL (Also enter on Line 7, Recapitulation) (If more space is neetle4 atltlitional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. 1,012,825.07 Form PA-1500 Schedule G (Rev. 08-09) REV-0151 EX+110-09) COM ~NF,ALT~OF p Dr~$VRLVANIA SCHEDULE H FUNERAL EXPENSES AND ESTATE OF FILE NUMBER Pedati. John Ralph 21-72-0578 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached B. I ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) 10,303.05 Street Address City State Zio Year(s) Commission Paid 2. Attorney's Fees Hazen Elder Law 9,800.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zio Relationship of Claimant to Decedent 4. Probate Fees Register of Wills 208.50 5. Accountant's Fees Errol Flynn, CPA 375.00 6. Tax Return Preparer's Fees 7. Other Administrative Costs 385.17 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 21,089.72 Copyright (c) 2009 form software only The Lackner Group, Inc. Fonn PA-1500 Schedule H (Rev. 10-09) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Pedati, John Ralph 27-12-0576 ITEM NUMBER DESCRIPTION AMOUNT 1 Funeral Expenses Funeral/Internment -New Park Tavern -luncheon after internment in NY cemetery 138.50 2 Hillside Cemetery -burial of ashes 800.00 3 Hillside Cemetery -foundation for grave marker 252.00 4 Malpezzi Funeral Home 8,140.40 5 Pennsylvania Bakery -funeral 48.85 6 St. Michaels Church -burial prayer service 50.00 7 Wegman's-catering for funeral luncheon 288.30 8 White Eagle Monumental Co. Inc. -grave marker 585.00 H-A 10,303.05 9 Other Administrative Costs BBS:T Investors Bank -wire transfer fee to close out account 24.00 10 Cumberland Law Joumai -estate notice 75.00 11 Hazen Elder Law -disbursements 10.40 12 Reg. of Wills - fiing fee for Inventory/Inheritance tax return 30.00 13 Sentinel -estate notice 232.02 14 Staples -copies 9.75 Copyright (c) 2002 form software only The Lackner Group, Inc. Fonn PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF John 21 NUMBER ITEM NUMBER DESCRIPTION AMOUNT 15 US Postal Service -postage 4.00 H-67 385.17 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 E%+ (12-08) COMMONWEALTHOF PENNSYLVANIA INHERITANCE TPX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Pedati, John Ralph 21-12-0576 Report tlebb irwurratl by the decedent prior to death that remained unpaid at the date o1 tleaM, Including unrelmDUreetl medical ezpenaas. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Alert Pharmacy 124.09 2 Hillside Cemetery - -burial of ashes for decedent's late wife, Alma Pedati 800.00 3 Holy Spirit Hospital - co-payment on insurance 112.50 4 Messiah Village - Lifeways 4,168.67 5 PA Dept. of Revenue -2011 personal PA income tax 176.00 6 US Treasury - 2011 personal income tax 38,523.00 7 Verizon telephone 17.06 8 West Shore Ambulance 1,002.62 SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS TOTAL (Also enter on Line 10, Recapitulation) I 44,923.94 (If more space is needed, additional pages of the same size) Copyright (c) 2008 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 12-OB) REV-1513 E%t (01-10) SCHEDULE J COMM~/~D ~~~S,VLI~ANIA BENEFICIARIES ESTATE OF FILE NUMBER Pedati, John Ralph 21-12-0576 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal distnbuhons, and transfers under Sec. 9116 a 1.2 Cynthia M. Bruno Stepchild Half of the 3D Round Ridge Rd residue Mechanicsburg, PA 17055 Judith Hanley Stepchild Half of the 7020 Windwood Covers Blvd residue Mineral, VA 23117 Total Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 150 0 cover sheet as a r o riate. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-t500 COVER SHEET Copyright (c) 2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 01-10) REGISTER OF WILLS CUMBERLAND COUNTY PENNSYLVANIA CERTIFICATE OF GRANT OF LETTERS No . 2012- 00576 PA No . 21- 12- 0576 Estate Of : JOHN RALPH PEDATI iFirst Middle, Last) a /k/a : JOHN PEDATI Late Of: UPPER ALLEN TOWNSHIP CUMBERLAND COUNTY Deceased Social Security No: 147-18-3591 WHEREAS, on the 18th day of May 2012 an instrument dated August 26th 1986 was admitted to probate as the last will of JOHN RALPH PEDATI (First, Middle, Lastl a/k/a JOHN PEDATI late of UPPER ALLEN TOWNSH/P, CUMBERLAND County, who died on the 23rd day of April 2012 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: CYNTHIA MARY BRUNO and JUDITH ANN HANLEY who have duly qualified as EXECUTORIR/Xl and have agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 18th day of May 2012. **NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) (~ , C O ~ :.,>" 77 Vic; `'-, LAST WILL AND TESi'ANffi~T ~ Tl iv. ~ i i '.. ~ ~ of - ~ . ~ _ oe_ JOHN RALPH PEDATI a/k/a JOHN PEDA TI C;~_- R' i r i~ r, I, JOFIId RALPH PEDATI a/k/a JOHN PEDATI, residing at 252 Philip Avenue in the Borough of E1mFx~od Park, County of Bergen and State of New Jersey, being of sound and disposing mind, m~rory and understanding, do hereby Hake, publish and declare this to be my Last Will and Testament, revoking all wills and codicils made before by me. ARTICLE ONE I direct that all my debts, funeral expenses, expenses of my last illness, if any, and the costs of administerir~ my estate, including taxes, be paid by my Executrix, hereinafter named, as soon as practicable after my death. ARTICLE Ti~JO I hereby give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed and wheresoever and howsoever situate and belonging to me at the time of my decease, to my wife, AIt~ GRACE PEUATI of Elnu~7od Park, New Jersey. In the event my wife predeceases me or fails to survive me by five (5) days, then Article III, below, shall becan? operative. ARTICLE THREE In the event that my said wife shall predecease me, or fail to survive me by five (S) days, then I hereby give, devise and bequeath my entire estate b? my step-daughters, JUDITH ANN HANf.F'V of CHkt~1, Virginia and CYNTHIA MARY BRUNO of Effort, Pennsylvania to be divided equally, share and share alike, absolutely and forever. In the event either of my step-daughters shall predecease me or fail to survive me by five (5) days, then said deceased step-daughter's share shall be divided equally among the issue of said deceased step-daughter. ARTICLE FOUR I hereby naninate, constitute and appoint my wife, ALMA GRACE PEDATI of Elmwood Park, New Jersey as Executrix of this, my Last Will and Testament. In the event that my aforesaid Executrix shall predecease me, fail to survive me by five (5) days, fail to serve or be unable to serve, then I hereby nominate, c~stitute and appoint my Step-daughters, JUDITH Atai HANf,F:y of CNkton, Virginia and CYNTHIA MARY BRUNO of Effort, Pennsylvania as Contingent Co-F~cecutrices of this, my Last Will and Testament. I hereby expressly direct that no bond or other security shall be required of my said Executrix or Contingent Co-F.lcecutrices or either of them, in any jurisdiction, for the faithful performance of their duties with full power of sale >n the premises. ARTICLE FIDE My fiduciaries (including any substitute or successor) will have all the powers and authority inferred by law, including Title 3B, Sections 14-23 of the laws of the State of New Jersey (New Jersey Statutes Annotated) in order to carry out the orderly administration of my estate or to manage any property for the benefit of a minor or mentally incang~etent beneficiary. In addition, my Executrix will have the sole authority to Hake distributions fran my estate in property or by selling Property and distributing the proceeds. 2 I, JOHN RALPH PEDATI a/k/a IDATI, the Testator, sign my name to JOHN P this instr~aneslt this r.~2 fJ , day of ~iy /~~~, 1986, and being first duly srdorn, do hereby declare to the undersigned authority, that I sign and execute this instrument, as my Last Will and that I sign it willingly (or willingly direct another to sign for me), that I execute it as my free and ~ voluntary act for the purposes therein expressed, and that I am eighteen ~ (".8) years of age or older, of sound mind and under no constraint or undue influence. ~ RALPH PEDATI a/k/a JOHN PE~TI STATE OF NEN7 JERSE7t: SS: C~iJNl'Y OF BEEZGFN: , g~, ~ i t. Gild ~.. " , the witnesses, being first duly sworn, do hereby declare to the undersigi~d authority that the Testator signs and executes this instrument as his Last Will, and that he signs it willingly (or willingly directs another to sign for him), and that each of us states that, in the presence and hearing of the Testator, we hereby sign this Will as witness tt~ the Testator's signing and that to the best of our knowledge, the Testator is eighteen (18) years of age or older, of sound mind aril under no constraint or undue influence. 3 .s Witness ' _. ' _.rt;`~ . Witness /'~~~ r'~ ~ ~f witness L STATE OF NEW JERSEY: OOi1NPY OF BERl,~N: SS: Subscribed, sworn to and aclmaaledged before me by JOHN RALPH PEDATI a/k/a JOIN PEDATI, the Testator, and subscribed and sworn to before me by 1 ~.~~... ~,~~.._~.;z-. ._., - l and ~. ~, ~ l L , the witnesses, this ~ day of ,~< ~.~ ~ , 1986. CLAUDIA B. AH ATTORNEY AT LAW OF THE STATE OF NEW JERSEY 4 _ __ _ Par,E eF!~5 J PMA accoun[ 2509095502 !f April t, 2012 -April 30, 2072 M Page 2 of 5 t~verv~ew of pour PIV~A account ASS@~S ARMInf tA.ey,.er NUNVA Pxrex(rt Saloncxlosf M OffofO( man Ml ($1 ffakncx thh rflWf7t (~f lttcnoxxF {rCVCdX (S) PerGPllt [MP](C' PMA• Frirtre r'hecking Account lasosovswv ~ 1% 100.02 100.03 aP7 - 0.0796 Crown Clossk Banking"itdto95a4er3rn) 246 l,tM.71 B6G89 (733.6$? (:3.38M6 Weiln Farga•Preferfed Rate Savings ~roiotasvarveat 4896 3i,078,efi 29,044.,M (4,434.&(h {13.Ct!46 Artrn)ity i; u Slob 3tP0~.54 37AJ7.3S b3.87 0.204 Turd aa7et7 $b6,5Y7.ta 562,a1t2.53 ($i,SW.63j (6.771% yr lnvesrment and Mwrurste raducrz: h Aft NQT insured try me Fj~1rv nr arty otfier kedetat 9wMtttnem agency Y Are HOT depo>ars of w guarameed by the bank a arty 6ardc arliliane t MAY Luse Yalux 7 arsat .ere<euattyp~ cnersws m Mvcamvx Y u„ »•+ aavx~ ru^ G+W interest, dividends and other Qncome - 7Ae intdrmooon below shaukrrror be used tare, planning papmes. lKSOUnk This month 7hh }year PMA'Prirrre Qiacking Aafwrrt a3oWkvOfi OA7 0.01 Crown CWSSi[6M71drg' (10l4aSnaat$691 D.01 0.06 Wells Faryo'Preferred Rare $aYMgs nowtr9pzrWW .5.40 30,93 TotallMaast divietapek asd atMrlr6edaa 3Sd2 $3tA2 The "Overview of your PMA Account' section of your statement is provided for informational and convenience purposes. The Overview shows activity and inforr7~tipn from (1) deposi4 credit and trust accounts with We11s Fargo Bank, N.A., and (2) ktroketage accotnts wrid'7 Wells Fargo Advisors, Lf.C, or Wells Fargo Advisors Financial Network. LLC (members SIPC); brokerage accounts are carried and cleared through First Clearing, LLC; tai Wells Fargo Funds Management, LIC provides investment advisory and administrative services for Welts Fargn Advantage funds: other aHiltates provide subadvisory and other services for the Funds; and (4y insurance products offered through non-bank insurar7ce agency affiliates of W ells Fargo & Company and underwritten by unaffiliated insurance companirs. asrm --,25<<r':.,'". ~"-:1' '1'59"`_912 Pr~6E 01:0? ~ --~~.'-~ PMA account 2544095502 ^ Aprii 7, 2012 -April 30, 2012 s Page 1 of5 ~~~~ Wells Fargo PMA Package Questions? Please contact us: 1Yells Fargo Premier Banking Teams' Huai IaWe 24 hours a day, T days a week Phone: 7-80D~742-4932, T7Y: 1-B00-ti00-A&33 Spanish; 1.877-727-2432 Chinese; t-800-288-2288 Onfrne: welksfargo.com Write Wells Fargo Bank, N.A P.O. Box 6995 Portland, pR 9J228~6995 JOHN R PEOA71 CYNTHIA RA BRUNO POA BD ROUND RI[~E RO MECHANICSBURG PA 17055-9248 Apri13O, 2012 Total aSSs-ts: $62,08253 Last month: S6b,587.1b Change in $: $(4,SOd.53) Change in %: (5.77)% Total IlabillUss: $0.00 Last month: $0.00 Change in $: $0.00 Change in 96: 0.004b _ 4ualifying Balance:-•-_.-... __ ,&~'r082.L4- Conteots ~ overvYew . ... ... .. .. ... ... .. .. ...2 AMA'Prime Checking ACCallnt ... . . .. ..........3 Armulty Htcounr ... ......... .... . ........ a ~ I I VIII I~ III II II VIII AII) NIII III IIUI VIII pUI WIC ~i~ IIII III HIII ~~I ~II ~II •e' net agaossaapl Iaa(ggqo~• WESTERN ~ NATIONAL L l f e Insurance C o m p a n y PO Box 87~ Amarillo, texas 79105-0871 1.SOOA24,4990 't July 14, 2012 HAZEN ELDER LAW 2000 LINGLESTOWN RD SUITE 202 HARRISBURG PA 17110 Re: Annuity Contract #: 2FC51510 Deceased: John R Pedati Dear Ms Woodhouse: JUL 2 v 2JE2 Thank you for your letter for the referenced contract. We would like to take this opportunity to provide you with the information requested. Owner /Annuitant - John R Pedati The date of death value of the Annuity as of 04/23/2012 was $31462.83 Non-Qualified First Choice Bonus Annuity Beneficiaries /Judith Hanley and Cynthia Bruno We appreciate your prompt attention to this matter. Should you have any questions or require further assistance, please feel free to contact our Client Care Center by using our toll free number oft-800-424-4990. Sincerely, ~4 / , Patrick Bailey Claims Department Page? of 3 04/OStt2 VA 0005230071893 441-13-01-00 60208 0 C 001 02 55 003 JOHN R PEDATI JUDITH HANLEY 1020 WINDWOOD COVES BLVD MINERAL VA 23117-4859 cur consolidated statement '04/05/2012 Contact us BBT.com (800) BANK-BBT or o (800) 226-5228 n ordinary spending into extraordinary rewards. g your BB&T credit card Is even more rewarding with BB&T Rewards. Now, your everyday purchases can eam points toward able merchandise, gift cards and travel. To team more, contact a Relationship Banker or visit BBTRewards.com today) t cards are subject to aedR approval. Credk cards aro Issued by BRB:T financial, FSB, a wbsidiary of B8&T CorporeNon. hk!rtrbar FDK. right O 2012, Branch Banking and 7rurt Comparry. All Rights Reserved. mmary of your accounts OUNT NAME ACCOUNT NUMBER BALANCE(S) DETAILS ON E GOIp-MM 0005230017893 6 664 91 page 1 ESTORS pEPOSIT ACCOUNT 0005236092471 148 202.01 page 2 1l checking and money market savings accounts $154,866.92 Checking and money market savings accounts LRE GOLD-MM 0005230017893 ount wmmery Interest summary rprevlous balance as of 03/06/2012 $6 638.69 Interest paid this statement period $0.11 ~s -0:00 2072 fnteres[paidyear-to-date $0.45 er withdrawals, debits and service charges - 0.00 Imerest rate 0.02% ~osits, credits and Interest -- + 26.22 ---- Annual percemage yle[d (APY) earned 0.02% Ir new balance as of 04/05/2012 = $6,664.91 3oslts, aedlts and Interost al deposits, a-edits and ktterest _ $2S.Z2 • PAGE 1 OF 3 Calculated Value of Your Paper Savings Bond(s) Calculated Value of Your Paper Savings Bond(s) Calculator Results for Redemption Date 04/2012 Total Price Total Value Total Interest YTD Interest Bonds: 1-12 of 12 issue Next Finai interest Serial # Series Denom Date Accrual Maturity Issue Price Interest Rate Value V002484623I. I $51000 12/1998;. 05/2012_'.., 12J2028,; .$5~000.00,~,~„ $5,904.00 6 41%i „,;101904 V002484624I. .[ $5 000,12J1998,~ OS(2012~ 12/2028 .$5~000.00.~ $5 904.00 6 41°k, :, ~30~904 V002484619L--I $5,000 12J1498,05/2012-12(2028 _:_$5,000.00: $5904;00_, 6.41%'-;10904 .._ ._ V002484622I4 I $51000 12%1998.r 05(2012,: ,,12/2028;_ $5,000.00,,,, $5904.00 6.41%i $101904 ' V0024646201; _ I $5000 12/1998., 05/2012!. 12J2028 - $5,000 00 $5,904 00 6 41%,~., $101904 V002484621I, .i. ,$51000 12%1998.; 05/2012 (_12~2028.$5~000 00~_ $5,904.00 6 41% ;101904 V002484617I T ,_,$5x000 O1/1999.:,05(2012018024;.,,_$500000:.,. _$584800. 641%; 10184E !V022484616I I $5,000 01/1999.,05/2012„: Ol/2029~__¢5,000.0,0 ,- $5~:848OO.i„ 641%_; ¢30R84VE Notes NI ;NOt Issued __,,,, NE. ~~No[ ellgibie for_payment_,_ , . _ „, _- P5, Includes 3 month Interest penalty, MA ~ Matured and not earnln Interest Page 1 of 1 L'yn~,~, I1t.~Jruno - Cb-DWhE.{'" http://www.treasurydirect.govBC/SBCPrice 7!512012 Calculated Value of Your Paper Savings Bond(s) Page 1 of 1 Calculated Value of Your Paper Savings Bond(s) Calculator Results for Redemption Date 04/2012 Total Prioe Total Value Total Interest YTD Interest Bonds: 1-36 of 36 Serial # Series Denom Issue Next Final issue Price Lnterest Interest Value Note Date Accrual Maturity Rate M80984432EE ""EE, ,,,.$1,000 O1/1993~07/2012 01/2023; $500.00:, .$841.20 4.00% -.$1r341.20. _.. M80984431EE ~ EE $1,000 01/1993 07%2012;,01/2023. $500,00.;.., 841.20 4.00% - 51,341 20' _ EE $1000 01/1993 07/2012; 01/2023' $400 00, $841.20 4 00%; ~1~341 20 M80984430EE EE $1000 01/1993 07/2012,"Ol/2023 $500 00,.. $841,20 4 00% i, #1341 20 __ „M80984429EE.,~,.,EE, $1,000 01/1993 07/2012-~_O1/2023 _ $400 00 ~.,- $841.20 4 00%!",; 1r341 20 w, ,M80984428EE'_ EE $1,000 01/1993 07/2012{,01/2023, $500.00; $641.20, 4.00% :. $1r341.20 M80984427EE EE ,.$1{000 01(1993 07/2012,01/2023,,,.., $500,00 ., $841.20 4 00% ;. $1341.20 M809984426EE.",,,EE $1-"000 01/1993 07/2012,;,01/2023 ,,, ., $500 00, $841.20 4 00%. X1,341.20 M80984425EE EE $1,000 01/1993 D7/2012r01/2023 $500.00,, $841.20 4 OOMo,, ,$1r341 20 _ _.. .. M80984424EE~ EE $1,000 Off 1993 07/2012, 01/2028 y",,..,$500.00;. .$841,.20, .4 00%.".;1,341.20 M80984423EE'~ EE _ $1,000 01/1993,07(2012"'.01/2023, _ $500;00` $841.20, 4.00% :_ #1341.20;,, M80984422EE ~~ EE -_$1.:000,01/1993 07/2012"~O1/2023 ._." $500.00,:_ $841 20 4 00% ;:,, $1,341.20- .M80984421EE EE $1,00004/1993{05/20121,04/2023 $500.00 $56160 4 00%: $1,061.60, ~, _... 116EE~ EE I i15EE-. EE _,.. 114EE' EE ; i13EE'. EE i12EE' EE V11EE ~' EE 110EE: EE i09EE' ... EE _.,_, ~i ~~.<. 0$/2012.,. $600.00 $564.80 400%: $1,064.80 ,___ $500.00,. $564.80 4 00%;' .$1r064.60 $500.00 ._.... $564.80 .... _.. ... 4 00 /° ~, .-.°... $1 064.80 _ r _,,. $500.00- $564.80 4.00%' $1,064.80 „_„ $500.00,x. $564.80 4.00°k .. _1,064, 80, _ $500.00: ,... $841.20 . 4.00% : .. $1,341.20 $500 00. $841.20 , 4 00%j, . $1341 20 , _. ,50000: $841.20 4.00%. , $1341.20 ~ _. $500.00 $641.20 400%~ $1,341.20 _,., $500.00' $841.20, 400%, $1,341.20 , ".,,.".$500.00 $841.20 4.00% '. $1341.20 ,, $500:00._, $561;60 4.00°k ~. . $1,061.§0, „ $500.00: $561 _60 4 00%,. _ $10¢1,60 __ $500.00 $561:60 4, 00%;: . $1,061.§0 _, $500.00' $561,60 4.00%' $1,063.60 $500.00;,_ $561.601 4.00%~ . $1,061.60 ._ $41000 00 $5,168.00 4.00% $30,168.00 $5,000.00 $5,168.00 4.00%' $10,168.00 r, _„_$5 000.00.: ~ $5 166.00 ~ 4.00%.', $10,168 00 ~ " __ $5 000 00 ~ $1,320,00 3.50%' $6,320.00 $5 000 00 $1,320.00 3 50% , $61320_00. ,.,. ',,.,-.5,000 00 ~ _ $1,320.00 , , 3 50%i - #6,320.00 ,, .,, -$45,000.00' 541.360.80 ~ 586.360.80 02/1993_ 04/1993' 04/1993 04/1993 X6179738EE: EE „$10,000 05/1994 09/2012,_"O5, X61,79739EE_ „EE $10,000_05/1894.,05/2012:05, X6269203EE'_ EE $30,000 07/2005.05%2012 071 X6269202EE _ EE ,$10,000 07/2009" 05/2012,"O7i - -_ X6269201EE' EE .$10,000 07/2005 05/2012;. D7, __. Totals for 36 0 Notes Ni :Not Issued NE • Not eligible forpaymen[ P@_ ~ Includes 3 month interest penalty MA ~Matu red and not earnin Interest J udl-4~, A Ka v~ (eY - ~ -awnE~ http://www.treasurydirect.govBC/SBCPrice 7/5/2012 Calculated Value of Your Paper Savings Bond(s) Calculated Value of Your Paper Savings Bond(s) Calculator Results for Redemption Date 04/2012 Price Total Value Total Interest YTD Interest Bonds: 1-33 of 33 Page 1 of 1 http://www.treasurydirect.gov/BC/SBCPrice 7/5/2012 Notes NI 'NOtlssued C.-yn lyllt~.'"' LJruno Cv -oWt~e.~ NE Not eligible, for payment ~ ~ / PS ,~, Includes 3 month Interest penalty,„_ _ MA ~ Matured and not ea ruin Interest dx ~ ~'!g, anth Ranking and Trust Ca'npgn)' r 223 ~"7w..t IJasl+ Strerrt ~ W&•on. I~baF Carolim 27897.3801 El l^I. Sd-151 ~ %0 (703}36?-5925 R3'SC~ 15trm_ti11_itt JDHN R PEDA7I 3G ROUN4 RIDGE RD MECHANIC36URG PA 17055-8248 PC,uE X53: ~I Page I of 2 Dmcember 31, 2012 Customer Number: 7147183541 Sodal Security Number: 147183591 2412 INDIVIDUAL RETIREMENT ACCOUNT STATEMENT -RA PtJlN suMMARr BALANCE JANUARY !, Z01Z DEPOSIT SUMMARY Regutar Contributions _. -_ ._ . Emplnye~Conirib~.tiRnS ._ _.,__..... Rollover Contributions Recharacferized Contributions Trustee To Trustee Transfer Transfer Between BB&T ERAS Interest Year-To-pate VYITHDRAWAL SUMMARY Distributions YearTo-pane Roth Conversion Retharaaer¢ation Excess Contribution Withdrawal Trustee To Trustee Transfer Transfer Between BB&T IRAs Direct Rolover To QRP Fetkral Tax Withheld Year-To-Date State Tax Withheld Year-TaDate Penaky Year•TaDate beet YeanTo_pata FAIR MARKET VALUE OF ACCOUNT .BOX 5 CONTRIBUTION SUMMARY IRA Contributions -201 i IRA Contributions - 2012 Box 1 $o-oo $o.ao s4l,sss.zs 50.00 R'811ovLi Cobti9fiiitions __ Boz 2 _ ........ ... _ _. _. $0:00._..... ---..._.... _ .. ~_-~..- 1e arester¢e +rontrv u`~i t7o»s"'"~-~'-"-~""_`•. - '"`0:40"" --~ ®IRA _ Box 7 _ ^ DISTRIBUTION REQUIRED FOR 20 f 3~- SOX l ! INV,=srMENr SUMMARY _ ptCOUNT NUMBER INVESTMENT TYPE fNTERESTINTEREST ~ NEXT CURRENT >lAtANCE RATE YEAH TO DATE RENEYdAL 00000000 5 73 5 8 1n59e lRA TIME CNePOSIT - I3 MONTHS TOTAL ACCOUNT SUt4Ma»Y O.IS% 519.F3 $4.~ $0.00 ...._ _. _.. ~_.~.6~. $0.00 $0.00 50.00 $49.13 $22,266.14 $0.00 $0.00 $0.40 $19,316.24 54.00 $0.00 '50.00 $0.00 50.04 $0.00 s49.1s >~.~ So.aa 5498 OMB No. 1545.0747 -IRA Contribution Information THIS INFORMATION IS BEING FURNISHED TO THE INTERNA!_ REVENUE SERVICE. `.1:43:08 Fri Jar. 11. 2013 T _TRAt 053137 Transaction History 3D2 O1-'.1-20"3 Mcre: - + kccour.=: QOOCOOOC573581059? Eff Dt: 00 00 0000 Short Name: PEGTiTZJOH R000D F_ocess Effect 6xt Iat DR Tran Fv°torant Serial Sequence D Cate Date T!C IiC CR 02 28 12 02 29 12 0000 0490 C 9.99 O~OCOOCDOODOOCOOCD 0000009154053 "v3 30 12 03 31 12 0000 0990 C 5.28 ODOOOCOOOOCDOC000 _.______---- C 000004159 54T u"c 29 12 G4 30 22 OOOC 0490 C 5.11 OJOCOOCOOOOOOC0003-'--~" 0000004155075 G5 30 12 C5 31 i2 OOOC 0990 C 5.28 O.,OOOCOO000OGC0000 Cp00004155586 C6 29 12 06 30 12 OOOC 6990 C 5.11 O'~000OOCOOCCCCD000 0000009156114 ... .,0 12 C? 31 12 OOOC 0990 C 5.28 OCOOOOOCOO:,C000003 0000004155625 Co:rueana====> TITFAN,5735810598,0,0,0, F.=Help E2=Becin F3=Exit F9aNext F7=Hackwaxd F8=Forward Fit=Break F12=Cancel F19=Detail -~--o.~ `~ ~"~2.r~e S ~ ~~~s r~ ~0 i ~-- ~~ ~ ,; d ztroo-or~co~ ~I! Z3~~ Z ~S. S~ xoi~~ni i ,~. ING r , July 18, 2012 HAZEN ELDER LAW 2000 LINGLESTOWN ROAD SUITE 202 HARRISBURG PA 17110 ING USA Annuity and Life Insurance Company Decedent: John Pedati Contract Number: 086101 Claim Code: 03010 Deaz Mrs. Woodhouse, Thank you for your recent inquiry regazding the annuity contract listed above. Please find the contract information below. 1.) The exact contract number is 086101. 2.) The sole owner on the contract is John Pedati. 3.) Death Benefit Value as of 04/23/2012 is $16,931.34. 4.) The contract type is a fixed annuity. 5.) Primary beneficiaries on the contract aze listed as: Judith Hanley 50% Cynthia Bruno 50% If you have questions regazding this information, please contact our Customer Contact Center, available Monday -Thursday, 8:30 a.m. to 6:30 p.m., Eastern Time, and Friday, 8:30 a.m. to 5:30 p.m., Eastern Time. Call 800-369-5303and press 3 to identify yourself as a beneficiary. When prompted, enter the five digit Claim Code above and press #. Your call will be addressed by a claims specialist. Sincerely, Claims Services sm 909 Locust Street Des Moines IA 50309-2899 a M1 W ~ a ~ O ~ eD i ;~. wm O ~'. ~~ wm~o7C ~ ~ ~ Zy y„ ~~ c m ~; a ~ jO ~.~ r ,~ ~ T. 5+ ~ , ~, ~/1 Z e~ ~: o m ~ ~ p~ ~ ~ 3 ~ { ~ ~ ~ ~ . ~ fy~l++7 In ^~ ~; , Z '~ n O 1~ ' .Z7 V ;G Z 7C i O~~' `~ Q ,~ ~ a a, ,, v m + ~ d 31. ~ A ~' Ir" ~ ~ N f W t00 r r ax ', N '~ n 0 K~" t" ,$. ~. ~` Oo V O A t0 O O O m N N O 0 0 N N O O 0 O O r .~ w '.~+ Nv G? ~ O O O 2 I S w O W aZ c 3 O y 3-„ a ~Gp~ N ? C a O YI ~~ 1 N ~rl 0 a ~ m Z a m ~ ~ .. A O A i U ( A ~~~ ppp N p O l ppp y - f p O ~ O N v<v = m s n ~ ~ N O -^ N '° 3 ~ m o; ~ om~ . ~ _ m ~ m ~ ~ ,e _ ~ O O O ~ S w ~ N N 01 W W A~ f~ N o _o o_ N N N _7 n m ~ ~v s~ ' ~ ~ O 1 N <D e~ c m m ._ S ~ '$ n~i ~ c ~ C ~~ m H S1 O ~G ~' C ~ _ D~ v C n 7 c ~ p ~ N .., m .. .. .. C ° m v '~ ~ ?. v m o ~ _ z ~ o ~~ -, -+ o c of n~~ ~~~~ ~m ~~~ ~~< Y < ~• ~3' ~ cF 3 ~6 ~ m c 7 d ,mom }~ ~ ~ O ~ W~q ~a ~ c N Z ~W ~ m `$ ~fi $133 ~ ~~ ~~ ~k$ _~ ~"~ "'~~ .GN~ m 7i ~' `~? r i+ ~ ~ ~ a i° ~w m3~(j $~'3' C gp, dpp¢¢ 3@$ 5' .. G ~~ JpKq K Q 9 ~ K d d 4 0.~ ~ t0 W n m .' l~~ ~.. C a N m P3 S A p ~~ ~ p~ ~ '~ .G ~ ~ ~ ~ A pq5 a g ~• o ~, d ~ _ O p '~ T ~ # ~. 25 ~ to y3 g ~c~ ~ '~ ~ m ~~m{~j$ ~ ~ p ~ ~~ '3yj n ~ Wig, o ~^~. ~S § g ~~ ~ W (~ ~ ~A p {p pN W - M m ~g~mT. T ~ $ ~ ~ y~~' & ~ 3t ~ d ~ N 3 `.~'~5 0~?5 ~ ~ m ~ 2X6' ~^, A $ $ 7 tn~ ~ g 9 ~ 444111 ~ m ~jr. ~ 'o ~c 9 ~ ~ ~ ~ m m ~ ^1 'd lffi6 c •~ ~i a ~ b ~. m w m °c ~ f3 ~' ~ ~ °c ~ 4j ~. `g' ~ 3 7 m g S .2 w ~y3~~ ~ s~ ~ 9. ~y o ~ ~ T> a. `~ S N ~ ~ 0 26g v 7. ' F Q! ~ ~ ~ m ~° ~ F ~ ~ ~ ~ n '~ 3y o ~° 3 ~ ~~ d CK o R Q d ~ ~' ~ ~ ~ ~ ~ gsg~y$ ~ ~ 3 .mac oy d d ~~ 3 a u g ~~ p C w ~9 Q ~ m M ~ ~~ ~ 6 N ~ a ~ c 3 °m IS ~: $ ~}} ~ G ~~ ~ j, 3S ~~ r 10 O• m :R ~' ~ ~ toC K f 3 ~ ~ A ~ S~ G 55 ~ iT~ p ~ $, S~ Ip C m d ~g $ '°~q~ °c, a ~ o, m, ~ ffi ~ ~w $ a m ~. ~ ~ ~i ~ ~ ~ mN ~ N ~ 3 ~ Cai ~ 'r "', a ~ ~' d g ~ m ~, S 0 5 m ~ n ~ m ~ ~ ~. d' `1e5 IC -a ~~ i ~~ ~~ '~s N 7S' 0 L ~S '~, ^~IJiyy.! 6 ~~ G 7• O Q dr ~ N ~ O ~ ~ rt O O W A ~~ O O N N ~ O ~ A Q f3 ~ W ~o ~ N O N 0 W <O 0 0 Cn N A ~+ V A tifOp v ~ S o ~ d W N d i'J ~ p N ~ O , .. AODN2 ~ O A w~Do 7, ~ ~ C I~ ~DN C7 7. ' ~ _o A o ~ , O N ~ ~ 7 _ O ~ N 0 ' ° ° v D o W O N O O O N O D o O O 0 0 W O 0 0 0 x H O F W S: c 3 O a ;-~ a ~0p1 N ~ 7. 0 v a <• ~ d 2 a m ~ N er y O N W W O . O O - op ~ ~ wit o o~ I~OD o~'A Np "t~ ~*. N \ N (q ^ N ~ N' O O ~ N ~ ~ :S 3 C '~ r ~ ~:~ o A W p O r ~ j. p ~„ < N N ' W N ~ Ai=:: O o 0:. , D ,' ~;rr";. o,.~:a•- rn ::,,: O w io N r 0 W v v<v o ~ d C ry N ~, O ~~ = o ~ v v v~g m m .. .. UOi A A ~ N N m W W O ~ O N N N 0 C'! vw d- ~~ om G~ ~~ ~ m t D G N N y , = J C N ~ m C ~ . n ~ N ~ o ~ "~"' c N D $ ~ + b n 3 c 3 c K m .. .. C .~+ m m ~ ~ ~ D -~ m 3. o ~ ~; ~ 2 Z ~ ~ x M a ~~3 3. ~ m .~ ~ ~ z O .%. -~ ,y m m m o dq~ 3 8 m ~ ~ ~~m n ~ ~ ~ d b ~ R 5' ~ m ~ ~ c mn y. 0 n3 o o ~ ~a m ~~ m n y o ~. m g ~. P N Q' N B. m as 0 s V m qL ~ N ~ m yj o ~ &~ ma ~~ ~, , a8 N ~ .m. ~~ m s ~_ 3. ~~ B° J ~ m iZ A m ~ v» $°a 8s 8~ 8~ ~" ~~ 0 m ~ <°~ o w m d o - n 1 ~ ~1 ~1 n m ~~ C C O1 pl .. ~ G W N C ~ O d m n d ~ D x fn ~ A A V V (NO fND fR ~ N ((~~ UI W A W i V f~T V 1 0~7 V1 p.. ~s N n A ~ ~ J O N N N _ (O W ~I N Oo .,tli A ~ ~ ~ f~ ~ W ~~T~O'r r ~ ~~ T O~ A~ ,G y D ~` O ~,~ 0 N ~ N W °C ~ 7 ~~ ~ G~ ' Z N~n~ ~ p i 0 ~... O ~ ~ >`~ ~ D r ~ ~ `~ ~ z O. ~ ~ W ? 2 ~ Z ~ ~ ~,D D N ry. ~ ~ f0 r ~t ay~' rc ~ k t~ 1. a + IV W O O O ~ .; ~; ...= O. r` °i W OD IV pC O ® ` O O i p v1 D ~ oZD~ 3 Dye v win e v N o Om ~ o r ~ fAD N ~: mW X ~ X A ~ ~ _ Q O -~ -1 N ~i -- ~. m AJ ~' +~+ W ^~Q D , y~ O N ~: < d W d~1 O N , CS N ~'-~ D G N N Q W io ". in N OD t0 m w~3rn4~ m N o ~1 N ~ ~~ n 2 m N Z 1 r Z O Z A 0 O 0 O O O 0 2 V N O O 0 N O) N N Ol D e w ~ v V ~ ~ /D ~ W IUD O Cy9 C ~~ S a H x 0 W a~ 3 a ~~ N ~ C W O 0 O d 2 a d H ,~i m C A S77y11 ~ me~~ Fixed Annuity Administration [he retirement specialist P.O. Box 9006 Amw'illq TX 79105-9006 .It+L. [:. („ 1[71 July 14, 2012 Corinne Eggers Woodhouse Hazen Elder Law 2000 Linglestowns Rd Ste 202 Harrisburg PA 17110 Re: Annuity Contract: Contract Owner: Dear Mrs. Eggers Woodhouse: A03O0008874 John Pedati, Deceased ~NO.ara+aa. rraarr+s+ Thank you for your recent inquiry regarding this annuity contract. We would like to take this opportunity to respond to your request. The accumulated value of contract A03O0008874 as of Apri123, 2012, the date of death is $24,269.53. The referenced contract is aNon-Qualified Tax Deferred Annuity that was solely owned by John Pedati. The named primary beneficiaries are Judith A Hanley and Cynthia M Bruno. We appreciate the opportunity to assist you. Should you have any questions, please contact our Client Care Center at 1-888-333-2349. Sincerely, ~~~ Angela Furlong Annuity Claims Department SunAmerica Annuity and Life Assurance Company SunAmerlca Life Insurance Company Administramr fur The Central National ]_ife Insurance Company of Omaha Administrator for John Alden Life Insurance Company SYli!"1•111~~W Nixed Annuity Administration the retirement specialist 1 :0. Box 91106 Amarillo, TX 79105-9006 ,~L~.. a i`; ~~i July 14, 2012 Corinne Eggers Woodhouse Hazen Elder Law 2000 Linglestowns Rd Ste 202 Harrisburg PA 17110 Re: Annuity Contract: Contract Owner: Deaz Mrs. Eggers Woodhouse: A637090268A John Pedati, Deceased S.lui_.1~_'-~ ____ --- Thank you for your recent inquiry regarding this annuity contract. We would like to take this opportunity to respond to your request. The accumulated value of contract A637090268A as of Apri123, 2012, the date of death is $8,829.44. The referenced contract is a Qualified Tax Deferred Annuity that was solely owned by John Pedati. The named primazy beneficiaries aze Judith A Hanley and Cynthia M Bruno. We appreciate the opportunity to assist you. Should you have any questions, please contact our Client Care Center at 1-888-333-2349. Sincerely, ~~1Q~,~(~~~~~~~~ Angela Furlong Annuity Claims Department SunAmerica Annuity and Life Assurance Company •SunAmerica Life Insurance Comptmy Administrator fix The Central National Life Insurance Company of Omaha Administrator for John Alden Life Insurance Company gd `naiusi-i ~ipn f pus ottnzg ,ipu?~ :aa samsoiaug ie3aiszsd asnogpoom sza~~g auo?zoo e~ ~3 aw.~ ~ ~ tom, ,.- "_ `~Clazaau?S ~ ;",:: ua ~-i ~-a r.,~ `'"'` ~- z , ``~•aut 3as3uoa o3 a3e3?sa ou o asea d `suo[ sanb ~Cus ane no~i u;:: ~ c, q l P I 3 q 3I _, '00'Sb$3o3unoure ~:.~f~~.u? s~ at~q" t~uo?3?pps aq; zo3 auo pus I9' I IL$ 30 3unotue aq3 u? anp xs3 aq; zo3 auo ~:;0~0£ 3unoo ~; u? aa3 Bugg aq; zo3 auo axaaga (£) aazq; aze pasoiaua osiy c.a t~s in.t CP_ U cr_ .=~, •adoianua passazppe Sias pasoiaua aq3 ut aat33o ,Cut o; uzag3 uzn;az pun ,Czo3uanul aq3;o ~idoa s pue utn;az aq; 3o abed ;szg aq; dote;s alsp aseald •uzn;ag xeZ aaus;?zaqui aq3 3o abed 3szg aq; 30 ,idoa e q3?n+ 2uoie `,izo3uanui pue uzn3ag xe1, ague;uaqui paauaza3az-anogs ag33o ,tdoa auo pus ieu?~?zo aq3 pug aseald ~u?ig zo3 pasoiaug ~sli?~Y13o za3s?fag aqZ :oy u.~n;ate xeZ aaue;-aaqui 9LS0-Zi-iZ ~'ol~I al!3 !lsPad u9of g/?I/g `RgPad 4alg2i uNof )o a;s;s~ :ag £ I OL I Fed `ais?I~~ azsnbs asnog3.tno~ aup asnoquno~ ,i;uno~ pusizagtzm~ sIt?Ac13o za3s?tag 7Ib7~V Q.~IdLL?I~~ £ I OZ `ZZ ~n~f mo~'Megaaplquaze} 1'Mn+M EIEb-06S (LIL) ~~'~ Z££6i1iS fLIL) ~~ OIILi dd'~angs!azeH ZOZ al!nS peon uMO;sa!;iu!q OOOZ 8u7uunld spaaN Imaads . mp7 aaPlg . $u7uunld aln)s~ M~j 2T3a7~ u'.3'Z`e'j j rr u~ ~,,: ~. rl s..-~ L,~ ~,~c~ ut _, -°~' ~. „ <~ `~'il f ~S j+~ ~ .17 ~~ ~a '- O a m .~ a 0 r •? OFFIG' `:~~' ~,^R•^ . n "l l ~ J - ~J ;~ a~ _.. , COU ~~ j'.' 3 'ND CC N ~ . a f+ ~ r ~+ ~ - a, U ~a o ~ r ~ o r y Q ~ W p ~ ~ c., . l ~ ~ ~ N y ~ ~ N r~ ' ~ 'a O x °o x ~ N ~'~ O H t