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HomeMy WebLinkAbout02-0341CONNONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-15~i5 EX AFP C09-00) INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 ACN 02110832 DATE 03-18-2002 EST. OF ETHELNYN ! KAUTZ S.S. NO. Z03-10-92q0 DATE OF DEATH 02-01-2002 COUNTY CUMBERLAND RITA M KEIM 22q5 LAMBS GAP RD ENOLA PA 17025-112q TYPE OF ACCOUNT [] SAVINGS [] CHECK/NO [] TRUST [] CERTZF. REMIT PAYMENT AND FORMS TO: REGISTER OF 14ILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ALLFIRST FINANCIAL SERVICE has provided the Department with the information 11sted below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint ouner/boneflciary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this fora and return it to the above address. This account is taxable Jn accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions may be answered by calling (7171 7R7-RR~7. COMPLETE PART ! BELON # # # SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0050320831 Date 05-28-197q Established Account Balance 1,2q5.ql Percent Taxable X 50.000 Amount Subject to Tax 622.71 Tax Rate X .15 Potential Tax Due 93.ql To insure p.~o.~;r~ cradiC~o your ~,~.~nt, two (Z) copies 04 this not~ must a~co~lpany your payment to ~ Register o~ ~11S. Hkke check payable to: ~Ragister ~Nills, Agent". NOTE: ~ t~ payments are made ~tn three (~) months ~; ~e deced~t's date of death, you aay deduct aSZ dJ~unt o~ ~e ~x due, Any inherit~e tax due will become delinquent nine (93 ao~s":after ~ data of death. PART TAXPAYER RESPONSE A. ~The above information and tax due is correct. 1. You may choose to remit payment to the Register of Rills with two copies of this notice to obtain CHECK a discount or avoid interest, or you may check box "A" and return this notice to the Register of E ONE ~ Hills and an official assessa~ent wlll 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 ONLY to be filed by the decedent's representative. C. ~The above information is incorrect and/or debts and deductions were paid by you. You must complete PART Iii and/or PART L[NETAX 1.RETURNDa~e Established' COMPUTATZON OF TAX ON JOZNT/TRUST ACCOUNTS 1 2. Account Balance [ 3. Percent Taxable $ ~ q. Amount Subject to Tax ~ $. Debts and Deductions ~ 6. Amount Taxable 6 7. Tax Rata 7 ~ 8. Tax Due ~ PART DATE PAID DEBTS AND DEDUCTTONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Co.~autat/on) Under penalties of parSur¥, Z declare that the facts ! have reported above ara true, correct and ~t' t° th'i~t °f ~'¥ kn°wl'dge and b'l~''f'~r~ -~./~ ~ WORK HOME ((~/'~) ) TAXPAYER STGNA E TELEPHONE NUMBER DATE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 001034 KEIM RITA M 2245 LAMBS GAP RD ENOLA, PA 17025-1124 f01d ESTATE INFORMATION: SSN: 203-10-9240 FILE NUMBER: 2102-0341 DECEDENT NAME: KAUTZ ETHELWYN I DATE OF PAYMENT: 04/03/2002 POSTMARK DATE: 03/27/2002 COUNTY: CUMBERLAND DATE OF DEATH: 02/01/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $93.41 TOTAL AMOUNT PAID: $93.41 REMARKS: RITA M KEIM SEAL CHECK#7516 INITIALS: JA RECEIVED BY' MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS Ms. Rita M. Keim 6018 Hummingbird Dr. Mechanicaburg, PA 17050-2040 Atl~ttlon: T/C 340 Zip Code PA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 28O6O1 HARRISBURG PA 17128-0601 h,.llh,,h,,Ih,hlh,hll,,,,Ih,lh,,.,Ihh,II ~Ex55 (9-93) ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TA Dear Register of Wills~_/ Enclosed you will find: L~check(s) J~l documents(s) which were received by the Department of Revenue in err These may be processed bccording to normal procedures. REMINDER: The POST MARK DATE on envelope attached to any checks enclosed must appear on y~ Official Receipt. Thank you. Sincerely, John Murphy, Chief Inheritance Tax Division '02 LOWELL R. GATES Also Admitted Io Massachusetts Bar MARK E. HALBRUNER Also Admitted to New Jersey Bar CRAIG A. HATCH CORY J SNOOK ALBERT N. PETERLIN Also Admitted to Maryland Bar STACEY L NACE ParalegaVOflice Manager TRACI L. SEPKOVlC Paralegal LAW OFFICES OF GATES HALBRUNER -HATCH P.C. 1013 MUMMA ROAD · SUITE 100 · LEMOYNE, PENNSYLVANIA 17043 (717) 731-9600 · FAX: (717) 731-9627 May 1, 2002 BRANCH OFFICE: 3 WEST MONUMENT SQUARE, SUITE 304 LEWISTOWN, PA 17044 (717) 248-6909 WEB SITE: www. GatesLawFirm.com Cumberland County Courthouse Office of the Register of Wills One Courthouse Square Carlisle, PA 17013 Ethelwyn I. Kautz, Deceased Date of Death: February 1, 2002 Social Security Number: 203-10-9240 Late of: East Pennsboro Township Dear Sir or Madam: Enclosed is a check in the amount of $5,500.00 as the inheritance tax prepayment for the above-referenced decedent. Ms. Kautz died owning no probate assets; therefore, an estate was not opened. I am enclosing an Estate Information Sheet and original death certificate for your files. Please send the receipt for the prepayment to our office in the enclosed envelope. Please contact our office if you need any additional information. Thank you for your assistance in this matter. Enclosures cc: Loft A. Mailey, Trustee Sincerely, Traci L. Sepkovic Paralegal LAW OFFICES OF GA~-E~fHALBRUNER &-HATCH, P.C. 1013 MUMMA ROAD, SUITE 100 LEMOYNE, PENNSYLVANIA 17043 Cumberland County Courthouse Office of the Register of Wills One Courthouse Square Carlisle, PA 17013 h,,llh,,lti,,,,,,Ih,lh,,Ih,,Ihhh,,,hlhh,h. PA DEPARTMENT OF REVENUE '~lil~' County Code Year ESTATE INFORMATION SHEET ~,~ / ~ ~z~ DECEDENT INFORMATION: Enter dat~ M it will appear on ell documents ~ubmittsd to the department. i....~..~) (~) (M,ddle) Kautz Ethelwyn I. 203 I 10 I 924O I Februaf~ 1, 2002 I February 26, 1920 TYPE FILING.' Enter choQk (,,') mark to Indicate the nmure of the return to be filed with the department. i ! lXlP~oR.~um i-Ij~m A.m o~ I-'l Eotlite Tm( Oflly · _..._.... ,~.... Enter check (,/) mark to indlcats the natore of the proceedings at the Rngister of Wlll8 LI= I I I:l~= brb"Uql/=U."''"'" Office. (Attach additiofld sheets if explanation ia necessary.) I-'~Te~my I'-]AdministratJofl I~] No Letters I-'lother (Please Explain) ATTORNEY/CORRESPONDENT INFORMATION: tax Information ~md. cor~.~pondence. Name (Last) (Hrst) Gates Lowell Enter idB data conceming the attorney or other individual to receive all (Middle) ISupmme Court I.D. # R. Gates, Halbruner & Hatch, P.C., 1013 Mumma Road, Suite 100 City State Zip Code ITelephone Number 717-731-9600 Lemoyne PA 17043 PERSONAL REPRESENTATIVE INFORMATION: Executor/Administrator Enter ell data concerning the personal representative(a) of the estate Name (l. ut) (l=im) Mailey Loll authoflzed by the Register of Willa 26 Bryans Mille Way (Middle) I Social Security Number City State Zip Code ITel°phone Number 410-465-1415 Cantonsville MD 21228 CoExecutor/Administrator Name (last) (First) (Middle) ;treat Addresl S~ate Zip Code ISocial Secudty Number I ITel°phone Number Co-ExecutorlAdministrstor Name (Lad) (Flint) (IdiddJ°) ISocial SecuTty Number State Zip Code ITel°phone Number Lowell R. Gates, Esquire COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 001146 LOWELL R GATES ESQUIRE 1013 MUMMA ROAD SUITE 1 O0 LEMOYNE, PA 17043 ........ fold ESTATE INFORMATION: SSN: 203-10-9240 FILE NUMBER: 21 02-0341 DECEDENT NAME: KAUTZ ETHELWYN I DATE OF PAYMENT: 05/03/2002 POSTMARK DATE: 05/01/2002 COUNTY: CUMBERLAND DATE OF DEATH: 02/01/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $5,500.00 TOTAL AMOUNT PAID: $5,500.00 REMARKS: LOWELL R GATES ESQUIRE SEAL CHECK//116 INITIALS: AC RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF XNHERITANCE TAX APPRAXSENENT. ALLOWANCE OR DXSALLOHANCE OF DEDUCTXON~, AND ASSESSNENT OF TAX ON JOINTLY HELD OR TRUST ASSETS R I TA M KE I l 2245 LAMBS GAP RD ENOLA t~.PA 17025-1124 DATE 05-15-2002 ESTATE OF KAUTZ ETHELWYN DATE OF DEATH 02-01-2002 FILE NUMBER 21 02-0541 COUNTY CUMBERLAND SSN/DC 205-10-9240 ACN 02110852 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS *~ ~-: [ ~- - ~--~- -~ 5~=5 ~¥ ................................................................................... NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 05-15-2002 ESTATE OF KAUTZ ETHELWYN DATE OF DEATH 02-01-2002 COUNTY CUHBERLAND FILE NO. 21 02-0541 S.S/D.C. NO. 205-10-9240 ACN 02110852 TAX RETURN NAS: CX} ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICE ACCOUNT NO. 0050520851 TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 05-28-1974 Account Balance 1,245.41 Percent Taxable X 0.500 Amount Subject to Tax 622.71 Debts and Deduct/ohs .00 Taxable Amount 622.71 Tax Rate ~ .15 Tax Due 95.41 TAX CREDTTS: NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID PAYMENT MUST BE MADE BY 11-02-2002~.' TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN ~, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" C CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. .00 95.41 .00 95.41 CON~ONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z80601 HARRISBURG, PA 171Z8-0601 REV-I$~S EX AFP (Dg-Oo) ZNFORHATZON NOTZCE AND TAXPAYER RESPONSE FZLE NO. 21 02-0341 ACN O21229Z8 DATE 05-09-2002 RITA M KEIM 6018 HUMMINGBIRDtDR MECHANICSBUR6 ~B~:17055 TYPE OF ACCOUNT EST. OF ETHELNYN I KAUTZ [] SAVZNGS S.S. NO. 205-10-9240 [] CHECKTNG DATE OF DEATH 02-01-2002 [] TRUST COUNTY CUMBERLAND [] CERTIF. REMTT PAYMENT AND FORMS TO: REGISTER OF NILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 MEMBERS 1ST FLU has provided the Department aith the information listed below ahich has been used in calculating the potantial tax due. Thalr records indlcata that at the death of the above decadent, you Hare a joint omnmr/benmfioiary of this account. If you feel this information ]s incorrect, please obtain aritten correction from the financial institution, attach a copy to this for~ and return it to the above address. This account is taxable in accordance Hith the Inheritance Tax Lams of the Co~aon#ealth of Pennsylvania. Questions may be ansHarad by calling (717) 787-8327. COMPLETE PART 1 BELON x # # SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 8005-05 Data 11-16-1998 Established Account Balance 3,168.81 Percent Taxable X 50.000 Amount Subject to Tax 1,58q.41 Tax Rate X .045 Potential Tax Due 71.30 To insure proper credit to your account, tho (2) copies of this notice must accompany your payment to the Register of Hills. Hake check payable to: "Register of Hills, Agent". NOTE: If tax payments are made Hithin three ($) months of the dacedent's date of death, you may deduct a 5Z discount of the tax due. Any inheritance tax due Hill become delinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE I. [] The above information and tax due is correct. 1. You may choose to remit payment to the Register of Hills with ted copies of this notice to obtain CHECK m discount or avoid interest, or you may check box "A" and return this notice to the Register of  ONE ~ Hills and an official assessment will be issued by the PA Department of Revenue. BLOCK ~ s. [] The above asset has been or will bm reported and tax paid with the Pennsylvania Inheritance Tax return ONLY to be filed by the dacedant's representative. C. [] The above information is incorrect and/or debts and deductions Here paid by you. You must complete PART [] and/or PART [] belcH. Tf you indicate a different tax rata, please state your relationship to decedent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PART TAX LINE 1 3 $ 6 7. 8. Data Established 1 Account Balance ~ Percent Taxable 3 ~ Amount Subject to Tax 4 Debts and Deductions ~. - Amount Taxable 6 Tax Rata 7 ~ Tax Due 8. PART DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line $ of Tax Computation) Under penalties of perjury, T declare that the facts Z have reported above ara true, correct and ~o the bast of .~ knowledge end belief. HOME ('~/ '~ ) ~/ q~-- -- ~ ~ UO K C TAXPAYER SIG~AT~E TELEPHONE NUMBER DATE Rita M. Keim 6018 Hummingbird Dr. Mechanicsburg, PA 17050-2040 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT, 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: KEIM RITA M 2245 LAMBS GAP RD ENOLA, PA 17025-1124 ........ fold ESTATE INFORMATION: SSN: 203-10-9240 FILE NUMBER: 2102-0341 DECEDENT NAME: KAUTZ ETHELWYN I DATE OF PAYMENT: 08/12/2002 POSTMARK DATE: 08/10/2002 COUNTY: CUMBERLAND DATE OF DEATH: 02/01/2002 REV-1162 EX(11-96) PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT DUPLICATE NO. CD 001511 ACN ASSESSMENT CONTROL NUMBER AMOUNT 02122928 $71.30 REMARKS: RITA M KEIM TOTAL AMOUNT PAID: $71.30 SEAL CHECK# 3433 INITIALS: JA RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS .AW OFFICES OF ~RUNER ~.-HATCH~ P.C. MMA ROAD, SUITE 100 PENNSYLVANIA 17043 D COUNTY COURTHOUSE THE REGISTER OF WILLS HOUSE SQUARE IPA 17013 OFFICES OF ~RUN£R~&- H~ MMA ROAD, SUITE 100 !, PENNSYLVANIA 17043 D COUNTY COURTHOUSE THE REGISTER OF WILLS HOUSE SQUARE 'PA 17013 BUREAU OF INDIVIDUAL TAXES TNHERTTANCE TAX DEPT. 280601 HARRISBURG, PA 17128-0601 RITA M KEIM 6018 HUMMINGBIRD DR MECHANICSBURG PA 17055 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTTCE OF TNHERTTANCE TAX APPRAISEHENT,, ALLOHAHCE OR DISALLOHANCE OF DEDUCT:IONS; AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 10-07-2002 ESTATE OF KAUTZ ETHELWYN DATE OF DEATH 02-01-2002 FILE NUMBER 21 02-0541 COUNTY CUMBERLAND SSN/DC 205-10-9240 ACN 02122928 I Amount Remitted I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~' RETAIN LOWER PORTION FOR YOUR RECORDS '~ REV-1548 EX AFP C01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 10-07-2002 ESTATE OF KAUTZ ETHELWYN DATE OF DEATH 02-01-2002 COUNTY CUMBERLAND FILE NO. 21 02-0541 S.S/D.C. NO. 205-10-9240 ACN 02122928 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 8005-05 TYPE OF ACCOUNT: C ~ SAVINGS ( ) CHECKING C ) TRUST ( } TIME CERTIFICATE DATE ESTABLISHED 11-16-1998 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS 5,168.81 X 0.500 1,584.41 - .00 1,584.41 X .45 71.50 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 08-10-2002 CDO01511 .00 71.50 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE [S LESS THAN 9[, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" C CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) 71.50 .00 .00 .00 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 001800 MARK E HALBRUNER ESQUIRE 1013 MUMMA ROAD SUITE' 100 LEMOYNE, PA 17043 ........ fold ESTATE INFORMATION: SSN: 203-10-9240 FILE NUMBER: 2102-0341 DECEDENT NAME: KAUTZ ETHELWYN I DATE OF PAYMENT: 11/01/2002 POSTMARK DATE: 10/31/2002 COUNTY: CUMBERLAND DATE OF DEATH: 02/01/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $46.20 TOTAL AMOUNT PAID: $46.20 REMARKS: MARK E HALBRUNER ESQUIRE SEAL CHECK# 2231 INITIALS: AC RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS F~_'(-1500 EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECE- DENT CHECK APPRO- PRIATE BLOCKS CDR- RE- SPON DENT RECA- PITULA- TION TAX COMPU- TATION REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Kautz, Bthelvyn Z. DATEOFDEATH(MM-DD-YEAR)02/01/2002 IDATEOFBIRTHlMM-DD-YEAR)2/26/1920 (IFAPPLICABLE) SURVIVINGSPOUSESNAME(LAST, FIRST, AND MIDDLEINmAL) OFFICIAL USE ONLY FILE NUMBER COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 203-10-9240 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 1. Original Return 4. limited Estate 6. Decedent Died Testate (Attach copy of Will) 9. Litigation Proceeds Received  2. Supplemental Return 48. Future InterestComprcmise ~date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attacha copy of Trust) 10. Spousal PovertyCredit(date of death between 12-31-91 and 1-1-95) 3. Remainder Return (date of death pdor to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes  '~ 11. Election to tax under Sec. 9113(A) (Attach Sch O) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE & CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME Ma.Tk u. Halbru.ue~-, Bfq'u:Lz*e FIRM NAME (If Applicable) Gate-,, Halbz'~ne',* & Hat;ch, TELEPHONE NUMBER 717-731-9600 COMPLETE MAlUNG ADDRESS 1013 MuteR Odd, Su~e 100 Lemoyna, PA 17043 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3, Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) $. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) E] Separate Billing Requested (6) 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 0.60: 0.00 0.00 0.00 2,955.00 5,017.81 (7) 142,334.82 OFFICIAL USE ONLY 8. Total Gross Assets (total Lines 1-7) (8) 9. Funeral Expenses & Administralive Costs (Schedule H)(9) 14,193.09 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) ~, 434 · 05 11. Total Deductions (total lines 9 & 10) (11 ) 12. Net Value of Estate (line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax (13) has not been made (Schedule J) 14. Net Value Subject to Tax (Une 12 minus line 13) (14) 155,325.43 20,626.14 1.29,681.49 0.00 129~681.49 15. SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES Amount of Line 14 taxable at the spousal tax rate. or transfers un der Sec. 9116 (aX1.2) 0 · 0 0 X .00 (15) 16. Amount of Line 14 taxable at lineal rate 12 9,681· 49 x .045 (16) 17. Amount of Line ~4 taxable at sibling rat~ 0.0 0 X .12 (17) 18. Amount of Line 14 taxable at collateral rate 0,00 X .15 (18) 19. Tax Due (19) 20. ~ I CHECK HERE IF YOU ARE REQUESTING A REFUHD OF AN OVERPAYMENT J 0.00 5,835.67 0.00 0.00 5,83S.67 >> BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND RECHECK MATH<< 0 PA15001 NTF 29755 Copyright2000G[eatland/Nelco LP- Forms Software Only PA R~E-'V-1500 EX (6-00) Decedent's Complete Address: IsiH~-~-~ ADDRESS Wear:: Bho~'e Ho&lt:h &Rehab 770 Popl~ (~huz*oh Road CiTY Page 2 Tax Paymei~L~ and CreGits: ISTATE ZIP 17011 Tax Due (Page I Line 19) Credits/Payments A. Spousal Poveriy Credit B. Prior Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty 0.00 5,500.00 289.47 0.00 0.00 (1) Total Credits (A + B + C) (2) Total Interest/Penalty (D + E) (3) 5,835.67 5,789.47 0.00 4. If Line 2 is greater than Line I + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ....................................... ~ ~ b. retain the right to designate who shall use the property transferred or its income; ................. c. retain a reversionary interest; or ........................................................ d. receive the promise for life of either payments, benefits or cam? .............................. 2. If death occurred after December 12, 1982, did decedent transier property within one year of death without receiving adequate consideration? ................................................... 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? . .. r-~ ~ ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................ M ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury I declare that have exam ned th s return, nc uding accompanying schedules and statements, and to the best of my knowledge and behef, it is true, correct and complete. Declaration of preparer other than the personal representative is based on information of which preparer has any knowledge. 46.20 0.00 46.20 SIGNATUR O ERSON SPON IBLE F FILING RETURN ADDRESS J.U.L~ _--_ ...... -_ ___o., ~u3. c~,~ iO0 Lmm:fy'ne, PA 17043 SIGNATUR~O~F PREPARE~ OT.,~-IER.,3;I-~AN .~~TIVE AD D R E S S ~}/'/~,c~v'~- '~('~-' ~ Gates, Halbruner & Hatch, P.C , 1013 Mumma Rd., Ste. 100, DATE IO DATE Lemoyne, PA 17043 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed ~ the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. ! 9118 (a)(1,1) (i)]. For dates of death on or after ,January 1, 1995, the tax rate is imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. S 9116 (a)(1.1)(ii)]. The statute does flotexe mp~ a transfer to a surviving spouse from tax, and the statutory roqsirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: T he tax rate imposed on th · net value of transfers fro m a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent. or a step parent of the ch lid is 0% [72 P.S. §9118(aX1.2)]. The tax rate imposed on the net value of transfers to or for the use of the dscedent's lineal beaeficiaries is 4.5%, except as noted in ?2.P,S. § 9118(1.2) [72 P.S. § 9118(aX1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. § 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an in dividual who has at least one parent in common with the decedent, whether by blood or adoption. 0 PA15002 NTF 29758 Copyright 2000 Greatland/Nelco LP- Forms Softw~Only REV-I'508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Knul:z, Bt:helwy'n Z. ._ Include proceeds of litigation & date proceeds were received by the estate. All prop. jointly-owned with right of survlvorshi 3 must be dlsc!_n_~ed on Sch. F. ITEM NO. DESCRIPTION 1. MJ. sool].an~ou. L2o:F.onn3. ~'~ez't:y (eeo nt:t:nohed nppra:l, anZ) 2 1988 Chev2rolet: atnt:l, on Wngon V'F~IO1,.TC8117,T,.T2 612 7 S (vn].ue pa= ]~ADA app=n:l, an].) TOTAL (Also enter on tine 5, Recapitulation) $ VALUE AT DATE Of DEATH 1,330.00 1,625.00 2,955.00 0 PA15081 NTF 33305 (If more space is needed, insert additionaJ sheets of the same size) Copyright 2000 Greatlafld/Nelco LP - Forms Software Only ' REV-'~509 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER K&u[s, u~holwlm Z. .. If an asset was made joint within one year of the decedent's date of death, It must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Ko4-,,, Ri~a M. Daugh~or 6018 R~,,--,,t ngbizd Ds*ire bohiniolburg, PA 17055 JOINTLY-OWNED PROPERTY: DESCRIPTION OF PROPI=RTY LETTER DATE Include name of financial institution and bank % OF DATE OF DEATH ITEM FOR MADE JOINT account number or similar identifying number. DATE OF DEATH DECD'S VALUE OF NO, TENANT JOINT Attach deed for jointly-held real estate, VALUE OF ASSET INTEREST DECEDENT'S INTERES] ,',ion Savings ~count I~ot. B'o. 8005-00 2 & 03/28/1974 JO.l£iz'st: Bank 1,24,5.41 50.00 622.71 Chaoking A~ooun~ A~c~. !o. 0050320831 3 & 11/16/1998 I~mbers 1st. Federal C=o4:Lt U 3,168.81 50.00 1,584.4,0 n:Lon &~t. ~o. 0005-05 t i 11/15/1~5 ~embers 1st ~eda~al C~adl~ U 5,$95.$7 50.00 2,7~7.70 mion ~he~king ~aount ~ct. !~o. 0005-11 TOTAL (Also enter on line 6, Recapitulation) $ 5,017.01 (If more space is needed, insert additional sheets of the same size) 0 PA15091 NTF 33308 Copyright 2000 Greatland/Nelco LP- Forms Software Only REV-~I510 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Keats · uthelvl~ Z. ._ This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROP~Hi¥ % OF INCLUDE NAME OF THE TRANSFEREE, THEIR ITEM RELATIONSHIP TO DECD & DATE OF TRANSFER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NO. ATrACH COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) XnvolCmont SaYingl Aooon~t Acer. !~O. 181163-05 (trane£erred to Truer on 01/14/ 1999) 2 1. On llov---~er 18, 1998, Uthelv 0.00 100.00 0.00 0.00 yn Z. I:autz aatabliahed The Eau ts Family (Xrrevooable) Trust b y end between herael£ ae Settle r end her granddaughter, Lori · hiley, am Trustee. Pe~ &trio lo 4.03 o£ the T~uet, upon the death o£ the Settlor· the ntng t~uet estate eb~ll be ributed to Settlor ti grenddaugh tar, Lori A. Mailey. The £ollo ring ia a aunnaFF o£ the T~uat 3 One-atoFy, aingle-£ancLl¥ dvelli 113,000.00 100.00 0.00 113,000.00 ng legated at 2245 Lmnba 4bp ad, Basle, ~--herland C~ounty, enne¥1venta~ being Ten PLTooX o. 10-12-2983-008; trena£erred by Btbelvyn Z. Kautz to The Kau tz Family T~uat by deed dated ovm-her 18, 1998, and recorded eoveaber 24, 1998, in Deed Book 180, page 860. Valuation pe~ a trashed appraisal. · Xembera let Federal ~redit Ohio 129.06 100.00 0.00' 120.06 Savinga acoount Asst. !~o. 181163-00 (trena£erred to Trust on 01/14/ 1999) S Meanbera lot Federal Credit Unio 315.97 100.00 0.00 315.97 a Chaoking Account ;-cot. IWo. 181163-11 (trana£orred to Truat on 04/13/ 1999) TOTAL (AJs0 enter 0n fine ?, Recapi~ta~on) $ 142,334.82 0 PA15101 NTF 33307 (If more space is needed, insert additional sheets of the same size) Copyright 2000 Greatland/Nelco LP - Forms Software Only ' REV-i511EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER K-,u~s, B~JaolvFz~ Z. .. Debts of decedent must be reported on Schedule I. ITEM NO, A. 1. 9 10 11 12 13 DESCRIPTION FUNERAL EXPENSES: l~lno~&l Qoods ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN No. of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Attomey Fees llamot ~a~og, HalbruneE & Ha~uh, 9.~. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Retum Preparer's Fees xocaA ~.;,~ co~cinuacAon pagll .... TOTAL (Also enter on line 9, Recapitulation) $ AMOUNT 3,670.00 0.00 5,000.00 0.00 25.00 0.00 0.00 5,000.00 27.25 29.50 28.00 37.34 75.00 aOo.uo 14,192.09 (If more space is needed, insert additional sheets of the same size) 0 PA15111 NTF 33308 Copyright 2000 Greatland/Nelco LP- Forms Software Only Estate of: Kautz, Ethelwyn I. Schedule H, Part B -- Administrative Costs Item Description 14 RSR Appraisers & Analysts real estate appraisal Page 2 Amount 300.00 TOTAL. (Carr~ forward to main schedule) ...... 300.00 ' REV-~512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES,& LIENS ESTATE OF FILE NUMBER Kentz, B~elw]m Z. .. Include unreimbursed medical expenses. ITEM NO. 1. 2 5 7 9 lO 11 12 13 14, 15 16 17 18 19 DESCRIPTION -"-~z~.~_y t~ans~G~t to Holy Sptrlt Hospltel AT&T phone aedile C~ao~ C~Xe c~le so--ice xn~o~al R~ue Series 2001 para.aX Ano~ t~ Xi~AIAty phone ao~A~o The Steo ~o. AT&T phone servtoe Pinnaole Health HospitaZs medioal ball ~,-~erland Valley Land Cleaxing dunpeter rented to olean house Colleoteoh Systa~-, Zno. va=izon C~uniaatione, Zno. past due aaoou nt AT&T Wireless cellula= phone sezvioe Best pennsboro Ambulance Berries emerganoy medioaX transport eleotrio eer~ioe Centuz~r Spouttn~ Co., Zno. Services oontraoted £or by B~belu3rn Z. Keut · prior to her death and paid e£ter her den th. PPL Utilities oleotrio servioe phone eervioe Eatbx-yn W. Fetrow, Treas%L~er 2002 Real Berate Tms TOTAL (Also enter on line 10, Recapitulation) $ AMOUNT 27.77 57.36 71.87 450.92 33.80 604.00 28.91 75.00 53.54 297.91 256.70 32.68 11.02 60.00 29.68 4,000.00 23.88 53.07 265.84 6,434.05 (If more space is needed, insert additional sheets of the same size) Copyright 2000 Greatland/Nelco LP - Forms Software Only 0 PA15121 NTF 3330g REV-~513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES £$TATE OF FILE NUMBER K&ut:z, ut. helwyn Z. NUMBER I 1. II 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outfight spousaJ distributions, and transfers under Sec. 9116 (a) (1.2)] ll~tley'~ Lo~:I. A. c-,,tonsv:Ll:Le, 2',220 Ko:LIn, R:Lt:& M. 603.8 H,,,,,.,,tngb:L~d D~*:I.'~'e b~han:l.~bu~g, PA 3.7055 RELATIONSHIP TO DECEDENT DO Not MSt Trustee(s) Daughl:e~ AMOUNT OR SHARE OF ESTATE 124,663.68 5,017.81 ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -- ENTER TOTAL NON-TAXABLE DISTRIBS. ON LINE 13 OF REV-1500 COVER SHEET $ 0.00 (If more space is needed, insert additional sheets of the same size) 0 PA15131 NTF 33293 Copyright 2000 Graatland/Nalco LP- Forms Softwara Only DEATH CERTIFICATE LAST WILL AND TESTAMENT OF ETHELWYN I. KAUTZ LAST WILL AND TESTAMENT O_EF ETHELWYN I. KAUTZ I, ETHELWYN I. KAUTZ, now of 2245 Lambs Gap Road, Enola, Cumberland County, Pennsylvania 17025, do publish and declare this to be my Last Will and Testament, hereby revoking all other prior wills and codicils made by me. FIRST: Family Background and ADpointment of ~Yecutor. (A) Family and Background Infor~_atio~. I am widowed. I was married to ROBERT KAUTZ. My children are RITA M. KEIM and ROBERT R. KAUTZ. Throughout this Will, RITA M. KEIM and ROBERT R. KAUTZ will be referred to as "my children". The word "issue" will include my children as well as my other descendants (excluding adopted issue). (B) Appointment of Executor. I appoint as my Executrix and successor Executrix (all hereinafter referred to as Executrix or Executor(s) under this Will, the following named persons or corporations to serve without bond and without being required to account to any Court: Executrix: My granddaughter, LORI A. MAILEY. Successor Executrix: My daughter, RITA M. KEIM. (C) Inter Vivos Trust. The inter vivos trust agreement referred to in this Will is entitled "THE KAUTZ FAMILY IRREVOCABLE TRUST", by and between myself as Settlor and my granddaughter, LORI A. MAILEY, as Trustee, as now in effect or as may hereafter be amended. SECOND: Funeral and Last Illness ExDenses; Taxes. (A) ExDenses of Funeral and Last Illness. I direct my Executrix to pay my funeral expenses (regardless of amount) and the expenses of my last illness from my estate. (B) Taxes. I direct my Executrix to pay any and all estate, inheritance, succession, legacy, transfer and other death ta~s or duties, by whatever name called, including any and all inter~ and penalties thereon, imposed under the laws of any jurisdiction by reason of my death upon or with respect to any and all [fr6Dertv LAST WILL AND TESTAMENT OF ETHELWYN I. KAUTZ PAGE 2 included in my gross estate for the purpose of such taxes, whether such property passes under or outside of this Will. Without any apportionment otherwise required by law and without being prorated or apportioned among or charged against the respective devises, legatees, beneficiaries, transferees, or other recipients of any such property or charged against any property passing or which may have passed to any of them, I direct that any taxes so paid shall be charged against my residuary estate. My Executrix shall not be entitled to reimbursement for any portion of any such taxes from any such person. The foregoing provisions of this Article SECOND shall not apply to such portion or portions of said taxes, interest and penalties which may be required to be paid, or are actually paid or reimbursed, by the Trustee of the Trust described in Paragraph FIRST (C), above. THIRD: Tangible Personal Property. Except for those items excluded below and those items enumerated in the Letter of Instruction, I bequeath all my tangible personal property, including but not limited to clothing, jewelry, heirlooms, furniture, household furnishings, personal effects, motor vehicles, and all other similar articles, which I own, and the insurance thereon, to my granddaughter, LORI A. MAILEY. Tangible personal property shall not include: (1) any and all property used by me in any business, (2) cash on hand or on deposit in banks, (3) stock or securities, (4) any type of evidence of indebtedness, and (5) any life, health or accident insurance policies. If my granddaughter, LORI A. MAILEY, does not survive me, I leave such tangible personal property to my children, in as nearly equal shares as is practical, per stirpes. If there is any disagreement as to distribution, I direct my Executrix to make such distribution. The decision of my Executrix shall be final and binding. Any items not selected or any items which my Executrix considers unsuitable for my children may be distributed or sold in the sole discretion of my Executrix and, if sold, the net proceeds therefrom shall be added to the residue of my estate. Any such article allocated to a minor may, as my Executrix deems advisable, either be delivered to the minor or to any person to safeguard on behalf of the minor. Notwithstanding any other provisions in this Article THIRD, I may leave a separate, dated and unsigned Letter of Instru ~on, which I shall place with my Will, containing directions ast 7the ultimate disposition of certain of the property bequeathed ~der LAST WILL AND TESTAMENT O__F ETHELWYN I. KAUTZ PAGE 3 this Article THIRD, and such Letter of Instruction shall determine the distribution of such items. FOURTH: Residuary Estate. I devise and bequeath all of the rest, residue and remainder of my estate, real, personal and mixed, of whatever nature and wherever situated to which I am legally or equitably entitled, to the then-acting Trustee of the Trust described in Paragraph FIRST (C) of this Will, to be held, administered and distributed pursuant to the terms thereof, as the same may be amended from time to time. By this devise and bequest of my residuary estate I hereby exercise all Powers of Appointment I possess at the time of my death except any power of appointment which I possess under the Trust described in Paragraph FIRST (C) of this Will. FIFTH: Powers of Executrix. In addition to the powers and duties as may have been granted elsewhere in this Will, but subject to any limitations stated elsewhere in this Will, the Executrix shall have and exercise exclusive management and control of the Estate and shall be vested with the following specific powers and discretion, in addition to the powers as may be generally conferred from time to time upon the Executrix by law: (A) In the management, care and disposition of the Estate, the Executrix shall have the power to do all things and to execute such instruments, deeds, or other documents as may be deemed necessary or proper, including the following powers, all of which may be exercised without order of or report to any Court: (1) To sell, exchange or otherwise dispose of any property at any time held or acquired hereunder, at public or private sale, for cash or on terms, without advertisement, including the right to lease for any term notwithstanding the period of the Estate, and to grant options, including any option for a period beyond the duration of the Estate. (2) To invest all monies in such stocks, bonds, securities, mortgages, notes, choses in action, real estate or improvements thereon, and any other property as the Executrix may deem best, without regard to any law now or hereafter enforced limiting investments of fiduciaries. (3) To retain for investment any property deDosi~ the Executrix hereunder. LAST WILL AND TESTAMENT o_g ETHELW~N I. KAUTZ PAGE 4 (4) To vote in person or by proxy any corporate stock or other security and to agree to or take any other action in regard to any reorganization, merger, consolidation, liquidation, bankruptcy or other procedure or proceedings affecting any stock, bond, note or other security. (5) To use attorneys, real estate brokers, accountants and other agents, if such employment is deemed necessary or desirable, and to pay reasonable compensation for their services. (6) To compromise, settle or adjust any claim or demand by or against the Estate and to agree to any rescission or modification of any contract or agreement affecting the Estate. (7) To renew any indebtedness, as well as to borrow money, and to secure the same by mortgaging, pledging or conveying any property of the Estate. (8) To retain and carry on any business in which the Estate may acquire an interest, to acquire additional interest in any such business, to agree to the liquidation in kind of any corporation in which the Estate may have an interest and to carry on the business thereof, to join with other owners in adopting any form of management for any business or property in which the Estate may have an interest, to become or remain a partner, general or limited, in regard to any such business or property and to hold the stock or other securities as an investment, and to employ agents and confer on them authority to manage and operate the business, property or corporation, without liability for the acts of such agent or for any loss, liability or indebtedness of such business if the management is selected or retained with reasonable care. (9) To register any stock, bond or other security in the name of a nominee, without the addition of words indicating that such security is held in a fiduciary capacity, but accurate records shall be maintained showing that such security is a Estate asset and the Executrix shall be responsible for the acts of such nominee. (B) Whenever the Executrix is directed Estate assets in fee simple to a person who is to distribu~ any then un~ LAST WILL AND TESTAMENT ETHELWYN I. KAUTZ PAGE 5 one (21) years of age, the Executrix shall be authorized to hold such property in Trust for such person until he/she becomes twenty- one (21) years of age, and in the meantime shall use such part of the income and the principal of the Estate as the Executrix may deem necessary to provide for the proper support and education of such person. If such person should die before becoming twenty-one (21) years of age, the property then remaining in trust shall be distributed to the personal representative of such person's estate. (C) In making distributions from the Estate to or for the benefit of any minor or other person under a legal disability, the Executrix need not require the appointment of a guardian, but shall be authorized to pay or deliver the same to the custodian of such person, to pay or deliver the same to such person without the intervention of a guardian, to pay or deliver the same to a legal guardian of such person if one has already been appointed, or to use the same for the benefit of such person. (D) In the disbursement of the Estate and any division into separate trusts or shares, the Executrix shall be authorized to make the distribution and division in money or in kind, or both, regardless of the basis for income tax purposes of any property distributed or divided in kind, and the distribution and division made and the values established by the Executrix shall be binding and conclusive on all persons taking hereunder. The Executrix may in making such distribution or division allot undivided interests in the same property to several trusts or shares. (E) The Executrix shall be authorized to lend or borrow, including the right to lend to or borrow from any trusts which I may have established during life or by will at an adequate rate of interest and with adequate security, and upon such terms and conditions as the Executrix shall deem fair and equitable. (F) The Executrix shall be authorized to sell or purchase at the fair market value as determined by the Executrix, any property to or from any trust created by me during life or by Will, even though the same person or corporation may be actingas Executrix of my estate or as Trustee of any of my other trusts. (G) The Executrix shall have discretion to determine whether items should be charged or credited to income or prlnclp~_ or allocated between income and principal as the Executrix m~Y~eem equitable and fair under all the circumstances, includi~g~h~er_~ LAST WILL AND TESTA~W. NT O_EF ETHELWYN I. KAUTZ PAGE 6 to amortize or fail to amortize any part or all of any premium or discount, to treat any part or all of the profit resulting from the maturity or sale of any asset, whether purchased at a premium or at a discount, as income or principal or apportion the same between income and principal, to apportion the sales price of any asset between income and principal, to treat any dividend or other distribution of any investment as income or principal, or apportion the same between income and principal, to charge any expense against income or principal or apportion the same, and to provide or fail to provide a reasonable reserve against depreciation or obsolescence on any assets subject to depreciation or obsolescence, all as the Executrix may reasonably deem equitable and just under all the circumstances. If the Executrix does not exercise the above discretionary power, the cash or accrual allocation shall be in accordance with Chapter 81 of Title 20 of the Pennsylvania Consolidated Statutes, or the corresponding provisions of subsequent state law. (H) If at any time the total fair market value of the assets of any trust established or to be established hereunder is so small that the corporate Trustee's annual fee for administering the trust would be the minimum annual fee set forth in the Trustee's regularly published fee schedule then, in effect, the Trustee in its discretion shall be authorized to terminate such trust or to decide not to establish such trust, and in such event the property then held in or to be distributed to such trust shall be distributed to the persons who are then or would be entitled to the income of such trust. If the amount of income to be received by such persons is to be determined in the discretion of the Trustee, then the Trustee shall distribute the property among such of the persons to whom the Trustee is authorized to distribute income, and in such proportions, as the Trustee in its discretion shall determine. (I) Except as otherwise provided in this Will, when the authority and power under this Will is vested in two (2) or more Executrixes or Trustees, the authority and powers are to be held jointly by the Executrixes or Trustees, respectively. A majority of the Executrixes or Trustees may exercise any authority or power granted under this Will or granted by law, and may act under this Will. Any attempt by one such Executrix or Trustee to act under this Will on other than ministerial acts shall be void. The action of one such Executrix or Trustee under this Will may be valuated by a subsequent ratification of the act by a ma jo 'r~the LAST WiLL AND TESTaMeNT 0! ETHELWYN I. KAUTZ PAGE 7 Executrixes or Trustees. SIXTH: Riqhts and Liabilities of ~Yecutrix ~-d Trustee. (A) No bond or other security shall be required of any Executrix. (B) This instrument always shall be construed in favor of the validity of any act or omission by any Executrix, and any Executrix shall not be liable for any act or omission except in the case of gross negligence, bad faith or fraud. Specifically, in assessing the propriety of any investment, the overall performance of the entire Estate shall be taken into account. (C) Each Executrix shall be entitled to receive reasonable compensation for services actually rendered to my estate, in an amount the Executrix normally and customarily charges for performing similar services during the time which she performs the services. SEVENTH: Tax Elections. (A) In determining the estate, inheritance and income tax liability relating to my Estate, the Executrix's decision as to all available tax elections shall be conclusive on all concerned. In accordance with IRC Section 2632(a) and without regard to whether a Federal estate tax return is actually filed, my Executrix shall allocate so much of the Federal Generation Skipping Transfer (GST) exemption amount as will fully exempt any generation skipping transfer which may occur under this Will. (B) The Executrix may, in its discretion, determine the date as of which my gross estate shall be valued for the purpose of determining the applicable tax payable by reason of my death. (C) The Executrix may, in her discretion, decide whether all or any part of certain deductions shall be taken as income tax deductions (even though theymay equal or exceed the taxable income of my estate and whether or not claimed or of benefit on my estate's income tax return) or as estate tax deductions when a choice is available; and in the event that all or any part of such deductions are taken as income tax deductions, no adjust~t of income and principal accounts in my estate shall be ma~e;~ ~ result of such decisions. LAST WILL AND TESTAmeNT 0! ETHELW~N I. KAUTZ PA~E 8 EIGHTH: Spendthrift Provision. No beneficiary shall have the power to anticipate, encumber or transfer his or her interest in the estate in any manner other than by the valid exercise of a power of appointment. No part of the estate shall be liable for or charged with any debts, contracts, liabilities or torts of a beneficiary or subject to seizure or other process by any creditor of a beneficiary. NINTH: Definitions and ~eneral Provisions. (A) Survival. Any beneficiary who dies within sixty (60) days after my death shall be considered not to have survived me. (B) Captions. The captions set forth in this Will at the beginning of the various articles hereof are for convenience of reference only and shall not be deemed to define or limit the provisions hereof or to affect in any way their construction and application. (C) Children. As used in this Will, the words "child" and "children" shall include persons who are legally adopted and the issue of said persons, whether born in or out of wedlock, so long as any person born out of wedlock is acknowledged in a written instrument executed by the one of their natural parents who is a descendant of mine to be the child of said descendant. The word "issue" shall include descendants of all generations including adopted persons. A posthumous child shall be considered as living at the death of his parent. The birth to me or the adoption by me of a child or children subsequent to the execution of this Will shall not operate to revoke this Will. (D) Code. Unless otherwise stated, all references in my Will to section and chapter numbers are to those of the Internal Revenue Code of 1986, as amended, or the corresponding provisions of any subsequent federal tax laws applicable to my estate. (E) Other terms. The use of any gender includes the other genders, and the use of either the singular or the plural includes the other. (F) Powers of Appointment are ~-~-ercised. By this Will I timeeXerciSeof myanYdeathand all Powers of Appointment which I possess/air]the except any power of appointment which I/po~sess under the Trust described in Paragraph FIRST (C), abo LAST WILL AND TESTAMENT O__F ETHELWYN I. KAUTZ PAGE 9 IN WITNESS WHEREOF, I, ETHELWYN I. KAUTZ, the Testatrix, have to this my Last Will and Testament, typewritten on ten (10) pages, including the Acknowledgment and Affidavit, set my hand and seal this 18th day of November, 1998. Signed., sealed, published and declared by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who have hereunto subscribed our names at her request, as witnesses hereto, in the presence of the said Testatrix, and in the presence of each other. Each of us further declares that he or she believ~.~ the Testatrix to be of sound mind and memory. The prece~ng instrument consists of this and nine (9) other consecutively numbered typewritten ~ckn( ~l~gement and Affidavit. pages including the (pr] nt name) (print name) ACKNOWLEDGMENT AND AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA : : COUNTY OF CUMBERLAND : SS: The Testatrix and the witnesses whose names are signed and subscribed to the attached or foregoing instrument, being first duly sworn and qualified according to law, do hereby acknowledge, depose and say to the undersigned authority, that the Testatrix signed and executed the instrument as her Last Will in the presence of the witnesses; that she signed it willingly or willingly directed another to sign it for her; that she executed it as her free and voluntary act for the purposes therein expressed; that each of the witnesses were present and saw the Testatrix sign and execute the instrument as her Last Will; that each subscribing witness in the hearing and sight of the Testatrix signed the will as witnesses; and that to the best of their knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Sworn to or affirmed, subscribed to, and acknowledged, before me by the above-named Testatrix and witnesses, this 18th day of ~ot]ary Pub]~fc U / My Co~ission E~ires: Notarial Seal Linda Lee Gates, Notary Public Shiremanstown Boro, Cumberland County Commission Expires Oct. 9, 1999 . i,;aoer, Pennsylvania Association of Notaries THE KAUTZ FAMILY TRUST dated November 18, 1998 THE KAUTZ FAMILY TRUST THIS TRUST AGREEMENT is executed in triplicate on this 18th day of November, 1998, by and between ETHELWYN I. KAUTZ, now of 2245 Lambs Gap Road, Enola, Cumberland County, Pennsylvania 17025 (hereinafter called "Settlor") and LORI A. MAILEY, now of 3 K Roberts Path, Sparks, Maryland, 21152 (hereinafter called "Trustee"). ARTICLE I. TRUST ESTATE 1.01. Initial Principal. Settlor, desiring to establish an irrevocable trust, does hereby irrevocably transfer, assign and deliver to the Trustee and its successors, and assigns the assets listed on Schedule A, attached hereto and made a part hereof. As further evidence of such assignment, the Settlor has executed or will execute or cause to be executed such other instruments as may be required for the purposes of completing the assignment or transfer of title to such property to the Trustee. The Trustee accepts such transfer and assignment to itself as Trustee, and undertakes to hold, manage, invest and reinvest the assets of this Trust, and to distribute the income and principal of the Trust in accordance with the provisions of this Agreement. 1.02. Additional Principal. The Settlor and any other person or persons, with the consent of the Trustee, shall have the right at any time to make additions to the corpus of this Trust or any share thereof hereby established. Ail such additions shall be held, governed, and distributed by the Trustee in accordance with the terms and conditions of this Agreement. The Trustee, in its sole discretion, may require, as a prerequisite to accepting property, that the transferring party provide evidence satisfactory to the Trustee that (i) the property is not contaminated by any hazardous or toxic materials or substances; and (ii) the property is not being used and has never been used for any activities directly or indirectly involving the generation, use, treatment, storage, disposal, release or discharge of any hazardous or toxic materials or substances. 1.03 Disclaimer. The Trustee shall have the right to disclaim, in whole or in part, prior to its acceptance by the Trustee, any interests in property for any reason, including but not limited to a concern that such property could cause potential liability under any federal, state, or local environmental law. 1 ARTICLE II. IRREVOCABILITY OF TRUST 2.01. Irrevocability. Settlor has been advised of the consequences of an irrevocable trust and hereby declares that this Trust shall be irrevocable and shall not be altered, amended, revoked, or terminated by Settlor or any other person or persons. ARTICLE III. LIFE INSURANCE POLICIES 3.01. General Provisions. If any insurance policies are transferred into this Trust, the Trustee shall be vested with all right, title, and interest in and to the transferred policies of insurance, and is authorized and empowered to exercise and enjoy, for the purposes of the Trust herein created and as absolute owner of such policies of insurance, all the options, benefits, rights and privileges under such policies, including the right to borrow upon and to pledge them for a loan or loans. The Trustee takes all rights, title, and interest in and to the above stated insurance policies subject to any prior split-dollar life insurance agreement and assignments, which may be in effect at the time of transfer. The insurance companies which have issued policies are hereby authorized and directed to recognize the Trustee as absolute owner of such policies of insurance and as fully entitled to all options, rights, privileges, and interests under such policies, and any receipts, releases, and other instruments executed by the Trustee in connection with such policies shall be binding upon all persons interested in this Trust. The Settlor hereby relinquishes all rights, title, interest and powers in such policies of insurance which Settlor may own and which rights, title, interest and powers are not assignable, and will, at the request of the Trustee, execute all other instruments reasonably required to effectuate this relinquishment. 3.02. Payment of Premiums. The Trustee shall be under no obligation to pay the premiums which may become due and payable under the provisions of any policy of insurance which may be transferred or assigned to this Trust, or to make certain that such premiums are paid by the transferor of such policy, or to notify any persons of the nonpayment of such premiums, and the Trustee shall be under no responsibility or liability of any kind in case such premiums are not paid, except the Trustee shall apply any dividends received on such policies to the payment of premiums thereon. Upon notice at any time during the continuance of this Trust that the premiums due upon such policies are in default, or that premiums which will become due will not be paid, either by the transferor or by any other person, the Trustee, within its sole discretion, may apply any cash values attributable to such policy to the purchase of paid-up insurance or of extended insurance, or may borrow upon such policy for the payment of premiums due thereon, or may accept the cash values of such policy upon the policy's forfeiture. In the event that the Trustee receives the cash value of such policy upon its forfeiture for nonpayment of premiums, the amount received shall be added to the corpus of this Trust, and shall be administered according to the terms of this Agreement. If the insured under such policies of insurance, becomes totally and permanently disabled within the meaning of any policies and because thereof the payment of premiums, or any of them, shall during the pendency of such disability, be waived, the Trustee, upon receipt of such knowledge, shall promptly notify the insurance company which has issued such policies, and shall take any and all steps necessary to make such waiver of premium provision effective. 3.03. Duties of Trustee With Regard to Life Insurance Policies. The Trustee shall be under no obligation or duty whatever except with respect to the safekeeping of such policies of insurance and the duty to receive such sums as may be paid to them, in accordance with the requirements of this Trust, by the companies issuing such policies, and to hold, manage and disburse such proceeds subject to the terms of this Agreement. Upon the death of the insured, the Trustee shall make reasonable efforts to carryout the provisions of this Agreement, including the maintenance or defense of any suit, provided, however, the Trustee shall be under no duty to maintain or enter into any litigation unless its expenses, including counsel fees and costs, have been advanced or guaranteed in an amount and in a manner reasonably satisfactory to the Trustee. The Trustee may repay any advances made by it or reimburse itself for any such fees and costs from any corpus or income of this Trust. ARTICLE IV. TRUST DISTRIBUTIONS 4.01. Trust PrinciDal. The entire corpus of this Trust, including the assets initially transferred to this Trust, subsequent additions to this Trust, and the proceeds of any sale, exchange or investment of such Trust assets, shall be used for the purposes herein contained. 4.02. Income Distribution. During the Settlor's lifetime, the Trustee shall distribute all of the net income of the trust to, or for the benefit of, ETHELWYN I. KAUTZ. The Trustee shall make no distributions of principal to ETHELWYN I. KAUTZ. 4.03. Principal Distributions. Upon the death of the Settlor, the Trust shall terminate. Upon termination, the remaining trust estate shall be distributed to Settlor's granddaughter, LORI A. MAILEY, per stirpes. If the Settlor's granddaughter, LORI A. MAILEY, predeceases the termination of this Trust, then her share shall be distributed equally to her issue, per stirpes. If the Settlor's granddaughter, LORI A. MAILEY, predeceases the termination of this Trust without leaving issue, then her share shall be distributed to Settlor's granddaughter, LISA M. HOCH, or in the event that LISA M. HOCH does not survive, then to Settlor's great-granddaughter, MELISSA M. HOCH. 3 4.04. General Power of Appointment. Settlor's granddaughter, LORI A. MAILEY, is hereby granted the general power to appoint some or all of the principal of this Trust to herself, her estate, her creditors, the creditors of her estate, in such' proportions and upon such terms (in trust, outright gifts, or in any other manner) as she deems advisable. This power shall not be exercisable under her Will. If Settlor's granddaughter fails, either in whole or in part, to exercise this general power of appointment herein granted, the unappointed principal shall continue in trust and shall be administered according to the terms of this Trust. Upon the death, resignation, removal or incapacity of Settlor's granddaughter, then Settlor shall have the authority to designate any person, other than herself, her creditors, or her estate, or her agents, successors or assigns, with the authority to exercise this General Power of Appointment. 4.05. Broad Special Power of Appointment. ETHELWYN I. KAUTZ is hereby granted the special power to appoint, at any time and from time to time, the principal of this Trust, in whole or in part, and in any manner and in such proportions as she deems advisable to whomever she desires. This power shall be exercisable by her Will, specifically referring to this special power of appointment in this paragraph 4.05 of this Trust. This special power of appointment does not grant to ETHELWYN I. KAUTZ the power to appoint the principal of this trust to herself, her estate, her creditors, or the creditors of her estate. If ETHELWYN I. KAUTZ fails, either in whole or in part, to exercise this special power of appointment herein granted, the unappointed principal shall continue in trust and shall be administered according to the terms of this trust. ARTICLE V. POWERS OF TRUSTEE 5.01. General Powers. In addition to such other powers and duties as may have been granted elsewhere in this Trust, but subject to any limitations contained elsewhere in this Trust, the Trustee shall have the following powers and duties: A. In the management, care and disposition of this Trust, the Trustee shall have the power to do all things and to execute such deeds, instruments, and other documents as may be deemed necessary and proper, including the following powers, all of which may be exercised without order of or report to any court: (1) To sell, exchange, or otherwise dispose of any property, real, personal or mixed, wheresoever located, at any time held or acquired hereunder, at public or private sale, for cash or on terms as may be determined by the Trustee, without advertisement, including the right to lease for any term notwithstanding the period of the Trust, and to grant options, including an option for a period beyond the duration of the Trust. (2) To invest all monies in such stocks, bonds, securities, investment companies or trust shares, mortgages, notes, choses in action, real estate, improvements thereon, and other property as the Trustee may deem best, without regard to any law now or hereafter in force limiting investments of fiduciaries. (3) To retain for investment any property deposited with the Trustee hereunder. (4) To vote in person or by proxy any corporate stock or other security and to agree to or take any other action in regard to any reorganization, merger, consolidation, liquidation, bankruptcy or other procedure or proceedings affecting any stock, bond, note or other security held by this Trust. (5) To use lawyers, real estate brokers, accountants and any other agents, if such employment is deemed necessary or desirable, and to pay reasonable compensation for their services. (6) To compromise, settle or adjust any claim or demand by or against the Trust and to agree to any rescission or modification of any contact or agreement affecting the Trust. (7) To renew any indebtedness, as well as to borrow money, and to secure the same by mortgaging, pledging or conveying any property of the Trust, including the power to borrow from the Trustee (in the Trustee's individual capacity) at a reasonable rate of interest. (8) To retain any business interest transferred to the trustee, as shareholder, security holder, creditor, partner or otherwise, for any period of time whatsoever, even though the interest may constitute all or a large portion of the trust principal; to comply with the provisions of any agreement restricting transfer of the interest; to participate in the conduct of the related business or rely upon others to do so, and to take or delegate to others discretionary power to take any action with respect to its management and affairs which an individual could take as outright owner of the business or the business interest, including the voting of stock (by separate trust or otherwise regardless of whether that separate trust will extend for a term within or beyond the term of the trust) and the determination of all questions of policy; to execute and amend partnership agreements; to participate in any incorporation, reorganization, merger, consolidation, sale of assets, recapitalization, liquidation or dissolution of the business, or any change in its nature, or in any buy- sell, stock restriction, or stock redemption agreements; to invest in additional stock or securities of, or make secured, unsecured, or subordinated loans to, the business with trust funds; to take all appropriate actions to prevent identify, or respond to actual or threatened violations of any environmental law or regulation thereunder; to elect or employ with compensation, as directors, officers, employees, or agents of the business, any persons, including a trustee of any trust held under this instrument, or any director, officer, employee, or agent of a corporate trustee of any trust held under this instrument, without adversely affecting the compensation to which that trustee would otherwise be entitled; to rely upon reports of certified public accountants as to the operations and financial condition of the business, without independent investigation; to deal with and act for the business in any capacity (including in the case of a corporate trustee any banking or trust capacity and the loaning of money out of the trustee's own funds) and to be compensated therefor; and to sell or liquidate the business or any interest in the business. (9) To register any stock, bond or other security in the name of a nominee, without the addition of words indicating that such security is held in a fiduciary capacity, but accurate records shall be maintained showing that the stock, bond or other security is a trust asset and the Trustee shall be responsible for the acts of the nominee. (10) To set aside as a separate trust, to be held and administered upon the same terms as those governing the remaining trust property, any interests in property, for any reason, including but not limited to a concern that such property could cause potential liability under any federal, state, or local environmental law. B. Whenever the Trustee is directed to distribute any trust principal in fee simple to a person who is then under twenty-one (21) years of age, the Trustee shall be authorized to hold such property in trust for such person until he becomes twenty-one (21) years of age, and in the meantime shall use such part of the income and the principal of the trust as the Trustee may deem necessary to provide for the proper support and education of such person in the standard of living to which he has become accustomed. If such person should die before becoming twenty-one (21) years of age, the property then remaining in trust shall be distributed to the personal representative of such person's estate. 6 C. In making distributions from the Trust to or for the benefit of any minor or other person under a legal disability, the Trustee need not require the appointment of a ~uardian, but shall be authorized to pay or deliver the distribution to the custodian of such person, to pay or deliver the distribution to such person without the intervention of a guardian, to pay or deliver the distribution to the legal guardian of such person if a guardian has already been appointed, or to use the distribution for the benefit of such person. D. In the distribution of the Trust and any division into separate trusts and shares, the Trustee shall be authorized to make the distribution and division in money or in kind or in both, regardless of the basis for income tax purposes of any property distributed or divided in kind, and the distribution and division made and the values established by the Trustee shall be binding and conclusive on all persons taking hereunder. The Trustee may in making such distribution or division allot undivided interests in the same property to several trusts or shares. E. If at any time after Settlor's death the total fair market value of the assets of any trust established or to be established hereunder is so small that the corporate Trustee's annual fee for administering the trust would be equal to or less that the minimum annual fee set forth in the Trustee's regularly published fee schedule, then the Trustee in its discretion shall be authorized to terminate such trust or to decide not to establish such trust, and in such event the property then held in or to be distributed to such trust shall be distributed to the persons who are then or would be entitled to the income of such trust. If the amount of income to be received by such persons is to be determined in the discretion of the Trustee, then the Trustee shall distribute the property among such of the persons to whom the Trustee is authorized to distribute income, and in such proportions, as the Trustee in its discretion shall determine. F. The Trustee shall be authorized to lend or borrow, including the right to lend to or borrow from the Settlor's estate, at an adequate rate of ±nterest and with adequate security and upon such terms and conditions as the Trustee shall deem fair and equitable. G. The Trustee shall be authorized to sell or purchase, at the fair market value as determined by the Trustee, any property to or from Settlor's estate, the estate of Settlor's spouse, or any trust created by Settlor or Settlor's spouse during life or by will, even though the same person or corporation may be acting as executor of Settlor's estate or the estate of Settlor's spouse or as trustee of any other such trusts and as the Trustee of this Trust. H. The Trustee shall have discretion to determine whether items should be charged or credited to income or principal or allocated between income and principal as the Trustee may deem equitable and fair under all the circumstances, including the power to amortize or fail to amortize any part or all of any premium or discount, to treat any part or all of the profit resulting from the maturity or sale of any asset, whether purchased at a premium or at a discount, as income or principal or apportion the same between income and principal, to apportion the sales price of any asset between income and principal, to treat any dividend or other distribution on any investment as income or principal or to. apportion the same between income or principal, to charge any expense against income or principal or apportion the same, and to provide or fail to provide a reasonable reserve against depreciation or obsolescence on any asset subject to depreciation or obsolescence, all as the Trustee may reasonably deem equitable and just under all of the circumstances. I. The Trustee is hereby authorized and empowered to purchase such insurance policies as it deems appropriate. 5.02. Voting by Trustee. When the authority and power under this Trust is vested in two (2) or more Trustees or Co- Trustees, the authority and powers are to be jointly by the Trustees or Co-Trustees. A majority of the Trustees or Co-Trustees may exercise any authority or power granted under this Trust Agreement or granted by law, and may act on behalf of the Trust. Any attempt by one such Trustee to act for the Trust on other than ministerial acts shall be void. The action of one such Trustee on behalf of the Trust may be (but need not be) validated by a subsequent ratification of the act by a majority of the Trustees or Co-Trustees. 5.03 Trustees Power to Deal with ~nvironmental Hazards. The Trustee shall have the power to use and expend the trust income and principal to (i) conduct environmental assessments, audits, and site monitoring to determine compliance with any environmental law or regulation thereunder; (ii) take all appropriate remedial action to contain, clean up or remove any environmental hazard including a spill, release, discharge or contamination, either on its own accord or in response to an actual or threatened violation of any environmental law or regulation thereunder; (iii) institute legal proceedings concerning environmental hazards or contest or settle legal proceedings brought by any local, state, or federal agency concerned with environmental compliance, or by a private litigant; (iv) comply with any local, state or federal agency order or court order directing an assessment, abatement or cleanup of any environmental hazards; and (v) employ agents, consultants and legal counsel to assist or perform the above undertakings or actions. Any expenses incurred by the trustee under this paragraph may be charged against income or principal as the trustee shall determine. ARTICLE VI. SPENDTHRIFT PROVISION 6.01. General Provision. No beneficiary shall have the power to anticipate, encumber or transfer his interest in the Trust Estate in any manner other than by the valid exercise of a Power of Appointment. No part of the Trust Estate shall be liable for or charged with any debts, contracts, liabilities or torts of a beneficiary or subject to seizure or other process by any creditor of a beneficiary. ARTICLE VII. CONSTRUCTION OF TRUST 7.01. Choice of Law. This Trust shall be administered and interpreted in accordance with the laws of the Commonwealth of Pennsylvania. 7.02. Code. Unless otherwise stated, all references in this Trust to section and chapter numbers are to those of the Internal Revenue Code of 1986, as amended, or corresponding provisions of any subsequent federal tax laws applicable to this Trust. 7.03. Other Terms. Unless the context otherwise requires, the use of one or more genders in the text includes all other genders, and the use of either the singular or the plural in the text includes both the singular and the plural. 7.04. Captions. The captions set forth in this Agreement at the beginning of the various divisions hereof are for convenience of reference only and shall not be deemed to define or limit the provisions hereof or to affect in any way their construction and application. 7.05. Situs of Trust. The Trust shall have its legal situs in Cumberland County, Pennsylvania. ARTICLE VIII. COMPENSATION OF TRUSTEE AND APPOINTMENT OF SUCCESSOR TRUSTEE 8.01. Compensation. The Trustee shall receive as its compensation for the services performed hereunder that sum of money, based on an hourly charge or percentage rate, which the Trustee normally and customarily charges for performing similar services during the time which it performs these services. 8.02. Removal of Trustee. Settlor may remove the Trustee, at any time or times, with or without cause, upon thirty (30) days written notice given to the current Trustee. Upon the death of the Settlor, a majority of the current beneficiaries may remove the Trustee, at any time or times, with or without cause, upon thirty (30) days written notice given to the Trustee. Upon the removal of the Trustee, a successor Trustee shall be appointed in accordance with the terms set forth in Paragraph 8.03. 8.03. Appointment of Successor Truste~. The Trustee may resign at any time upon thirty (30) days written notice given to the Settlor if Settlor is living, or in the event of Settlor's death, upon thirty (30) days written notice given to the current beneficiary or beneficiaries (including a beneficiary's natural or legal guardian or legal representative), hereunder. Upon the death, resignation, removal or incapacity of the Trustee, a successor trustee may be appointed by the Settlor during Settlor's lifetime, or, after Settlor's death, by a majority of the current income beneficiaries. The first successor Trustee shall be RITA M. KEIM. Any other successor trustee shall be a financially sound and competent corporate trustee. Any successor trustee thus appointed, or, if the Trustee shall merge with or be consolidated with another corporate fiduciary, then such corporate fiduciary, shall succeed to all the duties and to all the powers, including discretionary powers, herein granted to the Trustee. 8.04. Exoneration of Trustee. No Trustee shall be liable for any loss or depreciation in value sustained by the Trust as a result of the Trustee retaining any property upon which there is later discovered to by hazardous materials or substances requiring remedial action pursuant to any federal, state, or local environmental law, unless the Trustee contributed to the loss or depreciation in value through willful default, willful misconduct, or gross negligence. 8.05. Indemnification of Trustee Upon Distribution. Notwithstanding any contrary provision in this Trust Agreement, the Trustee may withhold a distribution to a beneficiary until receiving from the beneficiary an indemnification an agreement in which the beneficiary agrees to indemnify the Trustee against any claims filed against the Trustee as an "owner" or "operator" under the Comprehensive Environmental Response, Compensation and Liability Act of 1980, as from time to time amended, or any regulation thereunder. ARTICLE IX. PERPETUITIES CLAUSE 9.01. General Provision. Notwithstanding anything to the contrary in this Trust, each disposition I have made here, legal or equitable, to the extent it can be referred in its postponement of becoming a vested interest to a duration measured by some life or lives in being at the time of my death is definitely to vest in interest, although not necessarily in possession, not later that twenty-one (21) years after such lives (and any period of gestation involved); or, to the extent it cannot be referred in any such postponement to such lives, is to so vest not later than twenty-one (21) years from the time of my death. 10 ARTICLE X. ACQUISITION OF UNITED STATES TREASURY BONDS ELIGIBLE FOR TAX PAYMENT; PAYMENT OF TAXES, FUNERAL EXPENSES, AND EXPENSES OF ADMINISTRATION 10.01. Acquisition of Bonds. The Trustee may, at any time, without the prior approval or direction of the Settlor and whether or not the Settlor is able to manage Settlor's own affairs, acquire United States Treasury Bonds selling at a discount, which bonds are redeemable at their par value plus accrued interest thereon for the purposes of applying the proceeds to the payment of the United States estate tax on the Settlor's estate; and the Trustee may borrow from any lender, including itself, with or without security, to so acquire these bonds. 10.02. Payment of United States Estate Tax by Bond RedemDtion. The Settlor directs that any United States Treasury Bonds which may be redeemed at their par value plus accrued interest thereon for the purpose of applying the proceeds to the payment of the United States estate tax imposed on the Settlor's estate, and which are held by the Trustee, shall, to the extent of the amount determined to be required for payment of the estate tax, be distributed to the legal representative of the Settlor's estate to be used by the legal representative ahead of any other assets and to the fullest extent possible to pay the estate tax. 10.03. Payment of Death Taxes and Other Estate Settlement Costs. After the Trustee has complied with paragraph 10.02, above, and ascertained from the legal representative that all such bonds have been redeemed in payment of the United States estate tax, the Trustee shall also ascertain from the legal representative whether the legal representative has sufficient assets to pay the remaining legacy, succession, inheritance, transfer, estate and other death taxes or duties (except the additional estate tax imposed by Section 2032(c), or corresponding provisions of the Internal Revenue Code of 1986 applicable to the Settlor's estate and imposing the tax) levied or assessed against the Settlor's estate (including all interest and penalties thereon), all of which taxes, interest and penalties are hereafter referred to as the death taxes, interest and penalties. If the legal representative advises the Trustee that insufficient funds exist to pay all the death taxes, interest and penalties, the Trustee shall then pay to the legal representative from the trust property, an amount equal to all the death taxes, interest and penalties in excess of the funds available to the legal representative for this purposes, which payments are to be made without apportionment. In making the payments, the Trustee shall use only those assets or their proceeds which are includable in the Settlor's gross estate for purposes of the United States estate tax and shall not impair the marital portion without first exhausting the entire non-marital portion. 11 If the Executor of the Settlor's estate, in such Executor's sole discretion, shall determine that appropriate assets of Settlor's estate are not available in sufficient amount to pay (1) the Settlor's funeral expenses, and (2) expenses of administering the Settlor's estate, the Trustee shall, upon the request of the Executor of the Settlor's estate, contribute from the principal of the trust estate the amount of such deficiency; and in connection with any such action the Trustee shall rely upon the written statement of the Executor of the Settlor's estate as to the validity and correctness of the amounts of any such expenses, and shall furnish funds to such Executor so as to enable such Executor to discharge the same, or to discharge any part of all thereof itself by making payment directly to the person entitled or claiming to be entitled to receive payment thereof. No consideration need be required by the Trustee from the Executor of Settlor's estate for any disbursement made by the Trustee pursuant hereto, nor shall there be any obligation upon such Executor to repay to the Trustee any of the funds disbursed by it hereunder, and all amounts disbursed by the Trustee pursuant to the authority hereby conferred upon it shall be disbursed without any right in or duty upon the Trustee to seek or obtain contribution or reimbursement from any person or property on account of such payment. The Trustee shall not be responsible for the application of any funds delivered by it to the Executor of the Settlor's estate pursuant to the authority herein granted, nor shall the Trustee be subject to liability to any beneficiary hereunder on account of any payment made by it pursuant to the provisions hereof. IN WITNESS WHEREOF, the Settlor and Trustee have hereunto set their~nds and seals as of the day and year first above written. (SEAL) 12 COMMONWEALTH OF PENNSYLVANIA : COUNTY OF CUMBERLAND : SS: On this, the 18th day of November, 1998, before me, a Notary Public, the undersigned officer, personally appeared ETHELWYN I. KAUTZ, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within Trust Agreement, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have set my hand and official Seal. ~ot/ary Public 7 ./ My Co(~-u,ission Expires: Notarial Seal Llnda Lee Gates, Notary Public Shiremanstown Boro, Cumberland County My Commission Expires Oct. 9,'19~ r,",~mber, Pennsylvania Association of Notaries foregoing Trust Agreement was delivered, and is hereby at Lemoyne, Pennsylvania, on November 18, 1998. X~-_ (SEAL) 13 SCHEDULE "A" SCHEDULE REFERRED TO IN THE ANNEXED TRUST AGREEMENT DATED: NOVEMBER 18, 1998 FROM ETHELWYN I. KAUTZ, SETTLOR TO LORI A. MAILEY, TRUSTEE ProPerty Description: 14 PA REV-1500 SCHEDULE E CASH, BANK DEPOSITS & MISCELLANEOUS PERSONAL PROPERTY APPRAISAL Personal Property of ~'~2-A/'~/- Z~'),'A/~.~ v 7-2- z=:.s~ .2 -2_ z/~-Z .~,~ES',~ 4- ?/z d z::.,u e z4 /04, Appraised by Chuck E. Bricker AU094-L Date c~'-'/~ - ~..~. ITEM VALUE ITEM VALUE ~~ /o,~ DEPARTMENT OF TRANSPORTATION CERTIFICATE OF TITLE FOR A VEHICL~~0~979 issued itt accordance with Section 1105 of the Vehicle Code, Title 75, Peonsylvania Cottsolidated Statutes 031007 882180011001462-001 ETHELNYN I KALTZ 2245 LAMBS GAF RD ENOLA PA 1702..c " o%64a%Ol ' .... " CODELEGEND A = ANTIQUE VEHICLE C = CLASSIC VEHICLE F = OUT OF STATE VEHICLE H = AGRICULTURAL VEHICLE L = LOGGING VEHICLE~ 'P~ FORMERL¥"A~ POLICE, VEHICLE R = RECONSTRUCTED VEHICLE X FORMERLY A TAXI"~'~' ~ 0 SECOND LIEN FAVOR OF: LIEN RELEASED FL~I-;N'rATI V E DATE I certify that reasonable diligence has been used itt examining the statements presented in the application for Certificate of Title to the vehicle described hereon, and that the proof of ownership of said vehicle presented with said appllcatioa warrants the issuance of this certificate uaming the applicant tls lanful owner of said vehicle. Wherefore. I certify that as of the date inscribed hereon, the official records of the Pennsylvania Department of Transportation reflect that said applicant is the lawful owner oJ'said vehicle. LIEN Hal,DER BY · N. ADA Appraisal Gu/des - Get a Value - Older Used Cars - Domestic Page 1 of 2 NADJ~~.S~-- Your Destination for Free Vehicle Information .H~.me I e.uy.a...Ou..Pe. I .F^O. I _C.~.0.B.C.t..U_S. Powere Free Price Quote J Find a Car I Find a Dealer I Buy a Vehicle I Sell a Vehicle I Free Finance Quote I Free Insurance ~/arra[Lty_ I _C4msumer_I/ps I I~ew Car_Ee~ e~s I _(33~mkX_our_C~li_t I The Rece~nized Authority Si~ Older Used Car Consumer Pricing 1983 to 1991 CHE.VRO.LET 1988 CAVALIER-FWD Body Style: Station Wagon 4 Door Model Number: JC8 Weight: 2,413 Low Retail: $975 Average Retail: $1,625 High Retail: $2,050 Free. Free Click below on the first letter of the Manufacturer's Name. [-A I B ICI_DI_E IEILI U IOI P] [ Domestic Cars I Import Ca_~m. J Trucks, Vans & SUVs ] You have received I of the ! 0 free daily values for Older Used Cars - Domestic Low Retail Value -- A Iow retail vehicle may have extensively visible wear and tear. Th, body may have dents and other blemishes. The buyer can expect to invest in and/or mechanical work. It is likely that the seats and carpets will have visible vehicle should be able to pass local inspection standards and be in safe running Low retail vehicles usually are not found on dealer lots. Average Retail Value -- An average retail vehicle should be clean and without glarin defects. Tires and glass should be in good condition. The paint should match and have good finish. The interior should have wear in relation to lhe age of the vehicle. Carpet seat upholstery should be clean, and all power options should work. The mileage should be within the acceptable range for the model year. An Average Retail vehicle on a dealer lot may include a limited warranty or guarantee, and possibly a current safety and/or emission inspection (where applicable). High Retail Value -- A high retail vehicle should be in flawless condition. All power http://www2.nadaguides.com/ValueReport.asp?UserlD=053F02041E0&DID=37313&Typ... 2/26/2002 PA REV-1500 SCHEDULE F JOINTLY OWNED PROPERTY Membersl FEDERAL CREDIT UNION INSURANCE DEPARTMENT 5000 Louise Drive P. O. Box 40 Mechanicsburg, PA 17055 1-800-283-2328 or (717) 697-1161 ACCOUNTNAME: ..REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Interest Earned from 1/1/02 to Date of Death Name of Joint Owner Date Joint Ownership Created !NVESTMENT SAVINGS ACCOUNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Interest Earned from 1/1/02 to Date of Death Name of Joint Owner Date Joint Ownership Created CHECKING ACCOUNT. Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Interest Earned from 1/1/02 to Date of Death Name of Joint Owner Date Joint Ownership Created Ethelwyn I. Kautz 8005 -00 181163 -00 08/19/1965 01/14/1999 $25,82 $129.06 $.oo $.oo $25.82 $129.06 $.00 $.19 Rita M. Keim None 11/16/1998 8005 --05 181163 -05 11/16/1998 01/14/1999' $3,168.81 $28,889.79 $.oo $.oo $3,168.81 $28,889.79 $4.81 $50.95 Rita M. Keim None 11/16/1998 8005 -11 181163 -11 02/26/1982 04/13/1999 $5,595.57 $315.97 $.oo $.oo $5,595.57 $315.97 $4.72 $.00 Rita M. Keim None 11/16/1998 ME~'~ERS 1sT FEI;~A~DIT UNION Insurance Products Supervisor April 2, 2002 Estate of: ETHELWYN I. KAUTZ Date of Death: February 1, 2002 Social Security Number: 203-10-9240 allfirst March 28, 2002 Gates, Halbruner & Hatch, P.C. Att: Traci L. Sepkovic 1013 Mumma Road, Suite 100 Lemoyne, PA 17043 Allfirst Financial Center N.A. P.O. Box 900 Millsboro. DE 19966 Dear Ms. Sepkovic: Estate of Ethelwyn I. Kautz Date of Death: February 1, 2002 Social Security Number: 203-10-9240 In response to your request, please be advised that at the time of death, the above- named decedent had on deposit with this bank the following accounts. Account 7'iipe ........................... Golden Age Checking Account Account Number. ...................... 0050320831 Ownership (Names of) ............... Ethelwyn I. Kautz or Rita M. Keim or Robert Kautz Opening Date ........................... 03/28/74 Balance on Date of Deattt .......... $1,245.41 Accrued Interest. ...................... 0.00 Total ...................................... $1,245.41 o Account 7~pe ........................... Safe Deposit Box Account Number. ...................... 00001000553100001140 Ownership (Names of) ...............Ethelwyn I. Kautz Closed 2/8/02 This reSl~Omse does not apply to any assets held with Al~fl~st Bro&erage, where Al~Itrst Bank is servin~ as a t~tee, nor to any credit cards owned by Bank of America bearing Al~first l~mks's name · Page 2 March 28, 2002 If you have any further questions on these accounts, please contact the branch of record: 423 North Enola Road, Enola, PA 17025, telephone 717-255-2261. Sincerely, Mary Anne Macielag Associate I/CIS {302) 934-2240 PA REV-1500 SCHEDULE G INTER-VIVOS TRANSFERS and MISCELLANEOUS NON-PROBATE PROPERTY Membersl FEDERAL CREDIT UNION INSURANCE DEPARTMENT 5000 Louise Drive P. O. Box 40 Mechanicsburg, PA 17055 1-800-283-2328 or (717) 697-1161 ACCOUNTNAME: REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Interest Earned from 1/1/02 to Date of Death Name of Joint Owner Date Joint Ownership Created INVESTMENT SAVINGS ACCOUNT' Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Interest Earned from 1/1/02 to Date of Death Name of Joint Owner Date Joint Ownership Created CHECKING ACCOUNT. Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Interest Earned from 1/1/02 to Date of Death Name of Joint Owner Date Joint Ownership Created d Ethelwyn I. Kautz 8005 -00 181163 -00 08/19/1965 01/14/1999 $25,82 $129.06 $.oo $.oo $25.82 $129.06 $.oo $.19 Rita M. Keim None 11/16/1998 8005 -05 181163 -05 11/16/1998 01/14/1999 $3,168.81 $28,889.79 $.oo $.oo $3,168.81 $28,889.79 $4.81 $50.95 Rita M. Keim None 11/16/1998 8005 -11 181163 -11 02/26/1982 04/13/1999 $5,595.57 $315.97 $.oo $.oo $5,595.57 $315.97 $4.72 $.00 Rita M. Keim None 11/16/1998 Oenise A. Anoers Insurance Products Supervisor April 2, 2002 Estate of: ETHELWYN I. KAUTZ Date of Death: February 1, 2002 Social Security Number: 203-10-9240 TAX PARCEL NO. 10-12-2983-008 DEED THIS DEED is made the 18th day of November, in the year nin~e~i hundred and ninety-eight (1998). mo BETWEEN ETHELWYN I. KAUTZ, a widow, now of 2245 Lambs Gap Road~- Enola, Cumberland County, Pennsylvania, 17025, party of the ~s~ part, GRANTOR. ~ ~- AND ~ -~..... LORI A. MAILEY, Trustee of THE KAUTZ FAMILY TRUST, dated Nove~er[ 18, 1998, party of the second part, GRANTEE. WITNESSETH, that said party of the first part, for and in consideration of the sum of One ($1.00) Dollar, lawful money of the United States of America, well and truly paid by the said party of the second part to the said party of the first part, at or before the sealing and delivery of these presents, the receipt whereof is hereby acknowledged, has hereby granted, bargained, sold, aliened, enfeoffed, released, conveyed and confirmed, and by these presents does grant, bargain, sell, alien, enfeoff, release, convey and confirm unto the said party of the second part, her heirs, successors and assigns, ALL THAT CERTAIN house and tract of land situate in the Township of Hampden, County of Cumberland and State of Pennsylvania, bounded and described as follows, to wit: BEGINNING at a point on the Lamb's Gap Road at the corner of lands now or formerly of Wilson E. Forney; thence along said lands of' Wilson E. Forney in a westwardly direction seven hundred twenty- three and five-tenths (723.5) feet to a point at the corner of lands now or formerly of Mike Cekovic; thence along said land of Mike Cekovic in a northwardly direction two hundred forty (240) feet to a point at the corner of other lands now or formerly of Paris D. Wilfong and Flora I. Wilfong; thence along said lands of Paris D. Wilfong and Flora I. Wilfong in an eastwardly direction seven hundred fifty-six (756) feet to a point in the aforementioned Lamb's Gap Road; thence along the said road in a southwardly direction two hundred thirty-five (235) feet to a point on said road, the place of BEGINNING. CONTAINING four (4) acres of land more or less and having erected thereon a ranch-type dwelling house. BEING the same premises which Paris D. Wilfong and Flora I. Wilfong, his wife, by their deed dated December 2, 1952, and recorded in the Recorder of Deeds Office of Cumberland County, in Deed Book E, Volume 15, Page 169, granted and conveyed unto Robert Kautz and Ethelwyn I. Kautz, husband and wife. Robert Kautz died October 20, 1998, survived by his wife, Ethelwyn I. Kautz, thereby vesting full and complete title under operation of law in Ethelwyn I. Kautz, GRANTOR herein. THIS is a transfer for nominal consideration to a trustee of an living trust. TOGETHER with all and singular the buildings and improvements, ways, streets, alleys, driveways, passages, waters, watercourses, rights, liberties, privileges, hereditaments and appurtenances, whatsoever unto the hereby granted premises belonging, or in any wise appertaining, and the reversions and remainders, rents, issues, and profits thereof; and all the estate, right, title, interest, property, claim, and demand whatsoever of the said Grantor, as well at law as in equity, of, in, and to the same. TO HAVE AND TO HOLD, the said lot or piece of ground above- described, with all and singular the buildings and improvements thereon erected, hereditaments and premises hereby granted, or mentioned and intended so to be, with the appurtenances, unto the said Grantee, her heirs and assigns, to and for the only proper use and behoof of the said Grantee, her heirs and assigns forever. AND the said Grantor, for herself, her heirs, executors and administrators, does covenant, promise and agree, to and with the said Grantee, her heirs and assigns, by these presents, that she, the said Grantor, and her heirs, all and singular the hereditaments and premises hereby granted or mentioned and intended so to be, with the appurtenances, unto the said Grantee, her heirs and assigns, against her, the said Grantor and her heirs, and against all and every person and persons whomsoever lawfully claiming or to claim the same or any part thereof, by, from or under him, her, them or any of them, shall and will, subject as aforesaid, SPECIALLY WARRANT AND FOREVER DEFEND. IN WITNESS WHEREOF, the said party of the first part has hereunto set he~:~hand and seal, the day and year first above-written. COMMONWEALTH OF PENNSYLVANIA : : COUNTY OF CUMBERLAND : SS: On this, the 18th day of November, 1998, before me, a Notary Public for the Co~k~Lonwealth of Pennsylvania, the undersigned officer, personally appeared ETHELWYN I. KAUTZ, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purpose therein contained. seal. IN WITNESS WHEREOF, I have hereunto set my hand and notarial N6thry Publ%c /~ My Commission Expires: Notadal Seal I Linda Lee Gates, Notary Public Shiremanstown Bom, Cumberland County COMMONWEALTH OF PENNSYLVANIA : ~ Uy Commission Expires Oct 9,1999 : SS: L COUNTY OF CUMBE~ Member, Pennsylvan a As~9~mtion:.. . .. or. No~s.%.:.., for said County, in Deed Book No ~a~e ~,~3 .:~,,~.~%~.,:~,:~,:.t.~,-~--..--. WITNESS my hand and official seal this ~) I day of Recorder of Dee~s CERTIFICATE OF RESIDENCE ~ here~y certify that the present residence of The Ka~tz Famlly Trust ~.~:J.,'~ 3K Roberts Path Sparks, ~ 21152 RETURN DEED TO: The Kautz Family Trust Lori A. Mailey, Trus%ee 3K Roberts Path Sparks, MI) 21152 Actor fey for Grantee CLEMENT A. LEO 2ca1-1 Ip ] AI~PRAISAL OF A SINGLE FAMILY RESIDENCE L O C A T I O N : 2245 Lambs Gap Road Enola PA 17025 CLIENT : Gates 8, Associales 1013 Mumma Road, Lemoyne, PA 17043 AS OF DATE :Februao/1,2002 APPRAISER :ClementA. Leo, CREA CLEMENT A. LEO Gates & Associates 1013 Mumma Road, Lemoyne, PA 17043 In accordance with your request, I have personally inspected aud appraised tile property located at: 2245 Lambs Gap Road Enola PA 17025 The pu ~rp?sc of thc appraisa was to estimate the market value ol tile property, as improved, n unencumbered Ice simple title of ownership. The subject property consists of: Rooms 3 J~cdroolllS 1.0 Bath(s) The Ranch style residence contains Gross l.iving Area. it is my opinion that tile estimated market value of the property ils of February 1, 2002 is $ 113,000 The above inlbrmation has been automatically extracted l?om thc appraisal and inscrlcd in this cover page. 1,168 square t~et of Respectfully submitted, Clement A. Leo, CREA Property Description UNIFORM RESIDENTIAL APPRAISAL ,.EPORT File No. 2cal-11p Rroperty Address 2245 Lambs Gap Road City Enola Slate PA Zip Code 17025 Legal Description Deed Book 15E, Page 169 County Cumberland _ Assessor's Parcel No 10-12-2983 Tax Year01 RE Taxes $ 0.00Special Assessments Borrower Est ut Ethel Wynnkautz , .--- Current Owner Es of EhelWynnkautz Occupant: [XlOwner I jTena~t t Property rights appra,sed j X iFee Simple~-JLeasehold prelect Tv e ' PU 1-1Condominium (HUDNA only) HOASN/A I ~hborhood or Project N;me 'P ~ I D _ Map Reference 10-12-2983 Census Tract 0113 S~ Pri~ $ N/A Date of Sale NIA D~on ~ $ amouul of loan charges/concessions Io be paid by sel~er N/A L~er/Client Gales & Associates A~ess 1013 Mumma Road, Lemoyne, PA 17~3 Clement A Leo A~ss RSR, 308 Eas~ Penn Drive, Enola, PA 17025 Nlup ~ lover75% I~l ' I I Ioccupancy I $ib00~ (y,~ IOnefam'ly 80J X'Nolhkel ~'"~te I--IR~>'u I~1stau~ I- Is~°~. IlXlow"~ I 100 Low New 12-4famil~ 1.~J Pf~eRy value ~lncreasing ~supply ~Sho.age ~t~b.,e ~ea,n,ngl~Tenant I 500H,gh 901Uu,,,.,a;y ~".~,~v~,..,~I~vace.,(o.?l ~eUom,..~, Ico~al 51 ~eting timer ~Under3mos. iA 13~m~. IIo~.11 Ivac~.,(o~,5,~)l 170 40I Note: Race and the racial composition ef the neighbo~d are not appraisal factors. ~hborhood boundaries and characterisacs: Subj~t is I~ ~Rh ut Roule 944 We~ville Road on Lambs Gap Road. F~s that aff~I the markelability of the pro~s in the neigh~d (proximi~ In employment and amenities, emplo~enl stability, appeal to ~ neighborhh~ is comprised of propel/es re~fing similar Jn ~lity, maintenance, design and appeal. Availabili~ for this neighborh~ of mos~ s~es combined with average access Io em~ymenl, shopping ~ schools gives a similar appeal Io Ihe market on olher nearby neighborh~ds. Market condilions in the subiecl neighborhood (including support fa ii~e alive conclusions related Io Ihe Irend of properly values, demand/supply, and marketing time -- such as data on competitive properties for sale in the neighborhood, description of the prevalence of sales and financing concessions, etc.): Oveall market conditions are considered stable, morlgage interest rates are available at 6.5% Io 7.5% for 30 years. Marketing time and demand/supFly a:e - fa' similar areas in this market. New construction aclivily is moderale. No adverse marketability neighborhood factors were evident. Project Information for PUDs (If applicable) - - Is the devek)per/builder in control of the Home Owner's Association (HOA)? i _jYes ~',: ' Approximate total number of units ~n the subject project N/A Approximate total number of units for sale in the subject project N A I facilities: N/A Dimensions Topography Level S,tearea 4Acres CornerLotl ryes jxlNolSize Average for area Speclhc zomng classd~cation and descriptionR-C Residential CountPj __ JShape Rectangular Zoning compliance j X I Legal [jLegal nonconlorming (G,aedfalhaed use) ~-~lllegal I J No zoning JDrainage Good H~lhest 8, best use as impraved: p X~ Present use j Other use (e~alain) JView Average [~!ililies P~ublic Other JOri-site Improvements Type Public Pdvale]Landscaping Average I:,ecmc]ty J_~ JStree, Macadam ~.~ ~__~JDr,vewaysurface Macadam Gas J_~ JCurb/gutter Water j__j Private JSidewalk L I I I IApparent easemenls None noted San"fY sewer I j Private JStree, I,ghts ~ j~/FEMA Spec,al Flood Hazard Area Slormsewer I ! IAIley t I ] IIFEMAZ°ne C Map Date 2/15 78 I r I I IFEMA Map No. 420360A Cou~aems (apparent adverse easemenls, encroachments, special assess.~i~, slide areas, illegal or legal nonconforming zoning use, etc)i No adverse easements. encroachmenls or special assessments noted at time of inspection. GENERAL DESCRIPTION IEXTERIOR DESCRIPTION FOUNDATION BASEMENT !INSULATION No. o~ Units One ~Foundation Conc Block Slab No Area Sq. Ft. 1.168 Roof No. of Stories One ~Extarior Walls Per Stone/Alu~ Crawl Space No % Finished None Ceihng Type (Dm./Att.) Delached JRoof Surface Asp Shingle Basement Full Ceiling Joisls Walls Design (Style) Ranch IGulters & Dwnspls. Alum Sump Pump No :r Existing/Proposed Existing Walls Conc Block Floor i Age (Yrs.) 54 Years None J Window Type DH Dampness None noted Floor Conc ; - I Storm/Screens Yes Seltlement None noted Dulside EnI~/ Yes Unknown ' E#ecl~veA,~e (Yrs.) 20 Years IManulactured House NO infestation None noted -- ROOMSI F°yer I Living I Dining JKitchenJ J J J Bas~ntl I I I Oen =am,y.m. Rec. Rm. Sedr! .s # Bat~s Leundr~ J ,her J Area Sq Pt Levet l J I 1 I 1 I ~ . 1 0 ~: INTERIOR MatedalstCoedilion HEATING KITCHEN EQUIP. ATTIC AMENITIES ~ Floors Vinyl/CrptJAve Type HA CAR STORAGE: rfrigera~orJi~'_il ~lone [~ Fireplace(s)# 0~ None Walls Plasler/Ave Fuel Oil rage/Oven ~ ~tairs ~ Patio Garage 1 # of cars Trim/Finish Wood/Ave Condlllon Good sposal ~ )rop Slalr ~ Deck Attached X Bath Floor Vinyl/Ave COOLING shwasher J I ~cuttle I_X_J Porch Detached Bath Wainscot Fiberglass/Ave Central Yes n/Hood I-I :loor I--[ Fence Broil-In Doors Wood/Ave Other crowa~e ~ teated ~ Pool 3arport Condilion Good sher/D~er :inished ! I )riveway Macadam Add~tioaal features (special energy efficient items, etc ,: Sla.m wiodow units Condition of the improvements, depreciation (physical. functional and external), repairs needed quality of construction remodeling/additions, etc There aa no physical or functional obsolescence. The subject is in average condition on the outside as well as the inside. New asphalt shingle roof is m the process of being installed. Adverse environmental conditions (such as. but not lira ted to, hazardous wastes, toxic substances, etc.) present in lhe improvements, on the slle or in th~ immediate vicinity of lbo sub]ecl property Apl)raiser is I~ all oxpell in llut idl,'ulilic;llion ul il;Jzardou5 s Ills ~ ICc'; nl dl'llinll:UJ;ll I:llVlrOnHlJ:llt,ll Valuation Section ESTIMATED SITE VALUE ................. = $ ESTIMATED REPRODUCTION COST-NEW-OF IMPROVEMENTS: Dwelhng 1.168 Sq Fl @ 67.14 = $ 78,420 Bsmt 1,168 Sq. Ft. @ 12.26 = 14,320 Household Enc Pm' = 5,000 Garage/Carpod 360 Sq Ft. @ 21.84 = 7,862 Total Estimated Cost New ....... = $ 105,602 Physical Functional External Less Depreciation 10,5601 0~ 0 = $ Depreciated Value of Improvements ............. = $ "As-is" Value of Site Improvements ................. = $ INDICATED VALUE BY COST APPROACH ......... = $ ITEM I SUBJECT COMPARABLE NO. 1 Address 2245 Lambs Gap Road $ N/A $ 0.00 Inspection DESCRIPTION Enola Proximity to Sul:~ect Sales Price Price/Gross Liv. Area Data and/or Venfication Source VALUE ADJUSTMENTS Sales or Financing Concessions Date of Sale/Time Location .~uburban Leasehold/Fee Simple :ee Simple Site t AC View ~,verage Design and Appeal {anch/Good Quahly el Consuactm~ Stucco/Alum/Goed Age 54 Years Condition Average Above Grade Total Bdrms Baths Roonl Count 6 3 1.0 Gross Living Ama 1,168Sq. Ft. Basement & Finished Full Rooms Below Grade Un[in Functional Utility Average Heating/Cooling 3il HA/CA Energy Efficient Item ~verage ' Garage/Carport I/Car Alt Porch, Patio, De~, :'ncl Porch Fireplace(s), etc. ~lone Fence, Pool, etc Fence 6408 Cannon Drive Mechanicsburg 2 Miles CPML Settled, STEB 20,000 10,566 95,042 5,000 120,042 115,50~ File No. 2cal*llp Comments on Cost Approach (such as, source o1 cost es: ~- site value, square foot calculation and for HUD VA uno F .... lite estimated remaining econonl~c life of the property) ~ee attached sketch. ;cst figures from Marshall & Swift Residential Cost Handbe~k a~,: ,: ~ources. Est. Remaining economic life--50 to 60 years. COMPARABLE NO. 2 I COMPARABLE NO 3 4 Riven/iew Drive 1 208 Erford Road Enola ~ Camp Hill 3 Miles J 3 Miles CPML Settled, STEB | CPML Settled, STEB DESCRIPTION 60 DOM FHA 8/16/01 Suburban Fee Simple .80 AC Average Ranch/Goed AiumlBricklGood 40 Years Average t,24/Sq Fl Full/Fr Bt/Bath Average Oil BB/HW A~erage 1 Car Att Patio None None DESCRIPTION +(-)$l DESCRIPTION 232 DOM FHA 4/27/01 Suburban Fee Simple · 26 AC Average Ranch/Good Brick/Good 41 Years Average 2.~ 1,150Sq. Ft. Full Unfin Average Oil BB/HW Average 1 Car Crpt Patio None In Gr Pool 12 DOM Conv. 8/28/01 Suburban Fee Simple ;.21 AC Average Ranch/Good Brick 47 Years Bath;0 1,306Sq Ft. Full Unfin Average Gas HW/CA Average 1 Car Crpt Patio Fireplace None -I ..:; Adjusted Sales phc 1.6 % Net 2 % Net 1% Net of Comparable 8.0 % Grs 117,300J 9 % Grs 112~300J 7 % Grs 109 .c:: Comments on Sak~,s Comparison (including the subject property's compatibility to the neighborhood, etc.): All market data is similar in style and construction to lhe subject property. Comparable sales are the most recent, similar, nearest sales available. All comparables have been closed and settled on tr above dates. ITEM SUBJECT COMPARABLE NO. 1 COMPARABLE NO. 2 COMPARABLE NO 3 :)ate, Price, and Data 3ource, for prior sales q/A N/A NIA N/A ~ithin year ct appraisal ~, option, or listing of the subject property and analysis of any prior sales of subject and comparables wilhin one year of Ihe date of appraisal: No currant agreement of sale, option, or listing. No sale of comparables wilhin 1 year. INDICATED VALUE BY SALES COMPARISON APPROACH ............................................... $ 113,0~0 /Mo. x Gross Refit Mullil~ier NIA = ~ N/A This appraisal is made ' ' ~ .... I _1 bjec pi lion per pans and spec ficat~on$ nspecllons o~ ~.~uo~s listed below su I to corn e I Conditions of Appraisal: See attached Special Conditions Addendum and Statement of Limitin9 Conditions. All equipment with improvements ware in working condition, unless herein stated. ' Final Reconciliation: The Comparison Approach, reinforced b the Cost Approach, provides a 9cod indication of Market Value. Good range of vague $109,900 to $117,300. Chose value of $113,000. The purpose ct this aPprasal is to estimate the market va~e ct the real prope~ that is the sul~ct of this reporl, based on the above coalitions and the cetl~fication, contingent and ltmHin9 conditions, aed markel value delinil~n that are stated in the allached Freddie Mac Form 439/Fannie Mae Form 1004B (Revised 6193 ) I (WE) ESTIMATE THE MARKET VALUE, AS DEFINED, OF THE REAL PROPERTY THAT IS THE SUBJECT OF THIS REPORT, AB OF Febfua~/1, 2002 WHICH IS THE CATE OF INSPECTION AND THE APPRAISER: /' { i,, ~./~ <./~ .~ EFFECTIVE DATE OF THIS REPORT) 3'0 I~E $ 113,000 sig~ture ~ -'~ ILOL,/ I_XjDid i-]DidNot Name Clement A. Le~, CREA ' Name William G. Rothman~ ~, -inspect Properly Date Report Signed February 8, 2002 Date Report Signed February 8, 2002 State Certificahon # RL-001765-L Slate PA State Certitication # GLA 001455-1 State PA AR 03080,t-I ~;~te PA Or State License # RM 0527/2.A Sial,; PA SUBJECT PHOTOGRAPH ADDEN~,JM f.......... 2cai-11~ I~,rr~)',~C~ / ( 'hClH ESi of Ethel Wynnkaulz ~'~,,I,¢~1) .-".dd,c~,~ 2245 Lamb. Gap Road I'll~' Enola ( ',,, m~,. Cumberland IcJhl,..iGales & Associates Nliuc PA Zip ~',,dc 17025 ,',;'r R I!I!T S(-'ENli SKETCH ,MAP AND PHOTOGRAPH ADDENDUM ~ & Asso~-Jates I _Bor row~er / C._]llen__~t Proper1¥Ad~ress ~ [,drabs Gap R,~dd ~;Ity Eno] ~ ~ender ~nty Cumberland $lato ZIp Code I 7025 LAYOUT SKETCH 38 20' ] 6 ' ENCL POR , DR I ~ BR LR I ] 0.' " BRj . 28' PoRFH I !. , L. ~PARABLES PHOTOGRAPH ADf.,,_,~IDUM ............. Ilurm....,cr / ('h~:.l Esl ol Ethel Wynnkaulz I'u,p~:~b' A&h,:~ 2245 Lambs Gap Road (~1~, Enola (.'mmty Cumberland :',; u~lc PA Zip ('ode 17025 I cmlur Gales & Associates 6408 Cannon Drive Mechanicsburg I)alc ol'Salc: 8/16'01 :'hdc I'rlcc : 115 500 Nq. Ft. 1,247 $ / .";q I:~ : 92 62 (~()~ll',~l~,.~lll.l.; 5..~1.1~ # 2 4 Riverview Drive Enola I)i.col'Salc : 4127/01 Sale I'ricc :110,500 Sq FI :1,150 $/Nq FL :96 208 Edord Road Camp Hill I)alc of Sale : 8/28/01 Sale Price :108,600 Sq. Ft. :1,306 $ / Sq. FI. :83 ~,~-~' J oWaynesville ,? - New B~.al..o,._~ VictOria Furnace o oWhIte Spnr~ Ellendale Forge vBemer Island oSIone Glen oSingersville Heckto~.~3j Hollow vMillers Gap - Ridge _. ~ ~ 1.4'j · ~l-ambs Gap Hogestown Bill a~' oGood Hope Mill / New Kingstown o New Kingston Naval Trfndle: nicsburg Lane Williams GrOve BrandlsvJlle oMt AJl~n ~ ' ~,. ale Usburn ·Grantham Nauvoo -. oSiddonsburg eMt Pleasant irvtew Park oEmey Statement of Limiting Conditions I:ilc #: 2cal-llp DEFINITION OF MARKET VALUE: Thc most probable price which a property should bring in u ctmlpctilivc and {)pen markc: und~ all conditions rcquisilc lo u I~ir sale, thc buyer and ~11~, each acting prudcmly, knowledgeably and assuming Iht price is n~ al'lb~cd by nodo ~limulus. hnplicil in Ihis dclinilion is the co~ummion ufa ~lc ~ ol'a spccilicd dulc and lilt passing ol'liLIc lYom ~llcr Io huycr under condiliuns whereby: ( I ) buy~ and ~ller are lypicully molivalcd; (2) bulb parties are well inlbrmed or well Wised, and each acting in svhal hc considcm his own b~ imcrcsl; (3) a re,unable lime is allowed Ibr exposure in Ibc open m~cl; (4) puymcnL is made in lerms ofc~h in [J.S. dollars ~ in lcrms of Iinancial a~angemcnls comparable Ihcrclo; and (5) Ll~c price rcprcscuLs ~hc nurmal considcralion Ibr thc property sold unallbclcd by special or crc~livc linau~ing or sales couccssions* gran~ by anyone associated with Ibe sale. * Adjuslmcms to the comparables must be made for special or ercalive financing or sales concessions. No ad. juslmcnts are necessary lbr those costs which are normally paid by sellers as a result ol'trudilion or law in thc market area; thes~ costs are readily idenliliublc since the seller pays these costs in virtually all sales Imnsactions. Special or cruutivc linancing udjuslmems tun be made to thc compuruble propcny by comparisons Io linancing terms ol'lbred by a third puny inslitutionul lender that is not alrcudy involved in Ibc property or Iransuction. Any 'ad. jusmlenl should not be calculated on a mechanical dollar cost of thc linancing or concession bul Ibc dollar amount ofany adiusUnent should approximate thc market's reaction to tile linancing or coaccssi~ms based ILnl thc appraiser's.judgement ' STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S CERTIFICATION CONTINCENT AND LIMITING CONDITIONS: The appraiser's cenificalion Ihat appears in the appraisal report is subject to Iht Ibllowiug couditions: . I. The appraiser will not be responsible Ibr mattcra of legal nalure that affi:ct either the property being appraised or thc title [o iL Thc appraiser assumes Ihat thc lille is good and marketable and, Ihcrclbre, will nol render any opinions aboul Iht lhlc. Thc property is appraised on the basis of it being under responsible ownership. 2. Thc appraiser has provided a sketch in Ibe appraisal report to show approximate dimensions ot'tbe improvements and the sketch is included only tO assist Iht reader ol'thc report in visualizing Iht property and understanding the appraiser's dclcrmination of its size. 3. Tbe appraiser has examined Ihe available flood maps that are provided by Ibe Federal Emergency Management Agency (or other data sources) and has noted in thc appraisal report whether the sahieCt site is located in an idenlified Special Flood I lazard Area. Because thc appraiser is not a surveyor, be or she makes no guarantee, express or implied, regarding lhe determination. 4. The appraiser will nol give testimony ur appear in court because he or she made an appraisal of thc property in question, unless sp¢cilic arrangculcnls lo do so have I~cn made hcl~rchand. 5. The appraiser has eslimated the value of the land in thc cosl approach at ils highest and best usc and Iht improvements at Ihcir contribulory value. These saparule valuations ol'lhe land and improvements musl not be used in coniunctio I wilh any olhcr appraisal and arc invalid i l'lhcy arc so used. ' 6. Thc appraiser has nolcd in thc appraisal report uny adverse co~dilions (such as, needed repairs, depreciation, the presence o£ hazardous wastes, Ioxic substances, crc.) observed during lhe inspection oftbe suhiect property or thut he or she became aware ufduring Iht normal research involved in pcrlbrming Iht appraisal. Unless olherwisc slaled in thc appruisa report, the appraiser has no [:nowlcdge ol'any hidden or unupparcnt condiliuns ol'thc property or adverse environmental conditions (including tile prcs~:nsc ul'hitzardous waste, toxic substances, gtc.) tilul would make the property more or less valuable, and haas assumed that there un: no such conditions and makes no guarantcas or warranties, express or implied, regarding thc condition ol'lbe property. Thc appraiser will not be responsible Ibr any such conditions th~ do exist or lbr any engineering or tcsling Ihal might hc rcquircd Io discover whether such conditions exist. Ilccause thc appraiser is nol an cxpcn in thc field of cnviranmcntu hazards, thc appraisal report must not be considered as an environmental assessment of lbe property. 7. The appraiser obtained the information, estimates, and opinions that were expressed in the appraisal report from sources that he or she considers to be reliable and believes them to be true and correct. The appraiser does not assume responsibilily for the accuracy of such items that were Ihrnishcd by other panics. 8. The appraiser will not disclose the contents oftbe appraisal report except as provided for in the Uniform Standards of Prolbssional Appraisal Practice. 9. Thc appraiser has based his or her appraisal report and valualioe conclusion for an appraisal that is subject to satisfactory completion, repairs, or uhcrations on the assumption thai complcti~a of thc improvcmcms will bc pcrlbrmcd in a workmanlike Inanncr. 10. The appraiser must provide his or her prior written con.seat before the lender/client specified in the appraisal report can dislrihut¢ Ibc appraisal report (including conclusions ubout the properly value, the appraiser's identity and profi:ssional dcsignutions, and rcl~renccs to any prolbssional appraisal organizations or Iht lirm with which thc appraiser is associalcd) to anyone ~aber Ihun thc borrower; Ibc mortgagee or ils succas.,alrs and assigns; Ibc montage insurer; consultants; prolbssional appraisal urganizalions; uny slal¢ or federally approved linancial institution; or any dopanment agency, or instrumentality oftbe Untied States or any state or thc District of Columbia; except that the Icnder/cliem may distribute the property descriplion section o1' the rclx~rl only to data collection or reporting service(s) wilhoul having to obtain the appraiser's prior written consent. The uppraiscr's written consent and approval musl also he ohtainc~l bclb~: thc appraisal can be conveyed by anyone to Iht public tbrough udvenising, public rclutious, news, sales, or other media. APPRAISER CERTIFICATIOee File #: 2cal-llp APPRAISER'S CERTIFICATION: Thc Appraiser cenilics and agrees that I. I have researched thc subiccl market area and have sclecled a minimum oflhrac recent sales of properties most similar and proxiu]utc lo Iht ~u~j~ct prop~ lbr consideration in thc sales compari~n analysis ~d havc made u dollar u~just~ncnt tvhcn appropriate to rellect Iht mark~ reaclion to those ilems ol'signJlicanl variation. II'a si~ilicanl ilcm in a comparable property is superior to, or more I~vorabE Ihan, the subject property, I have m~c a negative adjustmcnl lo reduce Iht adjusted sales price of the comparable and, ifa statical item in a comparable prope~y is inlbrior to, or I~ I~vorablc th~, thc subject property I have made a positive u~jusxm~ lo incre~c Iht adjusted sales price ol*~c compa~blc. ' ' 2. I have lakcn inlo considcmtim thc I~clors thai have an im~cl on value in my dcvclo~cnl of thc cstimalc ol'markcl value in the uppraisal report. I have nm [nowingly wilhold uny ~i~nilicunl inlbrmaion I~om thc apprai~l report mid I hclicvc, to thc best el'my km~wlcdge, thai all ~lcmcnl~ and inlbrmulion in thc upprai~l rcpo~ arc trac ~d correct. 3. I staled in thc apprui~l rc~ only my ~rsonal, unbiased, ~d prolb~ional analysi~ opinions, ~d conclusions, which arc subjcc~ on y m thc condogcm ~ limidug ~pccilicd in thi~ Ibrm. 4. I have no present or prospe~c intcrasl in thc pro~ny thai is the subj.[ of Ibis re~n, and I have no prcsenl or prospective personal imcrcst or~ with rcspec[ 1o thc panicipams in thc Iran~clion. I did nol base, cilhcr purlially or complclcly, my ~ulysis mid/or ~ mlimalc of murkcl value in thc apprai~l rc~n on thc mcc, color, religion, sex, handicap, l~nfiliul slalus, or nulional origin el'either thc prospective ownc~ or ~cu~ of thc subject property or el'thc prcscm owucrs or occupunls of thc propcrlic~ ia thc vicinib' of thc ~ubjccl pro~ny. S. I have no present or conlcm~led lblura imcresl in thc subi~ prepay, ~d neither my cu~nl or future cmploymcnl nor my compcnsalion tbr pcrlbrm tnb th~ appraisal i5 coulingcnl on thc upprai~d value of thc property. 6. I w~ not required to report a ~dcle~incd value ur direction in value thai I~vom Ihe cause of thc clicm or uny mlutcd par[y, Ibc amounl el'thc value c~ialc, thc allaimncnl ol'u specific rasull, or thc occurancc ol'a suhscqucm cvcnl in order to rc~civc my cumpensation and/or ~ploymc II br pcrlbmiing thc apprai~l. I did nol b~ thc uppraisal report on a requested nmmnum vuluation, ~ spccilic v~uufion, ur Iht nccd lo approve a specilic mortgage Io~. 7. I perlbrmcd this appraisal in ~tb~ily wi~h ~hc Unilbrm Standards of Pml~ssional Appraisal Practice thai were adopled and promulgated hy thc Appraisal S~urds llomd el I'hc Apprai~l Foundalion and thai were in place as el'Ibc cll~clivc dale of this appraisal, with thc cxucpfion o1'~ departure provision el'those 51andards, which does nol apply. I acknowledge that an estimate ol'u reasonable lime Ibr exposure M thc open marke[ is a condition in the dclinilion ofm~kc[ value and the cslimatc I developed is consislent with Ibc markcling l~c nolcd in thc ueighborhuod ~clion of this report, unless I have otherwise slated in thc reconcilialion 5corian. 8. I have personally inspected the interior and cxlcrior ~e~ of the subj~t pmpe~ and the exterior of all properties listed ~ ~omparablcs in thc appraisal rcp~ I Ibnhcr centre, thai I have holed any apparent or known advcmc ~ndilions in thc subject m~provcmcnls, on thc su~jccl sil~ ~ on ~y silo within thc immedialc vicinily of thc surimi pro~ny el'which I am aware and have mude udiuslmcn s Ibr Ihcsc ~vc~ conditions in my analysis of thc pro~y value lo thc cxlcnl Ihal I had markcl evidence lo ~upport them. I huvc also com~mcd uhoul thc cllbcl of thc advc~ condilions on Iht m~kclability of thc ~u~iec~ propc~y. 9. I personally prepared all concl~ns and opinions about Ihe mai eslale the wm set fmh in Ihe appmi~l report. If I relied on signilicam prolbssional ~islacc I~om any individual or individu~(s) in thc ~rlb~ce of thc apprui~l ~ ~ha prepumlion ol'~he upprul~l r¢po~ I have numcd such individual(s) und diploid thc s~lllc ~ks perlbrmed hy th~ in thc rcconciliulion ~clioa el'this uppr~l rc~n. I ccniiy lhul any individual ~ named is qualified Io ~rlbm] thc tasks. I have nol uuthorizcd unyonc h) make chic lo any item in thc report; thcralbrc, il'an unauthorized change is made lo thc appruisul rcporl, I will luke no responsibility I~ iL SUPERVISORY APPRAISER'S CERTIFICATION: Ifa supervlnory appraiser signed tho appraisal report, ho or she cenilies and agrees that: I directly supervise the appraiser who prepared thc appraisal report, have reviewed the appraisal report, agree with thc statements and conclusions of thc appraiser, agree to be bound by the appraiser's certilications numbered 4 through 7 ubovc, and um taking full responsibility for thc appraisal and thc appraisal report. ADDRESS OF PROPERTY APPRAISED: 2245 Lambs Gap Road Enola APPRAISER: ~..../"" Date Signed: February& _2002- Stale Certilication #: RL.001765.L ........ Slate: PA or Stale License #: AB-030804-L Stutc: PA Expiration I)alc ol'Ccrlilication o~-~l.i~-"n.~: PA 17025 SUPERVISORy A~PR,~SEI~ (only il required): Signature: ~_._~ [~ Name: _W:e~ _~.-_ G.~.: .~__4n '. ~- Date Signed: F ..ebfl~__' 8,L2002 ............ state Certification RI: GLA 001455.1 State: PA or Slate I.iccnsa #: RM 052272-A ...... State: PA Expiration Date of Ccnilication'~*'l.i~.c~sc: .... [ ~]l)id [~.~ I)id N~,,I Inspect property ?~E~. 2 o1'2 I:mmie M!Lc I"orm~l ¢_~!_1:1_ t ~'~-qt _j PA REV-1500 SCHEDULE H FUNERAL EXPENSES and ADMINISTRATIVE COSTS 29 South Enola Drive Richardson [ aneral Home, ' · (717) 732 - 0587 Michael G, Murray STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED Supervisor Charges are only for those items that you selected or that are required. If we are required by law or by a cemetery or crematory to use any items, we will explain in writing below. If you selecled a funeral that may require embalming, such as a funeral with viewing, you may have to pay for embalming. You do nol have to pay for embalming you did nol approve if you selected arrangements such as a direct c~emation or immediate burial. If we charged for embalming, we will explain why below. For the Service of: Ethelwyn I. Kautz Date of Death: Pre-arrangement Charge to: Laurie Ann Mailey 26 Bryans Mill Way Catonsville Maryland 21228 (Name) (Address) (City) (State) A. CHARGE FOR SERVICES SELECTED: 1. PROFESSIONAL SERVICES Services of Funeral Director/Staff ................ $ _0 Embalming ................................. $ 0 Other preparation of body Ccemetology/Dressi~g/C asketing $ 0.00 OTHER SUB-TOTA~-'0~:'PR~I~ES~i0N~L ~ER~CE$' .' ,' .' .'.'.' .' .' .' .'. ........ ~ A1 $ 2. FACILITIES AND SERVICES Use of facdities and services for C. Evening Viewing (6:00 - 8:00) ............. $ 0.0___~0 Use of facilities and services Funeral ceremony ....................... $ 0.00 Use of facilities and services for Uemodal Service ....................... $ 0,00 Use of equipment and services For graveside service ..................... $ Q00 Use of equipment and services For Church or Off Premise Service ........... Other Use of Facilities Viewinq Pdor to Service (6:00 - 7:00) ...... $ 0.00 SUB-TOTAL OF FACILITIES/EQUIPMENT ......................... A2 $ 0.00 3. AUTOMOTIVE EQUIPMENT D. Vehicle to transfer remains to Funeral Home. Local, ................................. $ O.O__QO Hearse (Casket Coach) Local ................................... $ 0.00 Limousine Local. ................................. $ o.o._Q Family Car Local ................................... $ 0.0__..~0 Flower car or floral disposition Local .............................. $ 0.0__~0 Lead car/Clergy car Local. ................................. $ o,o._Qo Car for pallbearers Local .................................... $ 0.00 Out of town transpodation ................... $ 0.0~0 SUB-TOTAL OF AUTOMOTIVE EQUIPMENT ...................... A3 $ 0.00 TOTAL OF PROFESSIONAL SERVICES, FACILITIES AND AUTOMOTIVE EQUIPMENT... A $ 000 OtherClothing Cremation Urn ..................... $ (Description) 0,00 0.0_~0 O.O__Q TOTAL MERCHANDISE SELECTED ........ SPECIAL CHARGES Fo~Narding of remains to $ o.o_.Do $ 0.oo .... B $ Q00 (Funeral Home) Receiving of remains from (Funeral Home) immediate Budal ................... $ Direct Cremation .................... $ Full Service Cremation $ SUB-TOTAL OF SPECIAL CHARGES ....... $ o.o__Q O,O__QO O.O__QO O.O._Q 3555.00 · C $ 3555O0 CASH ADVANCED Opening Grave ..................... $ 0.0__p_0 Cemetery Equipment ................. $ 0.00 Lot and Deed ....................... $ 0.00 Newspaper Notices- Local ............ $ 0.00 Newspaper Notices - Out ol Town ...... $ 0.00 Telephone & Telegrams .............. $ 0.0~0 Airfare ........................... $ 0.00 Clergy/Mass Offering ................ $ 50,00 Pallbearers ........................ $ 00._.p_0 Certified Copies of the Death Certificate ......................... $ 20.00 Police Escort ....................... $ 0,00 Flowers ........................... $ 0.0.__~0 Vault Service Charge ................ $ 0.00 Organist ......................... $ ~ Soloist ........................... $ 0,00 Honor Guard ...................... $ 0~_ Beautician $ 45,00 $ o,o___Do SUB- TOTAL OF ADVANCES ................ D $ 115.00 We charge you for our se~ices in obtaining: (Special cash advances that are marked-up) CHARGE FOR MERCHANDISE SELECTED: Casket ..................................... $ 0.00 (Description) Other Receptacle ............................ $ 0.00 Outer Burial Conta her ......... $ 0.00 (Description) Acknowledgement Cards ....................... $ 0.00 Register Book(s) ............................. $ 0.00 Memory Folders ............................. $ 0,00 Prayer Cards ................................ $ 0,0~0 Temporary Grave Marker ...................... $ 0,0.__~0 Burial Clothing .............................. $ 0.00 SUMMARY OF CHARGES: A. Professional Services, Facilities and Services, and Automotive Equipment ..... $ 0,00 B. Merchandise ...................... $ 0.00 C Special Charges ................... $ 3555.00 D, Cash Advances ................... $ 115.00 TOTAL OF ALL SELECTIONS ................ $ 3570.00 PAID AT TIME OF OR PRIOR TO ARRANGEMENTS ......................... $ - 0,00 BALANCE DUE ............................ $ 3670.00 REASON FOR EMBALMING Family Requested Public Viewing or Buda 24 Hours after death If any law, cemetery or crematory requmements have required the purchase of any ( listed above the law or requirements is explained below. Outer Budal Container I agree that I have examined the items of goods and services selected above and found them to be con'ect and according to the arrangements I have requested. I acknowledge receipt of a copy of this Statement of Funeral Goods and Services Selected. I represent that I have sufficient funds available for payment of the cash price for the goods and e2ices selected. I also agree to make payment of $ 3670,00 within 35 days. I agree to be jointly and severally liable with anyone else who signs below, A late charge of · per month amounting to 12% . per year will be applied Io the unpaid balance beginning 35~days from the date of this agreement. I will also pay to the Funeral Director all reasonable costs paid by the Funeral Director to collect amounts I owe under this agreement. Those costs may include attorneys' fees, court costs and other costs. Any additional services or merchandise ordered or requested after the dates of this agreement will be considered part of this agreement and the cost thereof will be reflected on the final bill or statement. (Seal) Saturda¥~ January 26 2002 0CT-11-2002 FRI 06:55 AH PENN NATIONAL IN~ FAX NO. 4107858982 P. 05 allfirst Acct No 0050320831 ,,.. '//,%/,, <._ . C~ecic IT,riD! 28.C0 12200~; STATEMENT DATE TERMS DC5812 RSR appraisers & anab~sts February 8, 2002 Gates & Associates 1013 Mumma Road Lemoyne, Pa 17043 APPRAISAL: APPRAISAL FEE: 2245 Lambs Gap Road Enola, Pa 17025 Est of Ethelwynn Kautz Our Tax ID#23-2468209 Our File #2CAL-11P $300.00 Please make check payable to: Include File #2CAL-11P RSR Appraisers & Analysts 308 E. Penn Drive Enola, Pa 17025 THANK YOU! 308 East Penn Drive · Enola, PA 17025 · Phone (717) 763-1212 · Fax ('717) 763-1656 PA REV-1500 SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES and LIENS "MECHANICSBURG, PA 17055 .(717) 761-5343 TAX # 23-6050136 BILL TO: ETHELWYN KAUTZ 2245 LAMBS GAP RD ENOLA, PA 17025 DATE: 04/26/2002 PATIENT: ETHELWYN KAUTZ ACCOUNT #: 203109240A CONTROL #: 0200001 PATIENT PICKED UP: RESIDENCE 17025 PATIENT TAKEN TO: HOLY SPIRIT PATIENT HAS SYNCOPE, CHEST PAIN AND VERTIGO - REQUIRES OXYGE N DATE OF SERVICE: 01/02/2002 DESCRIPTION 2002 BLS BASE RATE BLS MILEAGE OXYGEN AND SUPPLIES UNIT COST QTX. A0429 250.00 1.0 A0380 5.00 7.0 A0422 25.00 1.0 250.00 35.00 25.00 Comments: THIS IS YOUR FIRST NOTICE. B~tLANCE IS DUE WITHIN 30 DAYS PLEASE WRITE THE INVOICE NUMBER ON YOUR CHECK THANK YOU THANK XOU. SUBTOTAL AMOUNT PAID TOTAL 310.00 282.23 ETHELWYN I. KAUTZ RITA M. KEIM 2245 LAMBS GAP RD. ENOLA, PA 17025 03-74 2786 80-'83/~ 13 5531 ~ OIU)F~ OF . · Harrisburg, PA 17101 gO '~ 20,B, :i I,,' 2 ?B, r-, ,"000 5 ? ~, F-,,,° ETHELWYN I. KAUTZ RITA M. KEIM 2245 LAMBS GAP RD. ENOLA, PA 17O25 03-74 2784 5531 ORDER OF _ allfirst Harrisburg, PA 17101 Fo. ~_~4.z d s'z, V~ ~.2o / ~:O ~ SO =. BOP, :t, 00000 ETHELWYN I. KAU'I-Z 03-74 2791 RITA M. KEIM ENOI.A, PA 17025 D~a~ ~-- fi0-83/0313 5531 ETHELWYN I. KAUTZ 03-74 2789 RITA M. KEIM 2245 LAMBS GAP RD. ~ / / 60"8310313 ENOLA, PA 17025 D,~I'E~ 553! ~ o.o= o~~. s. ~ $ 5/o-a, ETHELWYN I. KAUTZ RITA M. KEIM 2245 LAMBS GAP RD. ENOLA, PA 17025 ORDER OF__._~/__~ ~ 0~74 2794 Uallfirst Allfizst Bank Harrisburg, PA 17101 ~ ~ ~o.~ o - ~ f , oo ..-7, ,/q~. ,.. 27q4 ,"OOOO002q6P, o' ETHELWYN I. KAUTZ 03-74 ENOI.A, PA 17025 2790 ~bur8, PA 17101 ro~~ fBWNGFYV fOO15920021339801f w AV 01 017681 55461B 95 A~'*SDGT h,,llh,,llh,,,,hhhh,,,Ih,,Ih,hl,h,lhh,hh,hh,I ETHELWYN I. KAUTZ . [ ~ AT&T Wireless Questions? · www.attwireless.com · 1-800-888-7600 · 611 from your wireless phone · TTY use~ - 1-866-4-AWS-1-FY Date of Invoice: 04/03/02 S~Y OF NONTHLY CHARGES FOR ACCOUNT 2002133981) 11.02 .00 .~ .~ 11.~ .~ billing cycle ~an on 03/02 and e~ on ~/01. :~ ~?~:,~Due:,.~:::~., 11.02 Current Monthly Charges Monthly Service Charges Home Airtime Charges Home Long Distance Charges Text Messaging Charges Roaming Charges Other Charges and Credits Taxes, Surcharges & Regulatory Fees Total Current Monthly Charges TOTAL ANOUNTDUE .00 .00 .00 .00 .00 .00 .00 .00 11.02 You can now pay your invoice online ii vew.attwireless.cam AT&T WIRELESS APPRECIATES YOUR BUSINESS Note: mm~ We Print on Front and Back. GEN-OldmOl g2-~1 Consumer Service Department: 31229 Cedar Valley Dr. We~tlake Village, CA 91362 M- F 6 am to 4 pm PST (818) 879-2948 26 BRYANS Mll~I~ WAY BALTIMORE, MD 21228-5456 See Comumer Ri~ Information on Reverse Side Clie~ Name: Ammmt Da~: Client Ref. No: Placement l~: Social Security No: Client Phone: 7177321356061 0048088217 (800)652-5094 Our client, Verizon Communications, Inc., has been unable to resolve this outstanding balance due on your account. Since you have failed to resolve this issue with Verizon Communications, Inc., they have now assigned your account to us for collection. If you have questions or need assistance regarding payment, please call (800)652-5094. Send your check or money order payable to Ver/zon Communications, Inc. for the full amount due or see reverse side. It is in your best interest to resolve this matter to avoid any further collection efforts. To ensure accurate recording of your payment you must send your payment using the bottom tear-off portion of this letter with the enclosed envelope. When your obligation has been resolved, we will clear this record from our collection file. CUMBERLAND VALLEY LAND 6820 NERTZVILLE ROAD ENOLA, PA 17025 CLEARING Voice: 717-766-6403 Fax: 717-766-8690 Sold To: LORI MAILEY 26 BRYANS MILL WAY CATONSVILLE, MD 21228 Ship To Duplicate Invoice Invoice Number:. 430- Invoice Date: FeB 28, 2002 Page: I I Customer ID I Customer PO I' Payment Terms MAILEY, LORI I I Net 30 Days Sales Rep I I Shipping Method Ship Date Due Date Airborne 3/30/02 Quantity Item Description Unit Price I Extension 1.94 1. O0 ~K 284715 02/18/02 PULL CHARGE ~AID $315.00 CK 2075 2/4/02 kEFUND WITH THIS INVOICE $58.30 55.001 106.70 150.001 150.00 Check No: 2/28/02 Subtotal Sales Tax Total Invoice Amount Payment Received TOTAL 256.70 256.70 256.70. 0.00 Pinnacle Health Hospitals P.O. BOX 2353 HARRISBURG, PA 17105 (717)230-3414 SHIRLEY count Information, Please Call (717)230-3414 ansaction Date Statement of Account Description 03/12/02 Amount 2/20/01 2/20/01 2/20/01 2/20/01 2/20/01 2/20/01 2/20/01 ~/20/01 2/20/01 2/20/01 Z/20/01 2/20/01 2/20/01 Z/Z0/01 1/21/02 1/21/02 [/25/02 [/25/02 2/05/02 PREVIOUS BALANCE 1EMER MED VISIT III P/F99285 1 EMER MED VISIT III ~ 1 VISIT LEVEL 3 E 99283 I CBC & AUTO DIFFERENTIA85025 I CBC & AUTO DIFFERENTIA85025 I SEDIMENTATION RATE 85651 1 URINE DIPSTICK ONLY 81oo5 1 CBC & MANUAL DIFF 85025 1 BASIC METABOLIC PANEL 80068 1 KNEE COMP MIN 6 VIENS 73566RT I CHEST PA & LAT 710ZO 1 CT BRAIN W/O CNTRST 70650 I EKO 95005 I VENOUS DOPPLER LIM 11195971 PMT MEDI B XACT 701 MEDICARE MEDICARE DISCOUNT 701 MEDICARE PMT MEDI B VERITUS 701 MEDICARE MEDICARE DISCOUNT 701 MEDICARE PMT-PVT INS .00 129.00 .00 286.00 51.00- 51.o0 50.00 21.00 66.00 65.00 159.00 165.00 855.00 150.00 332.00 49.79- 66.76- 298.80- 1,686.29- 12.65- ;stimated Insurance Due: .00 Total Patient Credits: Account Bnlnm-,-: 297.91 ACCOUNT IS SERIOUSLY DELINQUENT! 5E CALL OR PAY IMMEDIATELY. OMER SERVICE HOURS NED-FRI 7:00AM TO 4:00PM -THUR 7:00AM TO 6:00PM 717-230-3717 LOCAL OR 1-800-603-6064 OUT OF AREA Please detach and return with your payment ,.., QOT-11-2002 FRI 08:55 aH PENN NATIONAL INS FaX NO. 4107858982 P. 03 ETHELWyN I. KAUTZ oa-?4 2799 RITA M. KEIM ENOLA, PA 17025 , . ETHELWYN I. KAUTZ RITA M. KEIM 2245 LAMBS GAP RD. EMCJ[4~, PA 1'71)25 '"""'"": 7;L, IIl(lll,,ll Iq' . ....... 03-74 2797 tlo,.l131r~313 bk'tl , .:.:-u,".~;~ /.f.-':~ ,:;t.'.".) ,t :, t.~.L'-~ .t.i ~, 'r~ . · allfirst ,t,r.,.,, t'(drr~hl,r~l[, I>A ] 710 ! ,:o3~ooa~'.,:~ so~aoa~,,' 2,"~?. ,,'ooooou?s.~,,,' ./ ,... .00T-11-2002 FR[ 06:55 AH PENN NATIONAL INS FAX NO, 4107858982 P. 04 ETHELWYN I. KAUTZ, o3-74 2800 ENOLA~ PA 50½aDB~,'" ~800 ,,'OOOOO05~O?," ETHELWYN I. KAUTZ RITA M. KEIM* 2245 T.AM[.I,$ GAP RD. ENOIA, PA 17025 (tllltl.;li i I1,' ................. ,,./ OCT- 11-2002 FR I 06:55 aH PENN NaTIONaL INS FaX NO. 4107858982 Scm,los.'., Spouting GLitter I .lehno! ® Replncnment Windows Slorm Windows & Doors Flooring & Rubber Roofing Siding £liz;d~ell~town 367-6693 .... Proposal 2147 $OUTFI MARKET STREET, ELIZADETHTOWN, PA 17022 Lancaster 653~2000 Camp Hill 975-9944 Carlisle 243-9192 TOLL FREE 1-800-292-9676 FAX: [717) 367-6211 P. 02 Patio Covers & Enclosures Mobile Home Roofove,'s Relracl~bte Fabric Awnings Screen Roo~ms Carports Hershcy 533-4186 ./ j~ ) ~ h , mater, I n labor corn otc ¢,~tccord~tn~ewtlhabove.~p~c.]hcatior',$ forthosumot (AIIg:~count~App,od) ........................ ................ ~ .; ==~.,' o~ .... "t~'~ ~... ~.. ~'. J l Accepta nco of Pro posal -. Th~..o~o p~.o~, spocir,c:tio,,s tO do ~1'1o wulk ~t:; ~t)oc[licd Payl-en[ will be m3de as outlined abuve. Siqnature S~gn;.~tL~re II Net: 10 days 1.5% after 30 days RE: Supply and Install Siding and Trim as per contract: Deposit Sub Total Tax $4,785.00 ($785.00)~ $o.oo / Total Due $4,000.001 Invoice Notes: Price includes all discounts. II I AXi'.'.~ Al I1: ~N E ~.:,t;I g)w. I'OI (WAI q'~ It I1~ L}II l 1'O YO~ MOH[GAC~[ I(ATI ir{YN w, FETI-iOW, TREASLJRErl 5000 (':rlEE-KVIEW ROAD MI,.'CI ANIU,?.,IJLII'[G t'A 17050-2099 MAP I',10:10-12-2983.008 2245 LAM[iS GAP I{OAD AC[lES 4.000 DFt~D 001 t{:¥ 00,360 Wflh [{ uik.llnrj~ IAI. :~x KAU'rZ F'AMII.Y TI"tU$1' TR , .,,.,.c,, tOIII M^II.E¥ ,?fi 131'IYAN& MII.I.. WAY (;;A ['(')NSVII.LE MD 212211 el TIC[: "(.:LOSE r) MONDAYS"' I'U[_-'B t HI F~AM-.51-'M,MAY.JUN DAM Al'fi) SL!P r 15 - DI'-:(; .~AM- 1 PM PHONE- (','17) C2.r";o!.N.q. q,!9_- o_ooO, s_4__ ...... 'couk~f R=tc:~ .O02lJ~Ou ~:)UN'f'Y R/~ 9~.00 .00i)~300~ TAXPAYEH COPY 2002 S,lale ,m~.. ,nt of Real Estate Taxes .UUOzu300 ..... '__Z.__0~, .__ ,0002O0O0 o ......... Z (- -- 231.5G 2(' 11.65 22.63 Bill No: 435: TAX AMOUNT DUE -','~. ,s265'e4 I $271,27 .,. ~.~. o_~. .......... ?_~. $298.40 'i/:)1/:; Return Dill with P~ymcnt. For a Receipt. Enclose Se:/Add~e,~od Str. nlped Envelope. BUREAU OF TNDZVZDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG.. PA 17128-0601 COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE I'NHERZTANCE TAX STATEHENT OF ACCOUNT RE¥-I6D7 EX AFP (01-0~} RITA H KEIH 2245 LAHBS GAP RD ENOLA PA 170Z5-1124 DATE 11-25-2002 ESTATE OF KAUTZ DATE OF DEATH 02-01-2002 FILE NUHBER 21 02-0541 COUNTY CUHBERLAND ACN 0Zl10852 Aeoun~ Reei'l:'l:ed ETHELWYN HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credi~ ~:o your account:, subei~: ~:he upper portion of ~:his fore wi~ch your ~:ax payeen~:. CUT ALONG THIS LINE ~ RETA'rN LOWER PORTION FOR YOUR RECORDS REV-1607 EX AFP (01-02) ~N~ INHERITANCE TAX STATEHENT OF ACCOUNT ESTATE OF KAUTZ ETHELWYN FILE NO. 21 02-0541 ACN 0Zl10832 DATE 11-25-2002 THIS STATEHENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAMED ESTATE. SHO#N BELO# ZSA SUNHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 05-13-2002 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYHENTS (TAX CREDITS): 93.41 PAYHENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 03-ZT-ZOOZ CD001054 4.67 93.41 IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( ZF TOTAL DUE IS LESS THAN $1, NO PAYMENT ZS REQUIRED. IF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), TOTAL TAX CRED'rT 98.08 BALANCE OF TAX DUE 4.67CR INTEREST AND PEN. .00 TOTAL DUE 4.67CR YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ,,BUREAU OF INDIVIDUAL TAXES TNHERTTANCE TAX DTVTSTON DEPT. 280601 HARRTSBURg,, PA 171:'8-0601 RITA M KEIM ZZq5 LAMBS GAP RD ENOLA PA 17025-112~ COMMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS DATE 12-02-2002 ESTATE OF KAUTZ DATE OF DEATH 02-01-2002 FILE NUMBER 210Z-OSql COUNTY CUMBERLAND SSN/DC 205-10-92q0 ACN 02110852 Amoun~ Rem/~ed REV-X~:O4 EX AFP (12-00) ETHELNYN MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF MILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS REV-1604 EX AFP (12-00) ~ INHERITANCE TAX RECORD ADdUSTMENT JOINTLY HELD OR TRUST ASSETS DATE 12-02-2002 ESTATE OF KAUTZ ETHELNYN DATE OF DEATH 02-01-2002 COUNTY CUMBERLAND FILE NO. 21 02-05ql S.S/D.C. NO. 205-10-92q0 ACN 02110832 ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICE ACCOUNT NO. 0050320831 TYPE OF ACCOUNT: ( ) SAVINGS (X) CHECKING C ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 03-28-1974 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions - Taxable Amount Tax Rate X Tax Oue TAX CRED'rTS: .00 NOTE: 0.500 .00 .00 .00 .15 .00 TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE NZTH YOUR TAX PAYMENT TO THE REGISTER OF MILLS AT THE ADDRESS SHONN ADOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: 'REGISTER OF MILLS, AGENT."" PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 03-27-2002 CD001034 .00 93.41 TOTAL TAX CREDIT I 93.41 BALANCE OF TAX DUEl 93.41CR INTEREST AND PEN. .00 TOTAL DUE 93.41CR TF pATD AFTER THIS DATE., SEE REVERSE FOR CALCULAT'rON OF ADDTTI'ONAL 'rNTEREST. ZF TOTAL DUE TS LESS THAN $1., NO PAYMENT TS REI~UZRED. IF TOTAL DUE TS REFLECTED AS A 'CREDTT' (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SI'DE OF THIS FORM FOR INSTRUCTIONS.) BUREAU OF ZND'rV'rDUAL TAXES TNHERTTANCE TAX DTVTSZON DEPT. 280601 HARRISBURG, PA 17126-060! RITA H KEIH 6018 HUMMINGBIRD DR HECHANICSBURG COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE INHERITANCE TAX RECORD ADJUSTHENT JOINTLY HELD OR TRUST ASSETS PA 17055-0000 DATE 12-02-2002 ESTATE OF KAUTZ DATE OF DEATH 02-01-2002 FILE NUHBER 21 02-03~1 COUNTY CUHBERLAND SSN/DC 203 - 10 - 9 Z ~ 0 ACN 02122928 Amount: Remi~ed REV-160~i EX AFP (1:)-00) ETHELWYN I HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THTS LTNE ~ RETATN LOWER PORT'rON FOR YOUR RECORDS ~ REV-1604 EX AFP (12-00) ~ 'rNHERZTANCE TAX RECORD ADJUSTHENT ,JO~'NTLY HELD OR TRUST ASSETS DATE 12-02-2002 ESTATE OF KAUTZ ETHELWYN DATE OF DEATH 02-01-2002 COUNTY CUHBERLAND FILE NO. 21 02-03~1 S.S/D.C. NO. 203-10-92~0 ACN OZIZZDZ8 ADJUSTMENT BASED ON: ADHINISTRATIVE CORRECTION JOINT OR TRUST ASSET ZNFORHATZON FINANCTAL TNSTITUTTON: HEHBERS 1ST FCU ACCOUNT NO. 8005-05 TYPE OF ACCOUNT: (X) SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 11-16-1998 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions - Taxable Amount Tax Rate X Tax Due TAX CREDI'TS: .00 0.500 .00 .00 .00 .c~5 .00 NOTE= TO /NSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHZT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYHENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. HAKE CHECK OR HONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." PAYHENT RECEIPT DISCOUNT (+) DATE NUHBER INTEREST/PEN PAID (-) AHOUNT PAID 08-10-2002 CD001511 .00 71.30 TOTAL TAX CRED*rT I 71.30 BALANCE OF TAX DUEl 71.30CR INTEREST AND PEN. .00 TOTAL DUE 71.3OCR TF pATD AFTER THTS DATE~ SEE REVERSE FOR CALCULATION OF ADDTTTONAL TNTEREST. TF TOTAL DUE IS LESS THAN $1,, NO PAYMENT IS REI~UTRED. 'rF TOTAL DUE 'rs REFLECTED AS A "CRED'rT" (CR},, YOU HAY BE DUE A REFUND. SEE REVERSE S'rDE OF TH'rS FORH FOR 'rNSTRUCT'rONS. } ~EV~1470 EX ~-88)  INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 28O6O1 HARRISBURG~ PA 17128-0601 DECEDENT'S NAME FILE NUMBER ETHELWYN KAUTZ 2102-0341 REVIEWED BY ACN Phyllis Hoch 02110832,02122928 ITEM SCHEDULE NO. EXPLANATION OF CHANGES ADJUSTED ABOVE ACN'S TO ZERO. REPORTED ON PROBATE RETURN. REFUND DUE. ROW Paqe 1 BUREAU OF ZNDZVIDUAL TAXES ZHHERTTANCE TAX DTVZS/ON DEPT. 280601 HARRISBURG, PA 17128-0601 MARK E HALBRUNER ESQ 101~ MUMMA RD STE 100 LEMOYNE PA 170q$ COMMONWEALTH OF PENNSYLVANZA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTZONS AND ASSESSMENT OF TAX DATE 12-02-2002 ESTATE OF KAUTZ DATE OF DEATH 02-01-2002 FILE NUMBER 21 02-05ql COUNTY CUMBERLAND ACN 101 RE¥-lS47 EX AFP (01-02) ETHELWYN Amount Remitted I MAKE CHECK PAYABLE AND REMZT PAYMENT TO: REGTSTER OF WTLLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAZN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-02) NOTZCE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DZSALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KAUTZ ETHELWYN FILE NO. 21 02-0541 ACN 101 DATE 12-OZ-ZOOZ TAX RETURN NAS: (X) ACCEPTED AS FTLED ( } CHANGED RESERVATION CONCERNZNG FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORI$INAL RETURN I Real Estate (Schedule A) 2 Stocks and Bends (Schedule B) $ Closely Held Stock/Partnership Interest (Schedule C) Mortgages/Notes Receivable (Schedule D) $ Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6 Jointly Owned Property (Schedule F) 7 Transfers (Schedule G) 8 Total Assets APPROVED DEDUCTZONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule 1) 11. Total Deductions Net VaIue of Tax Return (1) .00 (2) .00 ($) .00 (~) .00 (5) 2z955.00 (6) 5/017.81 (7) lq2;$$4.82 (B) NOTE: To insure proper credit ~o your account, submit the upper portion of this form with your tax payment. 150,$07.65 (9) lq,192.09 (10) 6,qSq.05 (].1) 20.62&. ]4 (12) 129,681.49 15. lq. NOTE: Charitable/govarneental Bequests; Non-elected 9115 Trusts (Schedule J) (15) Nat Value of Estate Subject to Tax (lq) :Zf an assessment was lssued previously, lines 1~, 15 and/or 16, 17, reflect figures that lnclude the total of ALL returns assessed to date. .00 129,681.49 18 and 19 Hill (].5) .00 x O0 = .00 (].6) 129,681.q9 x 045= 5,855.67 (].7) .00 x 12 = .00 (lB) .00 x 15 = .00 (].9)= 5,855.67 AMOUNT PAZD ASSESSMENT OF TAX: 15. Amount of Line lq at Spousal rate 16. Amount of Line lq taxable at Lineal/Class A rata 17. Amount of Line lq at Sibling rate 18. Amount of Line lq taxable at Collateral/Class B rate 19. Princ] )al Tax Due TAX CREDZTS PAYMENT RECEXrl D~SCOUNT DATE NUMBER INTEREST/PEN PA'rD (- 05-01-2002 CD001146 289. 11-01-2002 CD001800 . 5,500.00 46.20 TOTAL TAX CREDIT BALANCE OF TAX DUEI INTEREST AND PEN. TOTAL DUE IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 5,855.67 .00 .00 .00 ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT *rs RE{)UIRED. IF TOTAL DUE *rS REFLECTED AS A "CRED*rT" (CA), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF TH'rS FORH FOR INSTRUCTIONS.) BUREAU OF INDIVIDUAL TAXES TNHERTTANCE TAX DTVTSTON DEPT. Z80601 HARRISBURG, PA 171Z8-0601 MARK E HALBRUNER ESQ 1013 MUMMA RD STE 100 LEMOYNE PA 17043* COMNONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEHENT OF ACCOUNT DATE 1Z-O3-Z002 ESTATE OF KAUTZ DATE OF DEATH OZ-01-Z002 FILE NUMBER 21 02-0341 COUNTY CUHBERLAND ACN 101 RE¥-16n? EX AFP ¢01-02} ETHELNYN Amoun~ Remi:t:ted MAKE CHECK PAYABLE AND REMTT PAYNENT TO: REGISTER OF MILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credi:t :to your accoun:t, submi:t :the uppar por:tion of :this form wi:th your CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1607 EX AFP (01-02) ~ INHERITANCE TAX STATEMENT OF ACCOUNT ~ ESTATE OF KAUTZ ETHELNYN FILE NO. 21 02-0341 ACN 101 DATE 12-03-2002 THIS STATEHENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACM ZN THE NAHED ESTATE. SHO#N BELO# ZSA SUHNARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, ZF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 1Z-OZ-200Z PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): 5,835.67 PAYMENT RECEIPT DISCOUNT ¢+) DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID 289.47 05-01-2002 11-01-2002 CD001146 CDOO1800 .00 5,500.00 46.20 ZF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. { ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" {CR), TOTAL TAX CREDIT 5,835.67 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) BUREAU OF INDIVIDUAL TAXES TNHER/TANCE TAX D/VTS/ON DEPT. 280601 HARRTSBURG, PA 17128-0601 COHHONWEALTH OF PENNSYLVAN:iA DEPARTHENT OF REVENUE ZNHERTTANCE TAX STATEHENT OF ACCOUNT REV-i~O? EX AFP (01-02) MARK E HALBRUNER ESO 1015 MUMMA RD STE 100 LEMOYNE PA DATE ESTATE OF DATE OF DEATH FILE NUMBER · /i COUNTY ACN 12-09-2002 KAUTZ 02-01-2002 21 02-05ql CUMBERLAND 101 Aeount Reeitted ETHELWYN MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credi~ to your account, submit the upper portion of this fore with your tax payment. CUT ALONG THIS L'rNE ~ RETAIN LOWER PORTION FOR YOUR RECORDS REV-1607 EX AFP (01-02) aax INHERITANCE TAX STATEMENT OF ACCOUNT ESTATE OF KAUTZ ETHELWYN F'rLE NO. 21 OZ-OSql ACN 101 DATE 12-09-2002 THIS STATEMENT TS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN TN THE NAMED ESTATE. SHOWN BELO# TS A SUMMARY OF THE PRZNC/PAL TAX DUE, APPLICATION OF ALL PAYMENTS,, THE CURRENT BALANCE, AND,, ZF APPLICABLE, A PROJECTED TNTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-02-2002 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS CTAX CREDITS): 5,855.67 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER ZNTEREST/PEN PAID (-) AMOUNT PAID 289.q7 05-01-2002 10-$1-2002 CDOOllq6 CDO01800 .0O 5,500.00 q6.20 IF PAID AFTER THIS DATE, SEE REVERSE S/DE FOR CALCULATION OF ADDITIONAL INTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), TOTAL TAX CREDIT 5,835.67 BALANCE OF TAX DUE! .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF THTS FORM FOR ZNSTRUCTTONS. ) BUREAU OF INDIVIDUAL TAXES TNHERZTANCE TAX DTVTSZON DEPT. 280601 HARRISBURG, PA 17128-0601 CONHONWEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE INHERITANCE TAX STATEHENT OF ACCOUNT REV-Z69? EX AFP RITA H KEIH 6018 HUNNINGBIRD DR HECHANICSBURG PA '.17055 DATE 12-16-2002 ESTATE OF KAUTZ DATE OF DEATH OZ-01-ZOOZ FILE NUHBER 21 02-0541 COUNTY CUHBERLAND ACN 02122928 Amount: Rem ~/c'l:ed ETHELWYN HAKE CHECK PAYABLE AND RENXT PAYNENT TO= REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credi~ ~o your account, submit: ~he upper portion of ~his form wi~h your 1:ax payment. CUT ALONG TH'rS LTNE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1607 EX AFP (01-02) -## ZNHERXTANCE TAX STATENENT OF ACCOUNT ..~ ESTATE OF KAUTZ ETHELWYN FZLE NO. 21 02-0541 ACN 02122928 DATE 12-16-2002 THZS STATEHENT TS PROV/DED TO ADV]:SE OF THE CURRENT STATUS OF THE STATED ACN TN THE NANED ESTATE. SHO#N BELON IS A SUHNARY OF THE PRXNCTpAL TAX DUE, APPL]:CATZON OF ALL PAYNENTS, THE CURRENT BALANCE, AND, ZF APPL'rCABLE, A PROJECTED ZNTEREST FI';URE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 11-27-2002 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYHENTS (TAX CREDITS): .00 PAYHENT RECEIPT DISCOUNT (+) DATE NUNBER INTEREST/PEN PAID (-) AHOUNT PAID 08-10-2002 12-05-2002 CD001511 REFUND .00 .00 71.50 71.50- XF PAXD AFTER TH/S DATE, SEE REVERSE S~DE FOR CALCULAT[ON OF ADDZT[ONAL XNTEREST. ( ZF TOTAL DUE 1S LESS THAN $1, NO PAYNENT 1S REQUIRED. XF TOTAL DUE XS REFLECTED AS A 'CRED/T' (CR), TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. .00 .00 .00 TOTAL DUE .00 YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR /NSTRUCTTONS. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX BIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMHONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ZNHERZTANCE TAX STATEHENT OF ACCOUNT RITA M KEIM 22~5 LAMBS GAP RD ENOLA PA 17025-112~ DATE 12-16-2002 ESTATE OF KAUTZ DATE OF DEATH 02-01-2002 FZLE NUMBER 21 02-05~1 COUNTY CUMBERLAND ACN 02110832 Amoun~ Remi~ed RE¥-I~O? EX AFP (01-02) ETHELNYN HAKE CHECK PAYABLE AND REMZT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credit: ~o your account, submit: ~he upper por~:ion of ~:his for. wi~:h your ~:ax payment. CUT ALONG THIS L'rNE ~'* RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1607 EX AFP (01-0:~) ~N INHERITANCE TAX STATEHENT OF ACCOUNT N~ ESTATE OF KAUTZ ETHELNYN FILE NO. ZZ OZ-OSR1 ACN 02110852 DATE ZZ-16-Z00Z TNZS STATEMENT ZS PROVZDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAMED ESTATE. SHONN BELON ZSA SUHHARY OF THE PRZNCZPAL TAX DUE, APPLZCATZON OF ALL PAYHENTS, THE CURRENT BALANCE, AND, ZF APPLICABLE, A PROJECTED ZNTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-27-2002 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): PAYMENT DATE 05-27-2002 12-05-2002 .00 RECEIPT NUMBER CD00103~ REFUND DISCOUNT (+) INTEREST/PEN PAID (-) .00 .00 AMOUNT PAID ZF PAID AFTER TNZS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDZTZONAL INTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDZT" TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. .00 .00 .00 TOTAL DUE .00 YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR ZNSTRUCTZONS. )