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Home My WebLink About02-0910 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1162 EX(11-9B) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ALLFIRST TRUST C/O KATHLEEN A SMITH AST VP 21 EAST MARKET STREET YORK, PA 17401 n______ fold ESTATE INFORMATION: SSN: 067-03-1638 FILE NUMBER: 2102-0910 DECEDENT NAME: RESTIVO GRACE DATE OF PAYMENT: 10/08/2002 POSTMARK DATE: 10/07/2002 COUNTY: CUMBERLAND DATE OF DEATH: 06/05/2002 NO. CD 001702 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $2,159.04 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: ALLFIRST TRUST C/O KATHLEEN A SMITH ASST VP CHECK# 20351794 SEAL INITIALS: SK RECEIVED BY: REGISTER OF WILLS $2,159.04 MARY C. LEWIS REGISTER OF WILLS ~ }t1 ~ ~ ~ ~ w " '" a ~ '" 9 w '" ....'lJO\o efIJ-t: 1.0 ;:!: ,.." w ,",::E~<: .........00.. ~ ~~~~ ~"'Ow w . 0 M"'Ow l- t/) :) a: ~Ol- ~~... '-C'cc -C\/z =-~o~ . I.IJ a.. tIl '" ~ o ..c:tIl t::~ ~(j) 0.. C)CtIl .,..:t:: "- -= ......<l: C1l C') -=CI:J~ - ~ 0"0 -':O"'(j)r-- ""'=:C)StIl"- -=-0>'" =C....o~a.<l: = C1l 0 -= "t: l.-..c: _ = tIl tilt:: tIl :.01;) :J(ii = ~ "5,C!, .~ =~tIl'-'C1l -=C)!l::..-C) $ iii allflrsto Allfirst Trust 21 East Market Street P.O. Box R69 York. Pi\. 174050869 7178523072 ~J..I-oJ.-qJO October 3, 2002 Cumberland County Courthouse Register of Wills - Altn: Sue 1 Courthouse Square Carlisle, PA 17013 Re: Grace Restivo Estate Dear Sue: You will find enclosed an original and a copy of the Pennsylvania Inheritance Tax Return to be filed in regard to the above named estate along with checks in the amount of $2,159.04 for the tax due and $15.00 for the filing fee. I have also included a third copy to be clocked and returned to us in the enclosed envelope. Please do not hesitate to contact me if you have any questions. Thank you for your assistance. Very truly yours, Kathleen A. Smith Assistant Vice President and Trust Officer Direct Number: Fax Number: Toll-Free Number: (717) 852-3016 (717) 852-3004 (800) 624-4116 x3016 Enclosures ~"'f'i:}"32 HI05.805 REV 9/86 This is to certify that the information here given is correctly copied fran: an original certificate of death dul~ filed with me as Local Registrar. The original certificate will be forwarded to the State VItal Records Office for permanent filmg. WARNING: It is illegal to duplicate this copy by photostat or photograph, P 8453782 No. ,.,.//f/''''''''''''", ""~'I-\.1" OF Ptj;...... "'~'" 'f;f(. l~..-... . ~-=:.:~ $~--' <:;;:., ~~-~. :. ~~ ~:E! ~- .~..' '.';#~ ~~i' -=P-: I-~ \'-'~"'T !""l \*' . '_ ':' T/.i*,~ \.~ .-.-~<'~~~l ,..",fl,. '---r~'-':':'" ""..'"ENT\): //.'1' '"",,,,,,,,11/1 ~Lf!&r1l " Fee for this certificate, $2.00 6 -902- Date Hll)f,'''JR...2.'*l COMMONWEALTKOF PEHHSYLVAH1A. DEPARTMENT OF HEALTH. 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AU,HNEROfOElliIM - s- O o Ooill'EQFII'lIJURY ......."'o.r._l TIMEOfIlUllAY """""""R\/IIfOfIK1 OIESCRI8EItOoItItiAlflYOCCUIlNO_ _0 ..0 - -- .'....- P"'-'Il~ o o o 'lACEOfIKJUAY..l.i__._.'-'-....,. M. DuII<InI.-=-ISp.u., - ,.. 0 ,.,0 Al:G'SlRAR-SSlOHAfUf'EANONl,Juet:R 12-t.;<,;),.J,~l.- '" ":AlUpuZ;;Li-CER# llC(NSf;I<<JM8ER DMEs.QflIED~Otww;_1 o ,.(.;lC;)iJ~-'4'j- "... .J"'''''i!' S i'c;vZ, NMlEIoNOI\OOAeSSOf P(/ISQN WHO~lEOCAUSf:OF0lE1\{1'I (lIeml7}f_...P..... .4/~:J<>... t :r C6i-prn' 00 o ~. s:..~_~.~. (j~' f-~ / r/// (lRE'ILEO..........o.._. CIIuId___.....O>>d "'- aM.P'C~_.,...,.".., .CSlfIFY1Nll""~'~_~_rJ....._~..,.""_\;...Il'___......;CI'n_......231 Tcl__"'........................-..-_..__c.,__...-........._._..._... h,.._.,.___,.. H. ~ I ! a 1 . , .,fIoC C INCINGANOClIUIf'YINGil'HYSlCIAff~_"'''''''''"'>OQ_____'1'''9IO'......'''_1 Tcl__ol...'_.....,.._OICC......aII.._....I.,.....'_._.._.._e_.'_...._...,~.... -'-l;lICALEXJlMltllEAI(;OROlIUl o..tNltqi'"'..-..MIOft''''''''' 1.........._.III...Y",......... d._ace........, alltte II..... dOl.. _.pIKol. _ d...l" lh c...M(.,.... _Utt.IId.. ~,.. u b J> ;:::;;;>., REV.l500EX(S.(lO) . COMMONWEALTH OF PENNSYLVANIA . DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 OFFICIAL USE ONLY INHERITANCE TAX RETURN RESIDENT DECEDENT /7-C,3----? _~~~~~L,~"",.._._"_"""'"''''~,,~~_.~,_,_~''''''' FILE NUMBER tAL-fLd _4jJ_~~fJ COUNTY CODE YEAR NUMBER I- Z W Q W (,) W Q DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Restivo, Grace SOCIAL SECURITY NUMBER 067-03-1638 -~,- ~._..,--- , THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS DATE OF DEATH (MM-DD-YEAR) 06/05/02 DATE OF BIRTH (MM-DD-YEAR) 12/18/06 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER w ::.::;;'" ,,"'''' w"" ",00 ,,"'''' ..", .. .. ~ 1. Original Return D 4. Limited Estate D 6. Decedent Died Testate (Allach copy of Will) o 9. Litigation Proceeds Received D 3. Remainder Return (dale of death prior 10 12-1H2) D 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113{A) (AltadlSchO) D 2. Supplemental Return D 4a. Future Interest Compromise (dale of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Altadl copy of Trust) D 10. Spousal Poverty Credit (dale of death between 12-31--91 and 1-1--95) >- z w c z o .. '" w '" ~ " NAME Kathleen A, Smith FIRM NAME{ii Applicable) AI/first Trust TELEPHONENUMBER .. (717) 852-3016 COMPLETE MAILING ADDRESS 21 East Market Street York, PA 17401 1. Real Estate (Schedule AJ 2. Stocks and Bonds (Schedule B) (1) (2) , OFFICIAL USE ONIv 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) (4) (5) z o 5 :> l- ii: <l: (,) w IX 4. Mortgages & Notes Receivable (Schedule OJ 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) Q. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-VIVos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 11,111,97 47,978,85 (6) (7) 59,090_82 59,090.82 (9) (8) 8,826,76 2,285,21 (11) (12) (13) (10) 14. Net Value Subject to Tax (Line 12 minus Line 13) 47,978.85 (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o !ci: I-' :> II.. :!!! o (,) g 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x ,0 (15) 47,978_85 x ,0 45 (16) 2,159,04 16. Amount of Line 14 taxable at lineal rate 17. Amount of Une 14 taxable at sibling rate x .12 (17) x .15 (18) 18. Amount of Line 14 taxable at collateral rate 19. Tax Due (19) 2,159,04 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Decedent's Complete Address: STREET ADDRESS ___. Lona Meadow ADts #T7 1 Richland Lane CITY Camp Hill Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credils/Payments A. Spousal Poverty Credil B. Prior Payments C. Discount I STATE . PA (1) Tolal Credils (A + B + C ) (2) 3. InteresVPenalty if applicable D.lnleresl E. Penalty TotallnleresVPenalty ( D + E ) (3) 4. If Line 21s grealer Ihan Line 1 + Line 3, enler the difference. This is Ihe OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) I ZIP 17011 2,159.04 5. If line 1 + Line 3 is greater than line 2, enter the difference. This is the TAX DUE. 2,159.04 A. Enter the interest on the tax due. (5) (5A) B. Enler Ihe total of Line 5 + 5A. This is Ihe BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 2,159.04 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred;.......................................................................................... [R} b. retain the right to designate who shall use the property transferred or its income; ............................................ D c. retain a reversionary interest; or.......................................................................................................................... 0 d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 4. Did decedent own an Individual Retirement Account, annuity, or other non.probate property which contains a beneficiary designation? ....... ................................................................................................................. [:KI No D [KJ [KJ [KJ [KJ [KJ D IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ILlNG RETURN ADDRES Allfirst rust, 21 East Market Street. York, PA 17401 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS DATE 09/23/02 DATE ill" .~~ ~._-- Iml. ~ uNrIllllli!! ~ llllilllilil_ For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. ~9116 (a) (1.1) (i)]. For dales of dealh on or after January 1,1995, Ihe tax rale imposed on Ihe nel value of Iransfers 10 or for Ihe use of Ihe surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does nol exemDt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. ~9116(a)(1 .2)]. The tax rale imposed on Ihe net value of transfers 10 or for Ihe use of Ihe decedent's lineal beneficia"es is 4.5%, excepl as noted in 72 P.S. ~9116(1 ,2) [72 P.S. ~9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1737-6 EX + (9-00) , . '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN NONRESIDENT DECEDENT ESTATE OF sa ...I:'G INTER-Vl\ICS 1RANSFERS .. MSC NON-L. :JBf.UE.. , __." Use Schedule G, Part 2, ONLY for proportionate method of tax computation. Grace Restivo FILE NUMBER Part 1 must include all transfers of real estate and intangible personal property located in Pennsylvania. Complete Part 2 ONLY WHEN THE PROPORTIONATE METHOD OF TAX COMPUTATION IS ELECTED. Include in the description of property the date the transfer was made and the name and relationship of the transferee. This schedule must be completed and filed if the answer to questions 1 through 4 on the reverse side of the REV-1737 cover sheet is yes. FlART 1 - PROPERTY OR TANGIBLE PERSONAL PROPERTY LOCATED IN PENNSYLVANIA THAT WAS TRANSFERRED DESCRIPTION OF PROPERTY ITEM Include the name of the transferee, their relationship to Decedent and the date of NUMBER transfer. Attach a copy of the deed for real estate. 1. Grace Rest:ivo T/A ARK US Treasury Honey Market: Fund ARK Funds Int:ermediat:e Fixed Income Port:fo1io %OF DATE OF DEATH OECO'S EXCLUSION VALUE OF ASSET INTEREST (IF APPLICABLE) TAXABLE VALUE 5,509.74 100 53,324.16 100 256.92 100 2. Waypoint: Bank Checking Account: No. 700045073 FlART 2 - ALL OTHER TRANSFERS _ 1 'ICIN.. $ 59 090 82 100 $ $59 090 82 DESCRIPTION OF PROPERTY ITEM Include the name of the transferee, their relationship to Decedent and the date of NUMBER transfer. Attach a copy of the deed for real estate. DATE OF DEATH VALUE OF ASSET %OF DECD'S EXCLUSION INTEREST (IF APPLICABLE) TAXABLE VALUE 1. _ 2 'ICIN.. $ $ $ 'ICIN.. (Also enter on line 7. Recapitulation) $ (If more space is needed, insert additional sheets of the same size) REV-1737 -6 EX ... (9...{JO) . RE~ERSE _ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN NONRESIDENT DECEDENT ESTATE OF Grace Restivo 9a -..I:'H FU\ERAL EXPENSES Br ACIVII\I51Rm1VE UUlD.a Use Schedule H ONLY for proportionate method of tax computation. FILE NUMBER ITEM NUMBER A. Debts of decedent must be reported on Schedule I. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: Township of Hempstead - Grave Opening Neill Funeral Home, Inc. - Funeral Expense 530.00 8,007.42 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Represenlative(s) NI A Social Security Number(s) EIN Number of Personal Representative(s) Street Address City __________________~____________ Stale ________ Zip Year(s) Commission Paid 2. Attorney Fees NI A 3. Probate Fees N / A 4. Accountant's Fees NI A 5. Tax Return Preparer's Fees N/A 6. Miscellaneous Expenses Allfirst Trust - Trustee Fees 289.34 "R:J-... (Also enter on line 9. Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 8,826.76 REV.1737-7 EX + (9-DO) '*' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN NONRESIDENT DECEDENT ESTATE OF Grace Restivo Part 1 must include mortgage liabilities, liens and taxes against the Pennsylvania realty that were due and owing as of the date of decedent's death. Complete Part 2 ONLY when the proportionate method of tax computation is elected. Use Schedule J, Part 2, ONLY for ~.:t CJF L..... -- -~ proportionate method of tax computation. ~I~ U.AElU'1IES, Br UENS sa _ 1111 .1:" I ~ 1 _ OBLIGATIONS AGAINST PENNSYLVANIA REALTY ITEM NUMBER FILE NUMBER DESCRIPTION 1. AMOUNT "1OR-_1 $ ~ :2 _ ALL OTHER DEBTS OF THE DECEDENT ITEM NUMBER 1. . 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. DESCRIPTION Griswold Special Care - Contract Services Expense PA State Employees Credit Union - Caregiver Service 5/27 & 6/2 - 6/5/02 Commerce Bank - Lucille Phillips - clean out apartment Fast Tax - 2001 1040 Tax Preparation Fee Rite Aid Pharmacy - prescriptions Comcast Cable - final bill Albert J. Zanetti, DOPC - medical expense PPL Electric - utility expense Verizon - telephone expense AT&T - telephone expense UGI Utilities, Inc. - utility expense AMOUNT 45.00 250.00 800.00 1000.00 578.52 6.55 60.89 27.70 9.76 7.02 99.77 n:JPW.._ 2 "IODL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ 2,285.21 $ 2,285.21 REV-1737-7 EX + (9-00) REVERSE . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN NONRESIDENT DECEDENT ESTATE OF Grace Restivo 5CI -*_I::"J EEI\EFIOARIIES FILE NUMBER When flat rate method is elected, list the beneficiaries of the Pennsylvania property. When proportionate method is elected, list all beneficiaries. NUMBER I. RELATIONSHIP TO DECEDENT Do Not List Trustee(s) 1. NAME AND ADDRESS OF PERSON(S) RECEJV!NG PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions, and transfers under Sec. 9116 (a)(1.2)] Peter Joseph Restivo 73 Widdicombe Hill Blvd. Suite 1515 Toronto, Ontario H9R4B3 Canada Son . AMOUNT OR SHARE OF ESTATE 100% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON REV-1737 COVER SHEET ORTHE PROPORTIONATE METHOD WORKSHEET ON THE REVERSE SIDE OF REV-1737 COVER SHEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. "IODlL Of'_1I ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1737 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) :rltUST AGEEEMENT I, Grace Restivo, of York County, Pennsylvania, hereby transfer to The York Bank and Trust Company (hereinafter called the Trustee), a Pennsylvania bank and trust company, such property as may be delivered contemporaneously herewith, or at such time or times hereafter, to be held in Trust and hereby amend the Trust instrument executed by me on February 17th, 1998, as follows: FIRST: Dispositive Provisions For My Benefit - During my lifetime: A. All of tile net income shall be paid to me at least quanerly or shall be paid or accumulated and added to principal, as I may direct in writing; B. As much of the principal as I may from time to time request in writing shall be paid to me, or as I may otherwise direct; c. If, in the Trustee's opinion, I am at any time unable to act or to apply the payments to my best interest and advantage, the. Trustee may apply directly for my benefit as much of tile income andlor principal as the Trustee may, from time to time, deem appropriate for my welfare, comfon, suppon or emergency needs, directly and without the intervention of a guardian, and may add to principal as much of the income as the Trustee deems advisable. D. Trustee shall keep true and correct books of account, which books of account shall at all reasonable times be open to the inspection of myself or my duly appointed representative. Trustee shall also render quanerly to me, Grace Restivo, a detailed statement showing all receipts and disbursements on account of the trust estate and the manner and fonn in which the trust estate is invested at the time of the rendition of such statement. . SECOND: Dispositive Provisions After Death - Upon my death, the balance of any principal and income shall then be paid to my son, Peter Joseph Restivo or his heirs. I specifically and intentionally omit any bequest to my daughter, Marsha Douglas, formerly Martha A. Restivo, to my grandson, Frank Reda, or to my granddaughter, Sherri Reda. In addition, the Trustee shall pay to the Probated Estate any sums necessary to pay expenses of . administrat ion and debts of the Estate. In the event that Peter Joseph Restivo predeceases me, I then direct that all principal and accumulated income be paid over to the Salvation Army of York, 50 East King Street, York, Pennsylvania. THIRD: - Additions to Trust - Subject to the approval of the Trustee, I, or any other entity, may add property, real and personal, to the principal of this trust. FOURTH: Trustee's Powers - In addition to the powers granted by law, my Trustee shall have the following discretionary powers, applicable to principal and income, which shall be exercisable without leave of court and shall continue until distribution is actually made. A. To accept and retain any or all property at any time hereafter delivered or in any other manner hereafter acquired, including stock or other securities of the Trustee, or of a holding company controlling the Trustee; B. To invest in all forms of property (including, but not by way of limitation, real estate, all types of stocks, bonds, options, and participations in common trust funds and money market funds); without being corifined to investments prescribed by statute and without being required to diversify; C. To buy investments at a premium or discount; D. To hold property unregistered or in the name of a nominee; E. To give proxies, both ministerial and discretionary; F. To compromise claims; G. To join in any merger, consolidation, 'reorganization, voting trust plan, or other concerted action of security holders, and to delegate discretionary duties with respect thereto; Ii. To borrow from The York Bank and Trust Company or from others, and to pledge real or personal property as security therefor; to loan cash or securities upon such terms and cO!lditions as trustees deem appropriate. 2 I. To sell at public or private sale for cash or credit or partly for each to exchange. to improve or to lease for any period of time. any real or personal property; and to give options for sales. exchanges. or leases. J. To allocate any property received or charge incurred to principal or income or partly to each. without being obliged to apply the usual rules of trust accounting; K. To distribute in cash or in kind or partly in each; L. To retain any part or all of my business interests held in this Trust as long as the Trustee considers it advisable to do so; and to conduct. alone or with others. any such business in which either or both of us are engaged. with all the powers of an owner or with respect thereto. including the power to delegate discretionary duties to others and to pay adequate compensation to any such person; to invest other property in such business. and to incorporate it or change its form. FIFfH: Compensation - The Trustee shall be compensated in accordance with its standard schedule of charges in effect from time to time during the period of its services, and this compensation shall be paid from principal or income or partly from each in the sole discretion of the Trustee. I hereby acknowledge receipt of Trustee's current fee schedule, which is subject to revision from time to time. SIXTH: Non-Assignment. No part of the income or principal of the property held under this Trust shall be subject to attachment, levy or seizure by any creditor, spouse, assignee or trustee or receiver in bankruptcy prior to actual receipt thereof. The Trustee shall pay over the net income and the principal to the persons herein designated, as their interests may appear, without regard to any attempted anticipation (except as specifically provided in this agreement), pledging or assignment under the Trust, and witho"ut regard to any claim thereto or attempted levy, attachment, seizure or other process against me. 3 ~ SEVENTH: Guardianship - If at any time hereafter, a proceeding is initiated in any jurisdiction to have a Guardian appointed for my estate, it is my express intention that the Court making such a determination, appoint The York Bank and Trust Company or its successor, as the Guardian of my estate. EIGHTH: Law Governing Trust - This trust is created and accepted in the Commonwealth of PelU1Sylvania and shall in all respects be governed by its laws and shall have . its situs at York County, PelU1Sylvania. NINTH: This Trust Agreement is hereby declared to be irrevocable and the Grantor shall have no right to alter or amend Same in any respect or particular. Executed on February 17, 1998. tk rJ~ll.. i?, l1tuJj~ ~ Witness .../~<-~;.....; Grace Restivo The foregoing Trust is hereby''itecepted. Executed on February 17. 1998. {?j- ;# ~i;' "w'" The York Bank and Trust Company By: ~~2~~n. ;.-- Title:. \J:c.<C- {}<"-5 Ick-M.-E:- ,0' trusts\restivo 4 .' '\. 1?-;7'3 J 7 BUREAU OF INDIVIDUAL TAXES :;teERITAHCE nx DI"ISIDH DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX '(: DATE ESTATE OF DATE OF DEATH FILE NUMBER l::llUNTY ACN 11-19-2002 RESTIVO 06-05-2002 21 02-0910 CUMBERLAND 101 Amount R..jtted --) KATHLEEN A SMITH ALLFIRST TRUST 21 E MARKET ST YORK *' REW-1547EX'FPC01-In GRACE PA 17401' MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER Of WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REY=is4-j-iY-AFi'--foFozY-NOi"ici--OF-Yriiiiifii'Ai"-ci-YAX-APPRAiSE"iNi"~--ALi.-OWANCE-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF RESTIVO GRACE FILE NO. 21 02-0910 ACN 101 DATE 11-19-2002 TAX RETURN WAS: (X I ACCEPTED AS FILED I CHANGED I~ an assessment Nas issued previously, lines 14, 15 and/or 16, 17, 18 and 19 N111 rrilect ~igures that inclUde the total ~ M:!.. returns assessed to date. ASSESSMENT OF TAX: 15. AIIount of Line 14 at Spousal rat. (IS) 16. ~ount of Line 14 taxable at Lineal/Class A rat. (16) 17. A.aunt of Line 14 at Sibling rat. (17) 18. A.aunt of LIne 14 taxable at Collateral/Class Brat. (18) 19. Principal Tax Due DITS: RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estat. (Schedule A) 2. stocks end Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Recelvable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule El 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets III 121 131 ('II (51 161 (7) .00 .00 .00 .00 .00 .00 59.090.82 (81 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ad.. Costs/Misc. ExPenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net V.lue of Tax Return 13. Chariteble/GovernMental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate SUbject to Tax (9) 1101 8,826.76 2.285.21 (11) (121 1131 1141 NOTE: .00 X 47,978.85 X .00 X .00 X . INTEREST/PEN PAID (-I .00 AHOUNT PAID 2,159.0<0 NUllBER CD001702 DATE 10-07-2002 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE NOTE: To insure proper credit to your account, s~lt the upper portion of this form with your tax paYlMInt. 59,090.82 11 .111 97 <07,978.85 .00 47,978.85 00 = 045 = 12 = 15 = .00 2,159.0<0 .00 .00 2,159.04 1191= 2,159.0<0 .00 .00 .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TDTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU HAY 8E DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)