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HomeMy WebLinkAbout01-0088 c, I / (p _OFFI6?3~N~ :2. I FILE NUMBER " 21 01 00088 ~, COUNTY CODE YEAR NUMBER -~-._~---- -- -- T ~~C;~:~~UIR;;~UMB~- . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT2BQ601 HARRISBURG. PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT REV. 1,.,0 n. li-40j I -~ I DECEDe-NT'S NAME (LAST, -FIRST. AND MIDDLE' INITIAL) - --- ---- ,Seyfried, Michael D. . DATFOF DEATH' (MM.OO:VEARj-- ----I -oATE1)F ~IH f H (MM-UU-YEAR)- :,0111112001 0710311954 l<iF M>pjJCABLE)SURilIVINGSp6uSE'S-fIiAME (LAST. FIRST"AND MIDDLE INITIAL)- I Seyfried, Rosa G. 18I -'~ Origin-arReturn ~ ~ :rl o THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS -SOCIA[ SECURITYNUMBER i 0-- 3~lnaerR&urnlQateOf~pi'ioi1O'12"~13-81)-- ------cJ - 2. SupplementSl Retum ---- w ~!;i:U) uo:=~ w~" rOo ,,~~ ~m ~ ! 0 4. Limited Estate 0 4a. Future Interest Compromise (dale of death after 12-12-S2) 18I 6. Decedent Died Testate (Attach copy 0 7. Decedent Maintained a Living Trust (Attach of Will) copy of Trust) o 9 Litigation Proceeds Received 0 10. Spousal Poverty Credit (date of death between 0 11.Election to tax under Sec. 9113(A) (Attach Sch 0) I 12-31-91 and 1-1-95) Blnllfinmnnlinlmllll\ Mark A. Denlinger, Esq. fIRMNAME(ifapPhcable)-- -- - , Mattson DeardorffWllliams & Otto ~ELEPHONENUMBER 7171243-3341 o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes .~ <nz Ww ~o ~z 00 ,,~ 10 East High Street Carlisle, PA 17013 _~:---.L--=---__ -------~- ----- -------- --~-------~ OFFICIAL USE ONLY None (1) (2) (3) (4) (5) (6) (7) 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) None None 3. Closely Held Corporation, Partnership or Sole-Proprietorship None 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. 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) 27,660.93 None None 27,660.93 (8) 249.00 (9) 10. Debts of Decedent, Mortgage liabilities. & Liens (Schedule I) (10) 249.00 (11) 11. Total Deductions (total Lines 9 & 10) 27,411.93 (12) 12. Net Value of Estate (Line 8 minus Line 11) (13) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 27,411.93 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 0.00 15. Amount of Une 14 taxable at the spousal tax rate, 27,411.93 x .00 (15) or transfers under Sec. 9116(a)(1.2) z 16.Amount of Line 14 taxable at lineal rate x .045 (16) 0 ~ -- ----- . ~ => 17.Amount of Line 14 taxable at sibling rate ,12 (17) ~ x ~ 0 " :l 18. Amount of Line 14 taxable at collateral rate x .15 (18) ~ 19. Tax Due (19) 0.00 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 20. 0 , ,~\~UUN\\\\\\\\U\l\\\I.~ Form REV-1500 EX (Rev. 6-00) Copyright 2000 form software only The Lackner Group, Inc. Declldent's'Complete Address: STREET ADDRESS 50 South Pin Oak Drive CITY Boiling Springs ~- -.--.- 1- -- ~-T--- STATE PA ZIP 17007 Tax Payments and Credits: 1 ~ Tax Due (Page 1 Une 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penally B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (3) 0.00 -..-- (4) (5) 0.00 (SA) (5B) 0.00 TotallnteresUPenal1y (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 2Q to request a refund 5. If Line 1 + Une 3 is greater than Line 2, enter the difference. This is the TAX DUE, A. Enter the interest on the tax due. 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;...................................................,......................... 0 t8I b. retain the right to designate who shall use the property transferred or its income;................................ 0 181 c. retain a reversionary Interest; or........................................ ................................................................... 0 181 d. receive the promise for life of either payments, benefits or care?......................................................... 0 181 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideraUon? .., ..' ... .., .,. ... ..., .,. ... ...,'" ... ...' .., .... ." ... .... .... ... .... ...... .... ... .... '" ... ....... ... .... .... 0 181 o 181 o 181 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ...... 4. Did decedent own an Individual ReUrement Account, annuity, or other non-probate property which contains a beneficiary designation?.................................................... ........................................................... 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 peri-,illies 6fper"iury. I decla're ftlafThave examfned this return, including accompanying schedules and statements. and to thebeS! of my knowledge and belief, it isTrue, correct andcompleie.' Declaration of preparer other than the personal representative is based on all inforlTl8tion of which preparer has any knowledge. SIGNMURE OF PERSJf~ SPO-N~BlE FOR FlUNG RETURN - -----p;oDRESS - - - - - /" g. . (, , .,1 , 50 South Oak Pin Drive ( / I :j I SIt.;A~U!E~~ES;:~~~,N~ ~~ URN __ADllREss-.-!3oi1mg Springs, P A ~OO2- _~ 04 fi 11_~'I/ :J ~krE Jc. l / DATE AUUHl:;~S DATE , 10 East High Street Carlisle, PA 17013 ~Ur4 F r 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) (ill. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (Un. The statute does not 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 rate imposed on the net value of transfers to or for the use of the decedent's tineal beneficiaries is 4.5%, except as noted in 72 P.S. s9116 1 ~2) [72 P .S. ~9116 (a) (1 )]. The tax rate imposed on the net value of transfers to or for the use ofthe decedent's siblings is 12% (72 P.S. ~9116 (a) (1.3)]. A sibling is defined, unoer Section 9102, as an 'Individual who has at least one parent in common with the decedent, whether by blood or adoption. *' COMMONWEALTH OF PENNSYlVjl.,NIA INHERITANCE TAX RETURN RESIOENT DECEDENT ESTATE OF Seyfried, Michael D. I SCHEDULE E I CASH, BANK DEPOSITS, & MISC. I PERSONAL PROPERTY I ~_ __________1_____ -----.. - -_..._------.._---._-------------.---- I FILE NUMBER 21 - 01 - 00088 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorshIp must be disclosed on schedule F. ITEM NUMBER 1 2 3 Shippensburg UnIversity .'wages!benefits due ondeath-- DESCRIPTION Mary Seyfried Estate - Distribution from mother's estate Houghton Mifflin. accrued royalties TOTAL (Also enter on Line 5, Recapitulation) VALUE AT DATE OF DEATH 24,038.53 2,796.45 825.95 27,660.93 I I L _ ____ ___ _ -, FILENUPIIBER---- I 21-01-00088 . SCHEDULEH RJNERAL EXPENSES & ADMNIS1RATlVECOSlS COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RET\.JRN RESIDENT DECEDENT ESTATE OF Seyfried, Michael D. Debts of decedent must be reported on Schedule I. ITEJVI--- -- -- --- - _.._-_._-_._~.._-_..- - -'~-"._-- --- NUMBER \. ... DESCRIPTION A. ; FUNERAL EXPENSES: - - - - -- -- --- --" ------ ---- B. i ADMINISTRATIVE COSTS: 1. I Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): 2. i Street Address City Slate Zip Year(s) Commission paid Attorney's Fees Martson Deardorff Williams & Otto - Estimated 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Rosa G. Seyfried Street Address 50 South Pin Oak Drive City Boiling Springs State P A Zip 17007 Relationship of Claimant to Decedent Spouse 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 ! Register of Wills - filing of Inheritance Tax Return TOTAL (Also enter on line 9, Recapitulation) --r--.- - AMOUNT +- _._m.____ I \ I I \ I I I \ I I I i I I I I I + --. .--- 150.00 89.00 10.00 249.00 '* I \ _._._._.__ .__._ L__. _ _ ._ -' --' ---- ..-....--. -"--'-'-,.--- -- I FILE NUMBER 21 - 01 - 00088 SCHEDULE J BENEFICIARIES COMMONWEAlTH OF PEN.NSYLVANIA INHERITANCE TAX RETURN L RESIDENT DECEDENT ----- -- ---- ------ ---. ',--- ESTATE OF Seyfried, Michael D. NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATiONSHIP TO __ _l_~~;~;t~~~~e(sl _ I Spouse I I I I I I I I , 1- AM;UNT OR SHARE -+ _ OF ESTATE 1100% of Estate I. TAXABLE DISTRIBUTIONS (Include outright spousal distributions) Rosa Garcia Seyfried 50 South Pin Oak Drive Boiling Springs, P A 17007 Enter dollar amounts for distributions shown above on fines 15 through 17, as appropriate, on Rev 1500 cover she t II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX is NOT IBEING MADE I 'B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEJT I F\.FlLES\DATAfILE"WILLS\\OO41.h wil _WLI tIIr.. VIII TISf111Y3 .USUS HOIH J.SV! NU NOUYlIOdllOJ WNOISQ:IOlW V "11(jl .g """'171M.> 1J'<>y'rm;[j "''''1''''W'' S3..ll:l:tO AWl :.\9 CEJNIV13l1lVNfOI1fO LAST WILL AND TESTAMENT I, MICHAEL DAVID SEYFRIED, of South Middleton Township, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me made. ITEM ONE I direct that all my legally enforceable debts, funeral expenses, testamentary expenses and all inheritance taxes shall be paid to the extent possible from the assets held or passing under ITEM FIVE hereof as soon as practicable after my decease and as part of the administration of my estate. ITEM TWO In the event my spouse shall predecease or fail to survive me by thirty (30) days, then I give such items of personalty as are itemized in a certain list, if any, attached hereto to the persons named thereon, which list is signed and dated by me at the end thereof. ITEM THREE If my spouse, ROSA GARCIA SEYFRIED, is living thirty (30) days after my death, then I give, devise and bequeath all of my estate, both real and personal property, unto my said spouse absolutely. Ifmy said spouse does not so survive me, then I give, devise and bequeath all the rest, residue and remainder of my estate, both real and personal property, unto my Trustee to be held or distributed by such Trustee under ITEM FIVE, C., hereof. ITEM FOUR In the event my said spouse shall disclaim all or any portion of any devise or bequest made to my said spouse under the foregoing ITEM THREE, then the amount otherwise payable shall be held by my Trustee under ITEM FIVE hereof. For purposes of the Trust established under ITEM FIVE hereof, my said spouse shall not be deemed to have predeceased me by virtue of my said spouse's exercise ofthe right to disclaim set forth herein. rt, M.D.S. Page I of 7 Pages ITEM FIVE RESIDUARY AND DISCLAIMER TRUST My Trustee shall hold the assets received under ITEMS THREE and FOUR hereof, if any, for the following purposes: A. My Trustee shall pay the net income, at least quarter-annually, to my spouse, ROSA GARCIA SEYFRIED, for life. In addition, my Trustee in my Trustee's sole discretion, may invade the principal of the Trust for the proper and adequate support of my said spouse. B. My Trustee shall further pay to my said spouse annually, such sum from the principal of the Trust as my said spouse may request in writing, provided, however, that said sum may not exceed the greater of Five Thousand Dollars ($5,000.00) or five percent (5%) of the aggregate value, at the time of said request, of the principal of the Trust hereunder. C. Upon the death of my said spouse my Trustee shall hold the principal ofthe Trust for the following purposes: 1. The Trustee shall use and apply as much of the income and principal as may be necessary in the sole discretion of my Trustee, in equal shares, for the support, well being and education of my children, KATHRYN 1. SEYFRIED and LISA C. SEYFRIED. 2. I direct that each of my said children shall have the right of withdrawal ofthe principal and any accumulated income of his or her share in the following manner: One-half (1/2) thereof as each shall attain the age of twenty-five (25) years, and the remainder of said share as each shall attain the age of thirty (30) years. In the event any of my said children shall fail to attain the age for distribution of any part of their share and shall be survived by issue, then his or her share shall be held by my Trustee for said issue and distributed to them equally as each shall attain the age of twenty (20) years. The share or undistributed share of any of my said children who shall not be survived by issue shall be distributed by my said Trustee equally to my remaining children in accordance with the terms hereof. 3. Prior to the distribution of the principal of any such share, my said Trustee shall have the sole discretion to invade the principal of said share for the support, maintenance and education of such child or issue of such deceased child, regardless of age. I'AC M.D.S. Page 2 of7 Pages ITEM SIX POWERS OF EXECUTRIX AND TRUSTEE In addition to the powers conferred by case Jaw, by statute, and by other provisions hereof, my Executrix and Trustee and their successors, shall have the following discretionary powers applicable to all property held by them which powers shall be effective without order of any court and shall exist until final distribution: A. To retain any property of any nature received by them for whatever period they shall deem advisable; B. To invest and reinvest all or any part of said property in such stocks, bonds, common trust funds, securities, accounts, certificates of deposit (including, but not limited to, stocks, bonds, common trust funds, securities, accounts or certificates of deposit of the Trustee) or other property, real or personal, as in their discretion they shall deem proper, without regard to statutes limiting the property which a fiduciary may purchase; C. To sell, transfer, exchange or otherwise dispose of, any part of said property, for cash or on terms, publicly or privately, or to lease, even for a term exceeding five (5) years or the duration of any trust herein, without liability on the purchasers or lessees to see to the application of the proceeds, and to give options for these purchases without the obligation to repudiate them in favor of a higher offer; D. To execute and deliver any deeds, leases, assignments or other instruments as may be necessary to carry out the provisions of any trust hereunder; E. To borrow money, including the right to borrow money from any bank and to mortgage or pledge any asset ofthe estate as security; F. To assume continuance ofthe status of any beneficiary with regard to death, marriage, divorce, illness, incapacity and the like in the absence of information deemed reliable without liability for disbursements made on such assumption; G. To pay from the trust, or the income therefrom, all debts or claims against my estate, or any taxes or similar charges on my estate; H. To make any distribution hereunder either in kind or in money, or partially in kind i" M.D.S. Page 3 of7 Pages and partially in money. Distribution in kind shall be made at the market value of the property distributed, and my Trustee, in my Trustee's absolute discretion, may cause the share distributed to any distributee to be composed of property similar to or different from that distributed to any other distributee; 1. To exercise any subscription right in connection with any security held hereunder, to consent to or participate in any recapitalization, reorganization, consolidation or merger of any corporation, company or association, the securities of which may be held hereunder, to delegate authority with respect thereto, to deposit investments under agreements, to pay assessments, and generally to exercise all rights of investors; J. To invest in endowment, insurance or annuity policies on the lives of beneficiaries of any trust hereunder; K. To continue in any partnership, joint venture, joint ownership or other business enterprise of which I am a part at the time of my death; L. To compromise claims; M. To continue for whatever period of time as they shall deem necessary any ownership as a tenant in common or as a partner, in real estate or other property and to act as I could have done had I been living; N. To lend money to my estate or to any trust created hereunder or to purchase from the estate or from any trust created hereunder, at the market value thereof at the time of purchase, any securities or other property tendered to them by my estate or any trust created hereunder at any time and from time to time within a period of nine (9) months after my death; O. In the event that any amounts are payable hereunder or under any trust created hereunder to a minor, or to a person otherwise under legal disability, or to a person not adjudicated to be an incapacitated person, but who, by reason of illness or mental or physical disability is, in the opinion of fiduciary(ies) hereunder, unable to properly administer such amounts, such amounts may be paid by the fiduciary(ies) hereunder in his, her or their sole discretion in any of the following ways as he, she or they may deem best: I. Directly to such beneficiary; II M.D.S. Page 4 of 7 Pages 2. To a legally appointed guardian of such beneficiary for the benefit of such beneficiary; 3. To a person having custody of such beneficiary for the benefit of such beneficiary; 4. By the fiduciary(ies) hereunder using such amounts directly to the benefit of such beneficiary. Evidence of the application or payment of an amount in such a manner shall be a full and complete discharge of the fiduciary(ies) hereunder to the extent of such payment or application. This paragraph shall be applicable to payments of income as well as principal. P. To employ agents, attorneys and proxies and to delegate to them such power as my personal representatives and Trustees consider desirable and to pay reasonable compensation for such services as may be rendered by such agents, attorneys and proxies; Q. To conduct an inventory of any safe deposit box necessary to the administration of my estate. R. To do all other acts in their judgment necessary or desirable for the proper management, investment and distribution of my Estate. ITEM SEVEN PROTECTIVE PROVISIONS All income or principal held for the use and benefit of any trust hereunder shall not be in any way or manner subject to anticipation, assignment, pledge, sale or transfer, nor shall any such interest, while in the possession of my Trustee, be liable for or subject to the debts, contracts, obligations, liabilities or torts of any beneficiary, or to attachments, executions or sequestrations under process oflaw. ITEM EIGHT APPOINTMENT OF EXECUTRIX, TRUSTEE AND GUARDIAN I nominate, constitute and appoint my spouse, ROSA GARCIA SEYFRIED, as Executrix of my estate. In the event that my said spouse shall predecease me or fail to act as Executrix, then I appoint PETER M. GIGLIOTTI as Executor afmy estate. M.D.S. Page 5 of 7 Pages I nominate, constitute and appoint my spouse, ROSA GARCIA SEYFRIED, as Trustee of any trust created hereunder. In the event that my said spouse shall fail or be unwilling to act or continue to act as Trustee, then I appoint my spouse's parents, ESTANISLAO GARciA and ERNEST A RODRIGUEZ DE GARCiA, or the survivor of them, as Trustee of any trust created hereunder. I nominate, constitute and appoint my spouse's parents, ESTANISLAO GARCiA and ERNEST A RODRIGUEZ DE GARCiA, or the survivor of them, as Guardian(s) of the persons of any minor children. In the event either shall fail or be unwilling to act or continue to act as Guardian( s), then I nominate, constitute and appoint my spouse's sister, CARMEN SARA GARCiA, as Guardian of the persons of any minor children. ITEM NINE WAIVER OF BOND I direct that neither my Executrix or Executors nor my Trustee(s) shall be required to file any bond in any jurisdiction to secure the faithful performance oftheir duties, nor shall they be required to obtain any order or approval of any court for the exercise of any power or discretion set forth in this Will. nltl~ IN WITNESS WHEREOF I have hereunto set my hand and seal this aooo 31^ol- day of f1. Ld:..J 'Do..) Se:r./;.,'J Michael David Seyfried (SEAL) SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testator, as and for his Last Will and Testament, in the presence of us, who at his request, have hereunto subscribed our names as witnesses thereto, in the presence of the said Testator and of each other. ~ ~t~ -rrJL..-- 1d~~ r C !'>>'tf t:'^'-' {/ Page 6 of 7 Pages COMMONWEALTH OF PENNSYL VANIA ) SS. COUNTY OF CUMBERLAND ) I, Michael David Seyfried, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Kl'.1..J Oa",".t ~.f',.,;; Michael David Seyfried Sworn or affirmed to and acknowledged before me by Michael David Seyfried, the Testator, this 3rtL day of n~ ' ~OO . U V, Notary Public or ARIAl SEAL CORRINE l. MYERS, Notary Public Carlisle Bora. CumberlandCounty M Commission Exp~es Ma 27, 2003 COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) We, '1; t:/I'U&-..v, I ;, 1- L{) v t Yl Cr and lrir1 "'- ru it Y C 9 ~-fon . the witnesses whos&lnames are signed to the attached or foregoing instrument, being du y qualified according to law, do depose and say that we were present and saw Michael David Seyfried, the Testator, sign and execute the instrument as his Last Will; that the Testator signed willingly and that the Testator executed it as his free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight ofthe Testator, signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. A:~"'~'F:1.~ ~ l2..~ ~- Addr ss '/y . eA 17<'0-1 Sworn or affirmed to and subscribed before me this 3nl day of fY1[Ll-J ,.;J(jOO. C_LJ"A~'''--n~~ Notary Public___ I NOTARIAL SEAL CORRINE l. MYERS, Notary Public Cc"ligieBvra. CumberlandCounty Page 7 of 7 Pages' "..,'i.," "rp','.s May 27, 2003 PETITION FOR PROBATE and GRANT OF LETTERS Estate of MICHAEL DAVID SEYFRIED No. a/so known as To: Deceased. Social Security No. 080-46-1836 21-01-88 Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner is 18 years of age or older and the Executrix named in the last will of the above decedent, dated May 3, 2000, and codici1( s) dated [none]. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal residence at 50 South Pin Oak Drive, South Middleton Township Decedent, then 46 years of age, died January 11, 2001, at Carlisle Hospital, Carlisle, Pennsylvania. Except as follovis, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ unestimated $ $ $ WHEREFORE, petitioner respectfully request the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary t ereon. l) (L./ U tf Rosa Garcia Seyfried 50 South Pin Oak Drive Boiling Springs, P A 17007 (717) 258-8477 rl OATH OF PERSONAL REPRESENTATIVE COMMONWEAL TH OF PENNSYLVANIA) : SSe COUNTY OF CUMBERLAND ) The petitioner above-named swears or affirms that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner and that as personal representative of the above decedent, petitioner will well and truly admi ister the esta accordin to law. tI-. Sworn to or affirmed and subscribed before me this 19th day of JANUARY , 2001. >7J7.t{ j/ C' ijI//./ /, .. ~[ . /~.-tP-,(~/ /'.' . / Register I /b - ~(J~-~ No. 21-01-88 Estate of MICHAEL DAVID SEYFRIED, Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW, JANUARY 19, 2001 , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated May 3, 2000, described therein be admitted to probate and filed of record as the last will of Michael David Seyfried and Letters Testamentary are hereby granted to Rosa Garcia Seyfried. Will Book # 16 Page 204 ~ \., I 7j-2/ZLt,/ (/ '~~;e/r'j~i~~,,6'f / 0 ~Zy TOTAL $ $ $ $ $ 60.00 6.00 18.00 5.00 89.00 Mark A. Denling~r, Esquire (83794) ATTORNEY (Sup. Ct J.D. No.) MARTSON DEARDORFF WILLIAMS & OTTO 10 East High Street Carlisle, P A 17013 (717) 243-3341 FEES Probate, Letters, Etc. ~hort Certificates( ) x-page.s . RenuncIatton JCP Filed 1-19-2001 F: \FILES\DA T AFILE\EST A TES\ 1 0047 -petition.ltr 1.805 REV 9/86 This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be .forwarded to the State Vital Records Office for pern1anent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. ", II' JIll II """ """I', 1111'~ ~\\\\ OF PE";"',,, \I\~'" I;"p, _ l\~" ... .'. ... ~"\. l~_'.!I'- -. ~\ f~, c ~.'. '... ~~ ~Qf -f' )-;: ::: c.,.;) '''"5' ~~ \*~' ". ~..~.3.........,. ;/*$ \* ". '~~d- C ~l ~~ . ~l ~~~JtMENl \)\ ~~IIIII\\ ~"'-"'N#,,"'II'JIII' II 21'~ t:\. ~~~~~ Local Registrar Fee for this certificate, $2.00 P 6947778 JAN 1 2 2001 Date 21-01-88 OS. 143 Rev 2187 COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH a VITAL RECORDS CERTIFICATE OF DEATH Ie. SEX 2. Male STATE "lE NUMIIER SOCIAl SECURITY NUMBER OATE OF OEATH ,McnIIl, o..~, '.." NAME OF OECEOENT (F'f.. MlCldle. La., ,. Michael D. Se fried AGE (Latl BwMay) UNDER t YEAR UNDER' DItt 46 Y.... MonItIa o.y. Hours! MInt.l.. S. COUNT'r Of oeRH :1.080 46 - 1836 4. January 11, 2001 Cumberland PlACE Of OEATH CC"eck Ot*'f I)r>e - __ .nal,uctoOns on ome. _I HOSPITAL: OTI-4f.R: Buffalo, NY InpalientOO E~I""" 0 ~ D 7. ... FACILITY NAME (" no! ~1\A1Ofl. oove SlrHl anO number. Carlisle Hospital ... KIND Of' BUSINESSIINOUSTRY BIRTHI't..Aa: (C.rv anO SIa.. 01 f Cteql Country) =tIylO ~I' . ... RACE - A_Indian. lllKk. While. ate, (SpecIy, DECEDENT'S USUAL OCCUMION (~-=:~:O~:::r:t~ . "a. Professor nit. College OECEOENT'S MAILING ADOAESS (SIr". CiIyfTown. sw.. Zip Codel OECEDENT'S ACTUAL RESIDENCE /See ItIlIlrUI:IIONI on 0lI'Ier SIOeI to. White SUAVlVlNG SPOuSE (n ...... gMl matCIen namel WAS oeCEDENT EVER IN U.S. AAMED FORCES? __0 Ho[! MAAfTAL STATUS. MIItNd N_MUTied, ~. ~~ Married Rosa Garcia South Middleton 1Wp. '7., Stale PA 50 South Pin Oak ,e. Boilin S rin s FRltEA'S NAME IFIfSI. Middle. LaS!) 1.. John Se fried INFORMANT'S NAME (T ypetPrinIl . Rosa Seyfried METHOO OF DISPOSITION 8wIet 0 C'_1on IXI OIlIer (SpectIyI Dr. PA 17007 t7b. Did d8ceclenl I\Ie in I Cl1mb~rland 1ClOmIhip? t7cf.O ~-==':::OI MOTHER'S NAME IFirsl. Moddle. M...,.... Sufname, ciI'f/bcln). n PA 17007 Caskets Inc L 21cf. TV Hoffman-Roth Funera Uc.219 N. Hanove St. Carlisle PA 17013 LICENSE NUMBER DATE SIGNED (Monltl. Day. "-. nit. M.o(\':o9/~-.'(.. 23c. :::r<<."'.....&--.. I' 2.~.1 WAS CASE REFERREO TO ME~ EXAMINEAfCORONER? "'.~ No!] 21. . Apptol<imal. PART II: OIlIer aiQl\iIIcanI ~ concriIIullng to deeth. bul : =- ..:::' _l'HUtIing in tile undat1ying _ g;...., in PIVn' I. I I lb. c. d. WERE AU1Of>SY FINDINGS .aaAlLA8l.E PAIOA 10 COMPU:TlON Of' CAUU OF oeRH? G. V'l ' ~ ,r- DUE 10 (OR AS A CONSEOUENCE OF): Y" D MANNER OF DEATH ........ Jir HomiCide 0 Aceidenl 0 Pendir>g InvestigaUon 0 Suicide 0 Could _ be delam"ned 0 DATE OF INJURY IMonth. Oay. Year) TIME OF INJURY INJURY AT If.ORK7 DESCRIBE HOW INJURY OCCURRED. Yee 0 NoD 2Ie. 210. CUfTIf'IEA fC"acJt oniv onel .canIFYING PHYSICIAN (PhySIC_ Cl!r1l1ytng cause OIl <leaCh wt>.." anolher phYSOCo8n t\aa pronounced dealll ar><l completed "em 231 To lhe best of my knowledge. de.ttI 0<<,,"" _ to lhe causell,afld manne' a. It81ed. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . lS. . 3Gb. PLACE OF INJURY. AI 110m.. larm. au.... lactQ<'t. olllc. builcllng. arc. cSpecM :lao. M. :JOe. ~. ~eu..~~ ~ IO..d,ul o :lllt. LICENSE Noli! 'I"RONOUNCING AND CERTIFYINQ PHYSICIAN lPh~..n bolt1 ;:>tonOUflC'''9 oealh and CerldyonqlO cauS4I or deal"l To ttI. bee1 01 my kno.....g... dealll OC""'rH at lhe lIm<o, ct.,.. and placa. afld due 10 lhe "ausela' afld man"., al Ilaled.. . . . . . . . _ . . . . . . . . . . . . . . . . " OZ. v~) I 'MEDICAl EXAMIHERlCORONEA On the bu.. 0' ell,mln,tlon ,nd/o, Investigation, In my opinion, deat" occurred It the lime. dlte, and place, end due to the cluse("lnd m,nner I. stlted.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :l1a. REGISTRAR'S SIGNATURE ANO N B o :14. F: \FILES\DA T AFILE\EST A TES\ 1 0047-notice.cer ~ ~ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: MICHAEL DAVID SEYFRIED Date of Death: January 11, 2001 File No. 21-01-0088 To the Register: I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on or about March 27, 2001. Rosa Garcia Seyfried, 50 South Pin Oak Drive, Boiling Springs, P A 17007 Guardian of Kathryn 1. Seyfried, 50 South Pin Oak Drive, Boiling Springs, P A 17007 Guardian of Lisa C. Seyfried, 50 South Pin Oak Drive, Boiling Springs, P A 17007 Date: March 27, 2001 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: N/A tj~ A~ Mark A. Denlinger, Esquire MARTSON DEARDORFF WILLIAMS & OTTO Ten East High Street Carlisle, P A 17013 (717) 243-3341 Attorneys for Personal Representative Signature Name 1.......-., Name of Decedent: Date of Death: File No.: Social Security No. : {" \1 ", I-,.J! K- O. L-v ( REGISTER OF WILLS OF CUMBERLAND COUNTY STATUS REPORT UNDER RULE 6.12 (For Resident Decedents Dying After July 1, 1992) MICHAEL DAVID SEYFRIED January 11,2001 21-01-0088 080-46-1836 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes x No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: 0 ~. ("W') CL .' ~. :> 0 2 ...- c. p ;;<~ !i!1d the personal representative file a final account with the Court? ~tes No x ~....) ,1{te separate Orphans' Court No. (if any) for the personal f~presentative's account is: "'-f Ii),) d: fPid the personal representative state an account informally to the parties in tU- G ~nterest? . q;es No x [Personal representative was surviving spouse and sole heir; therefore, no accounting was necessary.] d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. f~A~ Mark: A. Denlinger, Esquire MARTSON DEARDORFF WILLIAMS & OTTO Ten East High Street Carlisle, P A 17013 (717) 243-3341 Counsel for personal representative Date: November 16,2001 F: \FILES\DA T AFILE\EST A TES\ 10047 -srep Signature: Name: Address: \/6'-0205/- ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG~ PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11-05-2001 SEYFRIED 01-11-2001 21 01-0088 CUMBERLAND 101 MARK A DENLINGER ESQ MARTSON ETAL 10 E HIGH ST CARLISLE PA 17013 '* REV-15li7 EX AFP n2-00) MICHAEL D Amount Remitted ) CHANGED (1) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 27~660.93 .00 .00 (8) 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 ~ iE-v = iS47-ix--AFP-fi'2:ocir-tioT-ici--OF-INHiifiTANci-T-A"X-A-ppijrisii.rENT~--Ai.i-oWANCi-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SEYFRIED MICHAEL D FILE NO. 21 01-0088 ACN 101 DATE 11-05-2001 TAX RETURN WAS: (X) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: NOTE: (9) (10) 249.00 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 27,660.93 '49 00 27,411.93 .00 27,411.93 (19)= .00 .00 .00 .00 .00 .00 (11) (12) (13) (14) 27,411.93 X 00 = .00 X 045= .00 X 12 = .00 X 15 = PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCT1~NS.) F. IFI LESIDA T AFILEI WILLSI 1 0047 -h.wil LAST WILL AND TESTAMENT 21-00-88 I, MICHAEL DAVID SEYFRIED, of South Middleton Township, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me made. ITEM ONE I direct that all my legally enforceable debts, funeral expenses, testamentary expenses and all inheritance taxes shall be paid to the extent possible from the assets held or passing under ITEM FIVE hereof as soon as practicable after my decease and as part of the administration of my estate. ITEM TWO In the event my spouse shall predecease or fail to survive me by thirty (30) days, then I give such items of personalty as are itemized in a certain list, if any, attached hereto to the persons named thereon, which list is signed and dated by me at the end thereof. ITEM THREE If my spouse, ROSA GARCIA SEYFRIED, is living thirty (30) days after my death, then I give, devise and bequeath all of my estate, both real and personal property, unto my said spouse absolutely. Ifmy said spouse does not so survive me, then I give, devise and bequeath all the rest, residue and remainder of my estate, both real and personal property, unto my Trustee to be held or distributed by such Trustee under ITEM FIVE, c., hereof. ITEM FOUR In the event my said spouse shall disclaim all or any portion of any devise or bequest made to my said spouse under the foregoing ITEM THREE, then the amount otherwise payable shall be held by my Trustee under ITEM FIVE hereof. For purposes of the Trust established under ITEM FIVE hereof, my said spouse shall not be deemed to have predeceased me by virtue of my said spouse's exercise of the right to disclaim set forth herein. /""{ : M.D.S. Page I of 7 Pages ITEM FIVE RESIDUARY AND DISCLAIMER TRUST My Trustee shall hold the assets received under ITEMS THREE and FOUR hereof, if any, for the following purposes: A. My Trustee shall pay the net income, at least quarter-annually, to my spouse, ROSA GARCIA SEYFRIED, for life. In addition, my Trustee in my Trustee's sole discretion, may invade the principal of the Trust for the proper and adequate support of my said spouse. B. My Trustee shall further pay to my said spouse annually, such sum from the principal of the Trust as my said spouse may request in writing, provided, however, that said sum may not exceed the greater of Five Thousand Dollars ($5,000.00) or five percent (5%) ofthe aggregate value, at the time of said request, of the principal of the Trust hereunder. C. Upon the death of my said spouse my Trustee shall hold the principal of the Trust for the following purposes: 1. The Trustee shall use and apply as much ofthe income and principal as may be necessary in the sole discretion of my Trustee, in equal shares, for the support, well being and education of my children, KATHRYN 1. SEYFRIED and LISA C. SEYFRIED. 2. I direct that each of my said children shall have the right of withdrawal ofthe principal and any accumulated income of his or her share in the following manner: One-half (1/2) thereof as each shall attain the age oftwenty-five (25) years, and the remainder of said share as each shall attain the age of thirty (30) years. In the event any of my said children shall fail to attain the age for distribution of any part oftheir share and shall be survived by issue, then his or her share shall be held by my Trustee for said issue and distributed to them equally as each shall attain the age oftwenty (20) years. The share or undistributed share of any of my said children who shall not be survived by issue shall be distributed by my said Trustee equally to my remaining children in accordance with the terms hereof. 3. Prior to the distribution of the principal of any such share, my said Trustee shall have the sole discretion to invade the principal of said share for the support, maintenance and education of such child or issue of such deceased child, regardless of age. f'1C M.D.S. Page 2 of 7 Pages ITEM SIX POWERS OF EXECUTRIX AND TRUSTEE In addition to the powers conferred by case law, by statute, and by other provisions hereof, my Executrix and Trustee and their successors, shall have the following discretionary powers applicable to all property held by them which powers shall be effective without order of any court and shall exist until final distribution: A. To retain any property of any nature received by them for whatever period they shall deem advisable; B. To invest and reinvest all or any part of said property in such stocks, bonds, common trust funds, securities, accounts, certificates of deposit (including, but not limited to, stocks, bonds, common trust funds, securities, accounts or certificates of deposit of the Trustee) or other property, real or personal, as in their discretion they shall deem proper, without regard to statutes limiting the property which a fiduciary may purchase; C. To sell, transfer, exchange or otherwise dispose of, any part of said property, for cash or on terms, publicly or privately, or to lease, even for a term exceeding five (5) years or the duration of any trust herein, without liability on the purchasers or lessees to see to the application of the proceeds, and to give options for these purchases without the obligation to repudiate them in favor of a higher offer; D. To execute and deliver any deeds, leases, assignments or other instruments as may be necessary to carry out the provisions of any trust hereunder; E. To borrow money, including the right to borrow money from any bank and to mortgage or pledge any asset ofthe estate as security; F. To assume continuance ofthe status of any beneficiary with regard to death, marriage, divorce, illness, incapacity and the like in the absence of information deemed reliable without liability for disbursements made on such assumption; G. To pay from the trust, or the income therefrom, all debts or claims against my estate, or any taxes or similar charges on my estate; H. To make any distribution hereunder either in kind or in money, or partially in kind '\1 M.D.S. Page 3 of 7 Pages and partially in money. Distribution in kind shall be made at the market value of the property distributed, and my Trustee, in my Trustee's absolute discretion, may cause the share distributed to any distributee to be composed of property similar to or different from that distributed to any other distributee; 1. To exercise any subscription right in connection with any security held hereunder, to consent to or participate in any recapitalization, reorganization, consolidation or merger of any corporation, company or association, the securities of which may be held hereunder, to delegate authority with respect thereto, to deposit investments under agreements, to pay assessments, and generally to exercise all rights of investors; 1. To invest in endowment, insurance or annuity policies on the lives of beneficiaries of any trust hereunder; K. To continue in any partnership, joint venture, joint ownership or other business enterprise of which I am a part at the time of my death; L. To compromise claims; M. To continue for whatever period oftime as they shall deem necessary any ownership as a tenant in common or as a partner, in real estate or other property and to act as I could have done had I been living; N. To lend money to my estate or to any trust created hereunder or to purchase from the estate or from any trust created hereunder, at the market value thereof at the time of purchase, any securities or other property tendered to them by my estate or any trust created hereunder at any time and from time to time within a period of nine (9) months after my death; O. In the event that any amounts are payable hereunder or under any trust created hereunder to a minor, or to a person otherwise under legal disability, or to a person not adjudicated to be an incapacitated person, but who, by reason of illness or mental or physical disability is, in the opinion of fiduciary(ies) hereunder, unable to properly administer such amounts, such amounts may be paid by the fiduciary(ies) hereunder in his, her or their sole discretion in any of the following ways as he, she or they may deem best: 1. Directly to such beneficiary; j I M.D.S. Page 4 of 7 Pages 2. To a legally appointed guardian of such beneficiary for the benefit of such beneficiary; 3. To a person having custody of such beneficiary for the benefit of such beneficiary; 4. By the fiduciary(ies) hereunder using such amounts directly to the benefit of such beneficiary. Evidence of the application or payment of an amount in such a manner shall be a full and complete discharge of the fiduciary(ies) hereunder to the extent of such payment or application. This paragraph shall be applicable to payments of income as well as principal. P. To employ agents, attorneys and proxies and to delegate to them such power as my personal representatives and Trustees consider desirable and to pay reasonable compensation for such services as may be rendered by such agents, attorneys and proxies; Q. To conduct an inventory of any safe deposit box necessary to the administration of my estate. R. To do all other acts in their judgment necessary or desirable for the proper management, investment and distribution of my Estate. ITEM SEVEN PROTECTIVE PROVISIONS All income or principal held for the use and benefit of any trust hereunder shall not be in any way or manner subject to anticipation, assignment, pledge, sale or transfer, nor shall any such interest, while in the possession of my Tmstee, be liable for or subject to the debts, contracts, obligations, liabilities or torts of any beneficiary, or to attachments, executions or sequestrations under process oflaw. ITEM EIGHT APPOINTMENT OF EXECUTRIX, TRUSTEE AND GUARDIAN I nominate, constitute and appoint my spouse, ROSA GARCIA SEYFRIED, as Executrix of my estate. In the event that my said spouse shall predecease me or fail to act as Executrix, then I appoint PETER M. GIGLIOTTI as Executor of my estate. ! L_ M.D.S. Page 5 of 7 Pages I nominate, constitute and appoint my spouse, ROSA GARCIA SEYFRIED, as Trustee of any trust created hereunder. In the event that my said spouse shall fail or be unwilling to act or continue to act as Trustee, then I appoint my spouse's parents, ESTANISLAO GARCIA and ERNEST A RODRIGUEZ DE GARCIA, or the survivor of them, as Trustee of any trust created hereunder. I nominate, constitute and appoint my spouse's parents, EST ANISLAO GARCIA and ERNESTA RODRIGUEZ DE GARCIA, or the survivor of them, as Guardian(s) of the persons of any minor children. In the event either shall fail or be unwilling to act or continue to act as Guardian( s), then I nominate, constitute and appoint my spouse's sister, CARMEN SARA GARCIA, as Guardian of the persons of any minor children. ITEM NINE WAIVER OF BOND I direct that neither my Executrix or Executors nor my Trustee( s) shall be required to file any bond in any jurisdiction to secure the faithful performance oftheir duties, nor shall they be required to obtain any order or approval of any court for the exercise of any power or discretion set forth in this Will. IN WITNESS WHEREOF I have hereunto set my hand and seal this 3 rPl.. day of do 00 n)~~ t1.L~ Vac.&J $~.(,./J Michael David Seyfried (SEAL) SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testator, as and for his Last Will and Testament, in the presence of us, who at his request, have hereunto subscribed our names as witnesses thereto, in the preseJ;1ce of the said Testator and of each other. -==61~~ 1 a~ f' c~'t.~ Page 6 of 7 Pages COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) I, Michael David Seyfried, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. H.lJavl Oal/C-~ ~f,.,;} Michael David Seyfried Sworn or affirmed to and acknowledged before me by Michael David Seyfried, the Testator, this 3rtt day of n~ ' ~OO . . U v 0 COUNTY OF CUMBERLAND ) : SS. ) OT ARIAL SEAL CORRINE L. MYERS, Notary Public Carlisle Boro, CumberlandCountv M Com~!~o~i2~ Expi',es Ma 27. 2003 COMMONWEALTH OF PENNSYLVANIA We, J:s 'C+~ll (:, --r LJ () (n LF and Y'vI it rw it Y. C ~ ~A:J+z-n ) the witnesses whos ames are signed to the attached or foregoing instrument, being dufy qualified according to law, do depose and say that we were present and saw Michael David Seyfried, the Testator, sign and execute the instrument as his Last Will; that the Testator signed willingly and that the Testator executed it as his free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the Testator, signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. ~-~ 6.JA __ Address :'t" ~ 1 ~~. a",~ ,&:, Addr ss ':5,q(, f/!, ~ I!do 0 ;:)~.~>. eA 1700f Sworn or affirmed to and subscribed before me this 3rtl day of }),\[L~ ' 0).(,;00. ~L'>A~'-n'rr~ Notary Public r NOT ARIAL SEAL I CORRINE L. MYERS, Notary Public Carlisle Bora, CumberlandCounty Page 7 of 7 Pages' - do""', 1 FlIiJ:~:~S May 27, 2003