HomeMy WebLinkAbout03-24-15 (2) 1505610149
Ex(02-11)JREV-1500 genn ania
OFFICIAL USE ONLY
PA Department of Revenue Countv Code Year File Number
Bureau of Individual Taxes
PO BOX 280601 INHERITANCE TAX RETURN 1
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
08 05 2014 07 23 1926
Decedent's Last Name Suffix Decedent's First Name MI
ERDMAN DANIEL R
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name Mf
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
® 1.Original Return O 2. Supplemental Return O 3. Remainder Return(Date of Death
Prior to 12-13-82)
O 4.Limited Estate O 4a. Future Interest Compromise(date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
O 6.Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
9. Litigation Proceeds Received 0 10. Spousal Poverty Credit(Date of Death = 11. Election to Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
ANTONIO D . MICHETTI , ESQUIRE 570 286 7777
REGISTER OF WILLS USE O%Y
First Line of Address
DIEHL , DLUGE , JONES & MICHETTI
Second Line of Address " r
1070 MARKET STREET J -r; T-1
DATE FILED 7__
c:7
City or Post Office State ZIP Code
SUNBURY PA 17801
- o --r-t
Correspondent's e-mail address: MICHETTILAW@GMAIL.COM
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN SL1�QUEsq1).9//✓4 7W0S7n-n/t1EST/YtE,tf7^(�o- USTEaE DATE
®� e-5
��
AD,,q// ss 400 ARK STREET
SUNBURY, PA 17801
SIGNA RE OF PREPARER OTHER THA RESENTATIVE DATE
ADDRESS 1070 MARKET STREET
SUNBURY, PA 17801
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610149 1505610149 J
1505610249
REV-1500 EX(FI)
Decedent's Social Security Number
Decedent's Name:
DANIEL R ERDMAN
RECAPITULATION
1. Real Estate(Schedule A).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 0 . 00
2. Stocks and Bonds(Schedule B) 0 . 00
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. 0 - 00
4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . 4. 0 - 00
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E) . . . . . . 5. 0 - 00
6. Jointly Owned Property(Schedule F) O Separate Billing Requested . . . . 6. 0 - 00
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested . . . . 7. 6 7 ,2 4 2 . 45
8. Total Gross Assets total Lines 1 through 7 6 7 ,242 - 4 5
9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . 9. 9 , 4 7 6 - 62
10. Debts of Decedent, Mortgage Liabilities and Liens Schedule I 11 , 626 - 20
11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 21 102 - 82
12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 46 , 139 - 63
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) . . . . . . . . . . . . . . . . . . . . . . . 13. 36 ,139 - 6 3
14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . 14. 10 -1000 - 00
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec. 9116
(a)(1.2)X.0 0 0 . 00 15. 0 . 00
16. Amount of Line 14 taxable
at lineal rate X .0 45 10 ,000 - 00 16. 450 - 00
17. Amount of Line 14 taxable
at sibling rate X .12 0 . 00 17 0 . 00
18. Amount of Line 14 taxable
at collateral rate X .15 0 - 00 18. 0 . 00
19. TAX DUE19. 450 - 00
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
1505610249 1505610249
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address: 14
DECEDENT'S NAME
DANIEL R ERDMAN
STREET ADDRESS
100 MT. ALLEN DRIVE
CITY STATE ZIP
MECHANICSBURG PA 17055
Tax Payments and Credits:
1. Tax Due(Page 2, Line 19) (1) 450.00
2. Credits/Payments
A.Prior Payments 0.00
B. Discount 0.00
Total Credits(A+B) (2) 0.00
3. Interest (3) 0.00
4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT.
Fill in oval on Page 2,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) 450.00
Make check payable to: REGISTER OF WILLS, AGENT.
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x.S I<f ., �!AS� !q wi�ila IiG�I1nm.. a� � ...�.AW.
,
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ ❑X
b. retain the right to designate who shall use the property transferred or its income . . . . . . . ❑ ❑X
c. retain a reversionary interest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ ❑X
d. receive the promise for life of either payments, benefits or care? . . . . . . . . . . . . . . . . . . . . ❑ ❑X
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of
death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ ❑X
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?. . . ❑ ❑X
4. Did decedent own an individual retirement account, annuity or other non-probate
property,which contains a beneficiary designation?.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑X ❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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Rig
For dates of death on or after July 1, 1994,and before Jan. 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an
adoptive parent or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)].A sibling is defined,
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
REV-1510 EX+ (08-09)
pennsylvania SCHEDULE G
DEPARTMENT OF REVENUE
INTER-VIVOS TRANSFERS AND
INHERITANCE TAX RETURN
RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
DANIEL R ERDMAN 14
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECO'S EXCLUSION TAXABLE
NUMBER INCLUDETHENAMEOFTHETRANSFEREE,THEIR RELATIONSHIPTODECEDENT VALUE OF ASSET INTEREST IF APPLICABLE VALUE
AND THE DATE OF TRANSFER.ATTACH COPY OF THE DEED FOR REAL ESATE.
1 $20,000 FEDERAL HOME LOAN BANKS 20,062.06
3.25% MATURITY 09/12/2014
ACCRUED INTEREST ON ABOVE ITEM 258.19
$10,000 FEDERAL HOME LOAN 10,126.64
BANKS4.75% MATURITY 11/14/2014
ACCRUED INTEREST ON ABOVE ITEM 105.56
FEDERAL GOVERNMENT MONEY MARKET 36,690.00
OBLIGATIONS ACCOUNT
The above assets were held in the decedent's 0.00
Agreement of Trust (Fifth Amendment) dated
February 28, 2013
TOTAL (Also enter on Line 7, Recapitulation) 67,242.45
If more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+ (08-13)
ip Pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITADECEDCE TAX ENT DENTTURN
RESIDENT ADMINSTRATIVE COSTS
ESTATE OF FILE NUMBER
DANIEL R ERDMAN 14
Decedents debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
1 OLLEY-GOTLOB FUNERAL HOME - FUNERAL EXPENSES 7,364.15
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
City State ZIP
Year(s) Commission Paid:
2. Attorney Fees:
2,000.00
3. 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
4. Probate Fees:
5. Accountant Fees:
6. Tax Return Preparer Fees:
7 SUSQUEHANNA BANK-TRUSTEE FEES 112.47
TOTAL (Also enter on Line 9, Recapitulation) 9,476.62
If more space is needed, use additional sheets of paper of the same size.
REV-1512 EX+ (12-12)
io pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE
DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
DANIEL R ERDMAN 14
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM DESCRIPTION VALUE AT DATE
NUMBER OF DEATH
1 ALERT PHARMACY SERVICE, INC. - PRESCRIPTIONS DUE 7.00
2 MESSIAH LIFEWAYS - NURSING HOME CARE DUE 11,619.20
TOTAL (Also enter on Line 10, Recapitulation) 11,626.20
If more space is needed, insert additional sheets of the same size
REV-1513 EX+ (01-10)
` pennsyLvania SCHEDULE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
DANIEL R ERDMAN 14
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and
transfers under Sec. 9116(a)(1.2).]
1 WILLIAM DAVEY SON 10,000.00
703 CHARLES STREET
MECHANICSBURG, PA
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1 SUSQUEHANNA UNIVERSITY 36,139.63
514 UNIVERSITY AVENUE
SELINSGROVE, PA 17870
100 % OF RESIDUE
.TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. 36,139.63
If more space is needed, use additional sheets of paper of the same size.
Estate Valuation
Date of Death: 08/05/2014 Estate of: Daniel a Erdman Jr.
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Valuation o��e� oo o�/xoz� n�couu�� ��o ouzr Daniel m Erdman Jr. Trust
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Processing nn� Date: 08/11/2014 xenurt Type: Date of ueDeatha e�
mumuv, of Securities: s
`
File ID: Erdman, Daniel u
Shares Security Mean and/or Div and Int Security
or ear Description High/Ask Low/Bid Adjustments Accruals value
z 10000 roouoxu omyo Lm oxa (szosxaMro)
Government/Agency (Dealer Quotations)
DTD: 04/13/2005 Mat: 11/14/2014 4.75o
uo/os/zoz« 101.2e640 Mkt
101.266400 10'126.64
Int: 05/15/2014 to 08/05/2014 105.56
z/ zoonn msnooAL HOME Lonm oxmxo (3133uUMmz)
co,ernmsnoaneo:v (Dealer Quotations)
DTD: 08/12/2009 Mat: 09/12/e014 3.25%
ou/os/euz^ 100.31030 Mkt
100.310300 20.0e2.06
Int: us/zz/onm to 08/05/2014 258.19
z> 36690 MONEY wxr ooLrao ro (onpa^wn«p) 36,690.00
roo sr ooLcmxGov
Total valve: $66'87e.70
Total xoccu*z. $363.75
Total: v67,242.45
Page z
This report was produced with ootatev^l, a product of Estate Valuations a Pricing avatema' Inc. If you have «oeotinns,
please contact onp Systems at (nzm ao-mno or www.evpnvs.com. (Revision 7.3.1)
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FIFTH AMENDMENT AND RESTATEMENT OF TRUST
"THIS INDENTURE, made this 28+` day of February, 2013, by and between
DANIEL RAYMOND ERDMAN, JR., of 1911 Logan Street, Camp Hill, Cumberland
County, Pennsylvania, party of the first part, hereinafter called "Settlor", and
SUSQUEHANNA TRUST& INVESTMENT COMPANY, successor in interest by
transfer of the trust accounts of First National Trust Bank, of Sunbury, having its office
or place of business in the City of Sunbury, at 400 Market Street, County of
Northumberland and Commonwealth of Pennsylvania, party of the second part and
hereinafter called "Trustee", WITNESSETH:
WHEREAS, Settlor and Trustee, then THE FIRST NATIONAL BANK OF
SUNBURY, entered into an Agreement of Trust dated February 13, 1962, which
Agreement amends in full the Indenture of Trust between the parties dated June 24, 1949;
and
WHEREAS, such 1962 Agreement of Trust was subsequently amended by
Amendments of Trust dated July 16, 1973, and January 26, 1989, and September 13,
2005; and
WHEREAS, it is Settlor's desire to hereby again amend and restate such 1962
Agreement of Trust; as amended, the same to be known as FIFTH AMENDMENT AND
RESTATEMENT OF TRUST;
NOW, THEREFORE, THIS INDENTURE WITNESSETH:
That for and in consideration of the premises and the sum of ONE ($1.00)
DOLLAR, lawful money of the United States, by the SETTLOR to the TRUSTEE paid,
the receipt whereof is hereby acknowledged, together with the mutual covenants herein
contained, the said SETTLOR has granted, conveyed, assigned, set over and delivered
and by these presents does hereby grant, convey, assign, set over and deliver unto the
TRUSTEE the entire sum or sums of principal and income accruals, if any there be, now
contained in the said Trust entered into between the parties hereto on or about the 24`h
day of June, A.D., 1949, as well as any other property, funds or securities which may be
subsequently added thereto:
TO HAVE AND TO HOLD the said sum or sums of principal and income
accruals, if any there be, now contained in the Trust entered into between the parties
hereto on or about the 24`h day of June, A.D., 1949, along with any other property, funds
or securities which may be subsequently added thereto, IN TRUST,NEVERTHELESS,
for and upon the following uses and purposes and subject to the following terms,
conditions and powers hereinafter set forth, viz.:
FIRST: The said TRUSTEE shall have full power and authority to retain,
manage, invest and re-invest, loan and re-loan, any of the funds hereunder in any stocks,
bonds or other property, real or personal, including any common trust fund operated by
the TRUSTEE hereunder and keep cash uninvested, without being confined or limited to
such investments as are defined and designated as "legal investments" for the investment
of trust funds, and without in any way being liable or responsible for any such investment
or loan or for any loss, dissipation or shrinkage in the value of the same, with the
obligation only to use good faith and to exercise its honest judgment as to what
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investments are from time to time for the best interests of the trust estate. TRUSTEE
shall be liable only for losses occasioned by gross negligence.
a. The said TRUSTEE shall have the power to become a party to and
participate in any dissolution, reorganization, consolidation, merger or capital
readjustment of any corporation or business in which the trust estate has an interest; to
subscribe for stock and bond privileges and to vote in person or by proxy upon all shares
of stock or bonds or other securities held by it and to consent in writing and join in any
voting trust, pooling or depository agreement with respect to any securities forming part
of the trust estate; to compromise controversies; to exchange or sell for cash, property or
credit, publicly or privately, or to lease for any term, considering, of course, the duration
of the trust hereunder, without liability on the purchasers or lessees, to see to application
of the consideration, and to give options for these purposes without obligation to
repudiate them in favor of a higher offer.
SECOND: The said TRUSTEE shall collect,recover and receive the interest,
income and proceeds as the same shall accrue or from time to time become due, and after
the payment, liquidation and satisfaction of any and all charges, costs, expenses, taxes
and compensation as TRUSTEE, pay quarterly unto the said SETTLOR the net income
arising from the said trust, for and during the term of his life. The first quarterly payment
to be made March 15 next. The SETTLOR may, from time to time, with the agreement
of the TRUSTEE, in writing, change the time of payment.
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THIRD: The SETTLOR shall have the right at any time,or from time to
time, to assign, transfer and deliver to the TRUSTEE any further sum or sums of money,
securities or other property. When and as such additional property shall be assigned,
transferred and delivered to the TRUSTEE, the same shall be received and held by it
under and upon the same terms and conditions as herein set forth, with the same force
and effect as if such additional property has been included and constituted a part of the
original trust estate.
FOURTH: The said TRUSTEE shall keep and maintain adequate books and
records reflecting all income and principal transactions hereunder, which books and
records shall be open at all reasonable times to the inspection of SETTLOR.
Paragraph FIFTH thereof is hereby revoked and amended by substitution as
follows:
FIFTH: The SETTLOR may revoke or amend this deed in whole or in part
at any time and from time to time,by a written instrument delivered to the TRUSTEE.
SIXTH: The TRUSTEE is authorized and directed to pay from the funds of
this trust the funeral and burial expenses of the SETTLOR as well as any expenses
connected with the last illness of the SETTLOR.
SEVENTH: In the event that the TRUSTEE shall at any time become a part of
any other corporation having trust powers or shall be merged with any other such
corporation or corporations into a new corporation having trust powers, then such
corporation of which TRUSTEE may become part, or which is created by such merger,
shall, without further action on the part of either of the parties hereto, be substituted in
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place and stead of the said THE FIRST NATIONAL BANK OF SUNBURY, PA, and
shall have all rights, duties and powers given to the TRUSTEE hereunder.
Paragraph EIGHTH thereof is hereby revoked and amended by substitution as
follows:
EIGHTH: The TRUSTEE shall be entitled to receive compensation for its
services in the administration of this trust. The compensation of the TRUSTEE shall be in
accordance with the TRUSTEE'S current fee schedule, said compensation may be
adjusted on an annual basis in accordance with annual changes in the TRUSTEE'S fee
schedule. The TRUSTEE is hereby authorized to deduct said compensation from income
received or the said principal fund at the time of distribution, or the final distribution, or
termination of the trust estate.
Paragraph NINETH thereof is hereby revoked and amended by substitution as
follows:
NINETH: At or upon the death of the SETTLOR,the within trust shall be
continued for the benefit of the widow of SETTLOR, DANIEL RAYMOND ERDMAN,
JR., if any, until the occurrence of the first of the following events: (a) the death of the
widow and (b) her remarriage, with the exception that the provision of the Indenture of
Trust in paragraph FIFTH supra shall not apply in so far as there shall no longer exist the
right to revoke or amend the Indenture of Trust in whole or in part and from time to time
in any manner whatsoever, nor shall there exist the right to withdraw principal from the
said trust residuary at any time except by the TRUSTEE pursuant to Paragraph EIGHTH
supra.
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TENTH: Paragraph tenth thereof was revoked and deleted by the THIRD
AMENDMENT OF TRUST.
ELEVENTH: Para graph eleventh thereof was revoked and deleted by the THIRD
AMENDMENT OF TRUST.
Paragraph TWELFTH thereof is hereby revoked and amended by substitution
as follows:
TWELFTH: Upon the death of the Settlor, any balance then remaining of said
trust, together with undistributed income shall be distributed as follows:
a. The sum of Ten Thousand Dollars ($10,000.00) to my step-son,
WILLIAM DAVEY, now of 703 Charles Street, Mechanicsburg, Pennsylvania, if he
survives me.
b. All rest, residue and remainder of said Trust residuary shall continue to
be held in trust by SUSQUEHANNA TRUST& INVESTMENT COMPANY, as
Trustee, the income from the Trust shall be used for the purpose of providing scholarship
money for Susquehanna University students who play for its football team. This
scholarship shall be known as the"DANIEL RAYMOND ERDMAN, JR.,
SCHOLARSHIP". The income from such trust fund shall be paid to one or more student
football player(s) who maintain satisfactory grades and who are in financial need. The
football player(s) to be awarded this scholarship shall be selected by the Director of
Financial Aid and the head football coach for the University, who in turn shall advise the
Trustee of their selection. The Trustee will then distribute the money to the Financial Aid
Office, or elsewhere as directed by that Office, for its handling of the funds on the
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selected student(s)' behalf according to Susquehanna University's Financial Aid Office's
customary procedure."
THIRTEENTH: This amended indenture of Trust constitutes the entire
agreement between the parties hereto.
1. In all other respects, we hereby ratify and confirm the provisions of the
aforesaid Agreement of Trust.
IN WITNESS WHEREOF, the said DANIEL RAYMOND ERDMAN, JR., has
hereunto set his hand and seal and SUSQUEHANNA TRUST& INVESTMENT
COMPANY has caused these presents to be executed by its duly authorized officers and
has affixed its corporate seal hereunto the day and year first above written.
WITNESS: ¢ &L--4
406-49 (SEAL)
Daniel Raymond Erdman, Jr.
SUSQUEHANNATRUST&
INVESTMENT COMPANY
ATTEST:
B
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COMMONWEALTH OF PENNSYLVANIA
i SS:
COUNTY OF �.��� ,,A ,\
On this day of j-i , 2013, before me, the undersigned
Officer, personally appeared DANIEL RAYMOND ERDMAN, JR., known to me(or
satisfactorily proven) to be the person whose name is subscribed to the within instrument,
and acknowledged that he executed the same for the purposes therein contained.
In Witness whereof, I hereunto set my hand and official seal.
COMMONWEALTH of pEW6nAANIA
Notarial Seal `
Hope L.Gulley,Notary Public ary Public
upper Allen Twp.,cumberiand County
Commission Ex fres Feb.
28tk NOTARIES
MEMBER,PENNSYWANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF rT T*
On the 6D.Ov),_day of ��4L , A.D., 2013, before me, the
undersigned, a Notary Public, in and for said County, personally came JOHN W.
STARTZEL, who is Vice President of SUSQUEHANNA TRUST & INVESTMENT
COMPANY, Sunbury, Pennsylvania, and acknowledged that the name of said Company
was subscribed to the foregoing Amendment of Trust by himself as Vice President
thereof, and that the seal affixed thereto is the seal of said Company, and that the said
name was subscribed and said seal attached to the foregoing Amendment of Trust, duly
attested by the direction and authority of said Company, and that the foregoing
Amendment of Trust is the free act and deed of said Company, for the uses and purposes
therein mentioned.
Witness my hand and seal.
tary Public
COMMONWEALTH OF PENNSnrlo
vANIA
Notarial seal Public
Hope L.Culley,Notary
upper Allen Twp.,Cumberland County
My Commission Expires Feb.28,2017
MEMBER,PENNM ANIA ASSOOA"OF NOTARIES
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