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HomeMy WebLinkAbout06-25-13 C1 .o Co x7 C_ C) Cn, LEISAWITZ HELLER ABRAMOWITCH PHILLIPS,P.C. n z Cn By: Frederick M.Nice,Esquire n 2 m, cNn m ry zcoX -73 CD, Attorney I.D.No. 40821 ;�q _ o C�. By: Latisha Bernard Schuenemann,Esquire o c 3 I n Attorney I.D.No. 204574 - ry 2755 Century Boulevard v 1 �v r— r Wyomissing,PA 19610 "' o c) o (610)372-3500 -n Attorneysfor Petitioner, Eugene A. Smith, Jr. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY,PENNSYLVANIA IN RE:ESTATE OF THRESSA E. SMITH, ORPHANS' COURT DIVISION DECEASED FILE No.21-12-0858 PETITION FOR CITATION TO SHOW CAUSE WHY AN AN ACCOUNT SHOULD NOT BE FILED PURSUANT TO 20 Pa.C.S. 113501.1 AND THE APPOINTMENT OF A TEMPORARY FIDUCIARY UNDER 20 Pa.C.S. § 4301 SHOULD NOT BE APPOINTED TO THE HONORABLE, JUDGES OF SAID COURT: Petitioner, Eugene A. Smith, Jr. by and through his attorneys, Frederick M. Nice, Esquire, Latisha Bernard Schuenemann, Esquire, and the law firm of Leisawitz Heller Abramowiteh Phillips, P.C.,hereby respectfully represents as follows: BACKGROUND FACTS 1. Petitioner, Eugene A. Smith, Jr., is an adult individual, who resides at 17869 SE 87u'Bourne Avenue, The Villages, Florida 32162. 2. Respondent, James W. Smith (the "Respondent"), is an adult individual, who resides at 315 Robson Road, Dillsburg, Pennsylvania 17019. 3. Thressa E. Smith (hereinafter the"Decedent") died July 10, 2012, testate, a resident of North Newton Township, Cumberland County, Pennsylvania, leaving a Last Will and Testament dated May 31, 2005 (the "Will"). A true and correct copy of the Decedent's Death Certificate and Will is attached hereto as Exhibit"A" and `B,"respectively. 4. Letters Testamentary of the Decedent's estate (the "Estate") were granted to the (00540980 ) Respondent by the Cumberland County Register of Wills on August 7, 2012. 5. On or about August 31, 2012, Respondent, as Executor, caused the first complete advertisement of the original grant of letters to be published pursuant to 20 Pa.C.S. § 3162. 6. Jurisdiction is proper in the Cumberland County Orphans' Court Division to hear the within Petition pursuant to 20 Pa.C.S.A. §711(1), as this is a judicial proceeding involving an estate with a situs in Cumberland County, Pennsylvania. 7. Standing is present as the Petitioner is a residuary beneficiary of the Decedent's Estate entitled to receive thirty-five percent (35%) of the residuary estate pursuant to Article IV.B. See Decedent's Will attached hereto as Exhibit`B." CITATION FOR ACCOUNTING UNDER 20 Pa.C.S.§3501.1 8. To date, despite repeated requests and telephone calls, the Petitioner has not heard from the Respondent in regard to the Estate, its administration or its status. 9. In addition, the Petitioner has not received any distribution from the Decedent's Estate or information regarding distributions from the Estate since the Respondent's appointment as Executor. See Estate of McCrea, 380 A.2d 773 (Pa. 1977) (a personal representative has a duty to make distributions in an estate in a prompt manner.). 10. Decedent owned a parcel of land, by operation of law, located in Butler County, Pennsylvania being tax map parcel no. 250-1F147-30AA-0000, having purchased the land with her husband in September 20, 1955 (the "Parcel"). 11. It is believed that the Decedent suffered from diminished mental capacity as early as 2005 when she was placed in a nursing facility. 12. On or about September 19, 2011, the Respondent, as agent under a power of attorney dated May 31, 2005 and recorded at Instrument Number 201008686 in the Cumberland County Recorder of Deeds Office (the "POA"), executed a Memorandum of Lease, with SWEPI {00540980 } LP on behalf of the Decedent, which is recorded at Instrument Number 201109280023436 (the "MOL") at the Butler County Recorder of Deeds Office, as well as a Paid Up Oil and Gas Lease and Right of Way, granting SWEPI LP the right to explore, develop and market oil and gas from the Parcel. A true and correct copy of the POA and MOL (and additional lease documentation) are attached hereto and marked as Exhibits "C" and "D,"respectively. 13. Respondent transferred the Parcel (as well as the rights under the MOL and gas lease), in his capacity as agent, to himself on April 17, 2012, less than three (3) months prior to the Decedent's death, for no consideration. A copy of the Deed, recorded at Instrument No. 201205010012087, is attached hereto and marked as Exhibit"E." 14. Respondent, as Executor of the Estate, has failed to list the Parcel as an asset of the Estate on the Inventory and the Pennsylvania Inheritance Tax Return (the "Return"). A copy of the Inventory and Pennsylvania Inheritance Tax Return is attached hereto and marked as Exhibits "F" and "G,"respectively. 15. The Return, as filed, has incomplete information regarding the assets of the Estate as it is missing required documentation and information. More specifically, the Pennsylvania Inheritance Tax Return fails to provide the following information: (a) It is believed that some or all of the joint accounts reported on Schedule F of the Return are "convenience accounts" and should be reported as an asset of the Decedent's Estate as the Decedent did not intend to create a joint account with right of survivorship nor intended to make a gift inter vivos of the account, but rather, intended the account to be used for the Decedent's benefit and thus all proceeds from the joint account should pass pursuant to the Will at the time of death; (b) It is believed that the "gifted to James Smith" reported on Schedule G, line 2 of the Return is an incomplete description of the property"gifted" to the Respondent. It f00540980 } is believed that the "gift" was cash of $43,500.00 received by the Decedent from the royalties pursuant to the MOL with SWEPI LP that the Respondent improperly retained. It is believed and averred that, the $43,500.00 is an asset of the Decedent's Estate and should be returned to the Estate as the Respondent improperly transferred the $43,500.00 to himself under the POA; (c) It is also believed that Respondent failed to list the Parcel on Schedule G as required under 72 Pa.C.S. § 9107(c)(3) (A transfer conforming to subclause (1) and made within one year of the death of the transferor is subject to tax only to the extent that the value at the time of the transfer or transfers in the aggregate to or for the benefit of the transferee exceeds three thousand dollars ($3,000) during any calendar year). The Parcel should have been appraised and valued at its fair market value with an appraisal attached to the Return. Moreover, it is believed and averred that, the Parcel is an asset of the Decedent's Estate and should be returned to the Estate as the Respondent improperly transferred the Parcel to himself under the POA; (d) It is believed that the "Prudential Insurance No. 24 728 099 — prepaid funeral costs/death claim" of$10,814.97 reported on Schedule G, line 3 of the Return, is listed on the wrong schedule and should be listed on Schedule E, not Schedule G; and (e) It is believed that the Return fails to report the value of any natural gas interest the Decedent had at the time of her death pursuant to the MOL and supporting documentation attached as Exhibit "D." Pursuant to Pennsylvania Department of Revenue, Inheritance Tax Bulletin 2012-01, all natural gas rights shall be reported on the Inheritance Tax Schedule E as Cash, Bank Deposits & Misc. Personal Property. A true and correct copy of the Pennsylvania Department of Revenue, Inheritance Tax Bulletin 2012-01 is attached hereto and marked as Exhibit"H." (00540980 16. With the discrepancies evident on the Return in conjunction with the lack of information provided to the Petitioner and transfer of assets immediately prior to the Decedent's death in contravention to Decedent's will, that an accounting of the Respondent, James W. Smith, as Executor is necessary for the proper review of the assets of the Estate and its administration. APPOINTMENT OF A TEMPORARY FIDUCIARY UNDER 20 PA.C.S. §4301 17. Petitioner believes, and therefore avers, that the Respondent, as Executor, has failed to pursue and collect all assets of the Decedent's Estate, including seeking the return of the Parcel to the Estate, and has breached his fiduciary duty of care to the Estate and the beneficiaries. See In re Lux' Estate, 389 A.2d 1053 (Pa. 1978) (A personal representative has a duty to see that estate assets in the hands of third parties are returned to the estate). 18. Petitioner believes, and therefore avers, that the Respondent, as Executor, has failed to fulfill his responsibilities as the personal representative of the Decedent's Estate, is in a conflict of interest, and that as a proximate result of his negligence, the beneficiaries of the Decedent's Estate have suffered, and will continue to suffer, significant economic loss. 19. Petitioner believes, and therefore avers, that an accounting of the Respondent's actions as agent of the POA is warranted to review his actions as agent under the POA and seek the return of the Parcel, including its oil and gas rights, and certain joint bank accounts to the Decedent's Estate as assets to be distributed4&ording to the terms and provisions of the Will. 20. Petitioner believes, and therefore avers, the Respondent should be removed as the Executor of the Decedent's Estate as he is in a conflict of interest as the agent under the POA and will not pursue an accounting of his actions as agent. See Houck Estate, 1 Fiduc. Rep. 3d 279 (O.C. Phila. 2010) citing Estate of Dobson, 417 A.2d 138, 142 (Pa. 1980) for the proposition that the Court may remove an executor when it has been found that a fiduciary's personal interest X00540980 ) is in conflict with that of the estate, such that the two interests cannot be served simultaneously...[w]hen a conflict of interest or self-dealing on the party of the fiduciary is apparent from the circumstances, bad faith or fraudulent intent by the fiduciary need not be proven." 21. In this Commonwealth, the authority is split over who may compel an agent's account. See Golub Trust, 27 Fiduc. Rep. 2d 260 (O.C. Phila. 2007) (only decedent's personal representative may seek an account); Haskins v. Carroll, 25 Fiduc. Rep. 2d 361 (C.D. Brad. 2005) (beneficiaries under decedent's will may seek an account). 22. Section 20 Pa.C.S. § 4301 allows the Court to appoint a substitute fiduciary pro tem to act in the place a fiduciary whenever and for so long as the fiduciary is in a position of conflicting interest or in any situation where his functioning as a fiduciary may not be in the best interests of the estate. See 20 Pa.C.S. § 4301. 23. Pursuant to 20 Pa.C.S. § 4302, the Petitioner has standing to make this request. See 20 Pa.C.S. § 4302 (the relief authorized by section 4301 of this code (omitted) may be granted upon petition of any party in interest). 24. Petitioner believes that either Mark T. Smith, successor Executor under Article IX of the Will or a temporary fiduciary pursuant to 20 Pa.C.S. § 4301 should be appointed in order to pursue an accounting of the Respondent as agent under the POA and to seek the return of assets to the Decedent's Estate. 25. Petitioner hereby respectfully requests the removal of the Respondent, James W. Smith, as the Executor of the Estate of Thressa E. Smith and the appointment of Mark T. Smith, successor Executor under Article IX of the Will or a temporary fiduciary pursuant to 20 Pa.C.S. § 4301. - (00540980 WHEREFORE, the Petitioner respectfully request that this Honorable Court issue a Citation to Respondent, James W. Smith, to show cause why he should not file a formal accounting of his actions as the Executor of the Estate of Thressa E. Smith, deceased and why he should not be removed as the Executor of the Estate of Thressa E. Smith and Mark T. Smith or a third party be appointed as the personal representative of the Estate of Thressa E. Smith. Respectfully submitted, LEISAWITZ HELLER ARRAmo CH PHILLIPS,P.C. BY: 10 � n F ed rick M. Nice, Esquire Attorney I.D. No. 40821 Latisha Bernard Schuenemann, Esquire Attorney I.D. No. 204574 2577 Century Boulevard Wyomissing,PA 19610 (610) 372-3500 Attorneys for Petitioner, Eugene A. Smith, Jr. {00540980 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA IN RE: ESTATE OF THRESSA E. SMITH, ORPHANS' COURT DIVISION DECEASED FILE NO. 21-12-0858 VERIFICATION • I, EUGENE A. SMITH, Jr., verify that the statements made in the foregoing Petition are true and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S.A § 4904, relating to unworn falsification to authorities. EuGffKE A. SMITH,JR. t o GE1J 6 if f J�Q (00540980 x1U59a5 ACV,i4ltr) This is to certify that this is a true copy of the record which is on file in the Pennsylvania Department of Health, in accordance with the Vital Statistics Law of 1953, as amended, - WARNING: It is illegal to duplicate this copy by photostat or photograph. „ WA ti U pE� a©�'� "„• -_,;'�J' `• Marina O'Reilly Matthew• State Registrar AUG 1 S 2017 6938417 No, Date C6RTIFICATG OF DEATH MI Nnn•an.: i_DaCatlan at NOmn(FlnL faipol+,G.,Y,R. 2.5x1[ fl.3acla 3ao+r2y NUmLpY 9,DKe of DeNhtaAP% Iit o5 ` iaBThrassa E_ Sm1th P 375-05-3995- July 10,2032 --",nhday IN) .Iingnr 4Una rl Oa 6.Onea.1 p In,kN,.1a'UYa•q(Spell Mmm�) q�t 1 �y 5� Ga ry a97 BMRnana onvi PMnun Inux + 15VC efA,YHCCY.YI9Y�V Xt1 .� Suna 29 . 197.5 in.untnm.aa(cn Ni Butler vil + nl5btw ol'POr ntN .anal ♦ +IStra•<and NUmee/.lnclue a.l e pPenns 1vanla 250 438 Sj]r1.ng RoadN v:,ane.d•nun•a m.r wnN or th Newton tw R.�n+na.+tcnwrnYl r•MF�d ea.aa.+u.nna mP Cmar - - rH� oNn.am+•a.nr n,,.a.aann n..,:.... ow/onra. c. n -$,.wi two _ s r 1 esPno N.mnt+r.ax.[r.rn n.mn pno=ta not mn/o..q poY )c IN. 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SMITH T THRESSA E.SMITH,now domiciled in Cumberland County,Pennsylvania,declare this to be my Last Will. I revoke all other Wills and Codicils that I may have previously made. Article I My just debts and expenses ofmylast illness, funeral,and administration of my estate shall be paid by my Executor from the principal of my residuary estate as soon as practicable after my death. Article II All inheritance,estate,and succession taxes(including interest and penalties thereon,but not including any generation skipping tax)payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement from any person. This provision is not a waiver of any right which my Executor has to claim reimbursement for any such taxes which become payable as the result of any property over which I have the power of appointment. Article III I give, devise and bequeath my tangible personal property in accordance with any memorandum I have handwritten or signed, located with my will or with my valuable papers and found within 30 days of the probate of my will. Gifts may only be to persons who survive me or to organizations which exist at my death, and if there is a conflict, the memorandum having the latest date shall govern. To the extent no such memorandum is found, or all of my tangible personal property is not disposed-of pursuant thereto, my tangible personal property shall be added to my residuary estate and pass under Article IV hereof. Article TV All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give, devise and bequeath according to the following: A. SD(TY-FIVE PERCENT (65%) of my estate to my son, JAMES W. SMITH, of Dillsburg, Pennsylvania, Per Stirpes. If JAMES W. SMITH predeceases me, leaving no surviving issue, I give, devise and bequeath his share IN EQUAL SHARES to the children of my son, EUGENE A. SMITH,Per Stirpes; and B. THIRTY-FIVE PERCENT (35%) of my estate to my son, EUGENE A. SMITH, JR., of Boiling Springs,Pennsylvania,Per Stirpes. Article V If a beneficiary under this Will has not attained the age of thirty-five(3 5)years,the share of the beneficiary shall be placed in a separate trust,for the benefit of that beneficiary according to the terms in Article VI. -2- Article VI In the event that a Trust is created by or as a result of any part of this Will, the terms and conditions of the Trust shall be as follows: A. To expend and apply so much of the net income and so much of the principal of the Trust as the Trustee shall consider advisable for the support,health, care and education of the child until the child attains the age of thirty-five (35) years. B. Upon attaining the age of thirty-five(35),the remaining principal and accumulated income of the child's share shall be distributed outright to the child. C. No beneficiary or remaindennan of this Trust shall have any right to alienate, encumber, or hypothecate his or her interest in the principal or income of the Trust in any manner, nor shall any interest be subject to claims of his or her creditors or liable to attachment,execution,or other processes of law. Article VII In order to carry out the purposes of the Trust established by this Will, the Trustee, in addition to all other powers granted by this Will or by law,shall have the following powers over the Trust estate, subject to any limitations specified elsewhere in this Will: (a) to retain in the form received and/or to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estate, -3- (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, I j (d) to exercise any option or right arising from the ownership of investments, G (e) to compromise claims without court approval and without consent of any beneficiary, (f) to file fiduciary/income tax returns and pay the tax due for any year for which such a return is required, (g) to make distributions in cash or in kind,or in both,and to determine the value of any such property, (h) to employ any attorney,investment advisor,or other agent deemed necessary by my Executor; to pay from my estate reasonable compensation for all their services, (i) to conduct along with or with.others,any business in which I am engaged in or have an interest in at the time of my death, and (j) to receive reasonable compensation in accordance with their standard schedule of fees in effect while their services are performed. Article VIII I hereby appoint my sons, EUGENE A. SMITH,JR. and/or JAMES W. SMITH,to act jointly and/or individually, as Co-Trustees of any Trust(s) created in this Will. Article IX I nominate, constitute,and appoint my son,JAMES W.SMITH,Executor of my Last Will and Testament. In the event of the renunciation,death,or inability to act,for any reason whatsoever -4- ! of my Executor, I nominate, constitute and appoint my grandson, MARK, T. SMITH, of Lititz, Pennsylvania, successor Executor of my Last Will and Testament. I direct that my Executor or successor Executor be permitted to serve without bond.In addition to those powers granted by law,I grant them power to distribute in cash or in kind,in like or in unlike shares,and to file any qualified disclaimer I could have filed if living. My Executor or successor Executor shall receive reasonable compensation for services rendered to my estate. Article X In addition to the powers conferred by law,I authorize my Executor or successor Executor in his/her absolute discretion: (a) to retain in the form received and to sell either at public or private sale,any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estate, (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, (f) to file any federal income tax return for any year for which I have not filed such return prior to my death, (g) to make distributions in cash or in kind,or in both,and to determine the value of any such property, s_ I (h) to employ any attorney,investment advisor,or other agent deemed necessary by my Executor; and to pay from my estate reasonable compensation for all their services, (i) to conduct alone or with others, any business in which I am engaged in, or have an 1 interest in at time of my death, and 0). to receive reasonable compensation in accordance with their standard schedule of fees in effect while their services are performed. IN WITNESS WHEREOF, I, THRESSA E. SMITH,hereby set my hand to this my Last Will and Testament, on / 2005, at Harrisburg, Pennsylvania. THRESSA E. SMITH In our presence,the above-named THRESSA E.SMITH signed this and declared this to be her Last Will and now at her request,in her presence, and in the presence of each other, we sign as witnesses. ame Address 2000 Linglestown Rd., Suite 202 Harrisburg, PA 17110 2000 Linglestown Rd., Suite 202 Harrisburg, PA 17110 6 1,THRESSA E.SMITH,Testatrix,who signed the foregoing instrument,having been duly qualified according to law,acknowledge that I signed and executed this instrument as my Will,and that I signed it willingly as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by THRESSA E. SMITH, the Testatrix, on - 31 2005. Y at'L // // ` ✓// No P lie T RESSA E. SMITH COMMONWEALTH OF PENNSYLVANIA Notarial Seel Mariellc F. Hazen. Notary Public Susquehanna Tvp., neuphtn CounlY My Commission Expires Sept 23, 2%06 We, the undersigned witnesses who signed the foregoing instrument, being duly qualified according to law,depose and say that we were present and saw the Testatrix sign and execute this instrument as her Will;that she signed and executed it willingly as her free and voluntary act for the purposes therein expressed;that each of us in her sight and hearing signed the Will as witnesses,and that to the best of our knowledge, that she was at that time eighteen(18) years or more of age, of sound mind, and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me T by f G / and mess witnesses, on '{_ / ) 2005. (!Wi ess ,Notary P lic COMMONWEALTH OF PENNSYLVANIA. Notarial Seal . _ Mariclle F. Hazen, Notary Public • Susquehanna 7Mp., Dauphm County My Commission Expires Sept. 23, 2006 lmstr.2B72050tBB12BB6 06101!2012 F:S36.50 10:01RM Paris:l3 r20t2001B515 Mich �1• I1u�t�llo 11l_JMES Y But Ur County Recorder DURABLE POWER OF ATTORNEY FOR THRESSA E. SMITH Prepared by: J�M�� �v �'o Law Office of Marielle F. Hazen 2000 Linglestown Road, Suite 202 2� /1� 7�� g Harrisburg, PA 17110 i[ �S 8J / 1- (717) 540-4332 r . NIIIII�I�III�I{�1�1{III 001RT7 NOTICE THE PURPOSE OF THIS POWER OF ATTORNEY IS TO GIVE THE PERSON YOU DESIGNATE(YOUR"AGENT")BROAD POWERS TO HANDLE YOUR PROPERTY, WHICH MAY INCLUDE POWERS TO SELL OR OTHERWISE DISPOSE OF ANY REAL OR PERSONAL PROPERTY WITHOUT ADVANCE NOTICE TO YOU OR APPROVAL BY YOU. THIS POWER OF ATTORNEY DOES NOT IMPOSE A DUTY ON YOUR AGENT TO EXERCISE GRANTED POWERS, BUT WHEN POWERS ARE EXERCISED,YOUR AGENT MUST USE DUE CARE TO ACT FOR YOUR BENEFIT AND IN ACCORDANCE WITH THIS POWER OF ATTORNEY. YOUR AGENT MAY EXERCISE THE POWERS GIVEN HERE THROUGHOUT YOUR LIFETIME, EVEN AFTER YOU BECOME INCAPACITATED, UNLESS YOU EXPRESSLY LIMIT THE DURATION OF THESE POWERS OR YOU REVOKE THESE POWERS OR A COURT ACTING ON YOUR BEHALF TERMINATES YOUR AGENT'S AUTHORITY. YOUR AGENT MUST KEEP YOUR FUNDS SEPARATE FROM YOUR AGENT'S FUNDS (UNLESS YOU HAVE AUTHORIZED THAT JOINT ASSETS MAY BE HELD IN YOUR NAME AND YOUR AGENT'S NAME). A COURT CAN TAKE AWAY THE POWERS OF YOUR AGENT IF IT FINDS YOUR AGENT IS NOT ACTING PROPERLY. THE POWERS AND DUTIES OF AN AGENT UNDER A POWER OF ATTORNEY ARE EXPLAINED MORE FULLY IN 20 PA. C.S. CH. 56. IF THERE IS ANYTHING ABOUTTHIS FORM THAT YOU DO NOT UNDERSTAND, YOU SHOULD ASK A LAWYER OF YOUR OWN CHOOSING TO EXPLAIN IT TO YOU. I HAVE READ OR HAD EXPLAINED TO ME THIS NOTICE AND I UNDERSTAND ITS CONTENTS. THRESSA E. SMIT , PRINCIPI�L- DATE L ACKNOWLEDGMENT 1,James W.Smith,have read the attached Power of Attorney and am the person identified as the agent for the principal. 1 hereby acknowledge that in the absence of a specific provision to the contrary in the Power of Attorney or in 20 Pa. C.S. when I act as agent. I shall exercise the powers for the benefit of the principal. 1 shall keep the assets of the principal separate from my assets(except where a gift of assets may be titled jointly in the names of Principal and Agent). 1 shall exercise reasonable caution and prudence. I shall keep a full and accurate record of all actions,receipts and disbursements on behalf of the principal. �Ines W.Smith,Agent Datk t DURABLE POWER OF ATTORNEY FOR THRESSA E. SMITH I,THRESSA E.SMITH,of Cumberland County,Pennsylvania,hereby revoke any and all prior Powers of Attorney and hereby appoint my son, JAMES W. SMITH, of Dillsburg, Pennsylvania,to act as my Agent(hereinafter referred to as my"Agent")for me and in my name and place to transact all my business and to manage all my property and affairs as completely as I myself might do if personally present, including but not limited to, exercising the following powers contained in this document. In the event of JAMES W. SMITH's death, written resignation or inability to serve as certified by my successor Agent, I hereby nominate and appoint my son, EUGENE A. SMITH,JR., of Boiling Springs, Pennsylvania,AND/OR my grandson, MARK T. SMITH, of Lititz, Pennsylvania, to act jointly and/or individually, as my Co-Agents with all the powers set forth below. 1. Persona!Property. To engage in tangible or intangible personal property transactions, including the power to sell, assign, transfer, exchange or otherwise dispose of, or to purchase any interest in any tangible or intangible personal property upon any terms. 2. Rea!Property. To engage in real property transactions,including the power to lease, sub-let, and manage in all respects any real estate now or hereafter owned or leased by me; and to. sell,exchange or otherwise dispose of my real estate on any terms,and to do all things and execute and deliver all documents in connection therewith,including,but in no way limited to,deeds,notes, mortgages,lease agreements and sales contracts. These powers shall specifically include,but not be limited to, my real property located at 257 West Ridge Street, Carlisle, Pennsylvania 17013. 3. Securities. To engage in stock, bond and other securities transactions, including the power to exercise all securities holders' rights, and to sell, cash or otherwise dispose of Treasury Securities,bonds(including U.S.Savings Bonds),or other instruments and to engage in commodity and option transactions. To vote in person or by proxy at any meeting, to join in any merger, reorganization,voting-trust plan or other concerted action of security holders,to make payments in connection therewith, and in general to exercise all rights of a security holder. 4. Investments. To invest and reinvest my assets in all forms of real and personal property without any restriction whatsoever as to the kind of investment, including, but not limited to, life insurance, annuity contracts and United States Treasury Bonds which are redeemable at par in payment of federal estate taxes. 5. Bank Accounts. To sign checks,drafts and other instruments or otherwise make withdrawals from any checking,savings,transaction or other deposit account in my name,and to endorse checks payable to me and receive the proceeds thereof in cash or otherwise; to open and close checking, savings, transaction or other deposit accounts in my name; to purchase and redeem savings 1 certificates,certificates ofdepositor similar instruments in my name;to exercise and deliver receipts for any funds withdrawn or certificates redeemed;and to do all acts regarding any checking account, savings account,savings certificate,certificate of deposit,or similar instrument which I now have or may hereafter acquire, the same as 1 could do if personally present. 6. Individual Retirement Account and Retirement Benefits. To request and receive distributions from any of my Individual Retirement Accounts;to give instructions for the purchase and sale of securities in those accounts; to execute on my behalf any powers of attorney or, other instruments needed for those purposes; to endorse notes, checks, drafts and bills of exchange; to make contributions to those accounts; and to engage in retirement plan transactions of any nature. 7. Governmental Benefits. To exercise complete dominion and control over any and all social security, veteran, county, state and federal benefits to which I may now or hereafter be entitled. 8. Insurance. To procure, alter, extend or cancel insurance against any and all risks affecting property and persons, and against liability, damage or claims of any sort. To request and authorize change or changes in the mode of payments of premiums of any policy of insurance on my life or property;to execute premium extension agreements;to receive and receipt for any dividend due or to become due under said policies; to request, authorize and obtain loans on policies; to execute necessary loan documents to keep policies in force;and to execute all necessary documents to obtain loans against policies and/or to obtain the cash surrender values of policies. 9. Bonds. To purchase for me United States of America Treasury Bonds of the kind which are redeemable at par in payment of federal estate taxes;to borrow money and obtain credit in my name from any source for such purpose, to make, execute, endorse and deliver promissory notes, drafts, agreements or other obligations for such bonds and, as security therefore, to pledge, mortgage and assign any stocks,bonds,securities,insurance values and other properties,real or personal,in which 1 may have an interest,and to arrange for the safekeeping and custody of any such Treasury Bonds. 10. Sate Deposit Boxes. To have access to and control over the contents of any safe deposit box rented by me,to rent safe deposit boxes in my name,to close out and execute and deliver receipts for safe deposit boxes in my name, and to do all acts regarding any safe deposit boxes in my name, which I now have or may hereafter acquire, the same as I could do if personally present. 11. Loans. To borrow money in such amounts for such periods and upon such terrns as my Agent shall deem proper and to mortgage or pledge my assets as security,and to execute and deliver any documents in connection therewith. 12. Debts. To pay and discharge my debts,present and future, and to compromise any of them on any terms. - 2 - 13. Execution of Contracts. To enter into, perform, modify, extend, cancel, compromise, enforce, or otherwise act with respect to any contract of any sort whatsoever -- including but not limited to, notes,leases and mortgages--and to pay any money or to transfer title and possession to any real or personal property that may be required to be paid or transferred by any contract or in the performance of any obligation entered into or incurred by me or on my behalf. 14. Execution of Documents. To execute, deliver, file of record, cancel, modify, endorse, acquire or dispose of any instrument including,but not limited to: stock and bond powers; vehicle registrations; financing statements and related filing documents; reports of any sort to any government,authority or agency,as required or permitted by law;deeds with or without covenants or warranties; and any other document appropriate for carrying out any of the foregoing powers. 15. Rexistration of Proyeriy. To hold property unregistered or in the name of a nominee; to apply and re-apply for registration of any automobile or other property or business requiring licensure or registration; 16. Receipts and Approval ofAccounts. To receive payment of any kind, including a bequest, devise,gift or other transfer of real or personal property to me in my own right or as a fiduciary for another, and to give full receipt and acquittance therefor,or a refunding bond therefore; to approve accounts of any business, estate, trust, partnership or other transaction whatsoever in which 1 may have any interest of any nature whatsoever; and to enter into any compromise and release in regard thereto. 17. Institution or Settlement of Claims. To ask,demand, sue for, receive, receipt for and give discharge of all property,debts,inheritances,and any pension,welfare,insurance,social security or other benefits due me,and to compromise any claims on any terms;to compromise or arbitrate any claim in which 1 may be in any manner interested, and for that purpose to enter into agreement to compromise or arbitrate, and either through counsel or otherwise to carry on such compromise or arbitration and perform or enforce any award entered in arbitration; to institute, prosecute, defend, compromise,or otherwise dispose of,and to appear for me in any proceedings at law or in equity or otherwise before any tribunal for the enforcement or for the defense of any claim,either alone or in conjunction with other persons, relating to me or to any property of mine or any other person (including the authority to sue if this power of attorney is not honored);and to retain,discharge and substitute counsel and authorize appearance of such counsel to be entered for me in any such action or proceeding. 18. Taxes. To prepare,execute and file in my name and on my behalf any return,report,protest, application for correction of assessed valuation of real or other property, appeal, brief, claim for refund or petition including petition to the United States Tax Court in connection with any tax imposed or purported to be imposed by any government, authority or agency,or claimed, levied or assessed by any government,authority or agency and to pay any such tax and to obtain any extension - 3 - of time for any of the foregoing;to execute waivers of restrictions on the assessment and collection of deficiency in any tax; to execute closing agreements and all other documents, instruments and papers relating to any tax liability of mine of any sort;to institute and carry on either through counsel or otherwise any proceeding in connection with contesting any such tax or to recover any tax paid,or to resist any claim for additional tax or any proposed assessment or levy thereof,and to enter into any agreements or stipulations for compromise or other adjustment or disposition of any tax. 19. Employment of Others. To employ accountants, attorneys-at-law, investment counsel, custodians, Agents, servants,and others,and to delegate to them, to remove them, and to pay them such remuneration as my Agents shall deem proper. 20. Desienate Beneficiaries. To make or change any designation of beneficiary or contingent beneficiary or to make or change any distribution option for any qualified retirement plan, IRA, annuity, insurance policy or other program for which I am entitled to so do. 21. Disclaimer. To execute, deliver and file or record disclaimers of any part or all of any property, power or interest passing to or for me under any will, deed or trust or otherwise; and to direct my spouse's executor to elect to qualify or to elect not to qualify for the marital deduction any portion or all of a marital deduction trust created for me by my spouse. 22. Spousal.Election To release or disclaim, any interest in property on behalf of me (the Principal). 1 direct my Agent to disclaim any and all interest in any and all property if it impacts or delays my eligibility for private and public benefits, including state, local, and federal benefits; specifically, I direct my Agent(s)to refuse to take or claim a spousal election if it will impact or delay the receiving or eligibility of Medical Assistance benefits. I specifically direct my Agent to refuse to claim an election share in such a situation,and I consider refusing to take or claim a spousal election a part of my estate planning,and it is my wish and reflcets my intentions regarding my estate planning and my directions of my estate to refuse to take or claim the elective share if it impacts or delays my eligibility for any private or public benefits. 23. Gift Making Powers. To make unlimited gifts,asset forth below,either outright or intrust, revocable or irrevocable,or,in the case of minors, in accordance with the Uniform Gifts to Minors Act and, for gifts made in trust, to persons, including my Agent, as original or successor trustees. This power includes the right to make additions to an existing trust and does not require my Agent to treat the donees equally or proportionately and may entirely exclude one or more perm issible donees. The pattern followed on the occasion of any such gift(or gifts)need not be followed on the occasion of any other gift(or gifts). The gifts shall be restricted to the following: my lineal descendants, including my Agent(s) hereunder; any trust(s) for my benefit and/or for my lineal deseendant(s)'benefit;and any organization described in IRC Section 501(c)(3). My Agent and the donee of the gift shall be responsible as equity and justice may require to the extent that a gift made by my Agent is inconsistent with my directions and planning of my probable intent with -4 respect to the disposition of my estate. The ability of my Agent to make gifts of my property shall be limited by and shall only be made in conformity with my prenuptial agreement, if any such agreement exists. I do not restrict or limit the amount of money or assets to be transferred and gifted, and direct the funds available for such gifts or transfers include principal and income. I specifically direct my Agent to make gifts to any and all persons listed in the above paragraph who he/she deems appropriate, and further direct my Agent to make transfers including gifts in order to accelerate or preserve my eligibility for public and private benefits, including Medical Assistance and Supplemental Security Income, so to allow me and/or my spouse or any family member to receive state, local, and federal benefits at the early possible time/date. It is my intention and my direction that my Agent be hereby empowered to make gifts to anyone and to transfer assets to anyone to obtain such benefits. Further, I consider transfers and gifting in order to obtain such benefits to be in accordance with my estate planning,and I direct such action to be taken to obtain said benefits for me. Any and all transfers and gifts are not inconsistent with my estate planning and in fact reflect my intention and direction with respect to the disposition of my estate. Gifts shall be made only after consultation, confirmed in writing, by an attorney-at-law experienced in estate planning and elder law. 24. Create a Trust. To execute a deed of trust,designating one or more persons(including my Agent)as original or successor trustee(s)and to transfer to the trust any or all property owned by me as my Agents may decide. The income and principal of the trust may,but need not,be distributed to me or to the guardian of my estate,or be applied for my benefit,and upon my death,any remaining principal or unexpended income of the trust may, but need not, be distributed to my estate. Furthermore, this trust or deed of trust may be amenable or revocable at any time by me or my Agents,or the trust or deed of trust may be irrevocable by me or my Agent. The establishment and funding of Trust,either revocable or irrevocable,is not inconsistent with my estate planning,and in fact reflects my intention and direction with respect to the disposition of my estate. 25. Fund the Trust. To add at any time, any or all of the property owned by me to trust in existence for my benefit when this power was created. The income and the principal of the trust may,but need not,be distributable to me or to the guardian of my estate or be applied for my benefit during my lifetime and upon mydeath any remaining principal and unexpended income of the trust, may, but need not, be distributed to my estate. The establishment and funding of a Trust, either revocable or irrevocable,is not inconsistent with my estate planning,and in fact reflects my intention and direction with respect to the disposition of my estate. 26. Healthcare Decisions. To consent, refuse or withdraw consent to any and all types of medical care, treatment, surgical procedures, diagnostic procedures, medication, blood and blood products, and the use of mechanical or other procedures that affect any bodily function, including, - 5 - but not limited to, artificial respiration, nutritional support and hydration, kidney dialysis and cardiopulmonary resuscitation; To authorize, or refuse to authorize, any medication or procedure intended to relieve pain, even though such use may lead to physical damage, addiction or hasten the moment of (but not intentionally cause) my death; To request and/or terminate an out-of-hospital do-not-resuscitate order on my behalf in accordance with Pennsylvania law; and To consult to the same extent as I am able with all medical providers, including but not limited to physicians,psychiatrists,nurses,physician assistants,nurse practitioners,therapists,technicians and all hospital personnel, regarding my care, condition and treatment. My Agent shall have access to medical records and information,including psychiatric records,to the same extent that I am entitled to, including the right to disclose the contents to others. In addition to the other powers granted by this document, my Agent shall have the power and authority to serve as my personal representative for all purposes of the Health Insurance Portability and Accountability Act of 1996, (Pub.L.104-191), 45 CFR Sections 160 through 164. My Agent shall be considered my personal representative for health care disclosures under the federal HIPAA regulations and shall have full authority to review my medical records and to execute releases of confidential information from medical providers and insurers or other third party payors. 27. Placement in an Institution. To take charge of my person in case of illness or disability of any kind;to authorize my admission to a medical,nursing,residential or similar facility,and to enter into agreements for my care;and to remove and place me in such institutions or places as my Agent may deem best for my personal care, comfort, benefit and safety after giving consideration to any wishes I have previously expressed on this subject. 28. Guardianship. if incapacity proceedings are hereafter commenced, I nominate my Agent designated herein to act as guardian over my estate and/or person. 29. Substitution. I empower my Agent to make,constitute and appoint one or more persons as substitute or substitutes in the place and stead of my said Agent and to revoke the same at pleasure, giving and granting unto such substitute or substitutes full power and authority to act hereunder in the place and stead of my said Agent, but in my name and on my behalf. 30. General. To do, in addition, all other acts or things whatsoever, and to exercise all other powers on my behalf, whether or not referred to herein, as fully as though herein specifically expressed,which in the sole discretion of my Agent may be deemed advisable to be done forme and in my name, as fully and completely as 1 might or could do personally, giving and granting to my - 6 - •f. Agent for that purpose full and complete power and authority to have,use and take all lawful means in my name for the purposes aforesaid. The enumeration of the specific powers conferred herein shall not be deemed to exclude herein any other power, it being my purpose and intent to give my Agent power to do any and all things on my behalf as fully as I could do myself. The descriptive headings of this general power of attorney are inserted for convenience only and shall not be deemed to affect the meaning or construction of any of the provision hereof or to limit in any way the construction thereof in the broadest possible manner. 31. Liability. Any person who is given instructions by my Agent in accordance with the terns of the Power of Attorney shall comply with the instructions. Any person who without reasonable cause fails to comply with these instructions shall be subject to civil liability for any damages resulting from non-compliance. Reasonable cause under this subsection shall include,but shall not be limited to, a good faith report having been made by the third party to the local protective services agency regarding abuse,neglect,exploitation,or abandonment. However, I consider qualifying for medical assistance benefits to be prudent planning. Any actions taken to hasten and facilitate my eligibility for Medical Assistance shall not be challenged by a third party, including the local protective services agency. My Agent is authorized to proceed to obtain incidental and consequential damages, including court costs and attorneys' fees,pursuant to 20 Pa.C.S.A. §5608,for any delay caused by a third party's refusal to honor this Power of Attorney. 32. Third Party fmmunity and Ratification. Any person who acts in good faith,reliance on my Power of Attorney shall incur no liability as a result of acting in accordance with the instructions of my Agent. This power of attorney shall continue in full force and effect and may be accepted and relied upon by anyone to whom it is presented despite my purported revocation of this power,the age of this power,the issuance of a court decree declaring my incapacity or my death,until written notice of such event is received by such person. For the purpose of inducing any bank, trust company, savings bank,brokerage firm,or any other financial institution,and their respective successors and assigns,to recognize this instrument,I hereby agree that any such bank,trust company,savings bank, brokerage firm,or other financial institution shall be held harmless from any loss suffered or liability incurred by it or them in acting hereunder until a certificate of death certifying to my death shall issue and actual notice thereof be received by said bank,trust company,saving bank,brokerage firm, or other financial institution, and their respective successors and assigns or until actual notice or revocation or lawful termination according to law shall be received by it or them. I hereby ratify and confirm all that my Agent or the substitute or substitutes therefore shall lawfully do or cause to be done by virtue hereof. 33. Compensation and Reimbursement for Expenses. My Agent shall be entitled to reasonable compensation based on the actual responsibilities assumed and performed. My Agent shall also be entitled to reimbursement for actual expenses advanced on behalf of the Principal and to reasonable expenses incurred in connection with the performance of my Agent's duty. - 7 - 34. Effect of My Disability. This power of attorney shall survive and not be affected by my future mental or physical incapacity,disability or incompetence if such should occur. 35. Severability. Should any of the provisions of this document be for any reason declared invalid,such invalidity shall not affect any of the other provisions of this document and powers,and all invalid provisions or powers shall be wholly disregarded in interpreting this document. 36. Conies of this document. I expressly direct that for all purposes,a photocopy of this Power of Attorney be deemed an original and any person shall be authorized to act upon such a copy as if it were an original. t Dated e 3 LIj ' 2005. THRESSA E. SMITH itnesses: 2000 Linglestown Rd., Suite 202, Harrisburg, PA 17110 Name Address I P Al 2000 Linglestown Rd., Suite 202, Harrisburg, PA 17110 Address - 8 - COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF DAUPHIN On 2005,before me a Notary Public for the Commonwealth of Pennsylvania, personally appeared THRESSA E. SMITH, known to me to be the person whose name is subscribed to the within instrument and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. s Notary Public �,r,Nx1X'+e57yH roc;. COMMONWEALTH OF PENNSYLVANIA Notarial Seel ��\Z•'� ,5+;�+� �_ �1'�, Marielle F. Hazen, Not PobIrc .i°b -;12�J`Yn•�� •y y Sus uchanna Tvry., Dauphin County �y r MY Commission Expires Sept. 23, 2006 > q; "•'° I!"Ft ao� thereby CERTiPY that this document Is recorded in the Recorder's Office p of Buser County, caul Pennsylvania Michele M.Mustello-Recorder of Deeds - 9- ROBERT P. ZIEGLER RECORDER OF DEEDS u CUMBERLAND COUNTY l COURTHOUSE SQUARE CARLISLE, PA 17013 717-240-6370 ' Instrument Number-201008686 Recorded On 4/7/2010 At 2:00:47 PM *Total Pages- 13 Instrument Type- POWER OF ATTORNEY Invoice Number-63564 User ID- KW *Grantor- SMITH,THRESSA E •Grantee-SMITH,JAMES W •Customer- PA REAL ESTATE *FEES STATE WRIT TAX $0. 50 Certification Page RECORDING FEES — $27.50 RECORDER OF DEEDS DO NOT .DETACH PARCEL CERTIFICATION $10.00 FEES This page is now part COUNTY ARCHIVES FEE $2.00 ROD ARCHIVES FEE $3.00 of this legal document. TOTAL PAID $43.00 1 Certify this to be recorded in Cumberland County PA 1°I C°ys a 4� oa ° RECORDER O D EDS rrw "-Information denoted by an asterisk may change during the verification process and may not be reflected on this page. OO1 R77 Illilllilllllllll�Il IIII PA PAID UP LEASE tnalllll1111111111111I111111111111II11111I11111 11 Lease No. Rev06,09.2011 P69.1 F416.610 2:50PM MieMle Must.11o T2011003269S Butler county Recard.r RP MEMORANDUM OF LEASE TiiISiiM_EMORANDUMO,r�,LEASE has been made to indicate the existence of en Oil and Gas Lease("Lease") dated n!Y ar I-Lr ti+ by and between T rrcssa I' Smi,lhh„n widasv,of 315 Robson Road Dillsbura. PA 17019 as Lessor mid SWEPT LP, having an oM" at 190 THORN 14ILL ROAD, WARRENDAL6, PENNSYLVANIA 15086,as Lessee. Lessor did grant,demise, lease and let exclusively to Lessee,its successors and assigns,the rights to explore,develop, produce and market oil and gas from the premises described below subject to the provisions contained in the Lease including the following; I.The primary term orthe Lease is for a period of Five(5)years commencing on the date immediately set forth above and for so tong thereafter as oil,gas or other substances covered by the Lease are capable of being produced in paying quantities from the lensed premises or from lairds pooled therewith or the Lease is otlicnwisc maintained or prolonged pursumnl to the provisions contained in the Lease,including un extension of term contained therein. Lessee may extend the prima y term or the Lease for art additional Five(5)years alter the end of the primary term, thereby continuing the term of the Lease to the end of the extended primary term. 2.All that certain tract of land situated in the Township of Odkland,County of DqujlLr,Commonwealth of Pennsylvania,generally bounded now or formerly its rullow•s: On the North by 250-1 F t47.0000029G-0000 Richard A.Lakin On the East by 290.1 F102dOOOOOIA-0000 Stephen C.Malis On the South by Saint Wcndelin Road Oil the West by 250.00OS4.000000OC-0000 Richard A.Eakin and for reference purposes only,being County Tax Parcel No.250-1 F147.000030AA-0000,being the same tract of tand acquired by Lessor by vinue of a document recorded in the office of the Recorder of Deeds in said county in Pennsylvania, Deed Book 675 and Page No. 499 aml stipulated to contain, for the purpose of calculating payments, Fi0x-Thrce and 15/100 (53.151,acres,more or less. 'this Memorandum of I-ease has been executed for the purpose of providing notice in the Recorders Office of dater County, Commonwealth of Pennsylvania, of the existence of the Lease and shall not be considered in any way a modification or alteration of the Leuse. The panics have executed this Memorandum of Lcase thislay of=� � 7 '201 L Nrl1'N'� rSSOIt; r I hondry CERTIFY that thit snt Is recorded In the Reeotdoes Omar r of ButlerCounry. SWEPI LP Pennsylvania Michele M.Must0lo-Recorder of Me& Its: Standard Acknowledgement COMMONWEALTH OF PENNSYLVANIA ) )ss: COUNTY OF_&-H- � {) On the 196 day or cQ?0fety) r in the cur 20 11 before me,the undersigned,a notary public in 7 and for said state,personally appeared�— Q.1f'�1nJ personally known to me or proved to me on the basis of salisfactory•evidence to be the individual(s)whose names)is(are) subscribed to the within instrument and acknowledged to me that helshetthey executed the same in hisficelfhcir capacity(ics),and that by his/her/their signatures)on the instrument,the individual(s)or the person upon behalf of which the individual(s)acted, executed the instrument. IN W rrNESS WI-ILREOF, I hereunto set my hand at RETURN TO PRESENTER ,'tA ----✓", , Notary Public . COMfAONWPALTH OF PENNSYLVANIA d Seal q [=Ho0yA.=X,?8,011 a6lker Twp„Buyer County isslon Exahes Aup.4.2653 Memhen Pennsryrvan a kasopadant9 Notartaa PA PAID UP LEASE Lease Nn. Rev.06.09.2011 PAID UP OIL AND GAS LEA E This Lease Agreement is made and entered Into this day of .2011. between Thri E.Smith a widow of 315 Robson Road _ Dillsbur PA 17019 as Lessor. (whether am or mach and SWEPT LP, having an Office at 190 TRORN FULL ROAD, WARRENDALE, PENNSVLVANIA 1511 as Lcssc. (1)LEASE-In consideration of the bonus consideration paid,the tuipt of which is hereby acknowledged,and in further consideration of the covenants and agreements herein contained, [ ram does hereby Room, anode, loose and let exclusively to Ii its ancestors and Psi the lands hereafter deserih for die purpose of exploring for,developing, producing and marketing oil,gas or other related substrates prwhiced in ass ciation therewith by all methods now known or hereafter known or hereafter discovered,in and under the following described It d•. (2) DESCRIPTION - All that ccnain Imet of lord situnteA in the Township of Oakland Blida County. Commonwealth of Pennsylvania,generally bmsnded now or formerly as follow On the North by 250-If147-00000290.0000 Richard A.Eakin _ On the Ent by 290-1FI02-0000001A-0000 Stephan C.Malls � On the Small by Saint Wendelin Road On the West by 250.OWS4-0000000C-0000 Ruchard A.Eakin and for reference purposes Only,being County Tax Parecl Nn. 52 O.IF I47_OQQ AA-0000,befnglhc same tract of land acquired by Lessor by virtue of a document recorded in the office of the Rcec der of floods in said county in Pennrylvanla Deed Ronk 675 and Page No. 4_q and stipulated to contain, for the purpose of calculating payments F'ftv-Th d 151x00 -L52j3],aces,more or less,and hercinnflo called"it And premises".This lave includes all accreted at submerged lands contiguous to the leased premisaa claimed Or owned by Lassa (3)TERM-Sublcct to the other provisions contained herein,this 1 e shall be in force rot a primary lotto of five(5) years and fM n long thereafter ai OIL,gal or other Substances covered here y capably orbiting produced in paying quandtics from the leased premises or from lends pooled therewith or this lease is Ann ire maintained pursuant to the provisions hereof. It is understand that so long as this)ease is extended beyond the primary arm by any provision of this Ican. Levee may m comence•resume,or continue the exercise of any of the rights,privilege of urposu berxfduring such extension. EXTENSION OF TERMt At Lessee's option,Lesace may exte the primary term of this Iwo for an additional period equal to the primary term by paying or rendering to Lessor an csmnsion payment of Than Thousand and 09A00 Dollars(SMO0.001 par acre payable at any tirile prior to the capitation of the primary tarn. If Lessee exercises this option.the primary term of this Ices-shell be can<idere to he continuous,commencing on the date heraef and cmalm,ing to the end of the attended primary term. (e)ROVATi PAYMENT—On oil and gas along with all hydros orhor and non-hydrocarbon substances producrd in association therewith,(except storage gas)Lassa.shall deliver to Lunt,as to Nry fifteen percent(15 11 of the proceeds(ICY all applicable excise taxes, including production, severance and windfall profits taxes. and less transporvidon, compression, dehydration and gathering costs,irony)realimd by Lessee for that produced n el marketed oft the leased prmises. (5)LESSOR'S INTEREST-If Lessor owns an interest in the lease d premises less than the entire and nndividcd estate , herein leased,then all payments herein provided shall he paid by Lessee only n the proportion to which Laiaw s interest henry to the whole tied undivided estate. If the I.sscd premises shall hereafter be set dividad,the leased pmmiaca shalt nevertheless be developed and operated as one lease,and all royalties accruing hoeuoder 5 nil be treated as an entirely,and shall be divided among and paid to such separate Owners in the proportion that the 110i owned by each owner bun to the entire leaned acreage. Wilco shall not be bound by any change in the ownership of the ka,ad premises nr any change of the address of Lessor until furnished with such documentation from Lessor as Levee may rusnnab c require. (6) DIRECTION OF PAYMENT—All payments herein may be mooted to the).error or delimited to Leasar'.5 credit or to the credit of Letcor-s respective heirs or assigns by check payable to the or and Address as. forth above, Luse shall not be abligatcd to altar payments as directed above unless with virmen notice by I assor At I<sliw's heirs or assigns direct losses Otherwise. (7)CONTINUING OPERATIONS—If at the end of the primary crm or any cxtensinn thereof this Icanc is not bang kept in force by any other provision herof but learn has commenced apart tonq for drilling,completing reworking,equipping or any other operation calculated to obtain production nn the feared promises or lands pooled therewith,this lease shall remain in force as long as such operations am conducted in a reasonably prudent mom ier, At oily time after me expiration of the primary ratio,this lease is not being kept in farce by Any other provision hereof,L.e Sor agrees to uti the term one year beyond the completion of plugging operations of the last well an lured promises to pern it Lessee to deepen,rework or focompdete laid well m to enmmenm np.rmio.,for the dritding of anothv well and if aneh n untinns msuh in the production of any substance covered hereby,this team will be extended as long the¢afor As produetion or union.,in paying quantities. (9)POOLING&UNITIZATION-Lessee Is hereby granted the right ro pool or unitise the leased promises,or any port thereof,with any other property for the production of any substance co creel hereby.so as to create one or mrrcc drilling or production units. Furthcrmom,Lus-shall in no event be required to dril i mom than One well on such unit.Saki drifting at I PA PAID UP LEASE Lease No. Rev.06.09.2011 production emits shall not exceed one thoaand two hundred eighty(1,280)ac ca or such sin Is may he pmnitwd to conform to the rules And regulations of any govemmcnml agency claiming jurisdiction.In The event this were!x so unitind, the Lesrr-r agrees to accept In lieu of the royalty herein before recited, such proponi in of the royalty above provided its the acreage contributed by this)ease hears to the tom)acreage comprising the unit Lessee shall maw the unit by executing an instnunmt identifying M describing the pooled acreage end shell mail A copy thereof to the Lush s It<known address.Lases shell have the mcuni g right to mist any unit mmiW hereunder either before or After commencement of production.In the event of a revision,leas a shall exeunt a written instrument describing the revised unit and staring the effective date of the revision.Wass shell mall acppy thereof to the Lit sor's Ina known address and the proportion of unit production an which royalties arc payable hereunder shall thereafter be adjusted Accordingly.Lessec may terminate the unit by filing of record a written dalarerion describing the unit i id acting the date oftaminmion. . Cemmenoemcnt of operations for dril ling,completing, mworkin equipping m any other operation calculated to obtain production,or pmductln anywhere on a unit which includes all or a y pan of the wasted promises shell,except for the paymot of royahia,herniated es if it were commencement of operations f driling,complering,eewoPdng,equipping or en other operation calculated to obtain production,err production on the wasted to iser. t9�a b� a .:a(rtgineaa.rekw�aw.0 cad-gtsa� Lmmm 'A ply k Keep an an"MR1 mitial Of A"M deltaic(65s(19)ON OVA �811 Oil'eased OFOR�� rqutxyssmM-ismadaaU " (10)ANCILLARY RIGHTS-Lcanr gems to the Lcxsce the nigh of ingress and egms over,under and through said leased premiss with the exclusive right to conduct such operatlom on the IAnsed premise as may be necessary for the exploration and production of al).gas or other retitled subatanm covered hereby. including but oat limited to geophysical operations,the drilling of wells,and the construction end list of roads.pi lines.Make,war wells,disposal wells,injeuinn wells,pits,electric and telephone lines,and other 11,01110 necessary,usdvl or convenient as isometrics,save,take can Of,treat, proa3s,store and transport oil,gm and other products with the right to tran spent by pipelines or otherwise,nil,ges,water and their constituents from the)eased premises and other leads regardless of the nurse of such substances and the"elusive right of Injecting wrest,air,brine gas and other Fluids into subsur4a State.wsi I shall also have the right of placing electric and telephone limes over the Icrdod premises;the right he oat necessary building,tanks,towers,stations or Otter structures thereon; • the right to use free them myalry sufficient ail,gas and water produced fimn the leased premise for all operAtio"theaan (provided it finds wets at its own,xpensc). The term"gas"u used herein Includes helium,carbon dioxide, axmu sulfur compounds,mahAne produced isnns coal formations and other commercial gases,as well its rmrmal hydrocarbon including casinghead gas. Lessee at cosy dmq and from time to time. may surrender this I."Is to All or any pan thereof by recording or appropriate instrument of surrender in the pmpa county and thereupon Ihi last and the rights,rmuls And ahligatinms of the ponies hereunder shall terminate as to the pan an sunendmil:provided ho ever.chat upon each macnder 1121 to any pan of the woes,Lune shall maintain such casements rights to the mrrandcrcd pin on as may be apprOprinre to its enjnyment of the panion not ssmendaed. When requested by Lustre in writing,Le»ec shall bury its pipelr his helow plow depth in Arco Wilfred for fanning operations.No well shell be located within two hundred(200)feet from any house now An the leased premises without Lessor's e insmt and lessee shall pay for reasonable damage caused by its opemtia s to growing crops and marketable timber thereon. Lessee shall have the right to remove its fixtures, equipment and motcrin . including well clang, from the lensed premises during the tam of this Isaac and within a reasonable time thaen0a. Y (I7)SHUT-IN ROYALTY—it after the primary lam of this lease,all wells on the IeaNA prunises nr within it unit that Includes all or a par of the leased premiss,arc shut-in,suspended or at erwise not producing for my Mason whasnever for A period of twelve(12)consecutive months, And there is no euaeni praduetiem of oil and gas o nperotlons an said leased premises sufficient to keep this lose in fora and this lease is rot otherwise lfept in forte by other provisions of this)else.Lessee may maintain this lease in spiel by tendering to Lessor As shut-in royalty,a bum equal to five dollars(55.00)per area Said shut- in royalty shall he paid nr tendered to the Lexmr an or before the nett crui ing yearly anniversary of the date of this lease,and thereafter on or before each yearly anniversary of the date h rrof while the wells do shut-in at production therefrom is not Acing mmkaod by Lessee.Upoo payment of the shut-in royalty As provided harc n,this lease will continue in force during all of the time nr times whit,such wells are shut-in but Jailurc to properly pay shu in rnyalties droll render Lessee liklaw only for the ammhm Nat and shall Alit nounue to terminate this lease. (12)TAXES—Subject In paragraph tour(a)show regarding past pmduerlon was ell taxis assessed nr payable on the oil and gas including Any ad vuloms,production,severamm business,OCC,il atlon m other excise tome orate increase in the real estate taxes,or taxes In lieu or Mal esu t taxes imposed because of the oil at d gas operations under this)case shall be paid by the panic,herein in poportion to their interest. 113)LTENS-Lesser may.at Its option,pay and discharge my rta�due taxes mortgages.judgmmts.And/or other licm and encumbrance on or Against Inv land nr interest included In the L M1old. Lessee shall be entitled to recover any such • Amounts paid from Lesser,with legal interest and costs,by deduction from iny future payments to l,.erw or by any Other lawful means. (14)FORCE MAJFURE—Should Losses be pmvcntod from complying with my expressed or implied covenant of this lose,from conducting drilling,or re-working operations thereon at that pmucing oil and gas or other substances by reason of scarcity of or inability to obtain or use equipmcml men or material.ear b operation of force majcum such es storm flood,fire. or mher Rea of God,war,mbe)Iion,Innnrection,rint,strikes,diffemnc4e with workmen err failure of sealers to transport or furnish Bcilhies fm transportation,At As a result of a lawsuit or some law,otda or regulation of the govcmmcnh or es A ruvlt Of A. shortage in material or equipment, or As a result of any cause whatso beyond the control of the Lesace,thin while so prevented.Leaa's obligation to comply with such covenant shell be suittit ruled for so long N compliance is thus pmented and for six(d)mnnths thereafter. 2 PA PAID UP LEASE Lease No. Rev.06.09.2011 (15) DEFAULT-No dcSult shall be dedared against the Lossisi for failure to make payment or perform any conditions provided fir bcrcia unless the Let=shall rcRac or neglect to pa 1 or pctfortn the same for sixty(60)days after having rcccivcd written notice from Lesiar. (16)SUCCESSORS AND ASSIGNS-All covenants and condition between the pasties hereto shall extend to their heir&exeemens, Ncwsors and resigns and the Lessor hereby generally we" to and agrees to defend the title to the leased premises,but no change or division in ownership of the lensed premises shall perstc to enlarge the obligations or diminish the tights of the Lessee. (17) ACCEPTANCE - This lease contains all of the agreement and understanding of the Lesser and Lessee respecting the subject miner hereof and no implied covenants or obligations, r verbal rcprescntatlons or promises have been made or relied upon by Lessor or Lessee supplementing or modifying this leax or as an inducement lhemlo. (18)WAIVER IN WRITING-The failure of either perry to enforce or ciercise any provision of this lease shall not constitute or he considered as a waiver of the provision in the Nturt unless the same is expressed in writing and signed by lbc respective patties. See attached addendum for additional Provisions. IN WITNESS WHEREOF,the parties have hereunm set their hands and official seals the date first written above. WITNESS: •�%—J�` -' LESSOR: qlat na p; i Print: Print: Phone u: Standard Acknowledgement COMMONWC•ALTHOPPENNSYI.VANIA ) )ss: COUNTY OF P-Ak(- A On the n8-day of in the year 20 before me.the undersigned,a notary public in and for said state,personally appeared personally known to me or proved to me on the basis of satisfactory cvid..t be the individual(s)whose camels)is(arc) subscribed to the withlp in5umment and acknowledged to me that hdshenhry c ecoted the same in his/her/their capacity0u),and that by hivherfthcir signaturc(s)on the instrument-the individuel(s)or the yers n upon behalf of which the individuals)acted, executed the instrument. lN WITNESS WHEREOF,1 hereunto set my hand and official seal. ^^ Nntury blk C0 EAL n I OF PENNSYLVANIA le see N ENNr Tar 1k. WIVPUy e A sly Compi Fiscal" .4,2013 M er, MnaaNa amsaees"a. darer. 3 Lease No. ADDENDUM Anached to and made a part of that certain it and Gas lease Dated: By and between:Thressa E.Smith a widow. And SWEPT LP In addition no provisions previously set forth in the attached Oil and GE 5 Lease,it is hereby agreed that: I. Compiler ofTerma: in lheeventoriconnimn,inconsistency between Shcprintadesmc afmis lints And*is milndme.the pit It., of this mddedam shag cnnAml and be deemed m Supersede she printed terms of the(case. 2. Le ere COesulefinm L."ue egrca m coati ltwim the surface MMCX failloding cepl¢cemant 0 1811-11 aitca,users,Haw and pipe Jinn,teak badmie,and omen nnrmr",end m loan,ell ofthcm a epdt locations mot will minstrun the eserfeencc wilO the Width"um of the land. 7, IMP Cma,linte:Lushe's operations An¢aid land shell he in Accordance with rc ulati en.acs forth by me Pennsylvania Departmear of Envimmm t.1 limmeien. 4. Watt,Tutlnet Lni=shall rest Lucia's damnsie water supply a in quality pri to commnwnent of,and following,drilling operations An said Ind to order to mpm that said water supply is not adversdy dssmcd by s lid aperauom. In the event it Is determined that said operations hem•din rcely offetted Said water supply,than Lessee,at its own exec=,.,hall take all stags metersmy,a arum mid water supply.mr As Miserably possible to pre-drilling cmulinns. 5. Madialre pan F dons lure Shall"Minch nr IMmll all wail sires,access mad and pipeline rightsoFway in a mmnee which would minimize my«Std soil erosion.Further,any rclmd sulfate Melamarim shell be time in a manner which rnmres:aid lend n nearly in original em om,AS reasonably pnpible. 6. A ace Fem: :Las=shall promptly leple"any fn=s and gate removed by cssco dining in Merrill on mid land and gmhe,shall another get.on ell amass roads An maid land upon written Mercer by Lesser. q, Covemmmnl timmtmz Leave sgmei the if any penalty,mllhock in racaptu of t•x ebalem=r created or imps d under my govemmean[.gram=chn.East. limpideCltEp,(ILPpn Cleanmad Grc matteLied eel of teely.•*nuts o[Lame's oocrnnone an Insect pemiSn,Lcsste will MimOnec Lcssm upon wain"rcouat d receipt of a mpY of me[ee¢Ily notire, A, Well Location as Acceser Road Fee Upon LesWnb Execution of a 0.deatc far In lividuld Well SiAA,Lessee agree'm pay Lessor a hu tiers fee in the greaum of fihten Thousand Dollars and 01111011(515,000.00)fm nth I d"nsmtcmd ne the surface of m0 reeled premises And the cress road(s)erantmctd in ass=isdon therewith fa the pugnn Of drilling orixnet gas wells. 9. Itold Harmless: Lessee shall taciturnity and hold lessor Mmsless from any and Il liability,Jim,demands,ju StAW1n.Suits,and claims afmy kind orehnrecter Laing our oL in conntetion wlN,or rdannA lolnsee's Dcradmna uda the limit ofthii issue,including bill not limited in.=vironmetmtl issues,claims Par injury in or death of any persois,or d Image,loss Or t esruetion of tiny pmpA ry,teal of pmsonaL Lases further covmann end Agra.In defend anymtits hamght agnins,(cssm nn any claims.and to pvy any judgment again" L.",.,¢getting from any mit ter suits raising from Lessee';,Apartment under the terms ofmis lose. Les al if it ao Musts,.shall have the right 10 peMritipute,at its sole vita ,m in defense in any mil or shin in which t may be a Perry,without relieving Waco of she obligation to oePod].nmr. h is al.Wwraim of Lessee end L"sm that Lessees all not be tiable m Lnfbr in mapW Af(rod the fomgning indamnityshml am--)-1 claim sO meessomOe Same msulted ham the grant neghgence,wisful misconduct or lid faith Areas, _ Leaver. 10. Nonaapf Dreeh: If LnseevioWq OAlcto perform.or brooches any material arms,-m'enonts,or Candidate in this lease,Laser Shall nMifyl"minwr6ngofe1]chvinlati0n,feilur4Otbr.th. Waco shall hivca period orsixty(60)days from the due of its receipt of Lessees wrinn—ii-,in whirls to reedy the material d0haime.failure,or bull ch. If Lome felts An larimm to scmcdy she mallet violation,failum.m hseach within the p.,fbW time partd,Listener may,et its lots Action.terminate this Leas at in all gills lease promisee. It. N F I Pineina Wimnuu sepuate-mina eprermem Di[elinn,ezccptf r those used to transport oil andlor gag from a wcIXd drilled inn leased premises At Iced psnid therewith,shell nnl hc=tsammted on c Lied premises. 12. Pueh Clause: In the Evans a pooled unit or units are crated pursuant m slit man aof this[me which eneompnses lands looted Austin,the knead premi,o,and mine,bin ram ell,of the loaned premises it included.Nc it is understood and agreed that the drilling or=working c paeiang on At production from a well im and upn such pmld unit shall cc Ifiner,This Isere in Poll three and effect undm its terms but only as to that pennon of the Leased Premiss enat imd falcon such pooled u its pained portion of the Ime not included in a unit or o amid by any other provision of the Ionic a the End of she primary ftm,LSice may etdcnd the primary term for an Additional paid =ue m the primary ran by prying or tendering M Lcasor,pea In the"Pi Grin of me primvy Co.,.,tin steasion payment of'rhtvx Hundred and 00/100 Doll."(S700,00)pee pie=. If Less=sercisn this omit IM primary term of this Lease shell be considered to he .firm.,commacing on cc cBee6ve date ofthi,Lenz and mntinni ng to 11 c And of the extended primary,(cm, If Lessee elects not to Sterols.this makin,inn rat me end of the Primary,tarn and ,pan Which rani A of Lcesm,Lessee denll nrrEnden Such partimis of Ianad przmin,hot cMu nAd within OcOlad units, 13. Gas Smmee:NmwithMding anything m the coeunry contained in the Lease.Lees"its not Wanted ray right-Iwrnove,m.c the 1 vholJ,a anY potion Neran(far gs enrage[rupees. jrIAWr wish"m An into An Assumed regarding gas swage using the lewd momiaa with a MW party.Lessor shall first give Levee wrirAn Amite f she identity of the third pmty.me into W the consideration for which the third Parry is prepand to offer,the dJactive dntc an Ling due of the trvnsomen And any other inmrmdm respecting the tenumlim Muth Lessee believes would be material to the once,se of the osfaing.Lester don hereby grant t.esn the Om notion and near to purchase the gas eoeage rights by marching and tondedng t the Lessor any third mity'S nrteneg.Nothing in this paragraph requires L assor m give Or sort such storage right•. 14. leasable,Why: gsrydtics shell be paid without deductions for he costs of producing,geheriA&storing,separating, nearing,dchydri ing nmpeasibg Musparting or Otherwise making the oil e dln gal produced from the]EASE PfeP'ius ready for We 11 Ledsc No. use. All nil and/or gas royally shall be delivered fma of cost into the rank or pipelin (fm oil)and into the DTpclim(for get),wM The R¢rytion of Laam S promoted sham Promote,masured by volume,an she nil md/h Co royally. Is. Timber Clam: Lesam and Latour epee That prior ftrho removal crony and all rateable timhm requiting Rom.moo's attentions under the terms ofthis loose,an DjOsy al shaft be conducted by a qualified third pn (boaster nod Lases shall pay I A.m the said appntiRd value prior to harvesting. 16 Fence Produclee Wells!Upoal writs request from Taurus.isasac shall:(a)feat all producing welb,lortk bmalm,pits,xparelors,drip stations,pump engines,and other equipment plewl on the lease promises,with n f a capable ntmming sheep,goap,and cattle;(b)keep The forms on the lease premises in good repair;and(a)keep all gams mod Rome at oil m all times.or in lint orgies.install ante gpmds. 12. Re mrc Prcmlaet m l!"401 o¢COndldem: On complclion ofany opmtia l ccashall rtetmo the least premises as nearly In original conumtmn rcmmNly pWSible,removc all debris,equipment,and persons property which lFSaCC placid on the lease promos¢ (except for equipment needed for the operation of producing welts,which shall be moved within six(S)months[weamer pemttiing.]ai a well pammently caso to mdu.). 19. WAMDIlynfiltle: It is understood That Lmor warrants this an said propary,only in nel that the tide is good to the hat oft,assar's knowledge and Lessce¢gtas that no claims will bemade again,Leona perteinin mwarrawyofikle, )P. plastic of Asrl¢nmcrrofLasx:Lattice shall notify I nvmr in writing if Lcssm tea gas ellora portion or this leave,or en undivided notion thertin,to n third early. Provided,however,that notice no the Lessor shell not be r quoted in The event of an essignmcut by(asses: a. man efflime,mobsidiroy,m Imemel pnrmcn; b. in consequence of a merger or amalgamation;or I of all or substantially all of ifs assess to n third parry 20. 5�ar iaul4c limit Notwithstanding anything to The mnlrary,herein,it is under food and ngrccd that this lease may not he maimaival in force for any continuous period uftimc longer than No(5)manculive years alter the expiration ofrhe primary most hemofsolely by Ile provision of Ott shut-in loyalty clause. lonsa shall leader an additional payment f 525 per arm or the end of to third year and each year tberceAer while the lased Dennis"arc shut-in. 21. Oil A Gas Only: This Lase shall cover only oil and gas and mlntud hydrol IMA that may loc produced Through the well hnrc,and all other minerals,including,but nth limited to,lignite,eel,uranium,sulphur,gravel copper.and metallic arm am not includes in this Laotc, 22. Ad valorem Tenet: In the event There is a change in Pmnrylvenla tar ands that maiden for do increase m ad valONm taxes nthihunhlc to or resulting from the aaaeaament of oil and go due to oil and gas production from The Ironed premises,Lessor and Lasses agree to abide by the low and pry their proportional sham tie endmAly, 23. Release Lem: Upon termination,expiation or suMdcf of Otis Team in whole in pros and upon written request by Worst,Lassen shall provide Losar whit a copy arm approprieterdase arlase. 24. No Cenlnl processing Faelllty: Lessee agrees that the Lased Pro nisut dacri ad heroin will not be and as a actual amcasing fecilky or slmnge era for equipment and materials except when said equipment and ma reels arc being usual in drilling and production operations m the Lena Premise or lands panted theewiOt. Inds¢coat Lance needs m in tell comprtenian in order m MUM the gas from any well that any be situated norm the Lensed Promises or lands pooled therewith,Less n granted the right Order This I omsc to msmll a wellhad wmprcvm unit fin 1e sole purpose of m wining with the Intervention tram Rah wit or wells only. In no event is l.aett&retired the righ ro install a Timor regions]compressor sift upon the herein Le coed plesnisa if chat c unpronar is In he utilized for other well sites not eimatetl upon the heroin Lased Premises or lends pacid therewith without first homing ncgmit ml a am.to an armo nr nits agreement from The Lasaf. 25. An : I,cauc fixther pane to Lessor the Tight annually in caaminc,audit,or i tsinot heats,reaMS,and account,of Lase pentrem to the patron of verifying the ecmmmy,of the mpal and statements fumisled to m,and far checking the ameuM ni payments lowfiilly due the Lessor under Biro teats of this miummanl, fn aacrting this tight.Isssor shall give masmoblo rmtice m teutt of is intadcd aafit and much audit shall be condulcted daring mranO business hours a the atPce of vme. This nddeodum shall nn,nfka the terms and conditions set fonb in the immancd 1 ere in my mother except a sot forth hcmin. RIGHT OF WAY AGREEN ENT COMMONWEALTH OF PENNSYLVANIA: COUNTY OF Butler For and in consideration of One Dollar($1.00)to Grantor(s)in her d paid,the receipt of which is hereby acknowledged. Thr s a E.Smith a widow 315 Robson Road Dillsburg.PA 17019 hereinafter called the"Grantor- hereby grant unto SWEPI LP, of 190 Thorn Hill Road, Warrendale, PA 15086, phone: (724)772-8600, hereinafter called the-Grantee",its successors and assigns, the right to lay, maintain and remove a pipelines) over and through the premises hereinafter described and to maintain, operate, repair, replace and remove the same together with valves, drips, measuring equipment, and other necessary appurtenances, along with the ight to install, maintain,operate, repair, replace and remove the same. Said lands are located in Oakland Township Butler County,Pennsylvania,and are the premises bounded and described as follows: On the North by the lands of:250.1 F147-000000290.0000 Richard A Eakin on the East by the lands of.290-1F102-0000001A-0000 Stepher C.Malls On the South by the lands of:Saint Wendelin Road _ On the West by the lands of: 50-000S4-0000000"000 Richard A.Eakin Tax Map Number. 5 -1F147-000030AA-0000 being all the property owned by Grantor or to which me Grantor may have any rights in said Township, containing 53.15 acres,more or less. Grantor hereby grants to Grantee the right of ingress and egress to and from the pipeline right-of-way, and Grantor shall fully use and enjoy said premises,except forte purposes herelnbefore granted to said Grantee. Said pipeline right-of-way area shall be a strip of land 50 feet wide, being 25 feet on each side of the center of the pipeline, unless and to the extent that the pilieline is installed nearer than 25 feet to a boundary of the premises, in which case the right-of-way shall a tend from the boundary on the near side to 25 feet on the other side of the pipeline,or the pipeline is ins ailed on an adjoining tract, in which case the dghtof-way area shall extend from the boundary into landowners lands to a point 25 feet from the pipeline. Grantee shall have the right to Change the location of n installed pipeline and permanent right- of-way area as may be necessary or advisable as the result of any conditions or events beyond its control,such as coal mining activities,ground slips, floods,roac Construction or relocation, or the like. In addition to the permanent right-of-way area as previously ascribed, Landowner grants grantee a temporary easement 25 feet on either side of and adjoining lh 4, permanent pipeline right-of-way, for the purpose of enabling Grantee to initially construct the pipeline. or to later relocate the pipeline or lay additional pipelines and to conduct all activities incident thereto including but not limited to restoration or clean-up activities. Each time a temporary construction easement is utilized, Grantee shall pay for damages caused to said property for said construction activities Said pipeline(s)shall be burled,at the request of said Grantor,so as not to interfere with the cultivation of the land, and said Grantee shall pay reasonable damages which, if any, may arise to crops, fences, buildings, and drain tile from laying, operating, maintaining, repairing, replacing and removing said pipelines(s). Any damages, if not mutually agreed upon, to be ascertained and determined by three disinterested persons,one thereof to be appointed by the said grantor(s),one by the Grantee,and a third by the two so appointed,and the award of such three persons shall be final and conclusive: each party shall pay the cost of their appraiser and shall share the cost f the third appraiser. Grantee is further granted the right from time to time to lay an additional pipelin, or pipelines alongside of, or to connect with,the first pipeline or another pipeline as herein provided. Grantee has the right to change the size of and replace any pipeline: damages, if any, to crops, buildin 3s, drain tile and fences in making such change or replacement to be paid by the Grantee. All payments hereunder may be made to Grantor by check me a payable to the order of and mailed and delivered to who is hereby authorized to receive and receipt for the same. It is understood that this grant contains and expresses all the i greements and obligations of the Grantee in regard to the subject matter hereof and no covenant, agreement or obligation not expressed herein Page 1 of 2 shall be imposed upon the Grantee: and this grant shall be binding upon the Grantor and Grantee and shall inure to benefit of their respective heirs,personal representatives,successors and assigns. IN WITNESS WHEREOF,the parties hereto have hereunto set their hands this!�1 ,-_day of .2011. I WITNESSES G O E : J' W FhLreRsa _boa E.Smith GRANTEE: SWEP�LP I By: Standard Acknowledgement COMMONWEALTH OF PENNSYLVANIA ) � ) }ss: COUNTY OF K11 QQ Onthedayof m f �..In``the year 20 before me,the undersigned,a notary public In and for sold state,personallY appeared W' , personally known tome or proved tome on the basis of satisfactory evlden a to be the individuals)whose names)Is(are) subscribed to the within Instrument and acknowledged tome that he/sheithf y executed the same In his/her/their capaclty(les),and that by his/her/their signature(s)on the Instrument,the Ind vldual(s)or the person upon behae of which the indlvidualls)acted,executed the Instrument. IN WITNESS WHEREOF,I hereunto set my hand and off icial�sea). I �i I 1 I lU-GYL(V� NadryP blicblic coy, NWEALTH OF PENNSYLVANIA Nandni Seal Neay A.me," NelstY PYklk eullar lwp.,Buaer aeuNv N CemmuNOn eaW�^F pVa.a,20ta emb r,PennsylvaMe ,socOmn d NCta m Page 2 of 2 CONSIDERATION FOR RIGHT O F WAY AGREEMENT The attached Right of Way Agreement dated t y ( I ,2011 by and between Thressa E.Smith,Grantor,and SWEPT LP,Gr ttee,shall not be recorded in the Recorder of Deeds Office of Butler County,Pennsylva i.a utiless and until full consideration for said right of way has been tendered unto Grantee. Prior to the installation of a pipeline in,on,and r or across Grentor's property under the terms and conditions of said Right of Way Agreement, antee shali measure the actual footage of the right of way to be utilized by Grantee and shall pfiy Grantor the sum of 5.00 per linear foot measured. Agreed to and accepted this&day of 2011. Grantor: T r " — ssa E. mlth � S WEPT L By: •K Illlllllllllllllllllllllllllllllllllllllllll In�lr:]Ot]OSOlaal]ffa] 0]101/]01] tO,OMX buti., it la i]Ot200te511 eKU.r cwna a.00re.r ra+Xrts u THIS DEED MADE the day of �I rR I ,2012,between JAMES W. SMITH, as attorney in fact for THRESSA E. SMITH, a widow,which Power of Attomey was executed on May 31,2005(the Grantor'), A N D r JAMES W.SMITH,(the"Grantee") WITNESSETH, that the Grantor, in consideration of the sum of One Dollar($1.00) to them now paid by the Grantee, do grant, bargain, sell and convey unto the Grantee, their heirs, executors, successors and assigns, ALL that certain piece, parcel or tract of land situate in Oakland Township, Butler County, Pennsylvania,bounded and described as follows,to-wit: Beginning at a point at the northwest comer of lot of G. Benson, being a point two hundred and sixty-four feet(264)northwardly from the center of Legislative Route 10125;thence along lands of H.E.Gudenbur,North 10 06' West a distance of one thousand seven hundred and ninety-four and seven-tenths (1,794.7) feet to a hub on lands of Rebecca Taylor; thence along lands of Rebecca Taylor, John Weichey, North 890 12' East a distance of one thousand three hundred twenty-two and twenty-eight one hundredths(1322.28) feet to a point on lands of W.J. Hempling; thence along line of Hempling, South 220 32' East a distance of eight hundred and twenty-six and ninety-six one hundredths (826.96) feet to a point on the north line of a creek; thence along said creek in a westerly direction to a point; thence along line of lands of now or formerly Krebs Heirs, South 210 49' West a distance of three hundred and forty-two and eighty one-hundredths (342.80) feet more or less; thence continuing along lands of now or formerly Krebs Heirs South 10 00' East a distance of seven hundred and twenty-one and twenty-three hundredths(721.23)feet to a stone; thence along lands of St. Wendelin's Church,North 890 33' West a distance of four hundred fifty-four and sixty-seven one hundredths(454.67)feet to a point in the center of a public road known as Legislative Route 10125; thence along the center of said road a distance of three hundred forty-two and fifty-seven one hundredths(342.57) feet,more or less, to a point in the center of said road at the southeast comer of lot of P. Fallacker; thence along line of lot of P.Fallacker, Nonh 10 6' West a distance of two hundred and sixty-four(264) feet to a point at the northeast comer of lot of P. Fallacker,thence along lots of P. Fallacker and Benson, South 880 23' West a distance of five hundred and twenty-three and twenty-five one hundredths (523.25) feet to a point at the northwest comer of lot of G. Benson, the place of beginning. AND containing 53.145 acres as per survey of Greenough, McMahon and Greenough made September 6, 1955. AND BEING the same land conveyed by Martin Leinenbach and Louisa Leinenbach,his wife,to Eugene A.Smith and Thressa E. Smith,his wife,dated September 20, 1955 and recorded in the Recorderof Deeds Office of Butler County, Pennsylvania in Deed Book 675, Page 499. Said Eugene-A. Smith having died on October 6, 1986 vesting full title in said land in Thressa E. Smith by operation of law. UNDER AND SUBJECT TO: a. Coal and coal bed methane gas and mining rights and all rights incident to the extraction or development of coal or coal bed methane gas heretofore conveyed, excepted and reserved by instruments of record; the right of surface, lateral or subjacent support; or any surface subsidence;and b. Oil, gas, and minerals,and rights incident to the extraction or development of oil, gas or minerals heretofore conveyed,leased,excepted or reserved by instruments of record. BEING Tax Map Parcel No.250-IF147-30AA-0000. - The Grantor certifies,pursuant to Act 97 of 1980,enacted July 7, 1980,Section 405,et seq., 35 Pa.C.S.A. §6018.405 et seq,that no hazardous waste is presently being deposited by them on or in the land conveyed by this deed, nor has any hazardous waste ever been deposited to their knowledge on or in the land conveyed by this deed. This paragraph is being inserted in this deed pursuant to Section 405 of said Act 97 of 1980,35 Pa.C.S.A. §6018.405 et seq. THIS CONVEYANCE IS FROM MOTHER TO SON AND EXEMPT FROM REALTY TRANSFERTAXES. With the appurtenances: To Have and To Hold the same unto and for the use of the Grantee,their heirs,executors,successors and assigns forever, AND the Grantor for herself, her heirs, executors and administrators covenant with the Grantee, their heirs, executors,successors and assigns against all lawful claimants the same and every part thereof to Warrant and Defend. NOTICE—THIS DOCUMENT MAY NOT SELL, CONVEY,TRANSFER, INCLUDE OR INSURE THE TITLE TO THE COAL AND RIGHT OF SUPPORT UNDERNEATH THE SURFACE LAND DESCRIBED OR REFERRED TO HEREIN, AND THE OWNER OR OWNERS OF SUCH COAL MAY HAVE THE COMPLETE LEGAL RIGHT TO REMOVE ALL OF SUCH COAL AND, IN THAT CONNECTION, DAMAGE MAY RESULT TO THE SURFACE OF THE LAND AND ANY HOUSE, BUILDING OR OTHER STRUCTURE ON OR IN SUCH LAND. THE INCLUSION OF THIS NOTICE DOES NOT ENLARGE,RESTRICT OR MODIFY ANY LEGAL RIGHTS OR ESTATES OTHERWISE CREATED, TRANSFERRED, EXCEPTED OR RESERVED BY THIS INSTRUMENT. (This notice is set forth in the manner provided in Section I of the Act of July 17, 1957,P.L.984,as amended,and is not intended as notice of unrecorded instruments,if any) WITNESS the hands and seals of the Grantor. Witness: t OYJ, O d4 W (SEAL) ""` essa E.Smith by tames W.Smith,P.O.A. oA &- .Ir s� a61aosojcro J aa840 NOTICE THE UNDERSIGNED, AS EVIDENCED BY THE SIGNATURE(S) TO THIS NOTICE AND THE ACCEPTANCE AND RECORDING OF THIS DEED, (IS, ARE) FULLY COGNIZANT OF THE FACT THAT THE UNDERSIGNED MAY NOT BE OBTAINING THE RIGHT OF PROTECTION AGAINST SUBSIDENCE, AS TO THE PROPERTY HEREIN CONVEYED,RESULTING FROM COAL MINING OPERATIONS AND THAT THE PURCHASED PROPERTY, HEREIN CONVEYED, MAY BE PROTECTED FROM DAMAGE DUE TO MINE SUBSIDENCE BY A PRIVATE CONTRACT WITH THE OWNERS OF THE ECONOMIC INTEREST IN THE COAL. THIS NOTICE IS INSERTED HEREIN TO COMPLY WITH THE BITUMINOUS MINE SUBSIDENCE AND LAND CONSERVATION ACT OF 1966. COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF DAUPHIN p On this the ���" day of t rPR�I . A.D. 2012, before me a notary public the undersigned officer, personally appeared, James W. Smile, known to me (or satisfactorily proven)to be the person whose name as attorney in fact(agent)for Thressa E.Smith, and acknowledged that he executed the within document as the act of his principal for the purposes therein contained. IN WITNESS WHEREOF,I hereunto set my hand and official seal. Notary Public Mycommission expires: ?Iilllq COMMpNMA a2NN9/LVANrA AMR p p�Wblk M'f°""ycbn e¢NS .Ir�p CERTIFICATE OF RESIDENCE 1,do hereby certify that precise residence of the Grantee is James W.Smith 315 Robson Road Dillburg,PA 17019 Witness my hand this /Nk dayof AP214 2012. COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF BU'T'LER Recorded on this day of A.D. 20. in the Recorder's Office of Butler County,Pennsylvania,at Instrument No. Given under my hand the seal of the said office,the day and year aforesaid. Recorder MAIL T0: 10rmtp CER H`1 NtdW!doom n,is riwdm in d: James W.Smith Rowde, 0lna efawia Camry. 315 Robson Road P Dillburg,PA 17019 MicMlc M.Mualln•Pcmdcc Mtkrda INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } SS File Number 21-12-0858 James W Smith Personal Representative(s)of the Estate of Thressa E Smith deceased,depose(s)and say(s)that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent,that the valuation placed opposite each item of said inventory represents its fair value as of the date of the decedent's death,and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a mem randum at the end of this inventory. I verity that the statements made in this Inven- to are true and correct. I understand that false state- � mes W Smith ments herein are made subject to the penalties of 18 Pa.C.S.§4904 relating to unsworn falsification to -- - _ authorities. Attorney— (Name) Linda J. Olsen Esq. _ (Supreme Court fo.No.) 92858 (Firm) Hazen Elder Law (Address) 2000 Linglestown Road,Ste 202, Harrisburg, PA 171.10 (Telephone) 717-540-4332 GATE OF DEATH LAST RESIDENCE Green Ridge Village DECEDENT'S SOC.SEC.NO 07/10!2012 Newville,PA 17241 FIGURES MUST BE TOTALED Personal Property Cash............................................................................................... T85.$la m Personal Property........................................................................ m z �`' c: Stocks/Listed...................................... m -.:. c, z o Stocks/Closely Held..................................................................... 1> Z= rt, o Cn Bonds....................................................... Partnerships and Sole Proprietorships..................................... —. Mortgages and Notes Receivable............................................... �= �^- .-- r>1 AllOther Property........................................................................ Total Personal Property........................................ 1,585.99 Total Real Property................................................ Total Personal and Real Property p rty........................ 1;5851619 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may at the election of the personal representative include the value of each item,out such figures should not be extended into the total of the Inventory.(See M Pa.C.S.§3301(b)) Form RW-09 Rev.1613-m6 INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } SS File Number 21-12-0858 DATE OF DEATH 1AST RESIDENCE Green Ridge Village DECEDENT'S SOC.SEC.NO, 07/1012012 Newville, PA 17241 376-05.3995 Casb PA Unclaimed property(Prudential&Highmark) 1,585.99 Total Cash 1,585.99 (Attach additional sheets if necessary) Total Personal Property and Real Estate 1,585.99 RECEIPT FOR PAYMENT GLENDA FARNER STRASBAUGH Receipt Date : 6/06/2013 Cumberland County - Register Of Wills Receipt Time : 14 : 57 : 16 One Courthouse Square Receipt No. : 1074442 Carlisle, PA 17613 SMITH THRESSA E Estate File No. : 2012-00858 Paid By Remarks : LEISAWITZ HELLER ET AL HMW --- -- - - - - ---- - - ---- - ---- Receipt Distribution -- - --- --- ------ - - - - - - ° - - Fee/Tax Description Payment Amount Payee Name PHOTOCOPIES 14 . 00 CUMBERLAND COUNTY GENERAL FUN --- - -- -- -- Check# 72918 $14 . 00 Total Received. . . . . . . . . $14 . 00 REV-1500 EX(02-11) 1, 1505610143 PA Department of Revenue OFFICIAL USE ONLY p Pennsylvania county code Year Fit.Number Bureau of Individual Taxes «ruTMeer«�«« PO BOX 280601 INHERITANCE TAX RETURN 21 12 0858 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Dale of Birth M 07 10 2012 06 29 1915 Decedent's Last Name Suffix Decedent's First Name MI SMITH THRESSA E (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1 0 1 Original Return 2. Supplemental Return F.J 3. Remainder Return(Date of Death Prior to 1213-82) n 4. Limited Estate 4a.Future Interest Compromise 5. Federal Estate Tax Rehm Required (date Wdeethefter 2-12A2) — tJ B' np 1B Decedent ow lij ApeqjV�. .. 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received 10.08M en 1Y 5191 aM JDa��a Deem �L 11.Election to tax under Sec 9113(A) A. (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX AFORMATION$1MULD0 914ECTED TO: Name DaytireeT�rlpephorleNlYmbern n C) LINDA J OLSEN ESQ 717--S40 43=32 —C,, C- ;0 _:. c REGISTER OFM1'.W11- USEON& First Line of Address 2000 LINGLESTOWN ROAD S tii G1 Second Line of Address SUITE 202 City or Post Office State ZIP Code DATE FILED HARRISBURG PA 17110 Correspondent's e-mail address: loisen @hazenelderlaw.com Under penahies of perjury.I declare that I have examined this retum.including accompanying now 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 representativEE Is based on all information of which preparer has any krloMedge SI NATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE zi�a James W Smith RESS 315 Robson Road Dillsburg. PA 17019 SIGNATU OF PREPARE OTHER REPRESENTATIVE DATE Linda J.Olsen, Esq. Esq. �//t�//j L-TDORESS 2000 Linglestown Rd. , Harrisburg, PA 17110 Side 1 L 1505610143 1505610143 J J 1505610243 REV-1500 EX Decedent's Social Security Number o�cea�x'.wsme Smith,Thressa E RECAPITULATION 1. Real Estate(Schedule A).,............................ ................................................. 1. 2. Stocks and Bonds(Schedule 8).............................................:............................... 2, 1 Closely Held Corporation,Partnership or Sote-Proprietorship(Schedule C)......... 3. 4. Mortgages&Notes Receivable(Schedule D)........................................--............ 4. 5. Cash.Bank Deposits&Miscellaneous Personal Property(Schedule E).............. S. 1,585. 99 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 13, 915. 91 7, Inter-Vwos Transfers&Miscellaneous coq-Probate Property (Schedule G) iJ Separate Billing Requested............ T 91,729. 97 8, Total Gross Assets(total Lines 1 through 7)........................................................ 8. 10-7,231 . 87 9, Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 9,576. 70 10. Debts of Decedent.Mortgage Liabilities and Liens(Schedule 1)............................ 10, 31, 391 .23 11. Total Deductions(total Lines 9 and 10t.-.-....--..............--...............-......... 11. 40, 967. 93 12. Not Value of Estate(Line 8 minus Line 11).......................................................... 12. 66,263 . 94 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J)................----........._....... 11 74. Net Value Subject to Tax(Line 12 minus Line 13)..............._............................. 14. 66,263 . 94 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(12)X.00 15. 0.00 16. Amount of Line 14 taxable at lineal rate X .045 66 2fi3. 94 16. 2, 981 .88 r 17. Amount of Line 14 taxable at sibling rate X.12 0. 00 17. 0.00 18. Amount of Line 14 taxable at collateral rate X.15 0 . 00 16. 0. 00 19. TAX DUE............................... ................. ..................................--- 19. 2, 981.88 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT, Q I + Side 2 1505610243 1505610243 J REV-1 500 EX Page 3 File Number 21-12-0858 Decedent's Complete Address: DECEDENTS NAME Smith, Thressa E STREET ADDRESS Green Ridge Village 210 Big Spring Rd CITY I STATE ZIP Nevirville PA 17241 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 2,981.88 2, CredbMayments A. Prior Payments 3,500.00 B. Discount 149.09 Total Credits(A +8) (2) 3,649.09 3. Interest (3) 4, If Line 2 is greater than Line 1+Line 3,enter the difference. This is the OVERPAYMENT, (4) 667.21 Check box on Page 2,Line 20 to request a refund 5, If Line I +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (51 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;....................... o retain a reversionary interest; .............--.............-..... .......................-.............................. d. receive the promise for life of either payments, benefits or care?,....... ............. ...... .... .....—....... 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?................... ........... .......... ...-....... ............................. D EX 3. Did decedent own an'in trust for' or payable upon death bank account or security at his or her death?.....,. 4. Old decedent own an individual retirement account,annuity,or other non-probate property which contains a beneficiary designation..._.............. .. ............... ......................................... E 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1,1994 and before Jan. 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent 172 P.S.§9116(a)(1.1)(1)1. 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 172 P.S.§9116(a)(1.1)(r)). 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 natum 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 172 P.S.§9116(a)(1.2)1. •The tax rate imposed on the net value of transfers to or for the use of the decedent's linear beraflixaries is 4,5 percent,except as noted in V2 P.S.§9116(a)(11)1� • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent 172 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. Rev-1508 EX+(11-10) SCHEDULE E Pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Smith,Thressa E 21-12-0858 _ lhrdude the proceede of lilipalim ON the dale the proceeds Oere recelved by the estate All property jolntlycvmed vnM Me right of survivorship must be disclosed m schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 PA Unclaimed property(Prudential&Highmark) 1,585,99 TOTAL(Also enter on line S.Recapitulation) 1,585.99 (H mom space is needed,additional pages of the Same size) Copyright(C)2010 form software only The Lackner Group,Inc. Form PA•1500 Schedule E(Rev. 11-10) 1 Rev-1509 EXt(01-10) pennsylvania SCHEDULE F DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Smith,Thressa E 21-12.0858 If an nut was made joint adman one year of the decedent's date of death,It must be reported on achedule 0. SURVIVING JOINT TENANTS)NAME ADDRESS RELATIONSHIP TO DECEDENT A. James W Smith 315 Robson Rd Child Duisburg,PA 17019 B. C. JOINTLY OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOIN MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT NUMBER OR S.&M IDENTIFYING NUMBER ATTACH DEED FOR ALUE OF ASSE INTEREST DECEDENT'S INTEREST JOINTLY-HELD REAL ESTATE, 1 A 07110/2000 Members 1st checking acct.0195069-11 -jt. 15,008.64 50.000% 7,504.32 w/James 2 A 09/22/2011 Members tat Investment savings acct. 6,804.38 50.000%e 3,402.19 #195069-05-A.w/James 3 A 0711012000 Members tat savings acct.#195069-00-jt.w/ 4,041.71 50.000% 2,020.86 James 4 A 07/10/2000 Members let suppi.Savings acct.#195069-01 1,977.07 50.000% 968.54 -j1 w1 James TOTAL(Also enter on Line 6,Recapitulation) 13,915.91 (If morn 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) Rne-191p IPX�(x9.09( SCHEDULE G pennsylvania INTER-VIVOS TRANSFERS AND DEPARTMENT Of REVENUE 11911EWTANCE TAI RETURN MISC. NON-PROBATE PROPERTY 11tSIUENT DECEDENT ESTATE OF FILE NUMBER Smith,_Thressa E_ 21-12-0858 TNs schodula musk En mmplpkzd And filed if the W9 r to any orQue911one 1 mmugh 4 on pegs lhw of the REV-1500 is y s, ITEM DESCRIPTION OF PROPERTY DATE OF DEATH 'A OF DECD'6 EXCLUSION TAXABLE NUMBER TMELDATrOFTRAANSFEEA.SAT'TACNTA C1 DPW FTHIi OE FOR REAIESTATOE. VALUE OF ASSET INTEREST (IFgPPUCABLE) VALUE 1 Employees Life Co. annuity#L114604-benef.sons 40.416.00 100.000% 40,415.00 James 8,Eugene 2 Gifted to James Smith 43,500.00 3,000.00 40,600.00 3 Prudential Ins.#24 728 099-pro-paid funeral 10,814.97 100.000% 10.814.97 costsldeath claim TOTAL(Also enter on Line 7, Recapitulation) 91,729.97 (if more space is needed,additional pages of the same size) Copyright(c)2009 Corm software only The Lackner Group. Inc. Form PA-1600 Schedule 0(Rev.08-09) REV-1511 E%�t1P09) Pennsylvania SCHEDULE H DEPARTMENT Or REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RESIDENT DECEDDENTTD"" ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Smith,Thressa E 21-12-0858 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: See continuation schedule(s)attached 5,204.09 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Year(s)Commission Paid 2012 2. Aftornev's Fees Hazen Elder Law 3,900.00 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) Claimant Street Address City State ZID Relationshi0 of Claimant to Decedent 4. Probate Fees Register of Wills 51.50 5. Accountant's Fees 6. Tax Return Preparer's Fees Paul Predmore,CPA 150.00 7. Other Administrative Costs 271.11 See continuation schedule(s)attached TOTAL(Also enter on line 9,Recapitulation) 9,576.70 Copynght(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev. 10-09) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Smith,Thressa E 21-12-0858 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Clarion Monuments-grave marker 1,479.00 2 Funeral -church service officiants-Father Dave Hillien and Dana Statler 150.00 3 General Sutter Inn/Lititz 7114112 222.09 4 Thompson Miller Funeral Home Inc. 3,353.00 H-A 5,204.09 Other Administrative Costs 5 Central Penn Business Journal-estate notice 150.00 6 Cumberland Law Joumal-estate notice 75.00 7 Hazen Elder Law--disbursements 21.20 8 Sheetz Gas- -travelexpenseforexecutor 24,91 H-B7 271.11 Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98) Rev-1512 EX.(12-08) SCHEDULE 1 pennsylvania DEBTS OF DECEDENT, DEPARTMENT OF REVENUE INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Smith,Thressa E 21-12-0858 Report debts incurred by the decedent prior to death Mat nmamed unpaid at the date of death,including unreimbuned medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Alpha Diagnostics-medical bill 25,17 2 DarrylGuistwiteDO-medical 141.81 3 Green Ridge Village-resident fees 21,730.76 4 Hazen Elder Law-EP fees 42.54 5 Millennium Pharmacy Systems-pharmacy bill 897.75 6 PA Department of Revenue-2012 personal state income taxes - 163.00 7 Pinker&Associates-medical 8,20 8 U.S.Treasury-2012 personal Federal income tax 8,382.00 TOTAL(Also enter on Line 10,Recapitulation) 31,391.23 (If more space is needed,additional pages of Me same size) Copyright(c)2008 form software only The Lackner Group,Inc. Form PA-1500 Schedule I(Rev.12-08) REV-1613 M(01-10) pennsylvanis SCHEDULE J DEPARTMENT OF REVENUE INNERrrANCE TAN RETURN BENEFICIARIES RESIOrh(T DECEDFNT ESTATE OF FILE NUMBER Smith, Thressa E 21-12-0858 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) (88S) TAXABLE DISTRIBUTIONS (include outright spousal " distributions,and transfers under Sec.9116(21(1.2)] Eugene A.Smith Child Thirty-Five 17865 SE 87 Bourne Ave Percent of the The Villages Residue of the Lady Lake, FL 32162.4802 Estate. James W Smith Child Sixty-Five 315 Robson Rd. Percent of the Dillssburg,PA 17019 Residue of the Estate Total Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 1500 cover sheet as a ro date. NON-YAXABLE DISTRIBUTIONS: ��. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS !_ TOTAL OF PART It-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright(c)2010 form software only The Lackner Group,(no. Form PA-1500 Schedule J(Rev,01-10) REGISTER OF WILLS CERTIFICATE OF CUMBERLAND COUNTY GRANT OF LETTERS PENNSYLVANIA No. 2012- 00858 PA No. 21- 12- 0858 Estate Of: THRESSA E SMITH (Filsl.Middle,Lae) Late Of: NORTH NEWTON TOWNSHIP CUMBERLAND COUNTY 0 Deceased Social Security No: 376-05-3995 WHEREAS, on the 7th day of August 2012 an instrument dated May 31st 2005 was admitted to probate as the last will of THRESSA E SMITH (Firs[Middle.La ll late of NORTH NEWTON TOWNSHIP, CUMBERLAND County, who died on the 10th day of July 2012 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA FARNER STRASBA UGH , Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARYto: JAMES W SMITH who has duly qualified as EXECUTOR(RIX) and has 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 7th day of August 2012, i or � —�te;oo, ,ls �►� tr 1 �f1�.�ii eputy U **NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) LAST WILL AND TESTAMENT OF THRESSA E. SMITH I,THRESSA E.SMITH,now domiciled in Cumberland County,Pennsylvania,declare this to be my Last Will. I revoke all other Wills and Codicils that I may have previously made. Article I My just debts and expenses of my last illness,funeral,and administration of my estate shall be paid by my Executor from the principal of my residuary estate as soon as practicable after my death. Article II All inheritance,estate,and succession taxes(including interest and penalties thereon,but not including any generation skipping tax)payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement from any person. This provision is not a waiver of any right which my Executor has to claim reimbursement for any such taxes which become payable as the result of any property over which I have the power of appointment. n - c O c `- r r- e C. 'b 01 in C::) O T Article III I give, devise and bequeath my tangible personal property in accordance with any memorandum I have handwritten or signed, located with my will or with my valuable papers and found within 30 days of the probate of my will. Gifts may only be to persons who survive me or to organizations which exist at my death,and if there is a conflict,the memorandum having the latest date shall govern. To the extent no such memorandum is found, or all of my tangible personal property is not disposed of pursuant thereto, my tangible personal property shall be added to my residuary estate and pass under Article IV hereof. Article IV All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give, devise and bequeath according to the following: A. SIXTY-FIVE PERCENT(65%) of my estate to my son, JAMES W. SMITH, of Dillsburg, Pennsylvania, Per Stirpes. If JAMES W. SMITH predeceases me, leaving no surviving issue, I give, devise and bequeath his share IN EQUAL SHARES to the children of my son, EUGENE A. SMITH,Per Stirpes; and B. THIRTY-FIVE PERCENT(35%) of my estate to my son, EUGENE A. SMITH, JR.,of Boiling Springs, Pennsylvania,Per Stirpes. Article V If a beneficiary under this Will has not attained the age of thirty-five(35)years,the share of the beneficiary shall be placed in a separate trust,for the benefit of that beneficiary according to the terms in Article VI. -2- Article VI In the event that a Trust is created by or as a result of any part of this Will, the terms and conditions of the Trust shall be as follows: A. To expend and apply so much of the net income and so much of the principal of the Trust as the Trustee shall consider advisable for the support,health,care and education of the child until the child attains the age of thirty-five(35)years. B. Upon attaining the age of thirty-five(35),the remaining principal and accumulated income of the child's share shall be distributed outright to the child. . C. No beneficiary or remainderman of this Trust shall have any right to alienate, encumber,or hypothecate his or her interest in the principal or income of the Trust in any manner, nor shall any interest be subject to claims of his or her creditors or liable to attachment,execution,or other processes of law. Article VII In order to carry out the purposes of the Trust established by this Will, the Trustee, in addition to all other powers granted by this Will or by law,shall have the following powers over the Trust estate, subject to any limitations specified elsewhere in this Will: (a) to retain in the form received and/or to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estate, -3- (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, (f) to file fiduciary/income tax returns and pay the tax due for any year for which such a return is required, (g) to make distributions in cash or in kind,or in both,and to determine the value of any such property, (h) to employ any attorney,investment advisor,or other agent deemed necessary by my Executor;to pay from my estate reasonable compensation for all their services, (i) to conduct along with or with others,any business in which I am engaged in or have an interest in at the time of my death, and (j) to receive reasonable compensation in accordance with their standard schedule of fees in effect while their services are performed. Article VIII I hereby appoint my sons, EUGENE A. SMITH,JR. and/or JAMES W. SMITH, to act jointly and/or individually, as Co-Trustees of any Trust(s) created in this Will. Article IX I nominate,constitute,and appoint my son,JAMES W.SMITH,Executor of my Last Will and Testament. In the event of the renunciation,death,or inability to act,for any reason whatsoever -4- of my Executor, I nominate, constitute and appoint my grandson, MARK T. SMITH, of Lititz, Pennsylvania, successor Executor of my Last Will and Testament. I direct that my Executor or successor Executor be permitted to serve without bond.In addition to those powers granted by law,I grant them power to distribute in cash or in kind,in like or in unlike shares,and to file any qualified disclaimer I could have filed if living. My Executor or successor Executor shall receive reasonable compensation for services rendered to my estate. Article X In addition to the powers conferred by law,I authorize my Executor or successor Executor in his/her absolute discretion: (a) to retain in the form received and to sell either at public or private sale,any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estate, (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, (0 to file any federal income tax return for any year for which I have not filed such return prior to my death, (g) to make distributions in cash or in kind,or in both,and to determine the value of any such property, _s_ (h) to employ any attorney,investment advisor,or other agent deemed necessary by my Executor; and to pay from my estate reasonable compensation for all their services, (i) to conduct alone or with others, any business in which I am engaged in, or have an interest in at time of my death, and (j) to receive reasonable compensation in accordance with their standard schedule of fees in effect while their services are performed. IN WITNESS WHEREOF, 1, THRESSA E. SMITH,hereby set my hand to this my Last Will and Testament, on 3/ 2005, at Harrisburg, Pennsylvania. THRESSA E. SMITH— In our presence,the above-named THRESSA E.SMITH signed this and declared this to be her Last Will and now at her request,in her presence,and in the presence of each other,we sign as witnesses. /blame Address 2000 Linelestown Rd., Suite 202,Harrisburg PA 17110 �? 2000 Lingjestown Rd., Suite 202, Harrisburg PA 17110 _6 I,THRESSA E.SMITH,Testatrix,who signed the foregoing instrument,having been duly qualified according to law,acknowledge that I signed and executed this instrument as my Will,and that I signed it willingly as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by THRESSA E. SMITH,the Testatrix, on g 3 2005.c No THRESSA E. S/MI rKi COMMONWEALTH OF PENNSYLVANIA Notarial Seal Marielle F. Haan. Nasty Public Susquehanna Twp., Daupphhin Canty My Commission Expires Sept. 23, 2006 We, the undersigned witnesses who signed the foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the Testatrix sign and execute this instrument as her Will;that she signed and executed it willingly as her free and voluntary act for the purposes therein expressed;that each of us in her sight and hearing signed the Will as witnesses,and that to the best of our knowledge, that she was at that time eighteen(18) years or more of age,of sound mind, and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me by f. and 2 1W toss witnesses, on 5_ 3/ , 2005. 4a" /tnj Witness Notary P bhc - COMMONWEALTH OF PENNSYLVANIA Notarial Seal Idarielle F. Haan, Notary Public Susquehanna Twp., Dauphin County My Commission F�pires Sept. 23. 2006 SC MEMBERS P Fmsrtti.cxmrr vrnon SAVINGS ACCOUNT: Account Number/Suffix 195069-00 Date Account Established 07/10/2000 Principal Balance at Date of Death $4,041.47 Accrued Interest to Date of Death $.24 Total Principal and Accrued Interest $4,041.71 Name of Joint Owner James W. Smith Date Joint Ownership Established 07/10/2000 CHECKING ACCOUNT: Account Number/Suffix 195069-11 Date Account Established 07/10/2000 Principal Balance at Date of Death $15,008.29 Accrued Interest to Date of Death $.35 Total Principal and Accrued Interest $15,008.64 Name of Joint Owner James W. Smith Date Joint Ownership Established 07/10/2000 INVESTMENT SAVINGS ACCOUNT: Account Number/Suffix 195069-05 Date Account Established 07/10/2000 Principal Balance at Date of Death $6,803.88 Accrued Interest to Date of Death $.50 Total Principal and Accrued Interest $6,804.38 Name of Joint Owner James W. Smith Date Joint Ownership Established 07/10/2000 SUPPLEMENTAL SAVINGS ACCOUNT: Account Number/Suffix 195069-01 Date Account Established 09/22/2011 Principal Balance at Date of Death $1,976.95 Accrued Interest to Date of Death $.12 Total Principal and Accrued Interest $1,977.07 Name of Joint Owner James W. Smith Date Joint Ownership Established 09/22/2011 E BERS 1sT FEDE CR ION, Danielle A. Kline Lending Insurance Support Specialist August 17, 2012 Estate of: THRESSA E.SMITH Date of Death: 07110/2012 Social Security Number: 376-053995 5000 Louise Drive • P.O. Box 40 • Mechanicsburg,Pennsylvania 17055 • (800)283-2328 wwwmemberslstorg P'' EMPLOYEES E,Uu ` 2012 LIFE COMPANY(MUTUAL) j 916 Sherwood Drive ........................ Lake Bluff, IL 60044-2285 August 21, 2012 Hazen Eldler Law ATTN: Corinne Eggers Woodhouse 2000 Linglestown Road, Suite 202 Harrisburg PA 17110 Re: Policy No. 1-114604 Owner/Deceased: Thressa E. Smith Primary Beneficiary: State of Pennsylvania-Medicaid Contingent Beneficiary(s): James W. Smith & Eugene A. Smith,Jr. Dear Ms. Woodhouse: We are very sorry to learn of the loss of our annuitant and extend our sincere sympathy to the surviving family members. The information directly below is in regard to the original contact on the deceased. This information will be helpful to you in electing a settlement option. Premium Paid - $68,000.00 Period Certain- 10 Months Payments $6,831.06 Payments remaining- 6 Months If the PA Dept of Puhlic Welfare has any interest in the claim, we will require in writing from the state, attesting to any benefits paid on behalf of our annuitant. In the event Medicaid was not applied for and/or no benefits were paid, we will accept a statement from an attorney attesting that no Medicaid benefits were paid on behalf of our annuitant, We have included a Hold Harmless Affidavit, the beneficiary(s) signature on this document will allow our company to pay the beneficiary(s), and make the bencficiary(s) responsible for any payment due the state. If applicable, for the contingent beneficiary(s), two settlement options are available, Continuation of Benefit or the Commuted Value. Once elected, an option cannot be changed. Be sure to complete the proper forms and return them along with one original death certificate that shows the cause of death. Under the Continuation of Benefit option the benefit continues as the original contract was issued. The beneficiary(s)must complete a Continuation of Benefit Form and a IRS W-9 form. 916 SHERWOOD DRIVE•LAKIL BLUFF, ILLINOIS 60121.4-2295•(847)295-611011•(8(X1)462-8610• FAX (8471295-1145 EMPLOYEES LIFE COMPANY(MUTUAL) 916 Sherwood Drive Lake Bluff, IL 60044-2285 August 21, 2012 Page Two The Commuted Value is the second option. This is a lump sum settlement. The commuted value is the present value of future benefits at the discounted rate listed below. If this is desired, the beneficiary(s) is to complete the Commuted Value Claim Form, IRS W-9 form for social security verification, and the original policy Discounted rate- 6% Commuted Value - $40,415.00 The continuation of benefit settlement is considered income. Therefore, you will receive a 1099-R from us each year. We are not tax consultants and do not give tax advice. The commuted value is normally not taxable since no gain will be realized. However, if the premium paid came to us directly from another company, some part of the value may be taxable. Please advise us where the deceased's 1099 is to be mailed You may provide this information below and return it with the proof of loss documents. If you do not notify us, we will assume that the address of record is correct. If you have any questions, please contact us in the claim department @ 800-962-8610 Monday through Thursday 8:00 a.m. to 4:30 p.m. or before 1:00 p.m. on Fridays(Central Time). Sincerely, EMPLOYEES LIFE COMPANY (MUTUAL) Mary Navulis, ACS Claims Supervisor Policyholders Benefits Department Enc. 916 SHERWOOD DRIVE•LAKE 111MIT, ILLINOIS 60044-2285•(847)295-6000•(800)962-8610• FAX(847)'-95.1145 y / PENNSYLVANIA INHERITANCE TAXI UREAU OF INDIVIDUAL TAXES INFORMATION NOTICE FILE NO. 67 B PO BOX 288601 Penn LV0n1E3 - AND ACN 12143288 HARRISBURG PA 17128-0601 DEPARTMENT OF TAXPAYER RESPONSE DATE 08-01-2012 " eEYI5f3 FI KP(1a-11) TYPE OF ACCOUNT EST. OF THRESSA E SMITH ® SAVINGS SSN 376-05-3995 E) CHECKING DATE OF DEATH 07-10-2012 ❑ TRUST COUNTY YORK CERTIF, REMIT PAYMENT AND FORMS TO: JAMES W SMITH REGISTER OF WILLS 315 ROBSON RD 45 NORTH GEORGE STREET DILLSBURG PA 17019-8920 YORK PA 17401-1240 MEMBERS 1ST FCU 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 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 1t to the above address. Nease call 717-787-8327 with questions. COMPLETE PART 1 BELOW a SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 195069-05 Date 07-10-2000 To ensure Proper credit to the account, two Established copies of this notice most accompany payment to the Register of Wills. Make check Account Balance f 6,804.38 Payable to "Register of wi Is, Agent". Percent Taxable X 50.000 NOTE: If tax Payments are made within Mrva Amount Subject to Tax $ 3.402.19 months of the deco dent`s dote of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Potential Tax Due $ 153.10 Arry inheritance tax due will become delinquent M months after the data of death. PART TAXPAYER RESPONSE A. ❑ The above information and tax du• is correct. Remit Payment to the Rapistor of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or return this notice to the Register of Wills and C ONE en official assessment will be issued by the PA Department of Revenue. BLOCK B. The above asset has been or will be reported and tax Paid with the Pennsylvania inheritance tax return ONL Y filed W the estate representative. C. ❑ The above informs ion is incorrect and/or debts and deductions were Paid. Up mvl ate PART 21 antl/., PART M below. PART If indicating a different tax rate, please state Pil relationship to decedent: Lti TAX RETURN - CALCULATION OF TAX ON 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 S 7. Tax Rate 7 X B. Tax Due a S PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Lino 5 of Tax Computation) e Under penalties of perjury, I declare that the facts I reported above are true, correct and complete too the beses, of my knowledge and belief. HOME ( Vl/ 4( YYvEw f7 WORK (1/7 ) -7.7a -'71 ) 7 S� XPAYER 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 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 setter of convenience. 4. Accounts (including those held between husband and wife) the decedent put in joint names within one year prior to death are fully taxable. 5. Accounts established jointly between husband and wife more 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 1. 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 I 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 asses s..sit (Form REV-1548 IX) upon receipt of the return from the register of wills. 2. BLOCK B - If the asset specified on this notice has been'., will be reported and tax Paid with the Pennsylvania inheritance tax 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 1s incorrect and/or deductions are being claimed, check Block C and complete Parts 2 and 3 according to the instructions bet w. Sign two 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 (Form REV-1548 EX) upon receipt of the return from the register of wills. TAX RETURN - PART 2 - TAX CALCULATION LINE 1. Enter the data the account originally was established or titled in the manner existing at date of death. NOTE: For a decedent who died after 12/12/62, accounts the decedent put in joint names within one Year of death are fully taxable. However, there is an exclusion not to exceed $3,000 per transfer..,'regardless of the value of the account or the number of accounts held. If a double asterisk (s is) appears before Your first name in the address portion of this notice, the $3,000 exclusion was deducted from the account balance as reported W the financial institution. F. Enter the total balance of the account includino interest accrued to the date of death. . S. 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 tleeth, 1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF MULTIPLIED BY 100 - PERCENT TAXABLE JOINT OWNERS SURVIVING JOINT OWNERS Examples A Joint asset registered 1. the nave of the decedent and two other Persons, 1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) - .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), I DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT MULTIPLIED BY 100 = PERCENT TAXABLE OWNERS OR 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 BY 2 (SURVIVORS) • .50 X 100 - 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 (Line 3). S. Enter the total of the debts and deductions listed in Part S. 6. The amount taxable (Line 6) is determined by subtracting the debts and deductions (Line 5) from the amount subject to tax (Line 4). 7. Enter the appropriate tax rate (Line 7) as determined 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 a 12 percent 15 percent +The tax rate imposed on the net ea ue,f transfers from a deceased chiltl 21 years of ago or Younger at death to or for the use of a natural parent, an adaptive parent or a stepparent of the child is 0 percent. The lineal class of hairs includes grandparents, parents, children and other lineal descendents. "Children" includes natural children whether or not they have been adopted ge others, adopted children and step children.,"Lineal descendents" includes all children of the natural Parents and their descendents, whether or not they have boon 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 me follws: A. Y.. ... legally r sp...ible for payment. or the estate subject to administration by a personal representative is insufficient t0 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 it..ixed fully in Part 3. If additional space is needed, use B 1/2" x 11" sheet of paper. P...f of payment may be ,.ousted W the PA Department of Revenue. Y PENNSYLVANIA INHERITANCE TAXI UREAU OF INDIVIDUAL TAXES INFORMATION NOTICE FILE NO. 67 B PO Box 280601 pennsylvania AND ACN 12143287 HARRISBURG PA 17128-0601 DEPARTMENT OF REVENUE TAXPAYER RESPONSE DATE 08-01-2012 arVl%)EY AIP!A)-111 TYPE OF ACCOUNT EST. OF THRESSA E SMITH ❑ SAVINGS SSN 376-05-3995 ® CHECKING DATE OF DEATH 07-10-2012 ❑ TRUST COUNTY YORK CERTIF. REMIT PAYMENT AND FORMS TO: JAMES W SMITH REGISTER OF WILLS 315 ROBSON RD 45 NORTH GEORGE STREET DILLSBURG PA 17019-8920 YORK PA 17401-1240 MEMBERS 1ST FCU - provided the department with the information below, which was used in calculating the inheritance tat 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. i you the ulieve he edInforma Please isc call ]J61p812 s with obtain written correction from the financial institution. attach a copy to this form and return t COMPLETE PART 1 BELOW K SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 195069-11 Date 07-10-2000 To ensure Proper credit to the account, two Established copies of this notice must accowpo" Account Balance 15,008.64 vavwmt to the Resister of Wills. Make check payable to !Rho of wills. Apent^. Percent Taxable X 50.000 NOTE: If tax nowments are made within three Amount Subject to Tax $` 7P504.32 months of the decedent's data of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Are; inheritance tax due will become delin4uent Potential Tax Due S 337.69 nine months of to the date pf demth. PART TAXPAYER RESPONSE RUN 11 11111111 IN 1111 li�li�ill�l�im A. The above information and tax due is correct. Remit Payment to the Resister of Wills with two copies of this notice to obtain r CHECK a discount or avoid interest, or return this notice to the Resister of Wills and ONE an official asses eme nt wiII be issued W the PA Department of Revenue. LBLOCK 1. The above asset has been or will be .Ported and tax Paid with the Pennsylvania inheritance tax return ONLY filed by the estate rep rasentativo. C. ❑ The above informs on is incorrect and/or debts and deductions were Paid. Complete PART 2M)and/or PART 13 1 below. PART If indicating a different tax rata, please stateI ❑2 relationship to decedent: TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 h 2. Account Balance 2 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 T. Tax Rate 7 X S. Tax Due a PART DEBTS AND DEDUCTIONS CLAIMED M DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Lino 5 of Tax Computation) s Under penalties of perjury. I declare that the facts I reported above are true, correct and omplete is/t'hep best of my knowledge and belief. HOME C ) 64 WORK (7/7 ) -2 -7,?--// 7? 0-7 T PAYER SIGNATURE TELEPHONE NUMBER DATE GENERAL INFORMATION 1, FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based an information submitted by the financial institution. 2. Inheritance tax becomes delinouent nine months after the decedent's date of death. S. A joint account is taxable oven when the decedent's page was added as a matter of convenience. A. Accounts (including those held between husband and wife) the decedent put in )eint names within env Year prior to death are fully taxable. S. Accounts established jointly between husband and wife a... then one Year prior to death are not taxable. 6. Account¢ held by a decadent "in trust for" another or others ere fully taxabl¢. REPORTING INSTRUCTIONS - PART I - TAXPAYER RESPONSE 1, BLOCK A - If the information and cal cul atfon in the notice are correct and deductions are not being claimed, place an "X" in Block A of Part 1 of the "Taxpayer Reagan..' section. Sign two copies and submit then with a cback for the amount of tax to the register of wills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-1548 a) upon receipt of the return from the register of wills, 2. BLOCK 0 - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania inheritance tax return filed by the estate's representative, place a n "X" in Block B of Part 1 of the "Taxpayer Response" section. Sign two copies and return to the register of wills of the c.unty indicated. 3. BLOCK C - If the optic. information is incorrect and/or deductions are being Claimed, check Black C and cesplate Parts 2 and 3 according to the instructions below. Sign two castes 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 (Form REV-1546 EX) upon receipt of the return from the register of wills. TAX RETURN - PART 2 - TAX CALCULATION LINE 1. Enter the date the account originally was established or titled in the manor existing at date of death. NOTE, For a decedent who died after 12/12/82, accounts the decedent put in joint names within one Year of death are fully taxable. However, there is an exclusion not to exceed *3,000 per transferee, regardless of the value of the account or the number of accounts held. If m double asterisk GU .,Pears before your first name in the address Portion of this notice, the 93,000 exclusion was deducted from 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 SS taxable to eAah survivor 15 determined as fellwst A. The Percentage taxabl. of Joint assets established mare than one year prior to the decadent's deaths 1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF MULTIPLIED BY 100 = PERCENT TAXABLE JOINT OWNERS SURVIVING JOINT OWNERS Example, A joint asset registered in the 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 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 BY TOTAL NUMBER OF SURVIVING JOINT MULTIPLIED BY 100 = PERCENT TAXABLE OWNERS OR TRUST BENEFICIARIES Exa.ele: 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 BY 2 (SURVIVORS) - .50 X 100 50 Percent (TAXABLE FOR EACH SURVIVOR) 4. The amount subject to tax (Line 4) is determined BY multiplying the account balance (Line 23 by the Percent taxable (tine 3). 5. Enter the total of the debts and deductions listed in Part S. 6. The amount taxable (Line 6) is determined be subtracting the debts end deductions (Line 5) from the amount sub3.Ct to tax (Line 4), 7. Enter the appropriate tax rate (Line 7) as determined below. Date of Death Spous¢ Lineal Sibling Collateral 07/01194 to 12/31/94 S percent 6 percent 15 Do...nt 15 percent 01/01/95 to 06/30/00 0 pare ant 6 percent 15 par.ant 15 percent 07/01/00 to present 0 percent 4.5 percent a 12 Parc¢nt IS po r.ent 'The tax rata imposed an the not value of transfers from a dacaased child 2I Years of sea or Youngs at death to or for the use of a natural Parent, an adoptive Parent or a stepparent of the child is 0 percent. The lineal class of hairs includes grandparents, parents, children and other lineal descendents. "Children' includes natural children whether or not they he,. been adopted by Others, adopted children and step children. "Lineal descendants" includes all children of the natural Parents and their descendents. whether or not they have boon adapted by others; adopted descendents and their descendants; and step-dascendants. "Siblings" are defined as individuals who have at least one parent in common with the decedent, whether by blood or adoption. Th. Collateral class of heirs includes ail other beneficiaries. CLAIMED DEDUCTIONS - PART 3 - DEBTS AND DEDUCTIONS CLAIMED A11wable debts and deductions ere determined as follows, A. You are legally responsible for Payment, or the estate sdbdeet to administration by a Personal representative is insufficient to pay the deductible items. e. You actually Paid the debts after the death of the decedent and can furnish Proof of Payment. C. Debts being e16i.ed spit be itemized fully in Part 3. It additional space is o.dad, use 8 112" x t)" sheet of paper. Proof of Payment may Be requested by the PA Department of Revenue, PENNSYLVANIA INHERITANCE TAX BUREAU of INDIVIDUAL TAXES INFORMATION NOTICE FILE NO. 67 PO lox 280601 pennsylvania AND ACN 12143286 HARRISBURG PA 17120-0601 DEPARTMENT OF REVew.a TAXPAYER RESPONSE DATE 08-01-2012 Pry.l f�a fr I.iP 105-II] TYPE OF ACCOUNT EST. OF THRESSA E SMITH ® SAVINGS SSN 376-05-3995 ❑ CHECKING DATE OF DEATH 07-10-2012 ❑ TRUST COUNTY YORK ❑ CERTIF. REMIT PAYMENT AND FORMS TO: JAMES W SMITH REGISTER OF WILLS 315 ROBSON RD 45 NORTH GEORGE STREET DILLSBURG PA 17019-8920 YORK PA 17401-1240 MEMBERS 1 ST FCU 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 yyou believe the information Is incorrect, please obtain written correction from the financial institution, attach a c.py to this form and return it to the above address. Please call 717-787.8327 with Questions. COMPLETE PART 1 BELOW a SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 195069-00 Date 07-10-2000 1. ensure Proper credit to the account, two Established copies of this notice most accompany nt Balance 4.041.71 Pmvoent to the Register of Wills. Make check Aee pu S` Puy able to ^Register of Wills, Agent'. Percent Taxable X 50.000 MOTEs If tee Payments are made within three .nt Amount Subject to Tax $ 2.020.86 months of the tlecetlent's data of death. Tax Rate X .045 deduct e 5 percent discount on the tax due. Aro inherit once tax due will become delinquent Potential Tax Due $ 90.94 nine months after the data of death. PART TAXPAYER RESPONSE t A. ❑The above information end tax due is correct. Rea it pament to the Register of Wills with two copies of this notice to .btafn r CHECK a discount or avoid interest, or return this notice to the Register of Wills and I ONE en official assessment will be issued by the PA ERP.rt...t of Revenue. LBLOCK B. The above asset Mas Eegn or will and tax maid with the Pmnsvlvanie inheritance tax return ONLY filed br the estate repregent oilve. C. ❑ The above inf o rma ion is incorrect and/or debts and deductions were Paid. COMPI eta PART E antl/., PART M belw. PART If indicating a different tax rate, Please state Orelationship to decedent: TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Data Established 1 2. Account Balance 2 $ S. Percent Taxable 3 X 4. Amount Subject to Tax 4 $ S. Debts and Deductions 5 6. Amount taxable 6 $ 7. Tax Rate 7 X a. Tax Du. 8 $ PART DEBTS AND DEDUCTIONS CLAIMED M DATE PAID PAYEE DESCRIPTION AMOUNT PAID T TOTAL (Enter on Lino 5 of Tax Computation) s Under p.nalties of perjury, I declare that the facts I reported above are true, correct and co let. to the best of knowl.dg• and belief-�� HOME C J �Z-; CN z.n�lLZiZ WORK C7/7 TAXP4YER SIGNATURE TELEPHONE NUMBER DATE GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based an infor..tied submitted by the financial institution. Z. Inheritance tax becomes delinquent nine months after the decedent's data of death. 3. A joint account is taxable even when the decedent's nam. was added as A natter of convenience. A. Accounts (including those held between husband and wife) the decedent at in Joint nerves within one year Prior to death are fully taxable. S. Accounts established jointly between husband and wife more than no year Prior to death are net t...him. 6. Accounts held by a decedent "in trust for" another or others are fully taxable. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. BLOCK A - If the information and calculation in the notice are correct and deductions are not being Claimed. Place an "X" I. Block A of Part 1 of the "Taxpayer Response" section. Sion two copies and submit then with a chock for the amount of tax to the register of wills of the county indicated. The PA Department of Revenue will issue an official assess..ot (Farm REV-1548 EX) upon receipt of the return from the register of wills. ' 2. BLOCK B - If the asset specified on this notice has been or will be reported and tax Paid with the Pennsylvania inheritance tax return filed by the estate's representative, Place an "X" in Block B of Part 1 of the "Taxpayer Response" section. Sion 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. Sion two copies and submit the. 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 (Form REV-1548 EX) upon receipt of the return from the register of wills. LINE TAX RETURN - PART 2 - TAX CALCULATION 1, Enter the date the account originally was established or titled in the manner existing at date of death, NOTE: For a tlecedent who died after 12/12/82, accounts the decedent Put in joint names within one year of death are fully taxable. Rwaver, there is an exclusion not to exceed $3,000 Per transferee, regardless of the value of the account or the number of accounts held- if a double asterisk Vo) to...rs before Your first name in the address Portion of this notice, the $3,000 exclusion was deducted from the account balance as reported by the financial institution. 2. Enter the total balance of the account including interest accrued to the data 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 JOINT OWNERS SURVIVING JOINT OWNERS Example: A joint asset registered in the name of the decedent and two other Persons: 1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVDRS) _ .167 X 100 z 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 BY TOTAL NUMBER OF SURVIVING JOINT MULTIPLIED BY 100 - PERCENT TAXABLE OWNERS OR TRUST BENEFICIARIES Example: Joint account registered to the name of the decedent and two other Persons and established within one Year of death by the decedent. 1 DIVIDED BY 2 (SURVIVORS) _ ,50 X 100 - 50 Percent (TAXABLE FOR EACH SURVIVOR) 4. Th. amount subject to tax (Lin. 4) is determined by multiplying the account balance (Line 2) by the Percent taxable (Line 3). 5. Enter the total of the debts and deductions listed in Pert 3, 6. The amount taxable (Line 6) is determined by subtracting the debts and deductions (Lin. 5) from the amount subject to tax (Line 0. T. Enter the appropriate tax rate (Line 7) as determined 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 portent 15 percent 15 percent 07/01/00 to present 0 percent 4.5 percent + 12 percent 15 percent he tax rat. imppsetl Pn t e net value of transfers from a deceased child.21 Years pf 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. The lineal class of heirs includes grandparents, Parents, children and other lineal descendents. "Children" includes natural children whether or not they have been adopted by others, adopted children and stop children. "Lineal descendents" includes all children of the natural Parents and their descendents, whether or not they have been adopted by others; .dented descendents and their descendants; and step-descendents. "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 Pavwant, 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 .Pit be itemised fully in Part S. If additional space is needed, use B 112" x )1" sheet of paper. Proof of Payment may be requested by the PA Department of Revenue. nn nrn n"r OF n N�ya ;;3 APR 10 i. l 52 O ii i r'a i " ! r CUMBERL) N:, PA = I - m � - 1 n C Er O 13 i I J 7 � J C C3 > 1 O • ;J �. _ tn CJ it J r I penmulvania DEPARTMENT OF REVENUE INHERITANCE TAX BULLETIN 2012-01 Issued; July 10, 2012 Revised: July 13, 2012 Taxation and Valuation of Mineral Rights and Natural Gas Interests for Pennsylvania Inheritance Tax Under provisions of the Inheritance and Estate Tax Act of 1991, (72 P.S. §§ 9102, 9121), the Secretary of the Department of Revenue ('Department") announces that the Department has clarified existing Department policy concerning the taxation of mineral rights and natural gas interests for Pennsylvania inheritance tax purposes. All mineral and natural gas rights shall be reported on Inheritance Tax Schedule E (REV-1508) as Cash, Bank Deposits & Misc. Personal Property. The Department clarifies its policy as follows: (1) The taxable value of mineral rights shall be determined using the same methodology used to value any real property or tangible personal property interest. Taxable value is established by determining the actual monetary worth of the interest determined by either a bona fide sale or, if the transfer is for no or nominal consideration, computed value (based on the common- level ratio applied to the assessed value of the mineral right). In the event that there is no sale and no computed value, then the taxable value is the interest's actual monetary worth, based upon the best available evidence. (2) The taxable value of natural gas rights shall be determined using the same methodology used to value any real property or tangible personal property interest Taxable value is most clearly established by determining the actual monetary worth of the interest determined by a bona fide sale. If there is no bona fide sale, natural gas rights can be determined from an appraisal or other credible evidence. A computed value using assessed value cannot be accomplished because natural gas rights do not have assessed values. Therefore, absent a bona fide sale, an appraisal or other credible evidence to the contrary, value shall be determined as follows: (i) For leased and producing properties, an estate shall value natural gas rights at an amount equal to any amounts received that were attributable to actual production of the natural gas interests at issue during the twelve months prior to the decedent's date of death, multiplied by two. (ii) For leased, non-producing properties, interests shall be reported at a value of zero unless, at the time of death, the properties were part of a contractual arrangement whereby the properties generated fixed future payments, in which case the Bureau of Individual Taxes I P.Q. Box 280601 1 Harrisburg, PA 17128-0601 1 717.787.8327 1 www.revenue.state.pa.us Page 1 of 2 natural gas rights shall be calculated by reducing the fixed future payments to present value as of the decedent's date of death using established Internal Revenue Service actuarial tables as found in IRS Publication 1457 Actuarial Values Table B, Section 3 Annuity, Income, and Remainder Interests For a Term Certain. (iii) For non-leased, non-producing properties, interests shall be reported at a value of zero. CONTACT INFORMATION PA Department of Revenue Bureau of Individual Taxes Inheritance Tax Division P.O. Box 280601 Harrisburg, PA 17128-0601 TEL: 1.717.787.8327 www.revenue.state.pa.us Bureau of Individual Taxes I P.O. Box 280601 i Harrisburg, PA 17128-0601 1 717.787.8327 i www.revenue.state.pa.us Page 2 of 2