Loading...
HomeMy WebLinkAbout01-0896 Estate of Francis L. Peredna also kno wn as PETITION FOR PROBATE and GRANT- OF LE'ITERS No. ~ I - 0/-. '6 q U To: Register of Wills for the Deceased. County of Cllmhf'rl ;:mrl in the Social Security No. 022-10-R21fl Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut r; v in the last will of the above decedent, dated ()(" r/"lhpr ? r.:; and codici1(s) dated named , 19 99 (state releo..anr circumstances. e.g. renunciation. de:lth of e~ecutor, ere.) DC\:endent was domiciled at death in Cumberland County, Pennsylvania, with h is last family or principal residence at 906 nrf'.xf'.l Hi 11 Q Rnt11 l=>'t7!l"l"'rj ~ BorQl.lgh Qf " New Cumberland (list street. num~r 3ftd muncipaJity) Deceqdent, ~hen ~l years of age, died necemhf'r 11 ~ 20Q" , at h1) 11 flV'\~ MsPIM , . Except as follows, decedent did not marry, was not <;fivorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendenc at de~th owned property with estimated values as fellows: (I f domiciled in Pa.) All personal property (I f not domiciled in Pa.) Personal property in PennsylJlania (I f not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follow~: S 2 .000 . 00 S S S . ... \\"HEREFORE. petitioner(s) respectfully request(s) the probate of the last will and codiciI(s) presenced herewith and the gram of letters Testamentarv {h~ron. (1~13mentary: administration C.La.; administration d.b.n.e-t.a.) .J" ';,0 "oJ _"'" -', ~ '7 ri...J i 4.. i-, /1 ~ r-. Yt' ,,- e cI ;1 '1. ~ ~ qOh nrl3Vl=> 1 l-1j] 1 ~ :SQ1.11Q:rrara !:~ Ne~~ Cymb~H'l:1IHC Pf4 17970 .J"~ ~= ;Q :.r. /' . ./,' , -1 (' / '" ", K/ L--1L......'--Y1A- -- \.-fLI--Pt:L-"1h::t. /' ' OATH OF PERSONAL REPRESENTATIVE CO~I~IO~WEALTH OF PE~NSYLVA~HA I ..... r :s:s CO{;~TY OF Cumberland ) The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true:: and I.:orrel.:t to the best of the knowledge and belief of petitioner(s) and that as personal represen- t:lti\'eh) of the:: above decedent peritioner(s) will w,>l~and truly administer the estate according to law. (.,i . """) ;- ~~ 4/Z.1,/J'-'.Q. -/ ~ Z./'y" t'--;- A~;-<-,_ :;" ~. ;S :: ~ ~ ...::. NO~ .dl- 01 ~ ~q U Estate of Francis L. Perpnn~ , Deceased DECREE OF PROBATE AND GRANT OF LElTERS AND NO~ Ot!-- T. J 2 _ y{f). cx::?n' consideration of the petition on the reverse side hereof, satisfactory proof having been (resented before me, IT IS DECREED that the instrument(s) dated October 25. 1999 described therein be admitted to probate and filed of record as the last will of Frane] R T. Pprprln"l and Letters TeRt"~mpnhJ""Y are hereby granted to Dianne F. Peredn.q FEES . f}6,OO Probate, ~e.tters, Etc. ......... Si!BB Shan Cenlficates..<t ) (J 65 . . . .. S · R."'ll1Wj..ti3<l .. ^-:~tiP.. ~ ' Filed~r: rz. J~2Mh =. ~~ 102 717-612-5802 ~~i~~ :>5.805 REV 9/86 This is to certify that the information here given is correctly copied fron: an original certificate of death dul~ filed with me as Local Registrar. The original certificate will be forwarded to the State VItal Records Office for permanent filmg, WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 p 7022901 No. ~~~p- Local Registrar (J JAN 0 2 Z001 Date COMMONWEALTH OF PENNSYLVANIA e DEPARTMENT Of HEALTH e VITAL RECORDS CERTIFICATE OF DEATH ley. 2187 . NAME OF OECEDeNT(F,;;t;i'oda.e.la511 ~,. Francis L. -. AGE (Lw llo<\tIoay) UNDER 1 YEAR Monlha O.ya 61 SEll Peredna ~male SlAT E FILE NUMIIER SOCIAL SECURITY NUMBER OATEOFOEATHIMCnlI't:Da~. '-1 4. r'e-te YYl b ( c.31 2~ 3. 022 - 30 8236 IJN(lEA 1 OM HcJuq MinuIea 8IRTHPl.ACf (C.Iy....d PlACE OF DEATH IC/>eClI 0IlIy Ilf'e - _ ,n""uc"",,", on _ -I 3\a1e at F Cl"'9" Counuy) HOSPITAl: lnpalienl fj(] ER/Oulpalienl 0 DCA 0 ,. Newton MA ... FACILITY NAME (N noll""'IUl1On. give sc.eet ana 1lUIll_' :dylD 5. COUNTY OF OEJiTH Cumberland Ie. .... DECEDENT'S uSUAl OCCUPRION (~=:~~':::t:'f . ".. Branch President t1ll.Steel DECEDENT'S MAIlING AOOAESS ($I.IMI. C.....Ibwn. ~.1:opCotlel Distributio DECEDENT'S ACTUAl. RESIDENCE (See _IlOna on """" slIlel RACE. Atnenr:an Il\diom. BlKk, White. etc:. tSc>od'tI 10. white SURVIVING SPOUSE In ""'e. gMI..-._I MAAtTAl STATUS.1MmecS Ne_ Manoed. Widowed. o.-ced (Speedy) 14. Married 11e.D ...... ~Ilwdln Dianne F. Marcin 1Wp. ,.. FArHER'S NAME (F;,51. MoOdIe. la"l 18. Anthon F. Peredna 1Nf'0000000'S NAME (T ype/Pr1f1l\ Dianne F. Peredna ME'T}l()() Of' DISPOSITION 8uIW M C._ion 0 "--aIlfom Slaroo 0lh0Ir (SpKlIy'I Did ...... Min. Cumberland -..nip? 17d.~ :t...-':::.=0I New Cumberland MOTHER'S NAME iF.... _. M_ Surname) ~ Ethel W eth NfOAMANT'S MAIlING AOOflESS (StrIMl. C.lyflOwn. S-. Zip eoo.) . 906 Drexel Hills Blvd., New Cumberland, PA PlACE OF DISPOSITION. M_ 01 c-tory. C,ematoty lOCAllON . CitylTown. Slat.. lip Code or Ol/lel PIac:. 11.. SI.le 906 Drexel Hills Blvd. New Cumberland, PA 17070 l1b. DATE OF DISPOSITION (Monlh. OlIY. 'IlIar) o itb.January 4, 2001 PERSON ACTING AS SUCH lICENSE NUMBeR 22b.FD 013 340 L 21e.Gate .... 24-28 _ be compleIed by . ...--~~. ze. \\. q~ 21. MR'T I: Entet ,lie diMaMa. in",ries 01 compIIcallOM ..hicl\ caused \IIe dealh l.. only _ cause on HCIl_. )- oc-c) ~TE~IFonaI _or CaodI\tOIl '-*'lI"'<lMIhI- (" A.--~ ~ G\ ' J I-e, .""'" 7 J ( ,,~ ,'.. , DUE 10 (OR AS A CONSEQUENCE Of): ( ::J~"" r;>>r"7 c;-~h......... DUE 10 COR AS A CONSEQUENCE Of): ~ o(Ur..~ \..... Seqo-.JIy .. condiIiona , MV.1McIln91O .......... .,.... E_ UNDeRLYING CAUSE (00MMa 01 tIl(UIy ....--- ,-..ng on o.fll LAST I :: d. DUE 10100 ASA CONSEQUENCE Of): ~AN AUlOPSv WERE AUlOPSY FINDINGS MANNER OF DEATH PERFOAMED1 AIIUlA8lE PAlOA 10 COMPlETION CJ/F CAUSE Natur-' ~ 0 OF OEJiTH1 Ham",. Ae_ 0 Paneling In"'''igalion 0 _81 NoD v.. D No 0 Suicide 0 Could no! be dele""fIIed 0 OATE OF INJURV (MonIh. Cay. ""ar) ellyJbon>. 17070 PA 17055 Norbl 21. I App<oJurneIo :=..=-: I l h. ...,,, PART II: OlhoIr.l\c:antoondlliaow~lOde.lII. but nal ~ in lIle ~_QivWlin PART I. 0"',-oi>,,- , \...- 1'7 '-yr '- () /11,,' r t e...// TIME OF INJURV INJURV AT INOAK? DESCRIBE HOW INJURY OCCURRED. _ 0 NoD M. 3OC. 29. 3010. PLACE OF INJURY. AI home. tann. ."....lacIOIy. olftce building, etc. 16pec,M 3Oe. 2k. :Db. CERf.lER ICheck only oneI .CUlTIFYING PtlYlllCIAN (PhyStCOaO ce<ltlyl(\Q ~sa ~ deaI/lwhen o>nolhe< ph.~.an has ptO<1OUoce<l deal/1 allO completed "em 23) To........ 0' M)' _...... de.... occ:llfNd due IDlIle eauM('I_ m....... .. .1a1ed. . . . . . . . . . . . . . . . . . . . . . . . . . 'PAONOUNClHG AHO Cl'RTIFYING PHYSICIAN (PhysIC"", bOth ;>tonounc"'9 lJealh all(] Cer1IIV"'9 to cause 01 <lea"'\ To.... _ 0111I)' kno~. do.... occu..... .,.... lime, dale. and place. .nd du.,o.... ea....I.I.nd manne... "aled.. "MEDICAl. EXAMINER/CORONER On !he b.aia 01 ......In.llon .ndlM invealig.lion, in my opinion. de.'" occurred at lhellm.. d.,., .nd place. and duo 10 the causels) and manner.a .t.,,,,.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31.. REGISTRAR'S SIGNATURE AND NUIolBER ~ ~ ~ 33. I~,I,~/I/I o 31b. LICENSE NUMBER o 31c. A? 'l> '1 F ..l } ~ - L 31d. "2.. l,:j.., I NAME AND AOORESS OF PERSON WHO COMPI.E'TEO CAUSE OF ~Ij. (I1em271TypeorPflnl T~'--./ A.. Y:::> .......-,. -~ o r-~ oJ /? ~ ("...... Ch-v--tA-.'", J 32. Cc..... '11 ,..-?A ,1411 DATE FILED (MOIl~Ih' lay. j'l ~. / -E&/ I LAST WILL AND TESTAMENT OF FRANCIS L. PEREDNA I, FRANCIS L. PEREDNA, of Cumberland County, Pennsylvania, do hereby make this my Last will and Testament, revoking any and all former Wills and Codicils made by me. FIRST: I am married to Dianne F. Peredna, and all references to my wife in this will are to her. I have no children. SECOND: I give my tangible personal property and all casualty insurance that I am carrying on said tangible personal property to my wife, Dianne F. Peredna, or, if she does not survive me, said property shall be sold and the proceeds added to my residuary estate. I have complete confidence that my wife or my Executor will honor any written instructions that I may leave with regard to said tangible personal property. THIRD: If my wife, Dianne F. Peredna, shall survive me, I bequeath to my Trustee, hereinafter named, IN TRUST NEVERTHE- LESS, cash, securities or other property in the amount specified below, to be known as the "Bypass Trust." (1) The bequest shall be $650,000, subject however, to Paragraphs (2) and (3) below. (2) The bequest shall increase or decrease, based upon the availability of my federal unified credit for estate ~ d., ~ -1- and gift taxes and the maximum allowable federal estate tax credit for state death taxes (but only to the extent that the use of such state death tax credit does not increase the death tax payable to any state), whether due to statutory changes, lifetime gifts in excess of the federal unified estate and gift tax exemption-equivalent amounts, or any other transfer which affects the availability of my federal credits aforesaid. (3) The bequest shall decrease, even to zero, if necessary to reduce federal estate tax payable as a result of my death to zero, considering that my intention is to fund the Bypass Trust by using my available federal unified credit for estate and gift taxes and my federal estate tax credit for state death taxes and to eliminate federal estate tax on the balance of my federal taxable estate by using the federal estate tax unlimited marital deduction. FOURTH: I give, devise, and bequeath the rest, residue and remainder of my estate, real and personal, to my wife. Should she not survive me, I give, devise, and bequeath such rest, residue and remainder to my Trustee, hereinafter named, IN TRUST NEVERTHELESS, to be held, administered and distributed for all purposes as part of the Bypass Trust. FIFTH: The Bypass Trust shall be held, administered and distributed as follows: ~~ d.~~~ -2- (1) My Trustee shall pay to or apply for the benefit of my said wife, until division into shares pursuant to paragraph (4), all of the net income from the Bypass Trust in convenient installments in such shares and proportions as my Trustee in its sole discretion shall determine primarily for the medical care, education, support and maintenance in reasonable comfort of my said wife, taking into consideration to the extent my Trustee deems advisable, any other income or resources of my said wife known to my Trustee, considering that my wife is the primary object of my bounty. (2) Prior to division into shares pursuant to Para- graph (4), my Trustee may pay to or apply for the benefit of my said wife such sums from the principal of the Bypass Trust in such shares and proportions as in its sole discretion shall be necessary or advisable from time to time for the medical care, education, support and maintenance in reasonable comfort of my said wife, taking into consideration to the extent my Trustee deems advisable, any other income or resources of my said wife known to my Trustee, considering that my wife is the primary object of my bounty. (3) In addition to the income and discretionary payments of principal from this Trust, there shall be paid to my said wife during her lifetime from the principal of this ~ d--~ -3- Trust upon her written request during the last month of each fiscal year of the Trust an amount not to exceed during such fiscal year the amount of Five Thousand Dollars ($5,000) or five percent (5%) of the aggregate value of the principal of the Bypass Trust on the last day of such fiscal year without reduction for the principal payment for such fiscal year, whichever is greater. This right of withdrawal is noncumula- tive, so that if my said wife does not withdraw, during such fiscal year, the full amount to which she is entitled under this Paragraph, her right to withdraw the amount not withdrawn shall lapse at the end of that fiscal year. (4) Upon the death of my said wife, the entire remaining principal of the Bypass Trust, or the part of such trust not effectively appointed shall be distributed as follows: Twenty-five percent (25%) to Janet F. Irons of Norwood, Massachusetts, per stirpes; and Thirty-seven and one-half percent (37-1/2%) to Robert Peredna of Hanover, Massachusetts, per stirpes; and Thirty-seven and one-half percent (37-1/2%) to Richard Peredna of Waltham, Massachusetts, per stirpes. SIXTH: If any beneficiary and I should die under such circumstances as would render it doubtful whether the benefi- ciary or I died first, then it shall be conclusively presumed for the purposes of this my Will that said beneficiary prede- ceased me; provided, however, that if my wife shall die with me ~~ ~- ~~ -4- as aforesaid, I direct that my wife shall be conclusively presumed to have survived me. SEVENTH: (1) I name Dianne F. peredna as my Executrix. If she is unable or unwilling to serve, I name Richard Peredna, of Waltham, Massachusetts and Robert Peredna of Hanover, Massachusetts, or the survivor of them, as my Execu- tors. I direct that my Executrix or Executor, herein referred to as my Executor regardless of number or gender, serve without bond in any jurisdiction in which called upon to act. (2) I name Robert Peredna of Hanover, Massachusetts, as my Trustee. I direct that my Trustee, herein referred to as my Trustee regardless of number or gender, serve without bond in any jurisdiction in which called upon to act. (3) Except as otherwise provided herein, if my Executor or Trustee or any successor as herein defined should fail to qualify as Executor or Trustee hereunder, or for any reason should cease to act in such capacity, the successor or substitute Executor or Trustee shall be some bank or trust company with trust powers, which successor or substitute Executor or Trustee shall be designated in a written instrument filed with the court having jurisdiction over the probate of my estate and signed by my wife or if she fails to act, signed by the court having jurisdiction over the Trust. The situs of the ~ ":).~ -5- Trust may be transferred to the situs of such successor or substitute Executor or Trustee by designation in the written instrument aforesaid. (4) For services as Executor and Trustee, my Executor and Trustee shall receive reasonable compensation. EIGHTH: (1) I give to any Executor and to any Trustee named in this will or any Codicil hereto or to any successor or substitute Executor or Trustee all of the powers enumerated in this Will and all of the powers applicable by law to fiduciaries in the Commonwealth of Pennsylvania and in particular through the Pennsylvania Probate, Estates and Fiduciaries Code, as effective and as in effect on the date hereof I during the administration and until the completion of the distribution of my estate, and until the termination of all trusts created in this Will or any Codicil hereto and until the completion of the distribution of the assets of such trusts. I direct that all such powers shall be construed in the broadest possible manner and shall be exercisable without court authorization. (2) In determining the federal estate and income tax liabilities of my estate, my Executor shall have discretion to select the valuation date and to determine whether any or all of the allowable administration expenses in my estate shall be used as federal estate tax deductions or as federal income tax ~~ d-_Y~ -6- deductions and shall have the discretion to file a joint income tax return with my wife. My Executor shall have the authority to make a QTIP election or a reverse QTIP election with respect to any trust created under this will and shall have the discretion to allocate the $1,000,000 Generation Skipping Tax exemption as he deems appropriate. (3) If at any time any trust created hereunder (or any share thereof if the trust shall have been divided into shares) shall be of such value that, in the opinion of my Trustee, the administration expense of holding the assets contained therein in trust is not justified, my Trustee, in its absolute discretion, may terminate such trust and distribute the trust property to the person or persons then entitled to receive or have the benefit of the income therefrom or the legal representative of such person. If there is more than one income beneficiary, my Trustee shall make such distribution to such income beneficiaries in the proportion in which they are beneficiaries or if no proportion is designated in equal shares to such beneficiaries. (4) My Executor and Trustee are authorized and em- powered to acquire and to retain, either permanently or for such period of time as my Executor or Trustee may determine, any assets, including the capital stock of any closely held corpora- ~~,~ -7- tion, whether such assets are or are not of the character approved or authorized by law for investment by fiduciaries and whether such assets do or do not represent an overconcentration in one investment. (5) My Executor and my Trustee are authorized and empowered to disclaim any interest, in whole or in part, of which I, my Executor, or my Trustee, may be the beneficiary, devisee, or legatee, by executing an appropriate instrument (in accordance with section 2518 of the Internal Revenue Code of 1986, as amended and supplemented, or such similar section as may then be in effect). (6) My Executor and Trustee are authorized and em- powered to sell at public or private sale, or exchange, and to encumber or lease, for any period of time, any real or personal property and to give options to buy or lease any such property. Additionally, my Executor and Trustee are authorized and em- powered to compromise claims, to borrow from anyone (including a fiduciary hereunder) and to pledge property as security therefor, to make loans to and to buy property from anyone (including a fiduciary or beneficiary hereunder); provided that any such loans shall be adequately secured and at a fair interest rate. (7) My Executor and Trustee are authorized and em- ~~ 6-~ -8- powered to allocate property, charges on property, receipts and income among and between principal or income, or partly to each, without regard to any law defining principal and income. NINTH: No person who at any time is acting as a Trustee or co-trustee (if any) hereunder shall have any power or obligation to participate in or to exercise any discretionary authority that I have given to my Trustee to pay principal or income to such person, or for his or her benefit or in relief of his or her legal obligations. Such discretionary authority shall be exercised solely by a disinterested co-trustee. TENTH: No interest of any beneficiary under this Will, any Codicil hereto, or any trust created herein, shall be sUbject to anticipation or to voluntary or involuntary alien- ation. ELEVENTH: All estate, inheritance, succession and other death taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property comprising my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid out of the residue of my estate, as if such taxes were expenses of administration, without apportionment or right of reimbursement. I authorize my Executor and Trustee to pay all such taxes at such time or times as deemed advisable. ~~r~ -9- IN WITNESS WHEREOF, I have set my hand and seal on this my Last will and Testament this 25th day of October 1999. SIGNED, SEALED, PUBLISHED, and DECLARED by FRANCIS L. PEREDNA, as and for his Last will and Testament, on the day and year last above written, in the presence of us, who, at his request, in his presence, and in the presence of each other, all being present at the same time, have hereunto subscribed our names as witnesses: ~~.~ FRANCIS L. PEREDNA (SEAL) UI- -10- SELF-PROVING AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA SSe COUNTY OF CUMBERLAND WE, Francis L. Peredna and Patricia D. Olyarnik Wayne M. Pecht and Stefanie A. Morrison the Testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last will and that he had signed willingly (willingly directed another to sign for him), and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witness and to the best of his or her knowledge the Testator was at that time eighteen (18) years of age or older, of sound mind, and under no constraint or undue influence. ~d~ 20en;a;tor ~~ "Y. witness Subscribed, sworn to, and acknowledged before me by Francis L. Peredna, the Testator, and subscribed and sworn to before me by Wayne M. Pecht Stefanie A. Morrison Patricia D. Olyarnik and , witnesses, this 25th day of October 1999. Cynthia JNotarial Seal / Camp Hill Bo'r~u~e. Ngtary Public My Commission 'Ex~~ e~lnd C. O"~fy , as an. 24, 2Mtl i __...l N~C}~ -11- . . CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Francis L. Peredna Date of Death: December 31, 2000 Will No.: 2001-00896 To the Register: I certify that notice of estate administration required by Rule 5.6 of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on January 22, 2002: Dianne F. Peredna 906 Drexel Hills Boulevard, New Cumberland, P A 17070 Robert F. Peredna, Trustee U/W Francis L. Peredna 153 Tecumseh Drive, Hanover, MA 02339 Notice has now been given to all persons entitled thereto under Rule 5.6 (a). w~q&- Keefer Wood Allen & Rahal, LLP 415 Fallowfield Road, Suite 301 Camp Hill, PAl 7011-4906 Date: January 22,2002 Capacity: Counsel for Personal Representative ~ I{) < \~'lj a {) OJ a: (Y") N z c:t: -, :i~ ~ 1..1) ,....... ,:,::::1;: (;) = Gc IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE Whether you will receive any money or property will be determined wholly or partly by the decedent's will. If the decedent died without a will, whether you will receive any money or property will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, CARLISLE, PA In re Estate of Francis L. Peredna, deceased, Estate No: 2001-00896 TO: Dianne F. Peredna 906 Drexel Hills Boulevard New Cumberland, PA 17070 Please take notice of the death of decedent and the grant of letters to the personal representative named below. The Decedent, Francis L. Peredna, died on the 31 st day of December 2000, at East Pennsboro Township, Cumberland County, Pennsylvania. The Decedent died testate (with a Will). The personal representative of the Decedent is: Dianne F. Peredna 906 Drexel Hills Boulevard New Cumberland, P A 17070 The Will has been filed with the Office of the Register of Wills of Cumberland County, One Courthouse Square, Carlisle, PA 17013. Phone number 717-240-6345. A copy of the Will may be obtained by contacting the Register of Wills and pa . g the charges for duplication. Date: / ~J..(~(}Y Capacity: Wayne . Pecht, Esquire Keefer Wood Allen & Rahal, LLP 415 Fallowfield Road, Suite 301 Camp Hill, PA 17011-4906 17108 Telephone 717-612-5802 Counsel for Personal Representative -- ," M ~ <.0 Q. .... ..... :...; ~ ~ aM ~ "S- ~ " . ."-- .0 .... .~ ~ ~ C :::I 8 ~ ~ 54 4) j u , fI) ~ GI ""' ca 4.J fI) WI ca 0# . .. ~;~ .. . STATUS REPORT UNDER RULE 6.12 Name of Decedent: Francis L. Peredna Date of Death: 12/31/00 Will No. 2001-00896 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes No X 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 6/03 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the ::::: o:2/::~02orPhan5' Court and may 2~ #eporto Wayne M. Pecht, Esquire Name (Please type or print) Keefer Wood Allen & Rahal, LLP 415 Fallowfield Road, Suite 301 AddressCamp Hill, PA 17011-4906 ( 717) 612-5802 Tel. No. Capacity: Personal Representative (MAH:rmf/AM3) x Counsel for personal representative "t L/ IN THE MATTER OF THE ESTATE OF FRANCIS L. PEREDNA,DECEASED IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 2001-00896 ESTATE SETTLEMENT AGREEMENT THIS AGREEMENT, made thisJ ~ay of August 2003, WITNESSETH: THE CIRCUMSTANCES leading up to the execution of this Agreement are as follows: 1. Francis L. Peredna (the "Decedent"), a married man, died testate on December 31, 2000, and Dianne F. Peredna duly qualified with the Register of Wills of Cumberland County, Pennsylvania as Executrix (the "Executrix") of his probate Estate (the "Estate"). 2. The Will provides as follows: Article THIRD: If my wife, Dianne F. Peredna, shall survive me, I bequeath to my Trustee, hereinafter named, IN TRUST NEVERTHELESS, cash, securities or other property in the amount specified below, to be known as the "Bypass Trust." (1) The bequest shall be $650,000, subject, however, to Paragraphs (2) and (3) below. (2) The bequest shall increase or decrease, based upon the availability of my federal unified credit for estate and gift taxes and the maximum allowable federal estate tax credit for state death taxes (but only to the extent that the use of such state death tax credit does not increase the death tax payable to any state), whether due to statutory changes, lifetime gifts in excess of the federal unified estate and gift tax exemption-equivalent amounts, or any other transfer which affects the availability of my federal credits afore- said.. (3) The bequest shall decrease, even to zero, if necessary to reduce federal estate tax payable as a result of my death to zero, considering that my intention is to fund the Bypass Trust by using my available federal unified credit for estate and gift taxes and my federal estate tax credit for state death taxes and to eliminate federal estate tax on the balance of my federal taxable estate by using the federal estate tax unlimited marital deduction. Article FOURTH: I give, devise, and bequeath the rest, residue and remainder of my estate, real and personal, to my wife. Should she not survive me, I give, devise, and bequeath such rest, residue and remainder to my Trustee, hereinafter named, IN TRUST NEVERTHELESS, to be held, administered and distributed for all purposes as part of the Bypass Trust. 3. At the time of the decedent's death he had probate assets totaling $10,160.08 comprised of: E*Trade Securities Inc. Account #4794-6945 $2,086.02 Northwestern Mutual Life Insurance Company Policy #5943901 on the life of Dianne F. Peredna $8,074.06 and non-probate assets totaling $652,776.01. 4. Due to the nature and amount of the probate assets, which would be used to fund -2- the Bypass Trust provided for under Article THIRD of decedent's Will, the Executrix and the Trustee, Robert Peredna, hereby agree that it would not be economical to fund the trust and that the assets that would be used should be distributed directly to Dianne F. Peredna. 5. The Beneficiaries desire to forever settle and compromise any and all claims and rights which they may possess, now or hereafter, in the Estate. 6. The Beneficiaries wish to release the Executrix and to indemnify her against any and all claims that may be asserted against the Estate or the Executrix after the date hereof. 7. The Executrix is willing to settle the Estate informally in consideration of the indemnifications hereinafter provided by the Beneficiaries. NOW, THEREFORE, in consideration of the foregoing and intending to be legally bound, jointly and severally, the Beneficiaries, for themselves, their heirs, personal representa- tives, successors and assigns: 1. Represent and warrant that they have read and understand this Agreement and confirm that the facts set forth above are true and correct, to the best of their knowledge, information, and belief. 2. Acknowledge receipt ofa copy of the Schedule of Distribution. 3. Declare that they have had the opportunity to review the Schedule of Distribution and based upon an examination (or on their decision not to make such an examination), they are satisfied that they have sufficient information to make an informed waiver of their right to a formal account- ing with the Court, and do hereby waive the filing and auditing of the same. -3- 4. Accept the Account, examined or not, as if the same had been duly filed with and audited, adjudicated, and confirmed absolutely by the Court. 5. Acknowledge that the distributive share or amount received shall be in full satisfaction of their respective entitlements under the Will, and ac- knowledge that they have each received their respective shares. 6. Release, remise, quitclaim and forever discharge the Executrix, her heirs, personal representatives, successors and assigns, from and against all claims that they, as residuary legatees and heirs had, now have, or may in the future have, in connection with the Estate. 7. Agree to refund on demand, all or any part of any aforesaid distribution, which has been determined by the Executrix, or by the Court, or by any court of competent jurisdiction to have been improperly made. 8. Agree to indemnify and hold harmless the Executrix, her heirs, personal representatives, successors and assigns, from and against any and all claims, loss, liability or damage (whether or not related to the negligence of the Executrix) that may hereafter be asserted against the Estate or against the Executrix. 9. Consent to the Court exercising personal jurisdiction over them in any suit or action arising out of the enforcement of this Agreement. IN WITNESS WHEREOF, and intending to be legally bound, the Beneficiaries have placed their hands and seals on the attached Consents to this Estate Settlement Agreement. -4- CONSENT TO ESTATE SETTLEMENT AGREEMENT I, DIANNE F. PEREDNA, hereby consent to and join in the Estate Settlement Agreement relating to the Estate of Francis L. Peredna, deceased, a copy of which Estate Settlement Agree- ment has been provided to me. Q~ -4:-' -#>J2-- -:/.D~~__ __"" D~PERED~ COMMONWEALTH OF PENNSYLVANIA COUNTYOF ~ SS. On this, the ~ ~day Of~i- 2003, before me, the undersigned officer, personally appeared DIANNE F. PEREDNA, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same in the capacities and for the purposes therein contained. IN WITNESS WHEREOF, I hereunder set my hand and official seal. ~~ Not Public NOTARIAL SEAL CYNTHIA J. RULE. Notary Public Camp Hill Bow., Cumberland County , mmi$$ion Ex ires Jan. 24, 2004 -5- CONSENT TO ESTATE SETTLEMENT AGREEMENT I, ROBERT PEREDNA, Trustee under the Last Will and Testament of Francis L. Peredna, hereby consent to and join in the Estate Settlement Agreement relating to the Estate of Francis L. Peredna, deceased, a copy of which Estate Settlement Agreement has been provided tome. STATE OF MASSACHUSETTS p~YfrJo VII H SS. COUNTY OF On this, the It 7ft..day of s'Errem861l...2003, before me, the undersigned officer, Cf personally appeared ROBERT PEREDNA, known to me (or satisfactorily proven) to be the ....- person whose name is subscribed to the within instrument, and acknowledged that he executed the same in the capacity and for the purposes therein contained. IN WITNESS WHEREOF, I hereunder set my hand official seal. ROBERT C. SHEA Notary Public Commonwealth of Massachusetts My Commission Expires JlJ[l~~QOa -6- EXHIBIT "A" SCHEDULE OF DISTRIBUTION 1. To: Dianne F. Peredna Proceeds ofE* Trade Securities, Inc. Account #4794-6945 $2,144.92 Northwestern Mutual Life Insurance Company Policy #5943901 on the life of Dianne F. Peredna 8.074.06 2. TOTAL ASSETS TO BE DISTRIBUTED $10.218.98 HEATH L. ALLEN N. DAVID RAHAL CHARLES W. RUBENDALL II ROBERT L. WELDON EUGENE E. PEPINSKY. .JR. .JOHN H. ENOS m GARY E. FRENCH DONNA $. WELDON BRADFORD DORRANCE .JEFFREY S. STOKES ROBERT R. CHURCH STEPHEN L. GROSE R. SCOTT SHEARER WAYNE M. PECHT ELYSE E. ROGERS CRAIG A. LONG YEAR DONALD M. LEWIS 1II BRIDGET M. WHITLEY .JOHN A. FEICHTEL ANN McGEE CARBON ELIZABETH .J. GOLDSTEIN BARBARA A. GALL STEPHANIE KLEINFELTER C~ KEEFER WOOD ALLEN & RAHAL, LLP 415 F ALLOWFIELD ROAD, SUITE 301 CAMP HILL. PA 17011-4906 ESTABLISHED IN 1878 OF COUNSEL: SAMUEL. C. HARRY PHONE 717-612-5800 FAX 717-612-5805 HARRISBURG OFFICE: 210 WALNUT STREET HARRISBURG. PA 17101 EIN No. 23-0716135 www.keeferwood.com PHONE 717-255-8000 November 5, 2003 717-612-5800 crule@keeferwood.com Register of Wills of Cumberland County Courthouse High and Hanover Streets Carlisle, PA 17013 \ _II Re: Estate of Francis L. Peredna, deceased No. 2001-00896 Dear Madam: Enclosed for filing with your office is an Estate Settlement Agreement for the above- referenced estate. Also enclosed is our check in the amount of $17 to cover your filing fees. Please time-stamp and return the additional copy of the Estate Settlement Agreement. A return envelope is enclosed for your use. If you have any questions, please call me. cJr Enclosures Very truly yours, Q~}-k Cynthia J. Rule Legal Secretary HEATH L. ALLEN N. DAVID RAHAL CHARLES W. RUBENDALL II ROBERT L. WELDON EUGENE E. PEPINSKY, .JR. .JOHN H. ENOS m GARY E. FRENCH DONNA S. WELDON BRADFORD DORRANCE ..JEFFREY S. STOKES ROBERT R. CHURCH STEPHEN L. GROSE R. SCOTT SHEARER WAYNE M. PECHT ELYSE E. ROGERS DONALD M. LEWIS JlJ: BRIDGET M. WHITLEY CRAIG A. LONGYEAR ..JOHN A. FEICHTEL ANN McGEE CARBON ELIZABETH ..J. GOLDSTEIN BARBARA A. GALL KEEFER WOOD ALLEN & RAHAL, LLP 415 F ALLOWFIELD ROAD, SUITE 102 CAMP HILL, PA 17011-4906 ESTABLISHED IN 1878 OF COUNSEL: SAMUEL C. HARRY PHONE 17171 612-5800 FAX 17171 612-5805 HARRISBURG OFFICE: 210 WALNUT STREET HARRISBURG, PA 17101 K'Q0 j))I" PHONE 17171 255-8000 FAX 17171 255-B050 EIN No. 23-0716135 i.- WRITER'S DIRECT DIAL: September 27, 2001 717-612-5802 wpecht@keeferwood.com Mary C. Lewis Register of Wills of Cumberland County High & Hanover Streets Carlisle, P A 17013 Re: Estate of Francis L. Peredna Date of Death: December 31, 2000 Social Security No: 022-30-8236 Dear Mary: Enclosed are the following items for filing with your office: 1. Original and one copy of the Pennsylvania Inheritance Tax Return; 2. Check in the amount of $15 payable to Register of Wills, Agent representing filing fees. I also enclose three copies of the front page of the of the Inheritance Tax Return which I ask that you time-stamp. Also, please issue your official receipt for the payment of the inheritance tax. A self- addressed, postage paid return envelope is enclosed for your use. If you have any questions, please call. WMP:cjr Enclosures cc: Dianne F. Peredna Very truly yours, KEEFER 'jPO~LEN & RAHAL. LLP By ~~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE /1-/tJ-/O I BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX RecorcJ:_ Reg:2,'t~-; 12-31-2001 PER EDNA 12-31-2000 21 01-0896 CUMBERLAND 101 .02 JAN -4 Pl2 :32 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN WAVNE M PECHT C/O KEEFER ETAL 415 FALLOWFIELD RD Clerk~C CAMP HILL PAGlmoD!nanC *' s~ (/ REY-1547 EX AFP 112-DDI FRANCIS L AIIount Re.1i tted ~i~ t PA 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 ~ Ri-,,=is4,-ix--AFP--ci'2:ooi--NCffici--OF-'rtiiiEififAHCi-.fAirirPPRAisiMENT-,--AL"rOWAifci-oli----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF PEREDNA FRANCIS l FILE NO. 21 01-0896 ACN 101 DATE 12-31-2001 TAX RETURN WAS: (X) ACCEPTED AS FILED CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (ll (2) (3) (4) (S) (6) (7) .00 .00 .00 .00 10,160.08 .00 642,615.93 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Hortgage Liabilities/Liens (Schedule I) (10) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate SUbject to Tax .00 .00 Ul) (2) (3) (4) US) 642,615.93 X 00 = (6) .00 X 045 = (7) .00 X 12 = (8) .00 X 15 = (9)= NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 652,776.01 00 652,776.01 10,160.08 642,615.93 TAX CREDITS: PAYHENT RECEIPT DISCOUNT (+) AI10UNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYI1ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A ..CREDIT.. (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORI1 FOR INSTRUCTIONS.) 1..///'7-/0- /0 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 WAYNE M PECHT C/O KEEFER ETAL 415 FALLOWFIELD RD CAMP HILL PA 17011 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN *' REY-75' EX AFP (01-02) 03-31-2003 PEREDNA 12-31-2000 21 01-0896 CUMBERLAND 202 FRANCIS L Allount Rellitted 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 FILES ~ iE-v: 736-EX-AFP--{oi:.-o21-----..-Nifficf-oF--oETERMiNA"Tiifti-Aiii-AS-SESSMENT----------------------- -- --- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER .. ESTATE OF PER EDNA FRANCIS L FILE NO.21 01-0896 ACN ZOZ DATE 03-31-2003 ESTATE TAX DETERMINATION 1. Credit For State Death Taxes as Verified .00 Z. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) .00 3. Inheritance Tax Assessed by Other States or Territories of the United States (Excluding Discount and/or Interest) .00 4. Total Inheritance Tax Assessed .00 5. Pennsylvania Estate Tax Due .00 6. Amount of Pennsylvania Estate Tax Previously Assessed Based on Federal Estate Tax Return .00 7. Additional Pennsylvania Estate Tax Due .00 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 TOTAL DUE .00 -IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN *' REV-483 EX AFP (01-03) WAYNE M PECHT C/O KEEFER ETAL 415 FALLOWFIELD RD CAMP HILL PA 17011 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-24-2003 PEREDNA 12-31-2000 21 01-0896 CUMBERLAND 201 FRANCIS L Amount Remitted 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, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ~ ---------------------------------------------------------------------------------------------------------------- REV-483 EX AFP (01-03) ~~ NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN ~~ ESTATE OF PEREDNA FRANCIS L FILE NO.21 01-0896 ACN 201 DATE 03-24-2003 ESTATE TAX DETERMINATION 1. Credit For State Death Taxes as Verified .00 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) .00 3. Inheritance Tax Assessed by Other States or Territories of the United States (Excluding Discount and/or Interest) .00 4. Total Inheritance Tax Assessed .00 5. Pennsylvania Estate Tax Due .00 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 TOTAL DUE .00 *IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) 01 elL STATUS REPORT UNDER RULE 6.12 Name of Decedent: Francis L. Peredna Date of Death: December 31.2000 No. 2001-00896 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: ~ Yes _ No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to NO.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes ..X- No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? ..X- Yes _ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphan's Court and may be attached to this report. ~~ f Date: November 10. 2003 Elyse E. Rogers, Esquire Keefer Wood Allen & Rahal, LLP 415 Fallowfield Road, Suite 301 Camp Hill, PA 17011-4906 717-612-5801 N ~ Capacity: _ Personal Representative -L Counsel for Personal Representative REV-1500 EX + (6-00) I COMMONWEALTH OF PENNSYLVANIA REV-1500 DEPARTMENT OF REVENUE I DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER HARRISBURG, PA 17128-0601 RESIDENT DECEDENT DECE- DENT CHECK APPRO- PRIATE BLOCKS COR- RE- SPON DENT RECA- PITULA- TION TAX COMPU- TATION o PA15001 6iJ/ 7 -/() - Ie) OFFICIAL USE ONLY o COUNTY CODE NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Peredna Francis L. DATE OF DEATH (MM-DD-YEAR) 12 31 00 01 24 1939 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Peredna, Dianne F. 022-30-8236 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ~ 1. Original Return 4. Limited Estate 6. Decedent Died Testate (Attach copy of Will) 9. Litigation Proceeds Received 3. Remainder Return o (date of death prior to 12-13-82) ~ 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 011. Election to tax under Sec. 9113(A) (Attach Sch 0) ~ 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach a copy of Trust) 10. Spousal Poverty Credit(da1e of death between 12-31-91 and 1-1-95) :tI11$:~CfloijMu$T~c.QMpU~f~p;AtWc.oaRe$iilQNii~ijG~~GoM~jQ~NTIAUTAXjijFoijM.Mf:iQN$BQijUp:~titR~~b.TQd NAME COMPLETE MAILING ADDRESS Wa e M. Pecht, ire 415 Fallowfield Road FIRM NAME (If Applicable) suite 102 Keefer Wcxxl Allen & Rahcl, UP Camp Hill, PA 17011 TELEPHONE NUMBER 717-612-5802 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) OFFICIAL USE ONLY (1) (2) None None None None 3. Closely Held Corporation, Partnership or SOI,-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested (6) 10,160.08 None 7. Inter-Vivos Transfers & Miscellaneow. Non-Probate Property (Schedule G (r L) (7) 642,615.93 8. Total Gross Assets (total Lines 1-i\ 9. Funeral Expenses & Administrative Cr,'-;ts (Schedule H)(9) 10. Debts of Decedent, Mortgage Liabilities, Co. '."ons (Schedule I) (10) 11. Total Deductions (total Lines 9 & 1/)) 12. Net Value of Estate (Line 8 minus U,le 11) 13. Charitable and Governmental Bequ(:5ts/Se9 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 m~nus Line 13) 652,776.01 (8) None None (11 ) (12) (13) 0.00 652,776.01 10,160.08 (14) 642,615.93 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) 642,615.93 X.O ~ (15) 16. Amount of Line 14 taxable at lineal rate 0.00 x.o 45 (16) 17. Amount of Line 14 taxable at sibling rate 0.00 X .12 (17) 18. Amount of Line 14 taxable at collatera, rate 0.00 X .15 (18) ~~: TaDul@f$qKflgijijjEVQQiijt~~i;!qQ~$tiNqAiij~fQNQQfiM'.QV$ijeAYMi;!fiJ'i(19) ::::::::n:#~:ij~$.QRttQ~~\l$wgF:lA@@Q~$t-@N$PNeA@~~Af;@8~qHg$~MAtB~M 0.00 0.00 0.00 0.00 0.00 ...................... ....................... ...................... ....................... ...................... .......... .... ....... .. ........... ............... ................................... ::::::::::::::::::::=:=::::::::::::::::::=::::::::===:;.:.:........ ......................... NTF 29755 Copyright 20CO Gn''''',nd/Nelco LP- Forms Software Only PA REV-15oo EX (6-00) Page 2 Decedent's Complete Address: STREET ADDRESS 906 Drexel Hill Boulevard --. CITY I STATE I ZIP New CUmberland PA 17070 - Tax Payments and Credits: 1. Tax Due (Page 1 Une 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty (3) 0.00 (4) (5) 0.00 (SA) 0.00 (5B) 0.00 Total Interest/Penalty (0 + E) 4. If Une 2 is greater than Une 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 Une 5 + SA. This is the BALANCE DUE. Make Check AGENT PLEASE ANSWER THE FOLLOWj~"3 QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Yes No ~ I B ~ 1. Did decedent make a transfer and: a. retain the use or income of the poperty transferred; ....................................... b. retain the right to designate who r.hall use the property transferred or its income; ................. c. retain a reversionary interest; or. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d. receive the promise for life of eithe' payments, benefits or care? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate considera'i.Jn? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? . . . 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. o 2. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than 1he personal representative is based on information 01 which preparer has any know1edQe. SIG E OF PfRSON RESPON FOR !:ILII'IG RETURN DATE ADDRESS 415 Fall~ield Road, suite 102, Camp Hill, PA 17011 .........'............................ ..... .......;::::::;:;:::;:::;:::::;:;:::;:::::-:.:............ .......................:.:.;.;.;.;.;.;.;.;.:.:.:.;.:.:.:.:. .:.;.:.:.:.:..... .............:.:.:.;.:.:.:.:.:.:.;.:.;.:.:.:.:.:.:.:. ... .::::::::;:;:;:;::.::::;:;:;::::::.:::. ...............:.:.:...:::::::;. F~/d~t~~~{d~~th~~o;~ft~/J~iy..l;..19.94a~.db~io;~J~~~~;y'i,i.99S;ih~'t~~;~i'~;;;'PO~~d~~th~~~t.~~i~~~ii;~~~f~;~'i~O;f~;th~'~;~~iih~'~;;;~;~i~'g~~~~~~i~':3~X"':.' ...... ....... [72 P.S. Ii 9116 (a)(1.1)(i)]. For dates of death on or after January 1, 1995, the tax rate is im~osed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. Ii 9116 (a)(1.1)(ii)]. The statute rlnA:!'i. not p.xlI!!mpt a transfer to a surviving spouse fl om 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 orafter 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 tor the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S.1i9116(aX1.2)]. The tax rate imposed on the net value of transfers to or for the use of th e decedent's lineal beneficiaries is 4.5%, except as noted in 72.P.S.1i 9116(1.2) [72 P.S.1i 9116(aX1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. Ii 9116(aXl.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedellt, whether by blood or adoption. o PA1S002 NTF 29756 Copyright 2000 Greal.ind/Nelco LP - Forms Software Only REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Francis L. Peredna Include proceeds of litigation & date proceeds were received by the estate. All DroD.lolntlv-owned with right of survlvorshlD must be disclosed on Sch. F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 E*Trade Securities Inc. Account #4794-6945 2,086.02 2 Northwestern Mutual Life Insurance Company Policy #5943901 Insured: Dianne F. Peredna OWner: Francis L. Peredna 8,074.06 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 10,160.08 7 CPA81 NTF 10908 Copyright Forms Software Only, 1997 Nelco, Inc. REV-1510 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Francis L. Peredna SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER This schedule must be completed and filed if the ulswer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY %OF EXCLUSION ITEM INCLUDE NAME OF THE TRANSFEREE, THEIR DATE OF DEATH DECD'S (IF TAXABLE VALUE RELATIONSHIP TO DECD & DATE OF TRANSFER. NO. ATTACH COpy OF THE DEED FOR REN. ESTATE. VALUE OF ASSET INTEREST APPLICABLE) 1 Prudential Securities elF Francis 298,232.64 100% 298,232.64 L. Peredna IRA Account #044-808625 Beneficiary: Dianne F. Peredna 2 Northwestern Mutual Variabh~ 27,889.70 100% 27,889.70 Annuity IRA Contract #9230125 Beneficiary: Dianne F. Peredna 3 American steel and Alumimnn 316,493.59 100% 316,493.59 Corporation 40lK Beneficiary: Dianne F. peredna TOTAL (Also enter on line 7, Recapitulation) $ 642,615.93 7 CPA01 NTF 10910 Copyright Forms Software Only, 1997 Nelco, Inc. (If more space is needed, insert additional sheets of the same size) REV-1513 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES Francis L. Peredna No. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 Dianne F. Pere.dna 906 Drexel Hill Boulevard New cumberland, PA 17070 FILE NUMBER RELATIONSHIP TO DECEDENT Do Not List Trustee(s) SUrviving spouse AMOUNT OR SHARE OF ESTATE 642,615.93 ENTER DOLLAR AMTS. FOR DISTRIBS. ;?HOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC~ ION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1 Trust under Will of Francis L. Peredna for the benefit of Dianne M. Peredna Robert Peredna, Trustee B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS None 10,160.08 7 CPA13 NTF 10913 TOTAL OF PART II -- ENTER TOTAL Nm.,.TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 10,160.08 Copyright Forms Software Only, 1997 Nelco, Inc. (If more ~,: ace is needed, insert additional sheets of the same size) LAST WILL AND TESTAMENT OF FRANCIS L. PEREDNA I, FRANCIS L. PEREDNA, of Cumberland County, Pennsylvania, do hereby make this my Last Will and Testament, revoking any and all former wills and Codicils made by me. FIRST: I am married to Dianne F. Peredna, and all references to my wife in this will are to her. I have no children. SECOND: I give my tangible personal property and all casualty insurance that I am carrying on said tangible personal property to my wife, Dianne F. Peredna, or, if she does not survive me, said property shall be sold and the proceeds added to my residuary estate. I have complete confidence that my wife or my Executor will honor any written instructions that I may leave with regard to said tangible personal property. THIRD: If my wife, Dianne F. Peredna, shall survive me, I bequeath to my Trustee, hereinafter named, IN TRUST NEVERTHE- LESS, cash, securities or other property in the amount specified below, to be known as the "Bypass Trust." (1) The bequest shall be $650,000, subject however, to Paragraphs (2) and (3) below. (2) The bequest shall increase or decrease, based upon the availability of my federal unified credit for estate ~ d. y~ -1- and gift taxes and the maximum allowable federal estate tax credit for state death taxes (but only to the extent that the use of such state death tax credit does not increase the death tax payable to any state), whether due to statutory changes, lifetime gifts in excess of the federal unified estate and gift tax exemption-equivalent amounts, or any other transfer which affects the availability of my federal credits aforesaid. (3) The bequest shall decrease, even to zero, if necessary to reduce federal estate tax payable as a result of my death to zero, considering that my intention is to fund the Bypass Trust by using my available federal unified credit for estate and gift taxes and my federal estate tax credit for state death taxes and to eliminate federal estate tax on the balance of my federal taxable estate by using the federal estate tax unlimited marital deduction. FOURTH: I give, devise, and bequeath the rest, residue and remainder of my estate, real and personal, to my wife. Should she not survive me, I give, devise, and bequeath such rest, residue and remainder to my Trustee, hereinafter named, IN TRUST NEVERTHELESS, to be held, administered and distributed for all purposes as part of the Bypass Trust. FIFTH: The Bypass Trust shall be held, administered and distributed as follows: ~~ d-~~~ -2- (1) My Trustee shall pay to or apply for the benefit of my said wife, until division into shares pursuant to Paragraph (4), all of the net income from the Bypass Trust in convenient installments in such shares and proportions as my Trustee in its sole discretion shall determine primarily for the medical care, education, support and maintenance in reasonable comfort of my said wife, taking into consideration to the extent my Trustee deems advisable, any other income or resources of my said wife known to my Trustee, considering that my wife is the primary object of my bounty. (2) Prior to division into shares pursuant to Para- graph (4), my Trustee may pay to or apply for the benefit of my said wife such sums from the principal of the Bypass Trust in such shares and proportions as in its sole discretion shall be necessary or advisable from time to time for the medical care, education, support and maintenance in reasonable comfort of my said wife, taking into consideration to the extent my Trustee deems advisable, any other income or resources of my said wife known to my Trustee, considering that my wife is the primary object of my bounty. (3) In addition to the income and discretionary payments of principal from this Trust, there shall be paid to my said wife during her lifetime from the principal of this ~~ ~-~. -3- Trust upon her written request during the last month of each fiscal year of the Trust an amount not to exceed during such fiscal year the amount of Five Thousand Dollars ($5,000) or five percent (5%) of the aggregate value of the principal of the Bypass Trust on the last day of such fiscal year without reduction for the principal paYment for such fiscal year, whichever is greater. This right of withdrawal is noncumula- tive, so that if my said wife does not withdraw, during such fiscal year, the full amount to which she is entitled under this Paragraph, her right to withdraw the amount not withdrawn shall lapse at the end of that fiscal year. (4) Upon the death of my said wife, the entire remaining principal of the Bypass Trust, or the part of such trust not effectively appointed shall be distributed as follows: Twenty-five percent (25%) to Janet F. Irons of Norwood, Massachusetts, per stirpes; and Thirty-seven and one-half percent (37-1/2%) to Robert Peredna of Hanover, Massachusetts, per stirpes; and Thirty-seven and one-half percent (37-1/2%) to Richard Peredna of Waltham, Massachusetts, per stirpes. SIXTH: If any beneficiary and I should die under such circumstances as would render it doubtful whether the benefi- ciary or I died first, then it shall be conclusively presumed for the purposes of this my Will that said beneficiary prede- ceased me; provided, however, that if my wife shall die with me ~~ 6~ ~~ -4- as aforesaid, I direct that my wife shall be conclusively presumed to have survived me. SEVENTH: (1) I name Dianne F. Peredna as my Executrix. If she is unable or unwilling to serve, I name Richard Peredna, of Waltham, Massachusetts and Robert Peredna of Hanover, Massachusetts, or the survivor of them, as my Execu- tors. I direct that my Executrix or Executor, herein referred to as my Executor regardless of number or gender, serve without bond in any jurisdiction in which called upon to act. (2) I name Robert Peredna of Hanover, Massachusetts, as my Trustee. I direct that my Trustee, herein referred to as my Trustee regardless of number or gender, serve without bond in any jurisdiction in which called upon to act. (3) Except as otherwise provided herein, if my Executor or Trustee or any successor as herein defined should fail to qualify as Executor or Trustee hereunder, or for any reason should cease to act in such capacity, the successor or substitute Executor or Trustee shall be some bank or trust company with trust powers, which successor or substitute Executor or Trustee shall be designated in a written instrument filed with the court having jurisdiction over the probate of my estate and signed by my wife or if she fails to act, signed by the court having jurisdiction over the Trust. The situs of the ~~,~, -5- Trust may be transferred to the situs of such successor or substitute Executor or Trustee by designation in the written instrument aforesaid. (4) For services as Executor and Trustee, my Executor and Trustee shall receive reasonable compensation. EIGHTH: (1) I give to any Executor and to any Trustee named in this will or any Codicil hereto or to any successor or substitute Executor or Trustee all of the powers enumerated in this Will and all of the powers applicable by law to fiduciaries in the Commonwealth of Pennsylvania and in particular through the Pennsylvania Probate, Estates and Fiduciaries Code, as effective and as in effect on the date hereof, during the administration and until the completion of the distribution of my estate, and until the termination of all trusts created in this Will or any Codicil hereto and until the completion of the distribution of the assets of such trusts. I direct that all such powers shall be construed in the broadest possible manner and shall be exercisable without court authorization. (2) In determining the federal estate and income tax liabilities of my estate, my Executor shall have discretion to select the valuation date and to determine whether any or all of the allowable administration expenses in my estate shall be used as federal estate tax deductions or as federal income tax ~~ d-~~ -6- deductions and shall have the discretion to file a joint income tax return with my wife. My Executor shall have the authority to make a QTIP election or a reverse QTIP election with respect to any trust created under this will and shall have the discretion to allocate the $1,000,000 Generation skipping Tax exemption as he deems appropriate. (3) If at any time any trust created hereunder (or any share thereof if the trust shall have been divided into shares) shall be of such value that, in the opinion of my Trustee, the administration expense of holding the assets contained therein in trust is not justified, my Trustee, in its absolute discretion, may terminate such trust and distribute the trust property to the person or persons then entitled to receive or have the benefit of the income therefrom or the legal representative of such person. If there is more than one income beneficiary, my Trustee shall make such distribution to such income beneficiaries in the proportion in which they are beneficiaries or if no proportion is designated in equal shares to such beneficiaries. (4) My Executor and Trustee are authorized and em- powered to acquire and to retain, either permanently or for such period of time as my Executor or Trustee may determine, any assets, including the capital stock of any closely held corpora- ~ ~,~~ -7- tion, whether such assets are or are not of the character approved or authorized by law for investment by fiduciaries and whether such assets do or do not represent an overconcentration in one investment. (5) My Executor and my Trustee are authorized and empowered to disclaim any interest, in whole or in part, of which I, my Executor, or my Trustee, may be the beneficiary, devisee, or legatee, by executing an appropriate instrument (in accordance with section 2518 of the Internal Revenue Code of 1986, as amended and supplemented, or such similar section as may then be in effect). (6) My Executor and Trustee are authorized and em- powered to sell at public or private sale, or exchange, and to encumber or lease, for any period of time, any real or personal property and to give options to buy or lease any such property. Additionally, my Executor and Trustee are authorized and em- powered to compromise claims, to borrow from anyone (including a fiduciary hereunder) and to pledge property as security therefor, to make loans to and to buy property from anyone (including a fiduciary or beneficiary hereunder); provided that any such loans shall be adequately secured and at a fair interest rate. (7) My Executor and Trustee are authorized and em- ~~ ~-~ -8- powered to allocate property, charges on property, receipts and income among and between principal or income, or partly to each, without regard to any law defining principal and income. NINTH: No person who at any time is acting as a Trustee or co-trustee (if any) hereunder shall have any power or obligation to participate in or to exercise any discretionary authority that I have given to my Trustee to pay principal or income to such person, or for his or her benefit or in relief of his or her legal obligations. Such discretionary authority shall be exercised solely by a disinterested co-trustee. TENTH: No interest of any beneficiary under this Will, any Codicil hereto, or any trust created herein, shall be subject to anticipation or to voluntary or involuntary alien- ation. ELEVENTH: All estate, inheritance, succession and other death taxes imposed or payable by reason of my death and interest and penal ties thereon with respect to all property comprising my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid out of the residue of my estate, as if such taxes were expenses of administration, without apportionment or right of reimbursement. I authorize my Executor and Trustee to pay all such taxes at such time or times as deemed advisable. ~~ ~r~ -9- IN WITNESS WHEREOF, I have set my hand and seal on this my Last Will and Testament this 25th day of October 1999. SIGNED, SEALED, PUBLISHED, and DECLARED by FRANCIS L. PEREDNA, as and for his Last will and Testament, on the day and year last above written, in the presence of us, who, at his request, in his presence, and in the presence of each other, all being present at the same time, have hereunto subscribed our names as witnesses: ~dr~ FRANCIS L. PEREDNA (SEAL) '. -10- SELF-PROVING AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF CUMBERLAND WE, Francis L. Peredna and Wayne M. Pecht Patricia D. Olyarnik and Stefanie A. Morrison the Testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last will and that he had signed willingly (willingly directed another to sign for him), and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witness and to the best of his or her knowledge the Testator was at that time eighteen (18) years of age or older, of sound mind, and under no constraint or undue influence. ~2>~ ~~enutor ~~~- Witness Subscribed, sworn to, and acknowledged before me by Francis L. Peredna, the Testator, and subscribed and sworn to before me by Wayne M. Pecht Patricia D. Olyarnik and Stefanie A. Morrison , witnesses, this 25th day of October 1999. Cynthia JN~ar;a' Seal I Camp Hill Boro ule, Notarypubllc I My Commission 'rRlJ1!'berllilnCl COUIi'" . pIres Jill). 24 2f':{j-\ ' ---__ : _;..;..1.... i ---.1' N~~~ -11-