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Home My WebLink About01-0892 \. /'?-/~')-6 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG~ PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX DAVID J LENOX ESQ THE WILEY GROUP 1 S BALTIMORE ST DILLSBURG '02 1'lhY 1 7 P:2 .I~l DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 05-13-2002 GASPARI 06-29-2001 21 01-0892 CUMBERLAND 101 *' REY-1547 EX AFP (01-02) VICTOR T Allount Rellitted IUl.111o:19 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 ~ R"E-y=is4j-ix--AFP--foi-':ozi--NO'fici-OF-i-NHiifiTANCi-;--AX-A-PPRA-isiifENT~-Ati-oWAirci-iri----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF GASPARI VICTOR T FILE NO. 21 01-0892 ACN 101 DATE 05-13-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and re~lect ~igures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. AMount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due 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. Hortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Hisc. Personel Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) .00 5~545.42 .00 .00 100.00 226~806.71 272.967.29 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/GovernMental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) nO) 40,216.26 3.780.73 (11) (2) (13) (4) NOTE: .00 X 00 = 461,422.43 X 045 = .00 X 12 = .00 x 15 = NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 5051419.42 43.996 99 4611422.43 .00 461,422.43 19 will (9)= .00 201764.01 .00 .00 201764.01 TAX CREDITS: .- " ".1.''1 . K~l;~~"1 IT (+ J AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 09-26-2001 CDOO0321 12.09 229.63 03-28-2002 CD001014 .00 201522.29 TOTAL TAX CREDIT 201764.01 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 PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) "'y BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REY-U07 EX AFP COI-02) on- 'i1'i 17 D ,,} '/l 1 DAVID J LENO~ E~d l , t L .-, THE WILEY GROUP 1 S BALTIMaRE ST DILLSBURG Ct'! m. ,.PA 17019 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 05-13-2002 GASPARI 06-29-2001 21 01-0892 CUMBERLAND 101 Allount Rellitted VICTOR T MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REY=i6Cfj-ix-AFP--foi-:02i-------...-iNHiRITANc'E--YAX--STA-fEHEtif-oF'-Accouiif--...--------------------- ESTATE OF GASPARI VICTOR T FILE NO.21 01-0892 ACN 101 DATE 05-13-2002 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-13-2002 PR I NCI PAL TAX DUE: .......................................................................................................................-................................................................................................ 20,764.01 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 09-26-2001 CDOO0321 12.09 229.63 03-28-2002 CDOOI014 .00 20,522.29 TOTAL TAX CREDIT 20,764.01 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR1, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. 1 .- - ~ 1'/-/0-6 BUREAU Of INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV-l'D7 EX AFP (01-02) '02 l"II\Y 1 0 'r" 5 DONNA GREENE 3803 BELLOWS DR CAMP HILlt~., PA 17011 C\~ln,. DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 05-06-2002 GASPARI 06-29-2001 21 01-0892 CUMBERLAND 01003047 AIIouot Rellitted VICTOR T MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax pay.ent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REY=i6oj-ix--AFP--foi-:ozl-------...--iNitEixr-ANc'E-fAx--sTjrfEMENf-oF"-ACCOUNY--.-..--------------------- ESTATE OF GASPARI VICTOR T FILE NO. 21 01-0892 ACN 01003047 DATE 05-06-2002 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS Of THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-01-2002 PR I NCI PAL TAX DUE: ........................................................................................................................................................................................................................... .00 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR1, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE Of THIS fORH FOR INSTRUCTIONS. 1 ... 1'1-/0-6 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z8D6Dl HARRISBURG, PA 171Z8-0601 NOTICE OF INHERITANCE TAX APPRAISEKENT~ ALLOHANCE OR DISALLOHANCE OF DEDUCTION~, AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REY-iS.. Ell UP 112-00) DONNA GREENE 3803 BEllOWS DR CAMP HILL PA 17011 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 11-12-2001 GASPARI 06-29-2001 21 01-0892 CUMBERLAND 207-07-7412 01003047 Amount Remitted VICTOR T 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 ~ Rifi=i54-i-i3f-AFP--riz-:ooi------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 11-12-2001 ESTATE OF GASPARI VICTOR T DATE OF DEATH 06-29-2001 COUNTY CUMBERLAND FILE NO. 21 01-0892 TAX RETURN WAS: S.S/D.C. NO. 207-07-7412 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01003047 FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 5003174818 TYPE OF ACCOUNT: (>0 SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 10-12-1999 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 32,227.46 0.166 5,371.35 .00 5,371.35 .45 241.71 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WIllS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WIllS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) PAYMENT MUST BE MADE BY 03-30-2002*. TOTAL TAX CREDIT .00 BALANCE OF TAX DUE 241.71 INTEREST AND PEN. .00 TOTAL DUE 241.71 . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. · ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT-- ( CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) ;'7-/0; " COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT <)'/ ~ C-~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 REV-IU7 EX iFP [12-00> Recoraed Reoistg( "'-'" "-= of VviHs DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11-19-2001 GASPARI 06-29-2001 21 01-0892 CUMBERLAND 01003047 VICTOR T .01 NaV 26 All:45 DONNA GREENE 3803 BELLOWb~ i~>,,_,. n . .' CAMP HILL ^" . -'iJ" , l1ti1t....OUfl Wllmbenana GO't PA Allount R...itted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REY=i6o"7-Ex--AFP--fi'2-.:ooi-------...--iNHERITANcE'-TAx--STA-fEME-NT-ifF-ACCouiif--...--------------------- ESTATE OF GASPARI VICTOR T FILE NO.21 01-0892 ACN 01003047 DATE 11-19-2001 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-12-2001 P R I NC I PAL TAX DUE: ...................................................................................................................................................._................................................................... 241.71 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 09-26-2001 CDOO0321 12.09 229.63 TOTAL TAX CREDIT 241.72 BALANCE OF TAX DUE .01CR INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .01CR SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRl, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. l 1:~' r ". .~ (j~~ s cP~ -0 eo ~tPo ~~s " ~~ ~~Q 7PfP~ -'o~ e()~ CD '. ...... ",f.j . i " .. .. . .. . ".:. ....\ "', l.. . t.I' (.) ..-.. l',.} (t.\ \,,) ,'.,,\ -- t~ ~cl ~. ~t t ~:"" /', ., :v~ /",'{.\' ~ " I -~ -J ~ 11\) ~ '-..c:: G '0 .', - ". ~\C;-~'" ,_'; \ ", \~ .":) ~ l.. '" ",.-..I -" :: ~~ ==- ... ... -... ~ -:;. ... ... ." .-:'..... ;? ..... .... ::-... ... ... ~. ... ." ... ... -:::- - ... ~. ::- ." ~ ~ ~.~ \\ \\ ~ ~ . l\\" ! \ \- l I\~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT GREENE DONNA 3803 BELLOWS DRIVE CAMP HILL, PA 17011 -------- fold ESTATE INFORMATION: SSN: 207-07-7412 FILE NUMBER: 21-2001- 0892 DECEDENT NAME: GASPARI VICTOR T DA TE OF PAYMENT: 09/27/2001 POSTMARK DATE: 09/26/2001 COUNTY: CUMBERLAND DATE OF DEATH: 06/29/2001 NO. CD 000321 ACN ASSESSMENT CONTROL NUMBER AMOUNT 01003047 I $229.63 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: DONNA GREENE CHECK# 806 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS $229.63 MARY C. LEWIS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT DAVID LENOX C/O WILEY LENOX AND COLGAN PC POBOX 288 DILLSBURG, PA 17019 -------- fold ESTATE INFORMATION: SSN: 207-07-7412 FILE NUMBER: 2101-0892 DECEDENT NAME: GASPARI VICTOR T DA TE OF PAYMENT: 03/28/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 06/29/2001 NO. CD 001014 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $20,522.29 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: DAVID LENOX CHECK# 5079 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS $20,522.29 MARY C. LEWIS REGISTER OF WILLS I THE WILEY GROUP Attorneys at La~ Wiley · Lenox · Colgan · Marzzacco · P.C. March 28, 2002 Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PAl 7013 In Re: Estate of Victor T. Gaspari, Sr., deceased File Number 21-01-0892 Dear Register: Enclosed for filing please find the inheritance tax return in duplicate. Also enclosed is a check in the amount of $20,522.29 representing the tax due, and a check in the amount of$15.00 representing the filing fee. No probate processing was required in this matter, as assets were owned in the Living Trust, or as joint owners) or in other manners that did not require true estate administration. Accordingly the return is signed by the decedent's daughter. Donna L. Greene, acting in her capacity as Successor Trustee to the Revocable Trust. Please return the recording receipts to my attention in the enclosed envelope. Thank you for your cooperation. ?:;Y' y David J. ~EsqUire I/~ DJL/dg encl. jan ~. Wiley · David j. Lenox · Timothy j. Colgan · Christopher J. Marzzacco . Christine J. Taylor 1 South Baltimore Street · Dillsburg, PA 17019 · Phone: (717) 432-9666 · (800) 682-4250 . Fax: (717) 432-0426 Offices in Harrisburg · York · Carbondale I I I I I I I I I 110. Debts of Decedent, Mortgage Liabilities! & Liens (Schedule I) 1111. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) I 113. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) I 14. Net Value Subject to Tax (Line 12 minus Line 13) ----t- - SEE INSTRUCTIONS ON REVERSE SlOE FOR APPLICABLE RATES I 15.Amount of Line 14 taxable at the spousal tax rate, i or transfers under Sec. 9116(a)(1.2) uv .1100 EX. (I.oD) I ----..-1-- I~ ~i12 10 011.0 ' 5f~ 110 ~ 0 *' ./ REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFF !C1AL USE ONLY , to FILE NUMBER 21 01 COUNTY CODE YEAR SOCIAL SECURITY NUMBER 207-07-7412 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0801 0892 NUMBER ~ z w Q W o W Q DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL) Gaspari, Victor T DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM.DD-YEAR) THIS RETURN MUST BE FILED IN DUPUCATE WITH THE 06/29/2001 11/20/1914 REGISTER OF WILLS SOCIAL SECURITY NUMBER (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL) 1. Original Return o 2. Supplemental Return o 181 o 3. Remainder Ratum (data of death prior to 12-13-82) 4. Limited Estate 4a. Future Interast Compromisa (dale of death after 12-12-8.2) 7. Decedent Maintained a Living Trust (Attach copy of Trust) 10. Spousal Poverty Credit (data of death between o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11.Eiection to tax under Sec. 9113(A) (Attach Sch 0) 6. Decedent Died Testate (Attach copy of Will) 9. Litigation Proceeds Received ,~ UlZ Ww It:Q It:z 8~ 1 S. Baltimore Street Dillsburg, PA 17019 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (1 ) None OFFICL..:\L USE ONLY .......r .I' . 5,545-A:i d j-...l (2) (3) None :"""1 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) None (4) z o i= :3 :::l ~ ii: ot o w It: 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) t', ) ex) (5) 100.00 (6) (7) 'J '.. .<~J 226,806.71 272,967.29 ,jJ U''i (8) 505,419.42 (9) 40,216.26 3,780.73 (10) (11) 43,996.99 (12) 461,422.43 (13) (14) 461,422.43 x .00 (15) z o ~ :::l ... :i! o U ~ 16.Amount of Line 14 taxable at lineal rate 461,422.43 x .045 (16) 20,764.01 -----.--.-- 17.Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 20,764.01 CHECK HERE IF YOU ARE REQUESTING A REfUND OF AN OVERPAYMENT. Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 125 Lancaster Blvd CITY Mechanicsburg STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 20,764.01 229.63 12.09 Total Credits (A + B + C) (2) 241. 72 3. InterestlPenalty if applicable D. Interest E. Penalty TotallnterestlPenalty (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 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (3) 0.00 (4) (5) 20,522.29 (5A) (58) 20,522.29 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;................................:.................................................; ~ ~: ~::::~ ~h~e~~:i~on:~s:~;e~~s~~~..~.~.~.I~.~~~. ~~~. :.~.~.~.~.~ .~~~~~~~~~~~. ~.~ .i.~~.~~~~~~: :::::::::::: :::::::::: :::::: ::::: ::: d. receive the promise for life of either payments, benefits or care?............................................................. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?..................... ......................................... ..................................... ..... ......... ..... D D 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... D ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?..................................................................................................................... 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. DATE 3803 Bellows Dr. Camp Hill, PA 17011 3- .2- ADDRESS ADDRESS ')-0.2 DATE 1 S. Baltimore Street Dillsburg, Pa 17019 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. 99116 (a) (1.1) (i)]. 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. 99116 (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 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 .5. 99116 (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%, except as noted in 72 P .5. 99116 1.2) [72 P.S. 99116 (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. 99116 (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. Estate of: Victor T. Gaspari 21-01-0892 The following person(s) are signing the return as representatives of the taxable estate in the capacity gIven: Donna L. Greene Successor Trustee 3803 Bellows Drive Camp Hill, PA 17011 REVOCABLE TRUST AGREEMENT MADE this 16th day of July, 1998 by and between Victor T. Gaspari, Sr., individual and resident of Cumberland County, Pennsylvania, (hereinafter alternatively referred to as the "Settlor"), and Victor T. Gaspari, Sr., individual and resident of Cumberland County, Pennsylvania, as the Trustee (hereinafter alternatively referred to as the "Trustee"). WIT N E SSE T H: ARTICLE ONE (A) Establishment of Trost Estate: The Settlor has transferred and delivered to the Trustee that property more fully described in Schedule "A", attached hereto and made part hereof (the "Property"). The Trustee shall hold and administer the Property, together with all other cash or property of any kind which the Trustee at any time may acquire from the Settlor or from others by inter-vivos transfer or pursuant to beneficiary designations by Last Will and Testament or otherwise, including, but not limited to, the residue and remainder of Settlor's Estate as provided for in Settlor's Last Will and Testament ("Additions"), together with the proceeds, investments and reinvestments with respect thereto as a trust estate ("Trust Estate") on the terms and conditions hereinafter set forth. The name of the Trost herein created shall be THE VICTOR T . GASPARI, SR. REVOCABLE LIVING TRUST. (B) Distributions to Settlor Durine Settlor's Lifetime: During the lifetime of the Settlor, the Trustee shall pay to the Settlor or expend for the Settlor's benefit the entire net income produced by the Trust Estate ("Income") in convenient installments or otherwise as Settlor may from time to time direct, together with such portion of the principal of said Trust Estate as Settlor may from time to time direct in writing or, if Settlor gives no directions, as the Trustee deems advisable to provide for the health, welfare and comfortable support of the Settlor, and to continue Settlor's accustomed pattern of giving to individuals and organizations. Any unexpended Income shall be added to principal and invested as such. (C) Distributions of Trost Estate in the Event a Settlor Becomes Incapacitated: If at any time Settlor is under a legal disability, or if by reason of illness or mental or physical disability Settlor is "incapacitated," as such term is defined below, and is unable to make or communicate responsible decisions concerning Settlor's affairs, the Trustee shall use the income and part or all of the principal of the Trust Estate for the care, comfort and support of the Settlor, or for any other purpose which the Trustee, in their sole and absolute discretion, deem to be for the best interests of the Settlor. T-l "Incapacity" of a Settlor shall be determined by the existence of one or more of the following: (1) There is a court order, which such Trustee or beneficiary deems to be jurisdictionally proper and still concurrently applicable, holding a person to be legally incapacitated to act on his or her own behalf or appointing a guardian to act for him or her, or (2) There are duly executed, witnessed, and acknowledged written certificates of a licensed physician (whom represents that he or she is certified by a recognized medical board), to the effect that the physician has examined the Settlor and has concluded that such person has become incapacitated to act rationally and prudently in his or her own financial best interests, or (3) There is evidence which such Trustee or beneficiary deems to be creditable and still currently applicable that the Trustee has disappeared, is unaccountable absent, or is being detained under duress where he or she is unable effectively and prudently to look after his or her own best interests. Given the occurrence of such events or circumstances, the affected Settlor shall be deemed to have become incapacitated. Such incapacity shall be deemed to continue until such court order, certificates, and/or circumstances have become inapplicable or have been revoked. Any physician's aforesaid certificate may be revoked by a similar certificate to the effect that the person is no longer incapacitated executed either: (a) by the originally certifying physician(s) or (b) by another licensed, board certified physician. No Trustee shall be under any duty to institute any inquiry into the person's possible incapacity, but the expense of any such inquiry reasonably instituted may be paid from the Trust assets. Payment for such inquiry refers both to a reasonable inquiry as to the incapacity of such individual and to that inquiry as to the revocation of such a certificate. (D) Distributions FolIowine the Death of the Settlor: 1. Income Distribution Upon Death of Settlor: Upon the death of the Settlor, the Successor Trustee shall pay to the personal representative of the estate of the Settlor, all Income accrued but undistributed as of the date of death of the Settlor. 2. Distribution of Principal to Estate of Settlor to Pay "Death Taxes": The Successor Trustee shall then make payment to the personal representative of the estate of Settlor, out of the principal of the Trust, an amount equal to the estate, inheritance, transfer, succession or other death taxes (" death taxes") federal, state and other, payable by reason of the inclusion of part or all of the trust property in his or her estate. The determination by the personal T-2 representative of the estate of the Settlor, of the amount payable hereunder shall be [mal and conclusive. The final determination of the amount due hereunder shall be based upon the values as finally determined for estate tax purposes in the estate of the Settlor. The Settlor hereby directs the Successor Trustee to pay such amount promptly upon written request of the personal representative of the estate of the Settlor, and upon payment of the amount finally determined to be due hereunder, the Successor Trustee shall be discharged from any further liapility with respect to such payment. 3. Power of Appointment Exercisable by the Settlor: Upon the death of the Settlor, the remaining principal and any accrued or undistributed Income shall be transferred and delivered to or for the benefit of such one or more persons, corporations or other organizations, including the estate of the Settlor or to the creditors of the Settlor, in such portions or amounts and subject to such trusts, terms and conditions as the Settlor, may appoint by specific reference in the Last Will and Testament of the Settlor to the power of appointment contained in this, Paragraph (D) 3 of Article One. If the Settlor does not exercise this power in full, the unappointed principal and accumulated and undistributed Income shall be distributed as hereinafter provided. 4. Distributions of Remaining Income and Principal: Upon the death of the Settlor, the remaining principal of the Trust and any accumulated or undistributed income shall be distributed as follows: (a) Specific Distributions from the Trust Estate: Prior to any distribution of the balance of the Trust Estate, the following specific distributions shall be made by the Successor Trustee. $100.00 to my granddaughter, CHRISTI GASPARI. (b) Distribution of the Balance of the Trust Estate: After provision has been made for the above-noted specific distributions, the balance of the Trust Estate shall be distributed as follows: 1) DONNA GREENE, Settlor's daughter, shall receive sixty percent (60%) of the balance of the Trust Estate. If she survives Settlor by a period of thirty (30) days. 2) VICTOR T. GASPARI, JR., Settlor's son, shall receive forty percent (40%) of the balance of the Trust Estate. If he survives Settlor by a period of thirty (30) days. T-3 3) Should DONNA GREENE fail to survive Settlor by a period of thirty (30) days, her share shall be divided equally between her children, Settlor's grandsons, namely, MICHAEL J. GREENE, JR. and MATTHEW T. GREENE, per stirpes. 4) Should VICTOR T. GASPARI, JR fail to survive Settlor by a period of thirty (30) days his share shall divided equally between his nephews, Settlor's grandsons, namely, MICHAEL J. GREENE, JR. and MATTHEW T. GREENE, per stirpes. 5) Should any devise or bequest called for herein lapse or fail for lack of a beneficiary or for any reason whatsoever, and be passed as if under Pennsylvania Intestacy Law, it is Settlor's specific intent and direction that no part of the residual trust estate shall pass either to Settlor's granddaughter, CHRISTI GASPARI or to Settlor's nephew, JESSE STAGO and instead such share or part shall be distributed as in CHRISTI GASPARI and JESSE STAGO had died without issue before the Settlor. ARTICLE TWO (A) Beneficiary Provisions: If any beneficiary who is entitled to receive a share of the principal of the Trust Estate shall not have attained the age of thirty-five (35) years, the Trustee is hereby authorized and empowered to hold and manage and distribute such share for the following uses and purposes. (1). Upon written request of the beneficiary, the Trustee shall payor apply to or for the use of the beneficiary thereof, all of the income and so much of the principal (even to the point of exhausting the same) as the trustee, his sole discretion, deem advisable, to provide for the health, welfare, maintenance, support and education of said beneficiary. (2). Upon written request made by the beneficiary thereof and delivered to the Trustee, the Trustee shall distribute to him or her up to one-half (1/2) of the then remaining principal and accumulated income thereon, on or after the date upon which said beneficiary attains the age of thirty (30) years. T-4 (3). The entire remaining balance of principal and accumulated income the remaining thereon shall be distributed to the beneficiary thereof when he or she attains the age of thirty-five (35) year, at which time said trust shall terminate. (4). If the beneficiary thereof dies before receiving final distribution hereunder, the undistributed balance thereof shall be distributed as appointed to said beneficiary's spouse or issue, or to Settlor's issue, in any valid will of said beneficiary or if none, to the intestate heirs of said beneficiary. (5). The Trustee of the Testamentary Trust established in this Article Two Paragraph A shall be DAVID J. LENOX, ESQUIRE, who shall serve without bond. (6). In the disbursement of funds directed to be paid to or for the use and benefit of any beneficiary who shall not have attained the age of eighteen (18) years, the Trustees may, i n their sole and absolute discretion, make payment of the same to the parent, guardian or such other person, if any, having custody of the beneficiary who has not yet attained the age of eighteen (18) years at the time such payments are made, to be used for the health, education, welfare, maintenance and support of such beneficiary, but without liability on the part of the Trustees to see the application of said payments by the payee, and the receipt of any such persons shall be a full acquittance of the Trustees as to any amounts so paid, or the Trustees may make payment of the same directly to or for the benefit of such beneficiary. This shall be construed as a power only and shall not operate to suspend the absolute ownership thereof by such beneficiary who has not yet attained the age of eighteen (18) years, nor prevent the absolute vesting thereof of such beneficiary. (B) Perpetuities Savin~s Provision: Notwithstanding anything to the contrary herein contained, upon the expiration of twenty-one (21) years following the death of the survivor of all the beneficiaries herein named or described who are living at the death of the first Settlor to die, all Trusts remaining hereunder shall terminate, and the principal shall be transferred and delivered to the person then entitled to the Income therefrom. (C) Spendthrift Clause: Neither the principal nor the Income of any portion of the Trust Estate shall be liable or subject to the contracts, debts, liabilities or torts, now or hereafter made, contracted, incurred or committed, of any beneficiary or remainderman; nor shall the principal or Income of the Trust Estate be liable to attachment by garnishment proceedings or other legal process; nor shall any assignment or order either of principal or income, given by any beneficiary or remainderman be valid, but the principal and Income shall be paid by the Trustee directly to or for the use of the beneficiary entitled thereto, without regard to any assignment, order, attachment or claim whatever. Every such attempted assignment or other disposition by any beneficiary or remainderman shall not be merely voidable, but absolutely void, except that this provision shall not impair or restrict the exercise of any power of appointment granted hereunder. No payment hereunder shall become the property of any beneficiary or remainderman until it is received by him or his guardian. T-5 ! (D) Disposition of Accrued Income Followin&: Death of Income Beneficiary: Upon the death of any Income beneficiary, any Income accrued or received by the Trustee subsequent to the last Income payment date shall be paid to the person or persons for whose benefit the principal producing such Income is continued in trust or to whom such principal is distributed under the terms hereof. (E) Stock Dividends Allocated To Principal: Corporate distributions received in shares of the distributing corporation shall be allocated to principal, regardless of the number of shares and however described or designated by the distributing corporation. (F) Characterization of "Income": "Accrued Income": Income accrued on any property received by the Trustee, either at the inception of the Trust Estate or as an addition thereto, shall be treated as Income and not as principal; PROVIDED, HOWEVER, that any lump-sum distribution payable to the Trustee under any employee benefit plan or individual retirement account in which the Settlor has an interest shall be treated as principal notwithstanding the options, elections or privileges that may be exercised by the Trustee, the Settlor or any beneficiary for income, estate or death tax purposes. Upon the death of any beneficiary of Income, any undistributed income then held by the Trustee for such beneficiary shall be paid to the person or persons for whose benefit the principal producing such income is continued in Trust or to whom it is distributed under the terms hereof. ARTICLE THREE (A) Powers of the Trustee: The Trustee hereunder shall have the following powers, in addition to and not in limitation of those granted by law: 1. Accept, Purchase and Retain Assets: To accept assets in kind from the Settlor, his estate or elsewhere, to purchase assets from the estate and to retain such assets in kind; 2. Sale and Investment of Other Assets: To sell assets and to invest and reinvest the proceeds and any other cash in any kind of property, real or personal, or part interest therein, located in the United States or abroad, including interest bearing accounts in or certificates issued by any firm, including a corporate fiduciary, and securities underwritten by syndicates of which the corporate fiduciary is a member but not purchased from the Trustee, all statutory and other limitations as to the investment of funds, now or hereafter enacted or in force, being waived; 3. Hold Cash: To hold Income cash uninvested until the next regular payment date, without liability for interest thereon; 4. Purchase Life Insurance: To retain or to purchase policies of life insurance, to pay premiums thereon from income or principal and to exercise all rights of ownership thereof; T-6 , 5. Encumber Assets: To pledge, exchange or mortgage real or personal property and to lease the same for terms exceeding five (5) years; 6. Give Options: To give options for sales, leases and exchanges; 7. Compromise Claims: To compromise claims and controversies; 8. Vote Common Stock: To vote shares of corporate stock, in person or by proxy, in favor of or against management proposals; 9. Carry Securities Without Identifying Trust Estate: To carry securities in the name of a nominee, including that of a clearing corporation or depository, or in book entry form or unregistered or in such other form as will pass by delivery; 10. Distribution in Kind: To make division or distribution hereunder either in cash or in kind; and, in connection therewith, to allocate to different kinds of, or interests in, property and property having different bases for federal income tax purposes, all as the Trustee deem equitable; 11. Investment of Trust Estate Assets: To invest and reinvest the Trust Estate funds (or leave them temporarily uninvested), in any type of property and every kind of investment, without regard to any principle of diversification of risk, and without being limited to "legal investments", including (but not limited to) corporate obligations of every kind, preferred or common stocks, securities of any regulated investment trust, and partnership interests. 12. Participate in Business Operations: To participate in the operation of any business or other enterprise for whatever period of time the Trustee deed proper, with full power to do any and all things deemed necessary or appropriate, including the power to incorporate any unincorporated business; to vote any and all shares of stock owned in any such business; to borrow and to pledge assets as security for such borrowing; to assent to, join in, or vote in favor of or against any merger, reorganization, voting trust plan, or similar action, and to delegate discretionary duties with respect thereto; to delegate all or any part of the supervision, management and operation of the business to such person or persons as may be selected; and to close out, liquidate, or sell the business at such time and upon such terms as the Trustee deem advisable. 13. Deposit Funds: To deposit Trust Estate funds in any commercial savings or savings and loan accounts, or in "money market" or similar accounts maintained by any corporate fiduciary. 14. Borrow Funds: To borrow money for any reasonable Trust Estate purpose from any lender, including the power to borrow from the probate estate of Settlor for the purpose of payment of taxes or on behalf of any separate trust hereunder T-7 from any other separate trust hereunder, upon such terms, including (but not limited to) interest rates, security, and loan duration, as they deem advisable. 15. Make Loans: To lend Trust Estate funds to such persons and on such terms, including (but not limited to) interest rates, security, and loan duration, as the Trustee deem advisable, including the power to make loans to the Settlor during his lifetime. 16. Sale of Trust Estate Assets: To sell or otherwise dispose of Trust Estate assets, including (but not limited to) Trust Estate real Property, for cash or credit, at public or private sale, and with such warranties or indemnifications as the Trustee deem advisable. 17. Alteration or Disposal of Trust Estate Assets: To improve, develop, manage, lease, or abandon and Trust Estate assets, as the Trustee deems advisable. 18. Hold Property Without Identifying Trust Estate: To hold property in the name of any Trustee or any custodian or nominee, without disclosing this trust, but the Trustee are responsible for the acts of any custodian or nominee the Trustee so use. 19. Compensate for Administration: To pay and advance money for the Trust Estate's protection and for all expenses, losses, and, liabilities sustained in its administration. 20. Act as Legal Representative: To prosecute or defend any action for the protection of the Trust Estate, the Trustee in the performance of their duties, or both, and to pay, contest, or settle any claim by or against the Trust Estate or the Trustee in the performance of their duties. 21. Hire Consultants. etc: To employ and dismiss agents, brokers, investment advisors, accountants, attorneys and employees, regardless of whether they are associated with the Trustee, or the Trustee or affiliates or employees thereof, and to advise or assist them in the performance of their duties. 22. Allocate Between Principal and Income: To determine what is principal or income and what items shall be charged or credited to either. 23. Execute Binding Legal Instruments: To execute and deliver any instruments necessary or useful in the exercise of any of the foregoing powers. 24. Retain Non-Income Producing Property: To retain, during the lifetime of the Settlor, for so long as the Trustee may deem advisable any property whatsoever, regardless of whether or not such property income producing. T-8 25. Retain Settlor's Personal Residence: Following the death of the Settlor, the Trustee are authorized to retain as part of the Trust Estate for the personal use of the Settlor, any property occupied by Settlor and the Settlor at the death of Settlor as their principal place of residence for so long as the Settlor wishes to occupy said residence. During such period of retention, the Trustee shall pay from the Income or principal of the separate trusts established hereunder as the Trustee may deem to be in the best interests of such trusts and their beneficiaries, all taxes and assessments levied upon or assessed against residence, and all costs of maintaining, repairing and insuring said residence. No obligation of rent shall be imposed upon the Settlor during any period of occupation of said residence. On written or oral request of the Settlor, the Trustee may sell said residence and replace it with other property which in the opinion of the Trustee is suitable as a residence for the Settlor, to be retained in the trust in the same manner as the property which was replaced. 26. Authority to Sign Documents: Either Trustee shall have the power to execute individually any and all documents necessary to carry out the powers, functions, and duties of the position of Trustee. Such power shall include, but shall not be limited to: the signing of checks, the opening of bank or other fmancial accounts, the disbursement of Trust funds, the execution of contracts, and other such financial transactions. (B) Resi2nation of Trustee: Any Trustee may resign at any time during Settlor's lifetimes by written notice to Settlor. After the death of the Settlor, a Trustee may resign at any time, without stating cause, by notice to the remaining Trustee(s); provided, however that prior to the resignation of a sole remaining individual Trustee, such Trustee's resignation shall not become effective until after such Trustee has appointed a corporate trustee as successor, and such corporate trustee has accepted such appointment. Absent such appointment and acceptance, said Trustee's resignation shall not become effective until said Trustee has petitioned a court of competent jurisdiction to designate a successor corporate trustee. (C) Successor Trustee(s): Upon the death, disability, incapacity or resignation of any Trustee, during the lifetime of the Settlor, the Settlor may appoint one or more successor Trustees. Upon the death, disability, incapacity or resignation of any individual Trustee following the death of the Settlor, the then remaining Trustee if any may appoint one or more successor Trustees, who may either be individuals or a corporate trustee; provided, however, that such right of appointment shall not exist to the extent a corporate trustee has already been appointed hereunder. Unless the Settlor makes other provisions during Settlor's lifetime as is his unlimited right then upon the death or incapacity of the Settlor, DONNA GREENE, Settlor's daughter, shall serve as Successor Trustee without bond. In the event DONNA GREENE fails or ceases to serve as Trustee, Settlor's son VICTOR T. GASPARI, JR., shall serve as Contingent Successor Trustee, also without bond. . T-9 (D) Replacement of A Corporate Trustee: If at any time a corporate trustee has been appointed during the lifetime of Settlor, the Settlor may replace such corporate trustee by written notice to said corporate trustee, and may, but shall not be required to, designate a successor corporate trustee. Following the death of the Settlor, an individual Trustee may replace a corporate trustee by written notice thereto, and may, but shall not be required to, designate a successor corporate trustee. (E) Compensation of Trustee: The Trustee shall be entitled to receive annual compensation for their services hereunder but not in excess of such compensation as would be approved by a court of competent jurisdiction. Payment of such compensation to a Trustee, in his, her or its capacity as such shall not preclude payment to any Trustee for the rendition of professional services for, or on behalf of, the Trust Estate. For any services performed by the Trustee in connection with Settlor's estates, which services are normally performed by the personal representative, the Trustee shall be entitled to such additional compensation as may be fair and reasonable under the circumstances. (I) Authority to Terminate Small Trusts: Should the principal of any Trust Estate herein provided for, be or become too small in the Trustee' discretion to make establishment or continuance of the Trust Estate advisable, the Trustee may make immediate distribution of the remaining principal and Income outright to the Income beneficiaries in the proportion to which they are then entitled to the Income. The receipts and releases of the distributee will terminate absolutely the right of all persons who might otherwise have a future interest in any portion of the Trust Estate, whether vested or contingent, without notice to them and without the necessity of filing an account with the court. (G) Mereer: The Trustee may merge or consolidate for administrative purposes any trust established under this Trust Agreement with any other trust established by Settlor of the Settlor having the same Trustee and substantially the same dispositive provisions. (H) Division and Deleeation of Duties by Trustee: One or more of the Trustee may, whenever, as often, and for such period as they shall deem it advisable to do so, delegate to one or more of the other Trustee, any or all ministerial and administrative duties, including the keeping of books and records, acting as custodian of the Trust Estate property, and preparing all necessary tax returns, as well as the authority to exercise in their names and behalf any or all the powers, authorizations, discretion, and duties vested in or devolving upon them as Trustee under the provisions of this Trust Estate. Any action taken by the Trustee to which such division or delegation shall be made shall have the same force and effect as if taken and exercised by the designating or delegating Trustee(s) acting in conjunction with the designated or delegated Trustee(s). Any such delegation shall be sufficiently evidenced for any and every purpose if contained in a writing, signed by the designating Trustee(s) and delivered to the designated Trustee(s). (I) Fiduciary Restrictions. Discretion and Elections: The powers and discretion granted to the Trustee are exercisable only in a fiduciary capacity and may not be used to shift or enlarge any beneficial interest except as an incidental consequence of the discharge of T-IO fiduciary duties. The Trustee may make discretionary payments of income and principal in unequal shares to the beneficiaries of any trust established hereunder, and may, but shall not be required to, consider other resources available to any beneficiary. The Trustee may make tax elections without regard to the relative interests of any beneficiaries and may, but shall not be required to, make equitable adjustments among beneficiaries. ARTICLE FOUR (A) Additions to Trost Estate: The Settlor or others may, by Last Will and Testament, inter-vivos transfer or beneficiary designation, add to the Trust Estate, cash or such property in kind as is acceptable to the Trustee at any time during the term of the present Trust Agreement. (B) Settlor's Rimt to Revoke Aereement: The Settlor expressly reserves the right at any time and from time to time to revoke this Agreement, in whole or in part, by written notice delivered to the Trustee during Settlor's lifetime. The Settlor shall have the right to revoke, in whole or in part, any portion of the present Trust Agreement relating to the Trust created herein. Upon the death of the Settlor, the Trust and all of its terms and conditions shall become irrevocable and not subject to amendment or modification. (C) Settlor's Ri~ht to Amend Trost Ae:reement: The Settlor further reserve the right at any time and from time to time to amend this Agreement at any time during her life by a proper instrument in writing, executed by the Settlor and delivered to the Trustee during Settlor's lifetime and accepted by the Trustee. The Settlor shall have the right to amend, in whole or in part, any provision in the present Trust Agreement relating to the Trust created herein. Upon the death of the Settlor, the Trust and of its terms and conditions shall not be subject to amendment or modification. (D) Life Insurance: If Settlor designate the Trustee as beneficiary of the proceeds of any policies of insurance on their lives, the duty and responsibility for the payment of premiums and other charges on such policies during the Settlor's lifetimes shall rest solely upon Settlor. The only duty of the Trustee shall be the safekeeping of such policies as are deposited with it, and the Trustee shall be under no duty to notify the Settlor that any such premium or other charge is due and payable. All options, rights, privileges and benefits exercisable by or accruing to the Settlor during their lifetimes by the terms of the policies shall be for the Settlor's sole benefit. The Settlor agree, however, not to exercise any options whereby the proceeds would be payable to the Trustee other than in one sum. Upon the written request of the Settlor, the Trustee shall execute and deliver such consents and instruments as may be requisite to enable the Settlor to exercise or avail themselves of any option right, privilege or benefit granted by any of the policies. Upon the Settlor's/Settlor's death(s), or at such later time as may be specified in the policies, the net proceeds of any policies then payable to the Trustee hereunder shall be collected by the Trustee; the receipt of the Trustee for such proceeds shall release the insurance companies from T-ll liability on the policies, and the insurance companies shall be under no duty to see to the application of such proceeds. The Trustee may take all steps necessary in their opinion to enforce payment of said policies and shall be entitled to indemnify themselves out of any property held hereunder against all expenses incurred in taking such action. (E) Emplovee Death Benefits: The Settlor may designate the Trustee as beneficiary of certain employee death benefits. In such case the Trustee shall collect the proceeds receivable therefrom upon the Settlor's death and hold them as part of the Trust Estate. The receipt of the Trustee for such proceeds shall be a full acquittance to the administrator of such benefit, and said administrators shall not be liable to see to the application of such proceeds. To the extent that such proceeds are not included in the Settlor's estate for federal estate tax purposes, they shall not be used for the payment of death taxes or any administration expenses of Settlor's estate. The Trustee may select any option available to it as to the time and method of payment of such proceeds and may also exercise any option with respect to the income or death taxes thereon as they in their sole discretion deem adv~sable, and their decision in these matters shall be binding upon, and shall not be subject to question by, the beneficiaries. ARTICLE FIVE (A) Incontestability: The beneficial provisions of this instrument (and of Settlor's Last Will and Testament) are intended to be in lieu of any other rights, claims, or interests of whatsoever nature, whether statutory or otherwise, except bona fide pre-death debts, which any beneficiary hereunder may have against or in Settlor's estate of the properties in Trust hereunder. Accordingly, if any beneficiary hereunder asserts any claim (except a legally. enforceable debt), statutory election, or other right or interest against or in Settlor's estate, Settlor's Will, or any properties of said Will, or directly or indirectly contests, disputes, or calls into question, before any court, the validity of this instrument or of said Will, then; (a) Such beneficiary shall thereby absolutely forfeit any and all beneficial interests of whatsoever kind and nature which such beneficiary might otherwise have under this il1strument and the interests of the other beneficiaries hereunder shall thereupon be appropriately and proportionally increased and/or advanced. (b) All of the provisions of this instrument, to the extent that they confer any benefits, powers, or rights whatsoever upon such claiming, electing or contesting beneficiary, shall thereupon become absolutely void and revoked, and ( c) Such claiming, electing, or contesting beneficiary, if then acting as a Trustee hereunder, shall automatically cease to be a Trustee and shall thereafter be ineligible either to select, remove, or become a Trustee hereunder. The foregoing shall not be construed, however, to limit the appearance of any beneficiary as a witness in any proceeding involving this instrument or said Will T-12 nor limit any beneficiary's appearance in any capacity in any proceeding solely for the construction of either of said documents. (B) Payment of Debts. Taxes and Other Charees upon Settlor's Death: Upon each Settlor's death, the Trustee may pay to or upon the order of Settlor's personal representative funds needed to pay Settlor's debts, funeral and burial expenses, -costs of administration, death taxes and specific bequests, if any, under the Settlor's Last Will and Testament. The Trustee may rely upon Settlor's personal representative as to the amount of such charges. The decision of the Trustee about whether to provide funds shall be final, except that the Trustee shall use any U.S. Treasury securities that may be redeemed at par to pay federal estate taxes for that purpose. Assets that are not included in Settlor's gross estate for federal estate tax purposes shall not be used for such payments. (C) Payment of Taxes at the Settlor's Death: If the Settlor does not negate this provision by specific reference to this paragraph in the Last Will and Testament of the Settlor, the Trustee shall, upon the death of the Settlor, pay to the estate of Settlor from the principal of the Trust a sum sufficient to cover the estate and inheritance taxes payable by reason of the death of the Settlor and attributable to the principal of the Trust. (D) Disclaimer: Any beneficiary hereunder, or the legal representative of any such beneficiary shall have the right, within the time prescribed by law, to disclaim any benefit or power under this Trust Agreement. (E) Word Meanine;s: The words "herein", hereinbefore", "hereinafter" and "hereunder" refer to this Agreement as a whole and not merely to a subdivision in which such words appear, unless the context requires otherwise. The singular shall include the plural, the plural the singular, and the use of any gender shall be applicable to all genders. The terms "child" "children" and "issue" and similar terms shall include adopted children, regardless of the date of adoption, with full effect as if they were the natural children of the adopting parents. The term "minor" shall mean any person under the age of twenty-one (21) years, regardless of the age of the majority provided by statute. (F) Paraeraph or Article Headin2s: Headings contained in this Trust Agreement are inserted only as a matter of convenience and for reference, and shall not be construed in any way to define, limit, extend or describe the scope of any of the provisions hereof. (G) Governine Law: This Agreement shall be deemed to have been delivered to and accepted by the Trustee in the State of Pennsylvania, regardless of the jurisdiction in which actual execution may have occurred, and shall be interpreted and governed in all respects by the laws of said State which shall be applied to any dispute arising hereunder. (H) Enforceability: The invalidity or enforceability of any particular provisions of this Agreement shall not affect the other provisions hereof and this Agreement shall be construed in all respects as if such invalid or unenforceable provision was omitted. T-13 (I) Chanee of A~reement: Except as otherwise specifically provided herein, no change, modification, amendment of, or waiver under, this Agreement shall be valid unless the same be in writing and signed by all of the parties hereto. (J) Notices: Any notice, request, direction, instruction or other communication permitted or requested to be made hereunder by any party to the other shall be in writing including telex, telegram or telecopier ["fax"], signed by the party giving such notice and shall be delivered personally, sent by registered or certified mail, postage prepaid, or by telex, telegram or fax (in each such case followed by written confirmation) to the other parties, to the addresses indicated below or to such other address as any or all of said undersigned may have submitted therefor by written notification. The date of personal delivery, the date of receipt (if mailed), when delivered by the telegraph company or in the case of telex or fax, when received, as the case may be, shall be the effective date of such notice. Whenever under the terms hereof the time for giving notice or performing an act falls upon a Saturday, Sunday or holiday, such time shall be extended to the next business day. Victor T. Gaspari, Sr. 125 Lancaster Boulevard Mechanicsburg, PA 17055 IN WITNESS WHEREOF, with the intentions to be legally bound hereby, the Settlor and the Trustee have executed this Trust Agreement on the day and year first above written. s~C) VICTOR T. GASPARI, WITNESS: Jo/VtZo.. ~, ( (}f')~ T-14 COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF '/~ ;e I~ ~ , On this, the ,:;0 tA day of Q,A /L~ ,1998, before me, a Notary Public, personally appeared Victor T. Gaspari~r., kno to me or satisfactorily proven to be the person whose name is subscribed to the within instrument as the Settlor and the Trustee and acknowledged that she executed the same for the purposes therein contained. SS: (\ IN WITNESS WHEREOF I hereunto set my hand and official seal this 3 0 .tl~ay of \ktA.~ , 1998. ~ () 5'AuunJt&#~ Notary Public My Commission Expires: Notarial Seal S. D~wn Gladfelter, Notary Public DillsburfJ Boro, York County My Commission Expires May 17, 2001 Member. Pennsylvania Association of Notaries T-15 *' SCHEDULE B STOCKS & BONDS COI>'MONWEAl.TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gaspari, Victor T I FILE NUMBER . 21 - 01 - 0892 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM~ .NU~BER I Met Life Stock I DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 5,545.42 30.98 ____1 ~- TOTAL (Also enter on line 2, Recapitulation) 5,545.42 ~ Mellon Mellon Investor Services August 14, 2001 David J Lenox The Wiley Group Attorneys at Law 1 South Baltimore Street Dillsburg PA 17019 RE: MetLife, Inc. AlC: Victor T Gaspari Sr Investor ID #: 806470130781: 179 Shares Control #: 200107241998 Dear Mr. Lenox: We are in receipt of your recent inquiry regarding the account of Victor T. Gaspari Sr. Our records indicate that Mr. Gaspari was allocated 179 shares of Met Life, Inc. common stock when MetLife converted from a mutual to a stock company. The Initial Public Offerring (or IPO) occurred on AprilS, 2000; however, the stock was allocated on April 7,2000, and is held in the MetLife' s Policyholder Trust in the above referenced account solely in the name of Victor Gaspari . MetLife declared its fIrst stock dividend on November 7, 2000. The cash dividend was paid to MetLife shareholders at the rate of $0.20 per share. We show that Mr. Gaspari received a dividend check in the amount of$35.80. On June 29,2001, the closing price ofthe MetLife stock was $30.980 per share. In order to transfer the shares in the MetLife Policyholder Trust due to the death of the registered shareholder, please note that you may either (A) continue participation in the Trust by re-registering the shares, or (B) sell all shares in the Trust and receive a check for the proceeds. Please send us the following: 1) A letter of instruction indicating whether you wish to re-register the shares or re-register the shares and then sell. Overpeck Centre. 65 Challenger Road. Ridgefield Park, NJ 07660 www.mellon-jnvestof.com A Mellon Financial Company"'! 2) The name, address and taxpayer identification number (Social Security number) of the person to whom the shares will be transferred or to whom the check will be issued. 3) If the estate is being probated, please send a certified copy of the court appointment ofthe estate representative, dated within 60 days (6 months for a New York decedent). If the estate is now closed, we will accept a certified copy of the final accounting statement. A photocopy ofthe will is required only if the final accounting statement and does not list how the assets of the estate were distributed. (The term "certified" means that the document has an original signature and seal affixed.) 4) A signed, completed copy of the enclosed stock power form. The signature must be signature guaranteed with a medallion imprint provided by a commercial bank, trust company, securities broker/dealer, credit union, or savings association participating in a medallion program approved by the Securities Transfer Association, Inc. Unfortunately, no other form of signature verification can be accepted. How to Communicate with Us Please forward this information, along with a daytime telephone number, to: Mellon Investor Services P.O. Box 4447 South Hackensack, NJ 07606-2047 If you have any questions, please call our Customer Service Center at 1-800-649-3593. How to Communicate with MetLife If this change also applies to the insurance'policy or contract, please contact MetLife directly. You may call the account representative or the customer service number found on the billing statement. You may also call the MetLife directory at 1-800-METLIFE (1- 800-638-5433) to reach the proper office. We appreciate the opportunity to assist you with this transfer. Sincerelv. '.'^ . \ f 11../'1 '\ (\ l~l~ llCQJlc) Lisette KimlJere MetLife Shareholder Services Enclosure: Stock Power *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT j FILE NUMBER 21 - 01 - 0892 ESTATE OF .. Gaspari, VIctor T 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 DESCRIPTION VALUE AT DATE OF DEATH 100.00 PNC Accnt. 500351858 TOTAL (Also enter on Line 5, Recapitulation) 100.00 . SCHEDULEF I JOINTLY-OWNED PROPERTY "- -----,. -..-----------.. ----_.,,---------- _._--...._-----~---_._----- ---I FILENUMBER------------- 21 - 01 - 0892 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gaspari, Victor T If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS -- -- ----------------- --------- A Donna L. Greene and Victor T. 3803 Bellows Dr Gaspari, Jr. Camp Hill, PA 17011 B Donna L. Greene 3803 Bellows Dr. Camp Hill PA 17011 C Victor T. Gaspari, Jr. 45 Allen Dr. Shermansdale, P A 17090 RELATIONSHIP TO DECEDENT Daughter and Son Daughter Son JOINTLY OWNED PROPERTY: ITEM F6~.R~~~Tl~~~- -. 1'lnCIUde nameo?;n~~~~T~~~u~:nPa~~~;~~cco~nt nU~ber NUMBER TENANT JOINT lor similar identifying number. Attach deed for jointly-held real ___. .._ _____~tate. _ ____________________ A .10/12/19991 PNC Savings 5003174818 A 10/12/19991 Interest on above accnt. ---------- -----~ --------------- DATE OF DEATH % OF DATE OF DEATH DECD'S VALUE OF VALUE OF ASSET INTEREST DECEDENT'S INTEREST -_ ------------0- __".___ ______._._________ 32,200.69 33.33% 10,732.49 , 2 3 B > 1 year Series E and EE US Savings Bonds see attachment "A" 26.77 33.33%1 8.92 221,018.401 50%1 110,509.20 j 211,112.20j 50% 105,556.10 4 C > 1 year Series E and EE US Savings Bonds see attachment 'B" _ ____J_______ TOTAL (Also enter on line 6, Recapitulation) 226,806.71 Attachment" A" Bonds owned jointly with Donna L. Green, daughter o \). 0 /, . \}. i7 ,'," \) l) fY) 5$l &0 '7 r:-I l . ." ?.> . f (,! ,/"'>- " I, 0'" u::J 'v 3S;I-l.pO ., .\. ~ ,~~,-,,-ij;;~,~::t,:~~;,f1'::;i44i!t~)~;:;t4"~~;l{~~~.~@~titt~_~i[lji:,~~Af .A.,~.......~...;~..,',._,~_",,,... 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( I i 1" . .-, .fi'___,...____.~ .".,-v...._...._..--.,~."--..-'~~..."'-_..__._"'""",."""".,,_,.....~~_'VI.~~"~~Jl\ iii. ,.i'>,oas.......~_",,:.~_ ~7__.' ."..~lIl~~..J.,<<,w_~.....~_~~i""_~__......,..-.............~._ . '-~.' -,~,.,,-...- ~.- ..... ....-. ~~", ~"-''"''~'' ' .>"'....-,, '-"'^"~_'fi~"" '_h "\0 t.. ~O. LiD , \ ~.Il' J I rv . '? ~, t 1 I I ; I 1.\0 I I. \ ,,?O - '1.\ t, )1 00' I "1) 0, '1' I ,.. 1 I I. " i I 1 '-\ t) )' ~O" ;\01 ~\\ ~o'1 , ~,'? I I . ji 1 01 d>}.'Pi A)fJJT co" ~ O' oQI \\) O' I, '?'v\\ 1. J r "'''''-''''''''''~-''"~-'''<'"'''~'''''~'''''~,,",,~''o/'~_'''~~I"'f.'"W ll!I:'I~ 'YO, T ~",",,,<41,,,.~~.,..,~~,.'fI'!fflI~.~~...,,, ~~ t v\C\ J .'" . ~.. I ')J:. ,,\U I 'l.. \ a'O' I, ~ .? IJ / I ! ,~~ I '7;0' ltO! '?) \\'1:7 7;!} '] '1, 40, .~.. {>J)....do /. or I ?j)v g., j I' \ I I I. i I y""""",~""",,,,'.~'V-"... '~'., W"'~"~""--W'~_'__""_'''_'''''1<_'''~''"':'''''''''''''N''''''__''',,__-,-,~,__.........:_,...__;."'.___,.._...........,___,..__..._----._.___._.._~~. . Attachment "B" Bonds owned jointly with Victor T. Gaspari, Jr., son 4Dlb.'iD 5/u.'10 i ( i j I I II ( I I I If ( I II ':, (;'9.:t:::' "_..'_ i:,;,t\;-: \'~';(-t~~,~~t;,'t~w~ ,',:OQOO)1 OqOf,lKlJ JI,;", \{ I { I ( II j ( t I JD3ce.8'D s'- :3& - ?5 () y I ( If ) ( ( I u .- _._-"---_.,-------_.,~---_._---- .---....---..--....-------...-.--. I ( r 9 t , { ( { ( I I . ~~ CTQR I 'II&~P',.I .1 .__ 1 ~ .-..__., J\-'1)~-:8 57-E_K :Q ~tl I .' . 1 ".'J""'" <f:! Ii i I' h' ~~i~!~",~~,l'!1I,. -~:f~~U\UjL! '... .......?)'.',.!>U,~. . 0''''00'''''"."0'' : ~qOO L,:28 5 70 5 '(11" ';'X,.'S;.:;;;.j;'k;':: "" L,;;t"..r,...T ~ . ,. ',". -..,.-~-;:r-.;"';"'.:;~~C:,; ... l ( ( ( <f? S-I. & 0 ":> 5-1. &0 I I L( I I ( { d --'"-_._-'-~""--- tt I' , ( J I ".\;.;.. . n~~r:i':;':' -" /,;,>,,::,;\ , ,', _ ".L7~-:::l't~~,~5,pp<~~.;~g} OL,,38SR070nl,' ", "'i ,'",- II . I I I I ' /( I ( { I I I I ( l ( , I I / I ( I r I ( I I t t' if Q3.'fO :2 'f 3. '-f 0 I ( , , .... ------..----...-- It . W Wi :... _- l "": _- _-: ~~~Q~ AT THE MATURITY HlERtO'"WlI.L.MY ~WlOO~~~ 207-34-6864 E03011 ToVICTOR T. GASPARI, JR. c INDDC 6226 BLU ESTON EAVE LINGLESTOWN, PA. .17112 ISSUE DATE WHICH 15 THE f"lR5T DAY OF VICTORT. GASPARI, -SR. MAR 1985 -fWONT~~:::::..-~~"-I-- . F~B PHIU'\ : ,.QJ.l..9a...,.. " ABR.Ol 198~ \ OATSNO ~ , \~~~ ~~/ X-0~ooo~i18~i58-EE -_....._-'-.... -~-~.--._. _::=~..- ........ ....~>./!- - .s-...,.,-~ SEUI~S EE X178758 EE ,D.t .--------.---r.-. . J 41":") _- v:_-_-t ~~~cm~ AT THE MATUfIIITYHe:qO,.Wtu..'AV' 207~r~~011 ToVI eTOR T. GASPAR I, JR.. INDOC 6226 BLUESTONE AVE LINGLESTOWN. PA. ISSUE DATE WHICH 15 ThE FIRST DAY OF' 11112 MAR 1985 -(~~:::=:~~l-- FRB PHI lA'-, .:, ,~.:i-n. -.. A~R 01 198~ '. o...YtNClaTNM"' , - , - , ~ ~ ~ I X-0-OOO-118-~S9-EE VICTOR T. GASPARI, SR. .0 -_._._.~-~-~.__. _:~::-"- .:~::.:.: hEN>.A~ - ~...,:.u? X178759 EE 1 , ,I ') 1. L-f c;5 I / ,7 '-l: <iJ N,f- 'VI \ ( . ) _- ! w: _- _ .. ISSUE DATE WHICH IS lHE F'IRSl DAY OF mtm~~)~wat~ AT TH! NAl'Uft.TY HlJIlI:Ol" WiLL PAY ~1Ol@jS~~ 2a7-3~-686~ . EO 30,71 ToVICTOR T. GASPARI9-.,R.'INDOC, 6226 B1.UESTONE AVE. LINGLESTOWN~ PA. 17112 MAR .1985 -t~~::::::f~I-- ,nfi PblH.A':' :' ,~.s....... '-. AP.R 01.1985 .. cw.TINCJI""""'" .. \~~ ,/ x-a ~O aO~178-.:,i6o,",,& \ \ OR VICTOR Ti;, GASPARI, SR. SEIUES EE ".,._.._or.oool~~~""-ACt,...._. __::=_n_ .<.. .n.~>. /1._ _~ ~K_:::::t X178760EE -~ ---------- ---------.------ ------~ --.. -. -- .-..._-- ._-~-----...------'- ---~----_. 'J..?32.OO ...,73'2- I i ( ( I "tww:....: < w'_- _< .. _-:... -~~Q!f~mJ~ AT THE MATURITY HEREOF WII.1.. PAY ~~Pl!~~~ 201~07-7412 . E03D57 , To VICTOR f T . GASPARI. SR... INDOC 125 t..ANCASTER :;BLVD. MECHANIC SBURG ,. PA ISSUE DATE WHICH IS THE FIRST OA Y OF MAR, .1985 -1~NTH~: ;=:~_-~~..'1-- 11055 F;RB PlUL.A\ / 1-'l.O.S..5'.:NT'a \ . A ~R _ 01 _ 198~ \ DATlt<<) .,.~ I , ' , ' , . OR VIet TOR T. GASPAR I,JR. x-o~ooo~i1~~730~ SEI~IES EE lM1l1OM) II ISIUItl UND. U\NJ'l'\oIQA8' UQIlTt~I)At:r.AI.....lftDliO. ...........'._n_ '::.' A"'~:'~ 6- DUAlmtllfTot'THl!TIlIAlUIl'l' . .... ,</~ ;: w-.l~ ~'Y.,.*j- v ^ ~ I 7 I :2 '1 '6. 00 C6, ?- <-t '6- 00 . 4q3 A< i;!~3 '-Ie 11 t1? LI6 :t t\ ?, l./t 413'1C ). 4.3'" l .. 4 q 3. uO ti 1.-/3 , L/O l./ q 3.LlO ;? Lj3 yo '4~,"/O L{., t..( () pL./::; t/~' ;,(I .~ t, i"l? lIQ3.Q: "1 1. I. ~t.b . Ii. .~ , ",q" .f ,."') ~ 1.1" ~ uQ30i.'O. 1 ol; &~ ':J- if ' 4301./' c.l,1. 1.1i, J 4:,,. trlD t\'? i 0 i..\ .l~:/' If '-'\ 1.\0 ~q?) 11\\ ~...A)' , ,,.,,d ~~~U' \)a ~\'lJ.C , ~\. ,?' ~ ,\). 0 <,t?/\ . \j II '7 '? V t 61-w ;J l- I. ...J ' ;}o<..:<-o CdS ~'-"-.'^-' ~ \ ~0V ~- :-,:" II . lJ U :.. I _- Y t _- _ t '-1 ~. I . lJD1f'd!C$~Ama5l,,",mw1'fI~Aa~t~rr'f,(~' ,._:-'II~ ',- 'Jil December U7',:;~ -{MONTH1:;:=::tYiAitj~-:'.<.g ,~, CCliBBANK'~tLA; J ~: " , ,.... ,':\' .~::a... " ISSUING AOENT"a ,',:'\~ _:~~ \D E'c,,2..,aJ9,'7.a.::~ . Victor T. Gaspari Jr. \, ~/ .a !I~' ~~OEC_LARATION Of '"15aOMOISIHUlOVIfDU,..,,,,'MOlllf1' 0' 8':"'''' .o",e AU, ""_l:ftO(O....O...u.. wl...... ....ark Of... ''-~'?:31 ~:,::;.>~1NO~~NEOENRcE IES E :==.:~::~::.::~:;::~::,~~.::: ~~'~:~'.:,~:.~':.:~~,'~~.';.'~~: M 210 4 tt9f:.i::H6..tftO-lgi6 8' 'E'PA.~" ~ '\: ~{:._'_._'_ -~0 W"'IlHINOIOtt W. H g.R.r-~1t.c--l. _ ~ II ~~I '<W"''''''''''''N'.', IE ~ c ;"f'~ ~-ti~""~~...~4!;~,,,";;.<Hj~~~"1 ,,~~ '''-~W1e~irl~_~&~~~~.~_~_~~bG''U:IhIloQ''~''':'' ......~~~..'--_~~~~d.......:"tjfllrOoIl;"6Ml.'''O_&__.~O,,~....lHIo-.G''Oay~..Ul.C'''o.a.N~"&,,",AIhf" .W;'~O.-. ~::..,l!;j4ll~-It .",. 1I~..''':1I'.-i: ./0: 'J'.... ~~;~ ~!;~r::~~~==..P.;:~...~.~..~~G~~:;:-~-;:~~~~~..t~ "';~l ~~tm).~w~m:~ AT THIS ORIGINAL MATURITY HEREOF WIL.L PAY ~~~~~~1l!>l@'p:Imm& 207-07-7U2 Victor To Gaspari Sr. 125 Lancaster Blvd. Mechanicsburg, Pao 17055 3> 11.10' I , " d. ~, '1 OE "" , VICTOR GASPARI, JR. BONDS CASHED ON 08/14/01 M210731180E $3,193.20 M210731181E $3,193.20 M210731182E $3,193.20 M210731183E $3,193.20 M210731184E $3,130.40 M210731185E $3,130.40 M210731186E $3,130.40 M210731187E $3,130.40 M210731188E $3,130.40 M210731189E $3,130.40 M210731190E $3,130.40 M210731191E $3,130.40 $5,000EE V191079EE $6.624.00 $10,000EE X490585EE $12,732.00 $5,OOOEE V496140EE $6,494.00 TOTAL: $63,666.00 *' SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gaspari, Victor T FILE NUMBER 21 - 01 - 0892 This schedule must be completed and filed if the answer to any of Questions 1 through 4 on page 2 is Yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF Include the name of the transferee, their relationship to decedent and the date of transfer. VALUE OF ASSET DECO'S EXCLUSION TAXABLE VALUE NUMBER Attach a copy of the dead for real estate. INTEREST (IF APPLICABLE) Victor T. Gaspari, Sr. Revocable Living Trust dated, July 30, 1998 1 Residence at 125 Lancaster Blvd., 127,900.00 100% 127,900.00 Mechanicsburg, P A 2 I Commerce Bank Checking 082002700 4,809.61 100% I 4,809.61 3 Postmark Credit Union Savings Account 2,049.44 100% I 2,049.44 4 ' Commerce Bank Savings 480000210 63,506.12 100% 63,506.12 5 Salomon Smith Barney Accnt. 724-25396-12 105 20,593.32 100% 20,593.32 Joint PNC Certificates of Deposit established less than one I year from the date of death 6 CD 31800201267 5,186.38 100% I 5,186.38 7 CD 31000200229 5,186.38 100% 5,186.38 8 CD 31000200230 5,186.38 100% 5,186.38 9 CD 31600201618 5,186.38 100% 5,186.38 10 CD 31900202120 5,186.38 100% I 5,186.38 11 CD 31000200231 5,186.38 100% 5,186.38 12 CD 31700201117 5,186.381 100% 5,186.38 I _~_J Total of Continuation Schedule(s) 12,617.76 TOTAL (Also enter on line 7, Recapitulation) 272,967.29 . SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Gaspari, Victor T FILE NUMBER 21 - 01 - 0892 ESTATE OF This schedule must be completed and filed if the answer to any of auestions 1 throuah 4 on oaae 2 is yes. I DESCRIPTION OF PROPERTY DATE OF DEATH %OF I~:R Include the name of the trensferee, their relationship to decedent and the date of trensfer. VALUE OF ASSET DECD'S EXCLUSION TAXABLE VALUE -~-t Attach a copy of the deed for real estate. INTEREST (IF APPLICABLE) 13 I CD 31100202365 5,186.38 100% 5,186.38 14 I CD 31100202366 5,186.38 100% 5,186.38 15 I CD 31400202555 5,186.38 100% 5,186.38 16 Household furnishings and miscelanious personal Property 2,245.00 100% I 2,245.00 I I I Page 2 of Schedule G -~ FILE COpy; THIS DEED MADE THIS . -;;; () tI day of , 1998, between VICTOR T. GASPARI, SR. , widott County, Pennsylvania, Cumberland GRANTOR AND VICTOR T. GASPARI, SR. I Trustee, of 125 Lancaster Boulevard, Mechanicsburg, Cumberland county, pennsylvania, GRANTEE WITNESS1TH, that the Grantor, for and in consideration of ONE DOLLAR ($l.od) lawful money of the united states of America, to the Grantor in hand well and truly paid by the Grantee, at or before the sealing and delivery of these presents, the receipt whereof is hereby acknowledged and the Grantor being therewith fully satisfied, does by these presents grant, bargain, sell and convey unto the Grantee forever, his heirs and assigns: ALL THAT CERTAIN lot of land situate in Lower Allen Township, Cumberland County, Pennsylvania, more particularly bounded and described as follows, to wit: BEGINNING at a point on the easterly side of Lancaster Boulevard which point is four hundred seventy-five and two hundredths (475 . 02) feet North of the northeast corner of Oxford Drive and Lancaster Boulevard at the dividing line between Lots Nos. 6 and 7, Block G, of the hereinafter mentioned Plan; thence by the easterly side of Lancaster Boulevard North forty-four (44) degrees thirty- eight (38) minutes West seventy-five (75) feet to a point at the dividing line between Lots Nos. 7 and 8, Block G, of the Plan; thence by said dividing line north forty-five (45) degrees twenty- two (22) minutes East one hundred ten (110) feet to a point at the dividing line between Lots No.7, Block G, of the Plan and Lot No.22, Block G, Plan 1, Orchard Crest Manor; thence by said dividing line and the line of Lot 23, Block G, plan 1, Orchard Crest Manor South forty-four (44) degrees thirty-eight (38) minutes East seventy-five (75) feet to a point at the dividing line between Lots No.6 and 7, Block G, of the Plan; thence by said dividing line South forty-five (45) degrees twenty-two (22) minutes West one hundred ten (110) feet to a point on the easterly side of Lancaster Boulevard, the Place of BEGINNING. BEING all of Lot No 7, Block G, Orchard Crest Manor, which Plan is recorded in the Cumberland County Recorder's Office in Plan Book 20, Page 66. HAVING thereon erected a one story ranch dwelling known and numbered as ~25 Lancaster Boulevard, Mechanicsburg, Pennsylvania. BEING the same premises which Robert E. Latsha and Janet L. Latsha, his wife, by their deed dated May 15, 1970 and recorded in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania on May 19, 1970 in Deed Book Q 23, Page 213 granted and conveyed unto victor T. Gaspari, Sr. and Theresa J. Gaspari, his wife. The said Theresa J. Gaspari predeceased her husband thereby vesting full and complete title unto Victor T. Gaspari, Sr. Grantor herein. UNDER AND SUBJECT, NEVERTHELESS, to easements, conditions and restrictions of prior record pertaining to said premises. i THIS CONVEYANCE :Yis made by Grantor to an Inter-Vivos Trust of which the Grantor is the beneficiary, and as such is exempt from Realty Transfer Tax. TOGETHER with all and singular the buildings, improvements, ways, woods, waters, watercourses, rights, liberties, privileges, hereditaments and appurtenances to the same belonging or in anyway appertaining; and the, reversion and reversions, remainder and remainders, rents, issues and profits thereof, and of every part and parcel thereof; AND ALSO all the estate, right, title, interest, use, possession, property, claim and demand whatsoever of the Grantor both in law and in equity, of, in and to the premises herein described and every part and parcel thereof with the appurtenances. TO HAVE AND TO HOLD all and singular the premises herein described together with the hereditaments and appurtenances unto the Grantee and to the Grantee's proper use and benefit forever. AND THE SAID GRANTOR, does hereby warrant specially the property hereby conveyed. Signed, sealed and delivered 4!CJ~ of: / /' / , / I i I Ii II r I ! IN WITNESS WHEREOF, the Grantor has hereunto set his hand and seal the day and year first above mentioned. -- COMMONWEALTH OF PENNSYLVANIA COUNTY OF ! () {(F- On this, the :::s () -cJ'\.... day of _ , 1998, before me, a notary public, personally ap ared Vi or T. Gaspari, sr., known to me or satisfactorily prov n to be the person whose name is subscribed to the within deed and acknowledged that he executed the same for the purposes therein contained. : SS . . WITNESS, my hand and notarial seal the day and year aforesaid. S~~4/k NOTARY PUBLIC Notarial Seal S. D?wn Gladfelter, Notary Public Dlilsburg Bora, York County My Commission Expires May 17, 2001 Memher. Pennsylvania Association Of N(Jtane.~ My CommissionfExpires: The undersigned certified that the precise residence and complete post office address of the Grantee 125 Lancaster Boulevard Mechanicsburg, PA 17055 COMMONWEALTH OF PENNSYLVANIA . . : SS COUNTY OF . . RECORDED on this day of , 1998, in the Recorder's office of the said County in Deed Book ( Page Given under my hand and the seal of the said office the day and year aforesaid. RECORDER _~~~!r~~~~ for first class financial services July 25, 2001 The Wiley Group Attorneys at Law 1 South Baltimore Street Dillsburg, PA 17019 Re: Estate of Victor T. Gaspari, Sr. SS # 207-07-7412 Account # 1391 Dear Mr. Lenox: The account of Victor T Gaspari, Sr. at POSTMARK Credit Union was owned since February 11, 1960. There were no other owners on this account. Ownership changed in July to "Victor T. Gaspari, Sr. Trustee of THE VICTOR T GASPARI, SR. REVOCABLE LIVING TRUST, dated July 30, 1998." Interest(dividends) is paid on the last day of the month for accounts and sub accounts. The following is an account status on June 29, 2001. ~ Opened Balance 6/2912001 Interest Rate Savings 2/11/1960 $2049.44 2.75% There are no beneficiaries on this account. This should provide the information for you to handle the estate. If you have any questions please call. Sincerely, ~//~ ~ ,../' ,/,'/<.. /,"" i '- Bonnie Sommer Member Services Representative 2630 Unglestown Road. Harrisburg, PA . 1 71 1 0- 3666 717.671.5119 Commerce flBank- August 6, 2001 The Wiley Group Attorneys at Law 1 South Baltimore Street Dillsburg, PA 17019 RE: Estate of: Victor T Gaspari Sr Social Security #: 207-07-7412 Date of Death: June 29, 2001 Dear Sir/Madam: In reference to the letter regarding the above mentioned Estate, we would like to inform you of the information that we have researched and found. Type: Checking Account #: 082002700 Date Opened: 12/5/97 Account Title: Victor T Gaspari Sr Revocable Living Trust Primary Owner/Trustee: Victor T Gaspari Sr Trustee: Victor T Gaspari Jr Trustee: Donna L Greene Date of Death Balance: $4,805.42 Accrued Interest: $4.19 Type: Savings Account #: 480000210 Date Opened: 10/8/97 Account Title: Victor T Gaspari Sr Revocable Living Trust Primary Owner/Trustee: Victor T Gaspari Sr Trustee: Victor T Gaspari Jr Trustee: Donna L Greene Date of Death Balance: $63,506.12 Accrued Interest: $0 Commerce Bank, N.A. P.O. Box 8599 100 Senate Avenue Camp Hill, Pennsylvania 17001-8599 Commerce "Bank.. If there are any questions or additional information that is needed, please feel free to contact me at (717) 795-7118 ext. 3151. Sincerely, I \ 1". - -d . .Jj LA.-TYl _ 6- c:o- m~ Wanda J. Morris CIP Associate Commerce Bank, N.A. P.O. Box 8599 100 Senate Avenue Camp Hill, Pennsylvania 17001.8599 .. , " .. ., JUL 27 '01 09:~0AM SMITH BARNEY . 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JUL 27 '01 09:00AM' SMITH BARNEY P.3 '. .. :;Z:' . y' : '. , .' Cl!I It) , 'l5' ; ; 'f~~ ' !~~ I = ! I ; ~ J.... . :'. I, ~ IN '" ~~'::lM: .' ~t~ . 0....,. , . , ,Is" " i "" ' I. ~ .. ' . ~Ii oJ . r.~ i'. . ' '. 'ij'h ... - ~ .i(!.i A.' , .' .; .ra . f~i>l , .. . I Q"l~~ , . '!' ~J.~ I". Lt ~ ~1;'1~ lli~ l'f-~~ ~ ~ i '. :] ~ ", 0 '1 : III I Iii .Jil ~ " m i. -8"tl~ 1. ' I j- jia 'J ' " · ~ . J!' I. U. .;.' .~,. ~ .j ....,. , ., ~~,l 'Ill; .;i.at I" ' ru! Ii "18.', f. I.. , :....' . f~i; .~a~ . , ;':f:~ ~. ,... ~-;lr.: ~';l ;-~!t I J .. ~il' I i.ij ~ .' ~- .. , Id ~ I ' . a ,.. ~ : ' .. ~i~ I I I ~I 1: I iii ~l~ i , ~I , ' ; II '0, 1 , ,. J ,~~ I ; , l~t J2 i2g ..I,.~. i g51 ill E ~ (J I i Bu~ ;, ~ ~ 'I CD iif,~ li I I s! 1 end :I t\; i ~ ' is'~~ Qg ~. . Z-' :lQ ,', c;J.~ "Cl l!:~ llaiS i Ii.Il. III :$ii,t .. -.... hl~ 2~ ~ !~~t . :lg . '. :!lD.. II ;J~ ~~ II d~1i: !I I . io~+'~ U-I ~ .. II ::i I... fS '!j :c ~ :Ii .! ;j 0 " ~'t6 . 1lI.al ~ ~(~ ': Q . ., 4 , l! t-Z ~ ;a i ca,~$ .... Ii ~ ,i ai . " ; o!'t!i, Q l:I ""D.. . .. , LI '~~ii I II o · ! .., t~ i 'a ZZ!l:,' i~~~ . . 5~~1 I E :s II . JI~ II . 111 '. II '9 . 'c:;.:c' ~ ~ r<' i .g .!! .1 u ,. , cu .. ~ I~' ~CL .1 ,; I It . Li I ,~ !-! " 1 9- -- fin CJ ;1. ! iii iii .. i . . II !:! ,; , .12 ~ !I :, i - ;. I ~ :"~""'.' Q I ' - . '- ~! Q\i;..... . , I I 11 08 . ;' '1 III If I .. ~. ;. , ' . '\j ',)1 .=1 ~ ; " " a: :, Ii! : I' " , . J SEP-14-2001 11:51 P.01/05 QPNCBAN< Deeedent Reporting Firstside Center P7-PFSC-4-F 500 First Avenue Pittsburgh. PA 15219.3128 September 14. 200 I David J. Lenox, Esquire 1 South Baltimore Street Dillsburg, PA 17019 RE: Estate of Victor T. Gaspari, Deceased SSN: 207-07-7412 DOD: 6/2912001 Dear Mr. Lenox: In response to our telephone conversation yesterday I send the following reply. According to 0\11" system our records show all the Certificates of Deposit were Established 10/30/2000. We will not change the Established Dates on the Certificates. The dates are correct per the infonnation on the system. There are no possible "rollovers" for the Cd's. However, with reference to the savings Account, we were able to trace it back to 1 0/12/ 1 999 from a CD which opened 10/12/1999. Please find that the correction has been made on the letter that I am. faxing over. Sincerely, ~tu~ Rachelle Wells 1-800-762-1775 A membt:r of The PNC Finan(!i.al Services Group One PNC ?la7.4.l 249 Firlh Avenue Pittsburgh Pt:nnsylvar'lia 15222 2707 SEP-13-2001 16:21 PNCBANK CIF DEPARTMENT 412 705 0057 P.01/04 QPNCBAN< Decedent Reporting Firstside Center P7-PFSC-4-F 500 First Avenue Pittsburgh, PA 15219-3128 ISCP September 13, 2001 David J. Lenox, Esquire 1 South Baltimore Street Dillsburg. PA 17019 RE: Estate of Victor T. Gaspari, Deceased SSN: 207-07-7412 DOD: 6/29/2001 Dear Mr. Lenox: Please find the date of death balances you have requested listed below. CERTIFICATES OF DEPOSIT #31800201267 Established 10/30/2000 VICTOR T GASPARI SR VICTOR T GASPARI JR DOD Balance: $5,186.38 + $0.00 accrued interest #31000200229 Established 10/30/2000 VICTOR T GASPARI SR VICTOR T GASPARI JR DOD Balance: $5,186.38 + SO.OO accrued interest Page 1 of4 A member of The: PNC Financial Servic:a Group One PNC Pla.a ;!49 Fifth Avenue Pittsburgh Pennsylvania 15222 27Q7 SEP-13-2001 16:21 PNCBANK CIF DEPARTMENT a PNCBAN< #31000200230 VICTOR T GASPARI SR VICTOR T GASPARI JR DOD Balance: $5,186.38 + $0.00 accrued interest #31600201618 VICTOR T GASPARI SR VICTOR T GASPARI JR DOD Balance: $5,186.38 + SO.OO accrued interest #31900202120 VICTOR T GASPARI SR DONNA L GREENE DOD Balance: $5,186.38 + $0.00 accrued interest #31000200231 VICTOR T GASPARI SR DONNA L GREENE ODD Balance: $5,186.38 + SO.OO accrued interest #31700201117 VICTOR T GASPARI SR DONNA L GREENE DOD Balance: $5,186.38 + $0.00 accrued interest #31100202365 VICTOR T GASPARI SR DONNA L GREENE ODD Balance: $5,186.38 + $0.00 accrued interest #31100202366 VICTOR T GASPARI SR MICHAEL JOSEPH GREEN JR DOD Balance: $5.186.38 + $0.00 aeemed interest Page 2 of4 A member or The PNe Financial Servi~ Group One PNC Plaza 249 Fifth Avenue Pittsbu'llh Pennsvlvania J 5222 27(]1 412 705 0057 P.02/04 Established 10/30/2000 Established 10/30/2000 Established 10/30/2000 Established 10/30/2000 Established 10/3012000 Established 10/30/2000 Established 10/30/2000 SEP-13-2001 16:21 PNCBANK CIF DEPARTMENT o PNCBA1\K #31400202555 VICTOR T GASP ARJ SR MAITHEWTHOMAS GREEN DOD Balance: $S,186.38 $0.00 accrued interest CHECKING ACCOUNT #5003501858 VICTOR T GASPARI SR DOD Balance: $100.00 + SO.OO accrued interest SAVINGS ACCOUNT #5003174818 VICTOR T GASPARI SR VICTOR T GASPARI JR DONNA L GREENE DOD Balance: $32,200.69 + $26.77 accrue4 interest SAFE DEPOSIT BOX #463 located: ~DSORPARKBRANCH 5288 SIMPSON FERRY RD. MECHANICS BURG P A 17055 717-697-3001 Page 3 of4 A memba of The PNC Finanela' xrvices Group Om= PNC Plaza 249 fifth Avenue Pittsburgh Pennsvlvania 1522:7. 2707 412 705 0057 P.03/04 Established 10/30/2000 Established 10/30/2000 Established 07/13/2000 . SCI-EDU..E H A..N:RAL. EXPENSES & AIlVINSTRATIVE COSTS I _ ____ __1______ _______________ ___ _____~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE T AA RETURN RESIDENT DECEDENT __ __"____ __n-----;--___ ___,.________".______________.____ ESTATE OF .. Gaspan, VIctor T I- FILE NUMBER 21 - 01 - 0892 --.,.--------- --- .------------- ------------- .-------...------.-------..------.---... ITEM NUMBER A. B. Debts of decedent must be reported on Schedule I. DESCRIPTION I AMOUNT ------------1------------------- 7,615.00 FUNERAL EXPENSES: Myers Funeral Home, Funeral and Burial Services 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): 2. Street Address City State Zip Year(s) Commission paid Attorney's Fees The Wiley Group -- David J Lenox, Esq. 5,415.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 650.00 7. 1 2 3 Other Administrative Costs Commissions on sale of Real Propertty, Homestead Group Real Estate Closing Cost Termite Treatment 7,500.00 2,900.00 983.70 _I Total of Continuation Schedule(s) -1 15,152.56 _____.,..____.._..____'.______ ____________ ___n_." ___ _____..___,,___'___'__' ".________..____.___'_ TOTAL (Also enter on line 9, Recapitulation) 40,216.26 *' Schedule H Funeral Expenses & MninistraliYe Costs continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT -,------'_... ------------.-.--- -- ----" ---- ..--- ----'.-, --------, ----' ---, -----.,.----- -'- ----------..------'.----'--.----..- -----------~,.'- ---.----...----.---.--- ----- ---_.._._,_.._----_.-_._..._-_._------_._-~-_.._--- ---...---- Ii FILE NUMBER 21 - 01 - 0892 ----..-----------'.---- ----------'------ ----.---.-- ESTATE OF Gaspari, Victor T 4 Structural Repair 720.00 5 Real Estate Transfer Tax 1,279.00 6 County and Township Real Estate Tax 435.25 7 Tax Certification Fee 4.00 8 Notary Fees 10.00 9 Headstone Inscription, Romberger Memorials 141.50 10 Real Estate School Taxes 1,108.50 11 Bond for Met Life Stock redemption 111.06 12 Trust Administration and Termination Fee, Donna L. Green 11,337.45 13 US Post Master 5.80 ._~._______..~__._L.___.____~____~_ Page 2 of Schedule H . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DEceDENT ESTATE OF G . V' T aspan, Jctor I FILE NUMBER 21 - 01 - 0892 . Include unreimbursed medical expenses. ITEM NUMBER 1 Pa. Dept. of Rev. (State Income Tax) DESCRIPTION AMOUNT 122.00 2 Veri son 3 AT&T 4 PP&L 5 Water Company 6 Comeast Cable 7 Municipal Trash and Sewer 8 Per Capita Tax 9 Painting, John Clemmer 10 Painting, Keith Early 11 Lawn and Yard Care, John Clemmer 12 Carpet Cleaning 13 Carpet Repair and Install 14 House cleaning 15 Snow Removal 16 Repair, Maintenance and Cleaning 112.60 17.81 674.84 119.43 31.42 202.50 10.00 600.00 600.00 115.00 51.94 363.19 95.00 40.00 625.00 TOTAL (Also enter on Line 10, Recapitulation) 3,780.73 . COMMONWEALTH OF PENNSYLVANIA 1 INHERITANCE TAX RETURN RESIDENT D~~~N~_ ____ _ _ ________________ ____L___________ _ ____ __ ______ ESTATE OF-- ------------- --- ----- -------- -\FILENUMBER------------ Gaspari, Victor T _ _______________ __ ___L____~~~1_=__?8.?2_____ SCHEDULE J BENEFICIARIES I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) Donna L. Greene 3803 Bellows Dr. , Camp Hill, PA 17011 2 I Victor T. Gaspari, Jr. 45 Allen Drive Shermansdale, P A 17090 I RELATIONSHIP TO I AMOUNT OR SHARE ! DECEDENT . OF ESTATE IDa::,"" _l -low. of residuary ~t - 'I~s~ate and respectIve ~omt property NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Son 40% of residuary trust estate and respective joint property 3 Christi Gaspari grand-daughter 100.00 i Enter dollar amounts for distributions shown above on lines 15 through 17, as appropriate, on Rev 1500 cover sheet II. I NON-TAXABLE DISTRIBUTIONS: IA. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE iB. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I I ----- --,-,--- -- -- ..--'-'--- --~.. -" -_.--- .---',----.-.-- .--------. ----.------,...------.-...--..----------- -_.._--._-._~-,,~.__.__.~-----_.-._._-_._- ./ 17 - lO-U COMMONWEAlT\LOF PENNSYLVANIA DE~~T~EHT ~ REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 '* INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. ACN DATE 21-01-~~ 01003047 09-24-2001 REV-1545 EX AFP (09-00) Li EST. OF VICTOR T GASPARI S.S. NO. 207-07-7412 DATE OF DEATH 06-29-2001 COUNTY CUMBERLAND TYPE OF ACCOUNT [Xl SAVINGS D CHECKING D TRUST D CERTIF. DONNA GREENE 3803 BELLOWS DR CAMP HILL PA 17011 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PNC BANK has provided the Depart.ent with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the InhpritancR Tax law~ of t~~ Cn~~~nwe~lth of PennsYlvania. Questions may be answered by calling (717) 787-8327. ' ' "' ' COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 5003174818 Date 10-12-1999 Established x 32,227.46 16.667 5,371.35 .045 241.71 TAXPAYER RESPONSE To insur~ proper credit to your account, two (2) copies of this notice must acco~any your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x NOTE: If tax payments are made within three (3) months of the decedent"s date of death, you may deduct a 5Z discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Tax PART [!] A. [ CHECK ] ONE BLOCK B. ONLY c. [] The above information and tax due is correct. 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. c=J The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent"s representative. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. If you indicate a different tax rate, please state your relationship to decedent: PART ~ TAX LINE RETUR~ ~ COMPUTATION 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax s. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOU~TS 1 2 3 X 4 S 6 7 X 8 PART [!] DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I $ I TOTAL (Enter on Line S of Tax Computation) Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME ( ) WORK ( ) TELEPHONE NUMBER DATE TAXPAYER SIGNATURE .. .. .' . . . . 3103 ;3d~.b'L-.- ~ /1..u-- J PA- /10f I ~.J..s; :JOOI . 10: Kells/Y a+ LJ:/b / be.pt. oJ- ReiJenul.- ~..: Donn'^-_ (J(p~~.c ' R6: [51- (.+VlC~(----r Ga$fdrt. S-c. ke-I: -:It S-()~ '317 ~ g 18'- ptJC