HomeMy WebLinkAbout09-27-05 (2)
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REV-1500 EX + (6-00)
4a Future Interest Compromise (date of death after
12-12-82)
X! 6 Decedent Died Testate (Atlach X I 7 Decedent Maintained a living Trust (Attach
copy of Will) copy of Trust)
, ,9. Litigation Proceeds Received 10 Spousal Poverty Credit (date of death between 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
I _ 1:2-31-91 and 1-1-95)
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~ NAME : COMPLETE MAILING ADDRESS
~ 'Michael L. Bang~
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFiCIAL
I FILE NUMBER
I
II
05
0627
NUM8ER
COUNTY COOE YEAR
SOCIAL SECURITY NUM8ER
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W
C
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C
I OECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Darcy, Helen F.
'DATE-OF DEATH (MM-OO-YEAR) DATE OF 61RTH (MM-DO-YEAR)
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
194-03-8760
06-08-2005
06-12-1912
-'---
REGISTER OF WILLS
; (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
186-10-8280
x 1 Original Return
3. Remainder Return (date of death prior to 12-13-B2)
2 Supplemental Return
4 Limited Estate
5. Federal Estate Tax Return Required
1 8. Total Number of Safe Deposit Boxes
FIRM NAME (If applicable)
429 South 18th Street
- Camp Hill, PA 17011
TELEPHONE NUMBER
717/730-7310
1. Real Estate (Schedule A)
2 Stocks and Bonds (Schedule B)
(1) None
--------------
(2) 2,368.08
------- ~--_._--_._-
(3) None
(4) None
(5) 125.00
(6) None
(7) 1,393,669.45
(8)
(9) 14,648.73
-
(10) 1,170.63
1,396,162.53
3, Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
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5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L) _ Separate Billing Requested
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
(11)
15,819.36
1,380,343.17
12. Net Value of Estate (Line 8 minus Line 11)
(12)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has
not been made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(13)
0.00
(14)
1,380,343.17
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15.Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15)
or transfers under Sec. 9116(a)(1.2)
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0 (16)
i= 16. Amount of Line 14 taxable at lineal rate 1,380,343.17 x .045
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ll. 17.Amount of Line 14 taxable at sibling rate 0.00 x .12 (17)
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0
Ll 18. Amount of Line 14 taxable at collateral rate 0.00 .15 (18)
x x
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f- 19. Tax Due
(19)
0.00
62,115.44
0.00
0.00
62,115.44
20. [KJ
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
>> BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECKMATH<<
Copyright 2002 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00'
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. ,
Decedent's Complete Address:
STREET ADDRESS
2810 Yale Avenue
CITY Camp Hill
STATE P A
ZIP 17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
62,115.44
59,013.53
-----_._-_.,..__._-~--
3,105.77
Total Credits (A + B + C)
(2)
62,119.30
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is thEOVERPAYMENT (4)
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 theTAX DUE (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of line 5 + 5A. This is theBAlANCE DUE (5B)
3.86
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIA TE BLOCKS
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred;........... ....................
b. retain the right to designate who shall use the property transferred Dr its income;.. . ........................
c. retain a reversionary interest; or.. ..............._ ...............,..............
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?.. .............._.. ...............
Yes
No
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.
Under penalties of perjury, I declare thaI I have examined this return, including accompanying schedules and statements, and to the besl of my knowledge and belief, it is true, correct and
c?mplele. DeclaratIOn of pre parer oth,er than the person~1 repr~sentatlve IS basE::!~ ~n alUnformallon of which preparer has any knowledge _ ____
SIGNATURE OF PERSON RESPONSIBLE FOR FlUNG RETURN ADDRESS
J eph M. Darcy
OF PE~ON R~SIB~N
OATE
3415 Fry Road
Harleysville, PA 19438-3201
lid llbr
DATE
71-~()r
A6DREss----~--------
h1ug i!E~RER 0
Michael L. Bangs
ADDRESS
429 South 18th Street
Camp Hill, PA 17011
For dales of death on Dr 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) (iJ].
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 statutedoes not exemDta 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 PS 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 PS
99116 12) [72 PS 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)J. A sibling is
defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption
, .
Rev-150J EX+ (6-98)
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Darcy, Helen F.
FILE NUMBER
21-05-0627
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM CUSIP VALUE AT DATE
NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH
1 99 shares of Lyondell Petrochemical Company - 99 23.92 2.368.08
Shares
TOTAL (Also enter on Line 2, Recapitulation) 2,368.08
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule B (Rev. 6-98)
. ,
Rev-150B EX+ (6-98)
'.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONVVEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Darcy, Helen F.
FILE NUMBER
21-05-0627
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
1 Members First Federal Credit Union - Account No. 568
VALUE AT DATE
OF DEATH
25.00
2 Automobile - Sale of 1979 Buick Automobile (in disrepair)
100.00
TOTAL (Also enter on Line 5, Recapitulation)
125.00
(If more space is needed, additional pages of the same size)
Copyright (el 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule E (Rev 6-98)
. .
MEMBERS 1st
FEDERAL CREDIT UNION
=
=
-
=-
Send Inquires to
5000 Louise Drive
PO Box 40
Mechanicsburg, PA 17055
www.members1st.org
Main Switchboard; (717) 697-1161 or (800) 283-2328
EZ Call: (717) 697-4372 or (800) 283-4372
TOO; (717) 697-5312 or (BOO) 283-2328 ex! 5312
Tel.Branch: (717) 795-6049 or (800) 237-7288
Statement of Accounts
Jan 01, 2005 thru Mar 31, 2005
Account Number:
Account Balances at a
Checking:
Savings:
Certificates:
Loans:
Money Management:
568
Glance:
0.00
25.00
0.00
0.00
0.00
Page: 1 of
1
We have partnered with Carlisle Events to provide you with the opportunity to
attend one of their ev~nts free of charge! See the enclosed insert for more
information.
7999 1 AV 0.278000 7999-/999
1",111".111"""11,.,11,1,1"1,,1,1,1,,,.11,,11.1,,1,,1,,11
HELEN F DARCY
C/O GERALD DARCY
2138 YALE AVE
CAMP HILL PA 17011-5246
SAVINGS ACCOUNTS
00 - REGULAR SAVINGS
Date
Jan 01
Transaction Description
Balance Forward
Joint Owner: JOHN C DARCY
Ending Ba/ance
Mar 31
YTO SUMMARIES
TOTAL DIVIDENDS PAID
00 REGULAR SAVINGS
l\/l.....-:TI"I1
0.00
Total Year To Date Dividends Paid
NOTE: Total includes c!ased shares
Additions
Subtractions
0.00
Balance
25,00
25.00
. .
Affordable 50's
1170 West Trindle Road Rt 641
Mechanicsburg, PA 17055
TOLL FREE 866-50S.CARS
717-795-8780
[TliVIE c.'Fe ~u.'.'. '~.- -~I.)W'~i-TTTit\tl~.(ART. 11IVIt.. C.-INIS!-l.Ri:=(j\-JE-Si~ED 8-:,....~I-;-.O:CAsEl-#r-~.li.-'r-r~lcE. R Ni\!'.W-
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APPRAIS::::H NAME
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I DATE I DRIVER
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PERSONALS TAKEIJ OY DATE I PHONE I
VEHICLE STORAGE TIME
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HeLEASED BY
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KEYS LEFT
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METHOD OF PAYMENT
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Rev.1510 EX+ (6-98)
..
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONVVEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Darcy, Helen F.
FILE NUMBER
21-05-0627
This schedule must be completed and filed if the answer to any of questions 1 through 4 on Ihe reverse side of the REV-1500 COVER SHEET is yes
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH TAXABLE
% OF DECO'S EXCLUSION
NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
THE DATE OF TRANSFER ATTACH A COPY OF THE DEED FOR REAL ESTATE.
1 AmerUS Annuity Group - American Investors Life 507.311.60 507,311.60
Insurance Company
Policy No. 410403; owned by the John C. Darcy
and Helen F. Darcy Revocable Living Trust
2 MetLife Individual Investment Account - Policy 151,708.97 151,708.97
No. A2070210; owned by John C. Darcy and
Helen F. Darcy Revocable Living Trust
3 Morgan Stanley - Account #665-023763-220; 467.414.87 467.414.87
owned by the John C. Darcy and Helen F. Darcy
Revocable Living Trust
4 Nuveen Investor Services - Account 88.499.34 88,499.34
#9603074178; owned by the John C. Darcy and
Helen F. Darcy Revocable Living Trust
5 PNC Bank - Account No. 5004336401; owned by 1,815.31 1,815.31
the John C. Darcy and Helen F. Darcy Revocable
Living Trust
6 PNC Bank - Account No. 5004336524; owned by 6,491.29 6,491.29
the John C. Darcy and Helen F. Darcy Revocable
Living Trust
7 PNC Bank - Account No. 5140014722; owned by 823.13 823.13
the John C. Darcy and Helen F. Darcy Revocable
Living Trust
8 PNC Bank - Account No. 5004334975; owned by 12,015.47 12,015.47
the John C. Darcy and Helen F. Darcy Revocable
Living Trust
Total of Continuation Schedule(s) pee attached page
TOTAL (Also enter on Line 7, Recapitulation) 1,393,669.45
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule G (Rev. 6-98)
, .
Rev-1510 EX+ (6-98)
*'
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
continued
COMMONVVEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Darcy, Helen F.
ESTATE OF
ITEM
NUMBER
DESCRIPTION OF PROPERTY
INClUOE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND
THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE.
Real Estate - Sale of Real Estate located at 2810
Yale Avenue, Camp Hill, Pennsylvania (see
settlement sheet attached) (owned by the John
C. Darcy and Helen F. Darcy Revocable Living
Trust)
157,589.47
DATE OF DEATH % OF DECO'S EXCLUSION
VALUE OF ASSET INTEREST (IF APPLICABLE)
9
NOTE: JOHN C. DARCY DIED ON
JANUARY 16, 2005. ATTACHED WITH
A COpy OF THE REVOCABLE LIVING
TRUST IS A COpy OF HIS DEATH
CERTIFICATE.
TOTAL (Also enter on Line 7, Recapitulation)
Copyright (c) 2002 form software only The Lackner Group, Inc.
IFILE NUMBER
21-05-0627
TAXABLE
VALUE
157.589.47
1,393.669.45
Form PA-1500 Schedule G (Rev 6-98)
. .
AmerVs Annuity Group Co.
555 South Kansas Ave
Topeka, KS 66603
1-800-ANNUITY
June 9, 2005
AMERUS
Annuity Group
Joe Darcy
2138 Yale Ave.
Camp Hill, PA. 17011
Re: American Investors Life Insurance Company
Policy Number - 410403
Annuitant - John Darcy (Deceased)
Dear Mr. Darcy:
We were sorry to learn of the death of John Darcy and offer our deepest sympathy to his family and
friends.
Please read the enclosed General Instructions for Completion of Annuity Death Claim Form. These
instructions list the documents required to process the claim on Policy #410403,
Our records indicate the beneficiary designation is the John C. Darcy & Helen F. Darcy Revocable
Living Trust dated 6-25-2002. The Death Benefit provided by this policy is the Accumulated Value
($507,311,60) applied under a fixed period equal to five years or longer. We have enclosed an
illustration of a five-year payout with monthly benefits for your review. Annual, semi-annual and
quarterly payouts may also be chosen. We will be pleased to provide illustrations of alternative payout
options for your review. In lieu of the Accumulated Value under a fixed period, the Beneficiary may
elect to receive the Cash Surrender Value ($461,653.56) in a lump sum.
The death benefit will be paid with interest from the date of death to the date of payment or other
settlement at the same rate that the Company would have credited if the Annuitant had not died. The
credited rate is currently 3.00 percent.
If you should have any questions or need additional assistance, please do not hesitate to contact our
Customer Service Department at 1-888-ANNUITY.
S". r,ely,
\~u1~
Anita Bloom
Claims Specialist
cc:
Enclosure
AMERICAN INVESTORS LIFE
~.~E.Rl'SC.""""1
AMERUS
Life
1-888-252-5530
(ClISTOMER SERVICE)
1888ANNUITY
iCUSTOMl:.R. SERVICE)
0~/17/2005 14:34
71 77300254
PNC
FAX NO. 5!54574301
,:UN-17-2005 FRf 01:31 PM HEW ENGLAIID ANNUITIES
MetLifelnvestors';
June 1 7. 2005
ATTN: BONNIE SNYDE:R
FAX 717.730-0:254
RE: Contract Number: A2070210
COntract OWner: John Oilrcy & HeIer- Darcy Revocable Living Trust
Oear Sir or Madam:
Thank you for your recent requo$t regarding the above referenced contract Our
records indicate tna acco\.lnt IIBlue on the date of deatr. aB follows:
Data of Death: 06/0612005
Account Value: $151.108.97
Ii you have any questions regardmg the above please contact an Annuity Service
Representative at 1-800-284-4536. Our staff will gladly help you ootween the
hours of 7:30 a-m and 5:30 p.m., Central Time. Monday through Thursday and
7:30 a,m. to 5;00 p.m. on Friday.
SQMk rht~
Amber Harthoorn
Annuity Policy Service Department
~:" s..od~" c.....~ lIoo: .
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PAGE 01
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. .
E. Scott d'Entremont, J r.
Financial Adt/;jor
Olle Tower Bridge
100 Front Street
Suite 600
West Cunshohocken, Pa 19428
"'l
MorganStanley
toll-free 8003474305
tel 610260 8600
direct 6102608604
fax 6102608631
June 30, 2005
429 South 18th Street
Camp Hill, PA 17011
Mr. Michael Bangs:
This is breakdown as of June 8, 2005 for the account of John C. Darcy and Helen F.
Darcy Rev Living Trust #665-023763-220. If you have any questions or require
additional information feci free to call.
Thank JOu,
((d/ c{j~
E. f~t d'Entremont
Financial Advisor
E. Scott d'Emrcmom, Jr.
Financial Adz!iJm.
'<:l
MorganStanley
Svmbol Quantitv June 8 2005 Value Total
Munivield PA Insured Fund 722 15.86 $11 450.92
Van Kampen PA Muni Tr 1111 15.15 $16,831.65
Verizon Communication 325 35.07 ~11 397.75
Ford Motor Preferred 240 22.43 $5,383.20
HRPT Properties Trust 203.706 12.1 $2 464.84
United Dominion 200 26.5 $5,300
ING 100 26.4 $2 640
Senior Housing Property trust 20 18.77 $375.40
Post Properties Inc. 200 25.5 $5100
NI Source 121 24.5 $2,964,50
PPL Corooration 2765 57.38 $158655.70
AON Canital 450 26.65 $11 992.50
Np.w Plan 175 26.18 $4581.50
General Motors 200 20.1 $4 020
AGL Caoital 200 25.8 $5,160
Hertz 410 25.8 $10,578
Enernv East Caoital Trust 160 26.22 $4,195.20
Public Storaqe 148 26.21 $3 879.08
General Motors 173 21.6 $3,736.80
USB Caoital 200 26.29 $5 258
Five Star Qualitv Care Inc 4.007 7.08 $28.37
Con Edison 120 26.6 $3 192
JP Moraan 200 26.14 $5 228
Peoco Holdinqs 1370 22.62 $30,989.40
Viqinia Power 280 26.44 $7,403.20
Fulton Financ_ial Corp 931 17.59 $16 376.29
Lvondell Chemical Comoanv 47 24 $1,128
Nuveen Muncinal Value 845 9.59 $8,103.55
Public Service Enterprise 1219 56.61 $69,007.59
Eaton Vance Muni Bond 75.327 10.77 $811.27
Franklin Income 1942.149 2.44 $4 738.84
SB Aqqressive Growth 61.387 82.6 $5,070.57
Ford Motor Cr 7 3/8 7 993 $6,951.00
Morgan Stanley Coins 7.5 3 1109.5 $3,328.50
GMAC 7 1/8 23 821.75 $18,900.25
D....II" Airlines 8.3 12 275 $3,300.00
Liquid Assest Fund $6,893_00
TOTAL $467,414.87
One Tower Bridge
100 Front Street
Suite 600
West Conshohocken, Pa 19428
toll-free 8003474305
tel 6102608600
direcr 610 260 8604
fax 6102608631
. .
NUVEEN
f!! !I (' S t 117 e n t :;-
September 7, 2005
Bangs Law Office
Attn: Michael L Bangs Esq
429 S 18th 8t
Camp Hill P A 17011-5902
Reference: 02615359
Nuveen Pennsylvania Muni Bd R
Account Number: 09603074178- 3
Joseph M Darcy Ttee
John C Darcy And Helen F Darcy
Revocable Living Trust
Ua Dtd 6/25/02
Dear Mr. Bangs:
We are contacting you regarding the above referenced account with Nuveen Funds.
As instructed, we wish to inform you of the following account information:
The account is registered as a trust account and there are no beneficiaries.
The tax reporting on the account is under social security number] 86-10-8280.
As of June 8, 2005, the account held a share balance of 8,333.271 shares.
The Net Asset Value ofthe Fund as of that date was $10.62 per share.
The account dollar value as of that date was $88,499.34.
NUVEEN INVESTMENTS INVESTOR SERVICES. P.O. BOX 8S30 . BOSTON, MA 02266-853G . WWWNlIVEENCOM
We hope this information is helpful. If you have any questions or require further assistance, please
contact Nuveen Investor Services at 1-800-257-8787, between the hours of9AM and 7 PM Eastern
Standard Time.
Sincerely,
4-1C-:
Gennaro J Cacavio
Service Specialist
cc: Joseph M Darcy
~UN- 29- 2005 23: 16
PNCBANK
412 768 3458
P.01
o PNCBAN<
June 30, 2005
Michael L Bangs
Attorney at Law
429 S 1811I St.
Camp Hill, PA 170n
RE: Estate of Helen F Darcy (Deceased)
SSN: 194-03-8760
DOD: 06-08-2005
scp
Dear Mr. Bangs:
In response to your request for Date of Death balances for the customer noted above, our
records show the following:
Checking Account
Account #5004336401 Established 05-07-2004
JOHN C AND HELEN DARCY TRUST
HELEN DARCY TIEE
URT AD 0612512002
DOD balance: $1,815.31 + $0,00 accrued interest
Account #5004336524 Established 04-29~2oo4
JOHN C & HELEN DARCY TRT
HELEN DARCY TIEE
DOD balance: $6,491.29 + $0.22 accrued interest
Account #5140014722 Established 10-29-2002
JOHN C & HELEN DARCY TRT
HELEN DARCY TTEE
URTAD 06/25/2002
OOD balance: $823.13 + $0.03 accrued interest
Savings Aeeonnt
Account #5004334975 Established 05-07-2004
JOHN C AND HELEN DARCY TRUST
HELEN DARCY ITEE
URT AD 06/2512002
DOD balance: $12,015.47 + $0.58 accrued interest
Page 1 of2
JUN-29-2005 23:16
PNCBANK
412 768 3458
Safe deposit box
The decedent maintained safe deposit box #7770. It was in one name only.
HELEN F DARCY
It is located at
CAMP HILL BRANCH
2101 MARKET STREET
CAMP HILL P A 17011
717-761-2372
Please note that this office only provides date of death balances for deposit accounts
(IRAs, CDs, Checking and Savings accounts). We do Dot process IIny financial
trflnsaetioDlI or provide statemenu. If you need assistance with any of these items,
please can 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch
office.
Sincerely,
~-:/.~
Erica L Schlegel
1-800-762-1775
P7-PFSC-04-F
500 first Ave.
Pittllburgh P A 15219
Manbct FDIC
Page2Qf2
P.02
TOTAL P.02
1r
A. B. TYPE OF LOAN;
-
U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 'DFHA 20FmHA 3. ~CONV. UNINS. 4.DVA 5. DCONV. INS.
G. FilE NUMBIOR; 17. LUAN NUMBER:
SETTLEMENT STATEMENT CHURCH 826857472
E.. MORTGAGE INS CASE NUMBER:
C. NOTE; Tllis form is furnished to give you a statement of actua;' settlement costs. Amounts paid to and by the settlement agent are shown.
Items marked "[POC]" were paid outside the closing; they Bfe .'Shown here for informational purposes and are not included In the totals.
1.0 3198 (CHURCH_pfd/CHURCH/10)
0 NAME AND ADDRESS OF BORROWER; E. NAME AND ADDRESS OF SELLER: F_ NAME AND ADDRESS OF LENDER:
JEAN CATHERINE CHURCH and SOVEREIGN BANK
ZACHARIAS G. CHURCH JOSEPH M. DARCY, Successor Trustee 1130 BERKSHIRE BOULEVARD
of the John C. Darcy and Helen F. Darcy WYOMISSING, PA 19610
Revocable living Trust Agreement dated
June 25, 2002
G PROPFRTY lOCATION H. SETTLEMENT AGENT: 23-2402316 I. SETTLEMENT DATE:
2810 YALE AVENUE PURITY ABSTRACT COMPANY
CAMP HilL, PA 17011 August 24, 2005
CUMBERLAND County. Pennsylvania PLACE OF SETTLEMENT
3329 Market Street
Camp Hill, PA 17011
J . vr 1\, 'u' '~'u~vIlUN
100, GROSS AMOUNT DUE FROM BORROWER; 400, GROSS AMOUNT DUE TO SELLER:
101. Contract Sales Price 174,900.00 401. L:onlract ::;a[65 Price 174,900.00
102. Personal Property 402. Personal Property
103. SeltJernent Charges to Borrower (Line 1400) 5,8h61 403.
104 404,
105. 405.
Adjustments For Items Paid By Seller In advance Adjustments For Items Paid By Seller in advance
106. County/Bora Taxes 08/24/05 to 01/01/06 '.0.00 406. County/Bora Taxes u81L4/05 to 01101/06 195.58
107. lilY18X to 407. Cily Tax to
108. School Tax 08/24/05 to 07/01/06 1,356.30 408. School Tax 08/24105 to 07101/06 1,356.30
109. 409.
110. 4'
111. 411.
112. 412,
120. GROSS AMOUNT DUE FROM BORROWER 182,324.49 420, GROSS AMOUNT DUE TO SELLER 176,451.88
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER;
201. Deposit or earnest money 2,000.00 501. Excess Deposit(~ee Instructlons)
202. t-'rincipal Amount of New oan s) 139,920.00 502. Settlement Charges to ~eller (Une 1400) 13,862.41
203. Existing loao(s) taken subject to 503. Existing loan(s) taken subject to
204. 504. Payoff of first Mortgage
205. ---.-- . bUt. payott at second Mortgage
206. 506.
207 507. (Deposit disb. as proceeds)
208. 508_
209 SELLER CREDIT 5,000.00 509, SELLER CREOI r 5,000.00
Adjustments For Items Unpaid By Seller Adjustments For Items Unpaid By Seller
210 County/Boro -r axes to 510. County/Boro Taxes to
---
211. City Tax to 511. C11y Tax 10
~?~_I,!~X. to 512. ::>chool Tax to
213. .- - 513.
214 514.
~-- -.-------~._- 515.
216. 516.
217 517.
218. 518.
219 519.
220 TOTAL PAID BY/FOR BORROWEH 146,920_00 520. TOTAL REDUCTION AMOUNT DUE SELLER 18,862.41
300. CASH AT SET I LCMCN I mu",,, u : 600. CASH AT SETTLEMENT, U/.KUM ~~LL~K;
301. Gross Amount Due From ljorrower (Line 120) 182,324.49 601. liross Amount Due To Seller (Llfle 420) 176,451.88
302. Less Amount Paid By/For Borrower (Line 220)' 146,920_00 602. less Reductions Due Seller (Line 520) 18,86241
303 CASI1 ( X FROM) ( TO) BORROWER 35,404.49 603. CASH ( X TO) ( FROM) SELLER 157,58947
OMB NO 25020260 '"
The undersigned hereby acknowledge receipt of a completed COpt of pages 1&2 of this statement & any attachments referred to herein.
Borrower
. If,;" {!I(~t",; tlt:,.~tL
'---1 _ __ ____________~
J~J<N CA THERIN~ CH~C;H . y.
(~~, '{W""",---=- ~, CLIl,rd....
LACFlARIAS G. CHURC .
Seller
JOSEPH M. DARCY, Successor Trustee
iZ:x -/ ..& rJ r-
BY:' ~ >; C/;J>, ""''-7'" ' I><",VL.1?.<;:
/' /
> . ..... _L.o. flo..._t......I..1 .......1"""1<1"-........._
700. TOTAL COMMISSION Based on Price $ 174,90C,OO @ 6,0000 % 10,494.00 PAID FROM PAID FROM
. VlVls/on or (;omm/ss/on (line 700) as Follows: BORROWER'S SELLER'S
IU1, ~ 1 U,4~4.UU [0, L-t:I~ I URY 21 I Kt:AL I Y, INC, fUNDS AT FUNDS AT
702,$ to SETTLEMENT SETTLEMENT
703, CommiSSion I-'ala at ::>emement 1U,4~4.UU
104, I IIUN rt:t: to Gt:N fURY 21 Kt:AL I Y, NG. l~O.UU
800, ITEMS PAYABLE IN CONNECTION WITH LOAN
801. Loan Origination ree "10 to
802. Loan Discount % to ,
803. APPLlL-f\ IIUI\j rt:t: to t'REMIERrUNUINl.j, INC. JLO,UU
804. 'rt:t: [0 t-'Kt:MIt:K FUNUINl.j, INL,;. 'IOU.UU
-8uo. Lender s Inspecnon ree 10
806. Fiood Cert Fee to
801. I ax Oiervlce ree 10
~u~. uocument t-'rep ree
809_ L-UMMII MI::I~ I rl::l:: to ;:,u._,,_, I BANK 050,00
81 U. IVIUK Il.jAGc : FEE t-'u I 0 PKe:MIe:K rUNlJlNG BY OiOVe:KEIGN $1399.20 PUI.;
811,
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901. Interest Fram 08/24/05 to 09/01/05 @ $ 23.281133/day ( 8 days %) 186.25
1902. Mortgage Insurance I-'remlum lOr montns to
903. Hazard Insurance Premium for 1.0 years to ERiE INSURANCE $325 POC
904.
905. .
1000, RESERVES DEPOSITED WITH LENDER ,
1001. Hazard Insurance 3.000 months @ $ 27.08 per month 81_24
1002. Mortgage Insurance months @ $ per month
1003. County/Bora Taxes 7,000 months @ $ 44.85 per month 313_95
1004. City Tax months (Ql $ per month
1005. School Tax 3.000 months @ $ 132,65 per month 397.95
1006. monms @ $ per momn
1007. months @ $ per month
1008. AGGREGATE ADJUSTMENT months @ $ per month -179.42
1100, TITLE CHARGES
1101. Settlement or Closing Fee to
1102. E-Mail Document Retrieval to PURITY ABSTRACT COMPANY 35.00
1103, Title Examination to
1104. Insured Ciosing Letter to First American Title Insurance 1.;0. 35.00
1105. Document Preparation to ATTORNEY MICHAEL BANGS DEED/POC
1106. Notary Fees to CASH 20.00 10.00
1107, Attorney's Fees to
(/Deludes aoove frem numbers: )
1108, Title Insurance to PURITY ABSTRACT COMPANY P_05-194 1,233.75
(includes above item numbers: )
11U~. Lenaer s Coverage ~ '"",,,~u,UU 'u~~uu, fLt-'AL
111 U. uwner S I.;ovcrage ~ 1 I 4,~UU,UU ~U
1111. PAl .~~, I I ;:,:1 00,300,80U 10 t-'UKII r At;::> I KAL-I L-UMPANY &ARM LUU,UU
1112, Overlllgm ree/pacKage to r-UKI I r At;::> I KAL-I ",n 15.50
1113.
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recording Fees: Deed $ 39.50; Mortgage $ 72,50; Releases $ 112,00
12Ll2. City/Coumy I aXf::>mmps: Ueea 1,749.00; MOrlgage 1 ,I4~,UU
1203. State TaxJStamps: Revenue Stamps 1,749.00; Mortgage 1,74900
1204. RECORDER OF DEEDS
1205, RECORDER OF DEEDS
1300. ADDITIONAL SETTLEMENT CHARGES
1301. Survey to
1302. Pest Inspection to BIECHLER & TILLERY &HOME INSP 310.00
1303. 2005-06 SCHOOL TAX to JANET L. MILLER, TAX COLLECTOR 1,591.80
1304. SEWER 7/1-12/31/05 $60 to BOROUGH OF CAMP HILL /) 42.39 17.61
1305. I /
1400. TOTAL SETTLEMENT CHARGES (Enter on Lines 103, Section J and 502, Section K) I / /1 5,872.61 13,862.41
Ry s;gn;ng page 1 of th;, s1atement, the s;gnatodes acknowledge 'ece;pl of a completed copy of page 2 of th;s two page "J: (//)
'J rl/ /I' ~
P :.,g~ M12I<I<JY
Certified to be a true copy.
Settlement Agent
REV-1151 EX+ (12-99)
'.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRA TIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Darcy, Helen F.
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-05-0627
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 6,893.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) I EIN Number of Personal Representative(s):
Street Address
City State Zip
-
Year(s) Commission paid
2. Attorney's Fees 7,000.00
See continuation schedule(s) attached
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 80.00
See continuation schedule(s) attached
5. Accountant's Fees 500.00
See continuation schedule(s) attached
6. Tax Return Preparer'5 Fees
7. Other Administrative Costs 175.73
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 14,648.73
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
> .
Rev-1502 EX+ (6-98)
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONVIIEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Darcy, Helen F.
FILE NUMBER
21-05-0627
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Myers-Harner Funeral Home, Inc.
6.893.00
Subtotal
6.893.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 ScheduleH-A (Rev 6-98)
Rev-1502 EX+ (6-98)
.
SCHEDULE H.82
ATTORNEY'S FEES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Darcy, Helen F.
FILE NUMBER
21-05-0627
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Michael L. Bangs, Esquire
7.000.00
Subtotal
7.000.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B2 (Rev 6-98)
Rev-1502 EX+ (6-98)
SCHEDULE H-B4
PROBATE FEES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Darcy, Helen F.
FILE NUMBER
21-05-0627
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Register of Wills
80.00
Subtotal
80.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B4 (Rev 6-98)
Rev-1502 EX+ (6-98)
*'
SCHEDULE H-BS
ACCOUNTANT'S FEES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Darcy, Helen F.
FILE NUMBER
21-05-0627
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Boyer & Ritter
500.00
Subtotal
500.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B5 (Rev 6-98)
Rev-1502 EX+ (6-98)
.
SCHEDULE H-B7
OTHER
ADMINISTRA TIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Darcy, Helen F.
FILE NUMBER
21-05-0627
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Cumberland Law Journal - Advertising Fee
75.00
2
The Sentinel - Legal Advertising
100.73
Subtotal
175.73
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev 6-98)
Rev.1512 EX+ (6.98)
'.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONVVEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Darcy, Helen F.
FILE NUMBER
21-05-0627
Include un reimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 Landscaping Services
VALUE AT DATE
OF DEATH
381.00
2 PAWC - Final Bill
16.39
3 PP&L Electric - Statement of 7/21/05
184.63
4 PP&L Electric - Final BiR
136.45
5 Trash Removal
420.00
6 UGI - Statement of 6/24/05
7.31
7 UGI - Final Bill
24.85
TOTAL (Also enter on Line 10, Recapitulation)
1,170.63
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule I (Rev 6-98)
REV-1513 EX+ (9-00)
*'
SCHEDULE ~
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
NUMBER
Darcy, Helen F.
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec, 9116(a)(1.2)]
RELATIONSHIP TO
DECEDENT
Do Not List Trustee(s)
FILE NUMBER
21-05-0627
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
I.
1
Gerald F. Darcy
2138 Yale Avenue
Camp Hill, PA 17011
Joseph M. Darcy
3415 Fry Road
Harleysville, PA 19438
Son
One-half
2
Son
One-half
3
PA
Total
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
0.00
Copyright (c) 2002 form software only The Lackner Group, Inc
Form PA-1500 ScheduleJ (Rev. 6-98)
~:~ 'C, (1
c.I ,."'
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!
__ ~.; \:< ~ C' J":;:' ,,_
~ i ~d..:;";
~
7'-~l,~,!
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J~Nt_~' 2005
CERTIFICATE OF DEATH
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEAL TII . VITAL RECORDS
ST.....TE FilE NUMElI::R
1-13 RlJv.2/67
82!J0
DAlE OF DEATH (Mooltl. Dill'. Y~ilr)
,January 1G,200S
AGE (La:.t Billhd<lY)
DATE OF BIRTH
(Monlh. Day, Year)
SEX
,Hale
BtRltlPlACE' (CIty and f-'LACfOFD-ATH Ch~[ko!ll on~
SId ~ ()J Furelgo Counlry) HOSPITAL
I.Philadelphia p; ~:.dli"nl D I::RIO"ljjdl'~"1 D
NAMi: OF O[CEDENT {FIISl, Mi<1!1Ie,! (isl)
John C. D;n-cy Sr
8G
Yrs.
5
COUNTY OF DEAIH
,ACIIIlY NAI\.'I-= (IInol insliluliull, IJIve :.llcc! ..1<10 n\ll11buI)
8b " n b~Lmd
DECEDENT'S USUAL 0CCUP.<>.lION
Manor Care
AS DECEDENT EVER IN
U.S. ARMED FO~C:ES?
Ye~D No~
12
8,
(~,~ :o','~~~II';:'-,}~" d~~," o~~' :'~y,,';~tj
pC!
17a. Sial"
Did
deceLlent
h"illa
lown:.hil.'?
2810 Yale Avenue
16 i 11 Pa 17011
FATHER'S NAME \Fil:'l. t...hLl<Jlc, Ld"l)
18, Josepl\ Dacey
INFORMANTS NAME LT-YI-lelrlinl)
20, Gecald llacey
/.,tEntOD OF OISPOSITION
Donat'on 0 Bu,i,,1 EJ Cre"l;;lliOIl ~ellloYa.j hurn Slelll.: 0 (Monlh, Day, "..ar]
21a. 01t1t'1 rjl-lecltyf 21b.January 21) 2005
SIGNA}tlRE OF f NSEE OR PERSON ACTING AS SUCH LICENSE NUMBEH
. 22, ~./;;;(~Z ~..---/- 22b01l65!,-L
comJ-'l"t~, e'~ s-;"-i3..:c nly hen rl<ty\og ]10\t'll; L;.;"'l of Ill; hI1DI'/I~lj!Jc-de,.llI~ OCCUIf~lllle tll'IC d~~~d--;;~~ "'l..t:,l-~
phySICian's not avail,.hlt" ..IIUI1, of 11l'Hlh Itl (SIgnature and Tllle) J
,",",~~""eo"e'''' 23, ~!{ r;fll7'_ty J'l t!.t!_f.J--- _ ,[11/
Items :>4.:,'6 must be completed by TIME OF DEATH ,I lDATEj.t\ONOUNCED DEAD (Mouth Da,. Yed')
persoo who l'(onmlfH es Ij,oHlh 24 7 -,0 M.~ .JUJ1UOi) I~ ;lLJ05
1'. PART I EnIG' th;dl;;a~--;;:;-J~I'I'<.a"'H," ~-':;-r~;;-'U~;:;<jd;-al~-D-;;;;'~'. "'(>~~-;n-;;;-;-';;~. ~,-;j~~-;;'~~IU'V a"..l Ir-QOl< Q' h.~'1 t.,lur8
LI.I"nl~on.c.ou"n ..ohll".
Curnbecland
lIb COUI'II\(
~~:~,Iy) D
RAe E A!lll:)riC.l11 ImJidn, Black, Whit';, '
(Specify)
\.Jhite
SUHVfVING SPOUSE
fll ""ru, (,1"., m~,ll." "am_I
17e. D Yes, Jeccoel\l lived in
,.
17d. rn ~~h~1e~:t~:711i:~~i~~ uf
Camp Hi 11
_ clly/bar
MOTIiER'S NAME (FilSI, MldLlle. MalLlen Surname)
19. Cecilia Dugan
'NFOR"A"I'~ 'M-\L1N~ AQDRE~S (S"e", C"ylw~'" s"'11Z'''''''""t.
20b. _1.5i) yale Avenue Ldmp 11.1, a
17011
LOCATION. Cily(Juwn, SlattJ,li~ Cuu.;
PLACE OF DISPlJSITION- Name of Cemch:IY, Crl::lIldllJry
Of OllwI Pl,Ke
",Ga te of lIeaven
21d
IMMEDIATE CAUSE (flndl
rjj5edse Of co,\dilion
re:.ullu1g In dCillhj______
SequentlilJlyli::;I\;UllUllioll:'
il "illY. ICdLlin<d 10 Imme,1ldle
c~u~e Enwr UNDERLYING
CAUSE (DIseit...,o '.ll IIlJul')'
lhat inillaled evCnlS
te~l.It;llg on dealh ) lAST
t:
WAS AN AUTOPSY
PERFORII.tED7
WEHE AUTOPSY FINDINGS
AVAILABLE PRIOH TO
c~OMf'LL liON Of- CAUS!::
Of (It.AIIl''
MANNER or OEA.3!J-"""-
r."lul,,1 0'
DAlE OF INJUHY
IMvnlf\, D~y. v.a,!
D
D
D
30,
PLACe Of INJLJI{Y
tJuilllJll!l. .I~ (SI'~f1ly)
30.
HOllliriLl~
D
U
CoutdllUltJ.::dd':lmlllicJ
AicuLlenl
P,"',d'''\j lnvl' .1'!J<flrOll
Yc,D ~
YbD
SIJI(;ldc
Nfl
2Ba 2Bb
CERllFIER (Check only one)
'y~~~~FJ~~IGor~~~~I~~~~IIU'~:r,~~~~i,l~~~t.'t~~:I'arl~~: t~ fheoJd~~~~~\~~1(~r~~~d\~~'A~'~~ol~~I':t~l~drll>\;<1L\;l! u.".lll ,,'Id G0I1I11lel\<J il~ln 23.l.
"
'PROIlOUNCING AND CERTIFYING PHYSICIAII (Ph~"lo.;idll L.uII, ~J1unl'ulluIl9 J"JlIl clOd ~tO'lll"'I(1Q 1,) CdU"ll 01 tfe~ltll
fo Ihd be:.1 of my knowlrildUIl. dtldth O(;Cllfflld atlllll timtl, tliJle, and place, iJllJ due 10 tllll C.lu!tolt~("l <llll.l lltellllH:1 <I!to !>t<llcd
'MEDICAL EXAMINERiCORONEH
On Iha basili olllllamillatioll amJ/of invtistillilliofl. in my OplllIOll, 0<)31h uccuJfed ~lthlllime, ,Jill", <lnd plao.;ll, .iI\d c1ulllu till! ciJustr~(") ,mtf
31,m.o"",,,','," 0
Hf(>I:ill~Aft.S SIGNAllJHt' ANI] NUMIlHI
/]
(L~n/)?
/>.) <-',{., '"'
< ..-c'-'-'-'-'
,'~
H (plV'(j
--~--~-~--,---_._----
33
NAME AND ADDRES~ 0F FACILITY
22,~1'ets-lIarner l'LJulleral lIome
LICENSE NUMBER
2>" IZ.Jj (,'1'1-97'1 L
WAS CASE RUlRfH-:D IOAMt'DICAi EXAMlNERICORONER7
26. Yes 0 No ~
. Al)pl(l~illl<ll~ PART
:illlelvill belwe~n
: ons.eti:ltlU tJe<llh
TIME OF INJURY
INJURY AT WORK? DESCRIBl: HOW INJUf{Y OCCURRi:U
,c,n NcD
Jut>
[]
~
II.'Nf:U lll.trD3't1tJl_
J4
/ 7~~~__~__~~
I, HELEN F, DARCY, residing in the County of Cumberland, Co
being of sound mind and memory, and not acting under duress or und
LAST WILL AND TESTAMENT
(Pour-Over Will)
OF
HELEN F. DARCY
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IDENTITY
All reference made herein to "spouse or my spouse" refers to the person to whom I am currently
married, namely, JOHN C. DARCY By the ensuing provisions of this Will, it is my intention to dispose
of my Interest In our property; I do not intend to dispose of anything belonging to my husband or to put
him to any election,
I have the following children: Joseph M. Darcy, born January I, 1944 and currently residing in
Worchester, PA 19490, and Gerald V: Darcy, born M<ly IS, 1952 and currently resIding in
Elizabethtown, KY 4270 I. r !1~ R.I.JI,;) j /7'1?
DEBTS, TAXES AND ADMINISTRATION EXPENSES
I have provided for the payment of all my debts, expenses of administration of property wherever
situated passing under this Will or otherwise, and estate, inheritance, transfer, and succession taxes, other
than any tax on a generation-skipping transfer that is not a liability of my Estate (including interest and
penalties, if any) that become due by reason of my death, under THE JOHN C. DARCY AND HELEN F,
DARCY REVOCABLE LIVING TRUST executed on even date herewith (the "Revocable Trust"), or if
my spouse predeceases me, under the Survivor's Trust created by the said Revocable Trust. If the
Revocable Trusl assets should be insufficient for these purposes, my Executor shall pay any unpaId items
from the residue of my Estate passing under this Will, without any apportionment or reimbursement. In
the alternative, my Executor may demand in a writing addressed to the Trustee of the Trust an amount
necessary to pay all or part of these items, plus claims, pecuniary legacies, and family allowances by court
order.
PERSONAL AND HOUSEHOLD EFFECTS
It is my intent that all my personal and household effects were transferred to the Revocable Trust
as a result of the Declaration of Intent signed this date. If there are any questions regarding the ownership
or disposition of these assets, it is my desire that such assets pour into the Revocable Trust, signed by me
this date in accordance with the provisions of the section titled "Residue of Estate."
RESIDUE OF ESTATE
I give, devise and bequeath all the rest, reSidue and remainder of my property of every kind and
description (including lapsed legacies and devices), wherever situated and whether acquired before or
after the execution of this Will, to the Trustee under that certain Trust executed by me on the same date of
the execution of this Will. The Trustee shall add the property bequeathed and devised by this item to the
POUR-OVER WILLS
Page 1
HQU
Testatrix
corpus of the abovc described Trust and shall hold, admllllster and distribute saId property in accordance
with the prOVIsions of the said Trust, Illcludlllg any amendments thereto made before my death.
If for any reason the said Trust shall not be In existence at the tllne of death, or if for any reason a
court of competent JUrisdiction shall declare the foregoing testamentary disposition to the Trustee under
said Trust as It exists at the tllne of my death to be invaltd, then I give all of my Estate includmg the
reSIdue and remainder thereof to that person who would have bcen the Trustee under th Trust, as
Trustee, and to their substItutes and successors under the Trust, deSCribed herem a~ve,l 0 be held.
managed, mvested, rem vested and dlstnbuted by the Trustee upon the tenns and condltl ns/ ertal~mg to
the period begmnmg with the date of my death as are constituted m the Trust as at r s t co tltuted
"
glvmg effect to amendments, If any, hereafter made and for that Pn~e I do h ~eb co orate.s
Trust by reference mto thiS my Will. ^ \ .
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I hereby nommate and appoint John C. Darcy as my Independent E ec~o'+~~~s.,~ j. tft"Will
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and Testament, to serve Without bond. C;~L CO'" r-Sl~
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In the event the first named Executor shall predecease me or is unable~r unwilltng to aet as my
Executor for any reasons whatsoever, then and in that event, I hereby nominate and appoint Joseph M.
Darcy to serve without bond as my Independent Executor.
In the event the second named Executor shall predecease me or IS unable or unwilling to act as
my Executor for any reasons whatsoever, then and in that event, I hcreby nominate and appoint Gerald
Mt-Darcy to serve without bond as my Independent Executor.
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Whenever the word "Executor" or any modifymg or substituted pronoun therefore is used III thIS
my Will, such words and respective pronouns shall be held and taken to include both the singular and the
plural, the masculIne, femlllllle and neuter gender thereof, and shall apply equal]y to the Executor named
herein and to any successor to substItute Executor acting hereunder, and such successor or substitute
Executor shall possess all the rights, powers, dutIes, authority, and responsibIlity conferred upon the
Executor originally named herein.
EXECUTOR POWERS
By way of Illustration and not of limitatIon and in addition to any inherent, implIed or statutory
powers granted to executors generally, my Executor IS specifically authOrized and empowered with
respect to any property, real or personal, at any time held under any provision of thIS my WIll: to allot,
allocate between principal and income, assign, borrow, buy, care for, collect, compromise claIms, contract
with respect to, contlllue any business of mille, convert, deal with, dispose of, enter into, exchange, hold,
improve, incorporate any bus mess of mine, invest, lease, manage, mortgage, grant and exercise options
WIth respect to, take possessIon of, pledge, receive, release, repair, sell, sue for, make distributions in cash
or in kllld of partly III each without regard to the income tax basis of such asset and in general, exercise all
of the powers in the management of my Estate whIch any Individual could exercise in the management of
similar property owned in ItS 0\\>11 right upon such terms and condItions as to my Executor may seem best,
and execute and deliver any and all instruments and do a]1 acts which my Executor may deem proper or
necessary to carry out the purpose of this my Wdl, WIthout beIng limited In any way by the speCific grants
or power made. and WIthout the necessity of a court order.
My Executor shall have absolute dIscretion, but shall not be required. to make adjustments III the
rights of any BenefiCiaries, or among the pnnclpal and income accounts to compensate for the
POUR-OVER WILLS
Page 2
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TestatriX
consequences of any tax decision or election, or of any IIlvestment or adml11lstratlvl: decIsion, that my
executor believes has had the effect, directly or indirectly, of preferring one Beneficiary or group of
Beneficiaries over others. In detennlnlllg the Federal Estate and Income Tax liabilities of my Estate. my
Executor shall have discretion to select the valuation date and to determlllc whether any or all of the
allowable admllllstratlon expenses in my Estate shall bc used as Federal Estate Tax deductions or as
Federal Income Tax deductIOns and shall have the discretIon to file a joint income tax return wIth my
spouse.
SPECIFIC OMISSIONS
I have intentionally omitted any and all persons and entities from thIS, my Last Will and
Testament, except those persons and entities specifically named herein. If any person or entity shall
challenge any tenn or condition of this Will, or of the Livlllg Trust to which I have made reference III the
sections "Household and Personal Effects" and "Residue of Estate," then, to that person or entIty, I gIve
and bequeath the sum of only one dollar ($1.00) only in lieu and in place of any other benefit, grant,
bequest or interest which that person or interest may have III my Estate or the Livlllg Trust and its Estate.
SIMULTANEOUS DEATH
If my spouse and I should die under Circumstances such that the order of our deaths cannot be
determined, then it shall be conclusively presumed for the purpose of this Will that my spouse survived
me.
If any other Beneficiary should not survive me for sixty (60) days, then it shall be conclusively
presumed for the purpose of this my Will that said Beneficiary predeceased me,
HEi:f.Jl CJ2~- \{- ;]
HE 'N F, DARCY
Testatrix
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POUR-OVER WILLS
Page 3
This instrument consists of 5 typewritten pages. including the Attestation Clause. Self-Proving
Clause, sIgnature of Witnesses, and acknowledgment of officer. I have signed my name at the bottom of
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each of the eceding pages. ThiS Instrument is being signed by me on this ~ day of
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ATTESTATION CLAUSE
The Testatrix whose name appears above declared to us, the undersigned, that the foregoing
instrument was his Last Will and Testament, and she requested us to act as witnesses to such Il1strument
and to her signature thereon. The Testatrix thereupon signed such instrument in our presence. At the
Testatnxr's request, the undersigned then subscnbed our names to the instrument in our own hand\\Titing
in the presence of the Testatrix, The undersigned hereby declare, in the presence of each of us, that we
believe the Testatrix to be of sound and disposing mind and memory,
Signed by us on the same day and year as this Last Will and Testament was signed by the
Testatrix,
WITNESSES:
ADDRESSES:
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SELF-PRaYING CLAUSE
, BEFORE Mj:, the up?ersigned authority, ~r thf, day personally appeared HELEN F. DARCY,
V\,v:\1 1......e /~I A ~'- \{l (;Land '.:)7 r~iPL- Ill^- f11 (Ie.... , known to me to be the
Testatrix and the witnesses, respectively, whose names are subscribed to the foregomg instrument in their
respective capacities, and all of them being by me duly sworn, HELEN F, DARCY, Testatnx, declared to
me and to the witnesses, in my presence, that the instrument is her Will and that she had willingly made
and executed it as her free act and deed for the purposes therein expressed; and the Witnesses, each on his
or her oath, stated to me in the presence and heanng of the Testator, that the Testator had declared to them
that the instrument IS her Will and that shc executed the same as such and wanted each of them to sign it
as a witness; and upon their oaths, each witness stated further that she did the same as a witness m the
presence of the Testatrix, and at her request and that she was at that time eighteen (18) years of age or
over and was of sound mind, and that each of the witnesses was then at least fourteen (14) years of age,
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iTELEN F, DARCY
Testatrix
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SUBSCRlBED AND ACKNOWLEDGED befor~ I)1c by HE~N F. DI\R~Y, Testatrix, and
sUb,bed <y1d sw\rn to befo, r,e me by fI1;V~ ~ H::' . 11 ^--~ /'tt'lfl ~ and
l--jvl.-.. f- A!vJ M{/~- , wItnesses, thIs the L J- day of
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Notary Public, Commonwealth of Pennsylvania
NO/aria I Seal
. William M. Hankin". Notary Public
City or PbdadClph,a Phlladelpbia County
My CommlS"On Expires Apr 30, 2006
Member, Pennsylvanja Assocl8tion of Notaries
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Page 5
REVOCABLE LIVING TRUST AGREEMENT
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THIS AGREEMENJ AND DECLARATION OF TRUST, made effective the 2-) day of
, 20('2::; between JOHN C. DARCY AND HELEN F_ DARCY, husband and
wife sidents of the County of Cumberland, Commonwealth of Pennsylvania, as Grantors, JOHN C.
DARCY AND HELEN F. DARCY, as Settlors, and JOHN C. DARCY AND HELEN F. DARCY, as
Co-Trustees;
WITNESSETH;
WHEREAS, in order to provide the future comfort and security of themselves and the other
beneficiaries hereafter mentioned, Grantors desire to create a revocable trust for the purposes hereinafter
set forth;
ARTICLE ONE
Terms of the Trust
Section 1.01 - Trust Estate Defined
NOW, THEREFORE, in consideration of the premises and of the mutual covenants herein contained, this
Revocable Trust is formed to hold title to real and personal property for the benefit of the Settlors of this
Trust and to provide for the orderly use and transfer of these assets upon the death of the Settlers, The
'Trust Estate" is defined as all property transferred or conveyed to and received by the Trustee held
pursuant to the terms of this instrument. The Trustee is required to hold, administer, and distribute this
property as provided in this Trust Agreement.
The name of this Trust Agreement shall be:
THE JOHN C. DARCY AND HELEN F_ DARCY
REVOCABLE LNING TRUST AGREEMENT
~tu~
DATED
,2oE~
Section 1.02 - Definitions of Terms
In the interpretation or construction of the provisions of this Trust Agreement, the followmg words and
phrases shall have the meanings set forth below:
I, The term "Husband" shall mean JOHN C. DARCY
2. The term "Wife" shall mean HELEN F. DARCY.
J_ The term "Settlor" shall refer individually and collectively to Husband and Wife.
4. The telm "Descendant" shall mean the lawful issue of a deceased parent in the line of
descent, but does not include the issue of any parent who is a descendant of the deceased
person in question and who is Iivmg at the time in question.
REVOCABLE LIVING TRUST AGREEMENT
Page I
5. The terms "Child" and "Descendant" include any issue born to decedent, a child legally
adopted by the decedent, and a posthumous child of a decedent. A posthumous chIld is to
be considered as living at the time of his or her parent's death.
6. The tenn "Survives" or "Surviving", unless otherwise indicated herem, shall be construed
to mean surviving the decedent for at least sixty (60) days, If the person referred to dies
within sixty (60) days of the death of the decedent, the reference to him or her will be
construed as ifhe or she had failed to survived the decedent; provided, however, that any
such person will have, during such period, the right to the use and enjoyment as a life
tenant of all property in which his or her interest will fail by reason of death during such
period.
7. The tenn "Issue" will include all natural and adopted children, if applicable, and
descendants and those legally adopted into the line of descent.
8_ The tenn "Per Stirpes" means strict per stirpes and does not mean per capita with
representation. Beneficiaries entitled to take under a "per stirpes" clause will include
both natural and adopted children and their dcscendants_
9. The tenns "Trust Assets" and "Trust Estate" include all assets of any trust created
hereunder and income derived from such assets and all proceeds of any description
derived from the sale, exchange, or other disposition of such assets.
10. When required to give reasonable effect to the context in which used, pronouns in the
masculine, feminine, or neuter gender include each other, and nouns and pronouns in the
plural or singular number include each other.
Section 1.03 - Trustee Designation
Husband and WIfe are hereby designated as Co-Trustees. The Co-Trustees shall serve jointly and
severally and either shall have full authority to act for the Trust independently_ Should either husband or
wife become unable because of death, incapacity, or other cause to serve as a Co-Trustee, or should either
resign as Co-Trustce before the natural termination of this Trust, the remaining Co-Trustee, husband or
wife, shall thereafter serve as sole Trustee. The tenn "Trustee" as used in this Trust Agreement shall refer
collectively to husband and wife so long as they serve as Co-Trustees, to the spouse who serves as the
sole Trustee, and/or to any Successor Trustee who assumes the role of Trustee_ These Trustees shall
serve in the order as provided in Section 9.01 of this Trust Agreement.
Section 1.04 - Additions to Trust Properties
L The Trustee, at any time during the continuance of this Trust in his or her sole discretion
after consideration of the possible tax consequences to all concerned, is authorized to
receive into the Trust additions of cash and other properties from any source whatsoever,
whether by gift, will, or otherwise, However, the Trustee shall accept all assets which
any person or persons may give, devise, or bequeath by Last Will and Testament to this
Trust, and shall accept all assets transferred to this Trust pursuant to the prOV1SlOns of any
other Trust document or documents.
2. 1n addition, any person or persons may designate this Trust as the Beneficiary, Primary or
Contingent, of any death benefits to include insurance benefits, penSlOn benefits, or other
benefits. Until such benefits mature, the Trustee shall have no responsibihty WIth respect
to those benefits.
REVOCABLE LIVING TRUST AGREEMFNT
Page 2
, .
Section 1.05 - Apportionment
The Trustee of the Trust is dIrected to apportion receipts and expenditures of the types described below
between principal and income as follows:
I. Whenever the principal, or any part thereof, of the Trust property is invested in securities
purchased at a premium or at a discount, any premium will be charged against principal
and any discount will be crcdited to principal;
2. Any stock dividcnds and rights to purchase additional stock issued on securities held in
trust will be treated as principal. All other dividends, except liquidating distributions,
will be treated as income; and
3, The amount of any applicable depletion allowance for federal income tax purposes will
be treated as income,
Section 1.06 - Administration of Trust During Our Ufetime
During our lifetime, the trust shall be held and administered as follows:
I. All property and other assets transferred to this trust shall be allocated to and held in
separate shares, the first such share being designated the "John C. Darcy Trust Share"
and the second share being designated the" Helen F. Darcy Trust Share".
2. Each Grantor's separate Trust Share shall be composed of the assets as follows:
a, The Grantor's one-half interest in jointly held property transferred to the Trust;
and
b, The Grantor's individually owned property which is transferred to the Trust.
While each share shall be held and administered separate from the other, for tax and accounting
purposes, the Trustee is authorized to hold or invest the separate shares in common investments
and co-ownership of assets.
3. The Trustee shall pay to or apply for the benefit of JOHN C. DARCY all of the net
income of the JOHN C. DARCY Trust Share, in convement installments, not less often
than quarter-annually, and in addition thcreto, shall pay so much of the income and
principal of such Trust Share to or for the benefit of JOHN C. DARCY as he may dIrect
from time to time, or in the absence of a direction, as the Trustee may determine to be
advisable for his medical care, support, maintenance, and general welfare.
4. The Trustee shall pay to or apply for the benefIt of HELEN F. DARCY all of the net
income of the HELEN F. DARCY Trust Share in convenient installments, not less often
than quarter-annually, and in addition thereto, shall pay so much of thc income and
principal of such Trust Share to or for the benefit of HELEN F. DARCY as she may
direct from time to time, or in the absence of a directIOn, as the Trustee may detennine to
be adVIsable for her medlcal care, support, maintenance, and general welfare.
All property that a Settlor transfers to the Trustee pursuant to this instrument which was
community property, quasi-conununity propcrty, or separate property at the time of the
REVOCABLE LIVING TRUST AGREEMENT
Page 3
, .
transfer shall remain respectively community property, quasi-community property, or the
separate property of the Settlor transferring such property to the Trust.
Community and quasi-community property transferred to the Trustee by the Seltlors shall
be theIr community property and treated as such. This property, as invested and
reinvested, together with the rents, issues, and profits therefrom (hereinafter referred to as
the "Community Estate" or the "Community Property") shall retain its character as
community property during the joint lifetimes of the Settlors in spite of any change in the
situs of the Tmst, subject, however, to the provisions of this Agreement.
Section 1.07 - Discretionary Termination
The Trustee may terminate any Tmst when, in the opinion of the Trustee, the principal is reduced to such
an extent that it is not in the best interest of the Beneficiary or Beneficiaries to continue the Trust. The
judgment of the Trustee with respect to this decision to terminate will be final and not subject to judicial
review. If the Trustee terminates a Trust according to this Section, the date the Trust terminates will be
deemed the date fixed for termination of the Trust, and the Trustee will distribute the assets of the
terminating Trust to the Beneficiary or Beneficiaries pursuant to this Agreement.
Section 1.08 - Amendment and Revocation
We hereby retain the following powers, exercisable at any time during our lifetimes:
1. To withdraw any of the property included in our separate share of the Trust Estate by
giving the Trustee written notice specifying the property so withdrawn, in which event,
the Trustee shall promptly transfer and deliver such property to us or our designee.
2, To amend the provisions of this Trust declaration in any respect without the necessity of
securing the consent of the Trustee to such changes, in which event, a copy of the
amendment shall be promptly furnished to the Trustee; provided, however, that following
the death of one of us, the survivor shall have no power to amend the terms of the Trust
declaration with respect to the Trust Share of the first of us to die.
3. To revoke this Trust by giving the Trustee written notice of such revocation, in which
event, the Trustee shall promptly transfer and deli vcr the property constituting the Trust
Estate to us or our designee together with an accounting therefore; provided, however,
that following the death of one of us, the survivor shall have no power to revoke the
terms of the Trust declaration with respect to the Trust Share of the first of us to die.
Section 1.09 - Revocation or Alteration by Settlor Alone
The rights of revocation, withdrawal, alteration, and amendment reserved in this Article may only be
exercised by the Settlor and may not be exercised by any other person, including an agent, a guardian, or
a conservator.
Section 1.10 - Irrevocability
Except as otherwise provided. on the death of either Settlor, the designation of BeneficJanes of specific
gifts in this Trust shall become irrevocable and not subject to amendment or modification.
REVOCABLE LIVING TRUST AGREEMENT
Page 4
Section 1.11 - Settlor Powers
The surviving Settlor shall be the Trustee unless and until he or she resigns in writing or is determined
incompetent under the terms provided herein. The surviving Settlor shall retam all absolutc rights to
dischargc or replace any Successor Trustee of any portion or share of the Trust which is revocable by the
surviving Settlor so long as the Settlor is competent.
ARTICLE TWO
Trust Administration
Section 2.01 - Trust Income
During the Joint lives of the Settlors, the Trustee shall at least annually, unless otherwise directed by both
Settlors in writing, pay to or apply for the benefit of husband and wife, all of the net income from the
Trust Estate in the same proportions as each of the spouse's respective interests in the Trust Estate.
Section 2.02 - Protection of Settlor in Event of Incapacity
During the joint lives of the Settlors, should either Settlor become incapacitated as defined in Section 2.03
below, the Trustee may, in the Trustee's absolute discretion, pay income and principal for the benefit of
the incapacitated Settlor. In addition, the Trustee, in his or her absolute discretion, may pay to or apply,
for the benefit of that Settlor, such sums from the net income and from the principal of the Settlor's
separate Estate as the Trustee believes is necessary or advisable for the medical care, comfortable
maintenance, and welfare of the Settlor.
Section 2.03 - Incapacity
I. ^ person is determined to be incapacitated if any Trustee or Beneficiary hereunder comes into
possession of any of the following:
a. A jurisdictionally applicable court order holding the party to be legally incapacitated to
act on his or her behalf and appointing a guardian or conservator to act for him or her; or
h_ Written certificates which are duly executed, witnessed, and acknowledged of two
licensed physicians, each certifying that the physician has examined the person and has
concluded that, by reason of accident, mental deterioration, or other cause, such person
has bccome incapacitated and can no longer act rationally and prudently in his or her own
financial best interest; or
c. Evidence which such Trustee or Beneficiary deems to be credible and currently
applicable that a person has disappeared, is unaccountably absent, or is being detained
under duress, and that he or she is unable to effectively and prudently look after his or her
own best interests, then in that event and under those circumstances:
1) Such person is deemed to have become incapacitated, as that term is used in this
"l'rust agreement; and
2) Such incapacity is deemed to continuc until such court order, certificates_ and / or
circumstances are inapplicable or have been revoked.
REVOCABLE I,IYING TRUST AGREEMENT
Page 5
2. A physician's certificate to the effect that the person is no longer incapacitated shall revoke a
certificate declaring the person incapacitated. The certificate which revokes the earlier certificate
may be executed by either the original certifying physician or by two other licensed, board
certified physicians. No Trustee shall be under any duty to institute any inquiry into a person's
possible incapacity, The reasonable expense of any such inquiry shall be paid from the Tmst
Assets.
Section 2.04 - Principal Invasion
During the joint lives of the Settlors, should the net income of assets contained in this Trust be
insufficient to provide for the care, maintenance, or support of the Settlors as herein defined, the Trustee
may, in the Trustee's sole and absolute discretion, pay to or apply for the benefit of the Settlors or either
of them, or any of their dependents, such amounts from the principal of the Trust Estate as the Trustee
deems necessary or advisable for the care, maintenance, or support ofthe Settlors.
Section 2.05 - Residence
If the Settlor's residence property is a part of the Tmst, the Settlors shall have possession of and full
management of the residence and shall have the right to occupy it free of rent. Any expenses arising from
the maintenance of the property and from all taxes, liens, assessments, and insurance premiums, are to be
paid from the Trust to the extent that assets are available for payment. It is the intent of the Settlors to
retain all homestead rights available to them under the applicable state law.
ARTICLE THREE
Administration upon Death of First Settlor
Section 3.01 - Provisions After The First Death
On the death of either Settlor leaving the other Settlor surviving him or her, the Trustee shall collect all
insurance proceeds payable to the Trustee by reason of such death and all bequests and devises
distributable to the Trust Estate.
Section 3.02 - Control of Assets
The surviving spouse may, at any time by written notice, require the Trustee either to make any
nonproductive property of this Trust productive or to convert productive property to nonproductive
property, each within a reasonable time. The surviving spouse may fUliher require the Trustee to invest
part or all of this share of Trust Assets for the purpose of maximizing income rather than growth or
growth rather than mcome,
Section 3.03 - Division into Shares
I, Upon the death of either Settlor, if the deceased Settlor is survived by the other Settlor, the
deceased's individual Trust Share, including any additions made by reason of the deceased
Settlor's death, shall be divided into two shares.
2. The Trustee, in his or her sole discretion, may defer the division or distribution of the deceased' s
indiVidual Trust Share until six months after the deceased Trustor's death_ If the dIVISIon or
distribution of the deceased's individual Trust Share is so deferred. the deferred division or
distribution shall be made as if it had taken place at the time prescribed above. In addition, all
REVOCABLE LIVING TRUST AGREEMENT
Page 6
rights given to the Beneficiaries under the provisions of this Trust Agreement which follow shall
be considered to have accrued and vested as of that prescribed time.
3. Upon the death of the first Settlor to die ("Predeceased Spouse"), the Trustee shall dIvide the
deceased's individual Tmst Share (which shall include any property which may be added from
the Predeceased Spouse's general estate) as follows:
a_ The Tmstee shall divide the balance of the deceased Trustor's individual Trust Share into
two (2) separate shares (hereinafter designated as "Share A" and "Share B")_ Share B
shall be composed of cash, securities, and/or other property of the deceased's individual
Trust Share (undiminished by any estate, inheritance, succession, death, or similar taxes)
having a value equal to the maximum marital deduction as finally determined in the
Predeceased Spouse's federal estate tax proceedings, less the aggregate amount of marital
deductions, if any, allowed for such estate tax purposes by reason of property or interest
in property passing or which have passed to the Surviving Spouse otherwise than
pursuant to the provisions of this paragraph; provided, however, that the amount of Share
B hereunder shall be reduced by the amount, if any, needed to increase the Predeceased
Spouse's taxable estate (for federal estate tax purposes) to the largest amount that, after
allowing for the unified credit against federal estate tax and the state death tax credit
against such tax (but only to the extent that the use of such state death tax credit does not
increase the death tax payable to any state), will result in the smallest (if any) federal
estate tax being imposed on the Predeceased Spouse's estate. The term "Maximum
Marital Deduction" shall not be construed as a direction by the Predeceased Spouse to
exercise any election respecting the deduction of estate administration expenses, the
determination of the estate tax valuation date, or any other tax election which may be
available under any tax laws, only in such manner as will result in a larger allowable
estate tax marital deduction than if the contrary election had been made, The Trustee
shall have the sole discretion to select the assets which shall constitute Share B. In no
event, however, shall there be included in Share B any assets or the proceeds of any asset
whIch will not qualify for the federal estate tax marital deduction. Share B shall be
reduced to the extent that it cannot be created with such qualifying assets, The Trustee
shall value any asset selected by the Trustee for distribution in kind as a part of Share B
at the value of such asset at the date of distribution of such asset. The balance of the
deceased's individual Tmst Share, after the assets have been selected for Share B, shall
be allocated to Share A.
Share A and Share B shall be administered and distributed as hereinafter set forth.
Section 3.04 - Credit Shelter Trust
If eIther of the Settlors survives the other, the Trustee shall set apart and hold as a separate trust (the
"Credit Shelter Trust") the assets referred to as Share A in Section 3.03 above, The Trustee shall hold,
manage, invest, and reinvest the assets of this Credit Shelter Trust, shall collect the income therefrom, and
shall pay the net income to or for the benefit of the surviving Settlor in convenient installments at least
quarter-annually; provided, however, that the surviving Grantor may elect to pass any portion of said
income to the remainder Beneficiaries of the Trust.
In addition, the Trustee may pay to or for the benefit of the surviving Settlor for the health, education,
maintenance, or support of the surviving Settlor, any part or all of the principal of this Trust, as the
Trustee may determine in Its sole discretion, without considering other resources available to the
survIVIng Settlor. The surviving Settlor shall have the right to demand and receive, from the principal of
this Trllst in each of its fiscal years, the greater of five thousand dollars ($5,000_00) or five percent (5%)
REVOCABLE LIVING TRUST AGREEMENT
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of the faIr market value of such principal determined as of the last day of such fiscal year. Such right
shall lapse to the extent it is not exercised in any year. Any commission payable with respect to principal
so withdrawn shall be charged against such principal.
No person, who at any time is acting as Trustee hereunder, shall have any power or obligation to
participate in any discretionary authority which the Settlor has given to the Trustee to pay principal or
income to such person, or for his or her benefit or in relief of his or her legal obligations; provided,
however, that if an individual Trustee has discretion to invade principal for himself or herself and such
discretionary authority is limited by an ascertainable standard, then such Trustee may invade principal (if
]llnited by such standard) for himself or herself, but not in relief of his or her legal obligations.
The plan of distnbution and all terms of this Credit Shelter Trust shall be irrevocable and unamenab]e at
any time after said Credit Shelter Trust comes into being.
The Credit Shelter Trustee(s) shall invest the assets of the Credit Shelter Trust to produce a reasonable
income for the benefit of the surviving Grantor without subjecting the principal to unreasonable risk of
loss. The Credit Shelter Trustee(s) shall be authorized and empowered to invest, reinvest, manage,
transfer, and convey any and all property held in this Credit Shelter Trust, including all powers now or
hereafter conferred upon Trustees by applicab]e state law, and also those power appropriate to the orderly
and effective administration of the Trust.
The Credit Shelter Trustee(s) shall make a written accounting to all income and remainder Beneficiaries
or to their guardians at least annually and at the time that all assets of this Credit Shelter Trust are
distributed. Said accounting shall consist of a record showing assets on hand at the time of the last
accounting, plus additions, minus expenses and distributions, which shall equal current assets on hand.
The Credit Shelter Trustee(s) shall not be required to obtain authority or approval of any court in the
exercise of any power conferred upon the Trustee(s), nor shall said Trustee(s) be required to make
accountings or reports to any court_
Upon the death of the surviving Settlor, any accrued income shall be paid to the estate of the surviving
Settlor and the remaining principal of this Credit Shelter Trust shall be held, administered, and disposed
of in accordance with the dispositive provisions of this agreement.
Section 3.05 - Qualified Terminable Interest Trust
If either of the Grantors survives the other and there are assets allocated to Share B described in Section
3.03 above, then the Trustee shall set apart said assets and hold them as a separate trust (the "Qualified
Terminab]e Interest Trust"). The Trustee shall hold, manage, invest, and reinvest the assets of this
Qualified Terminable Interest Trust, shall collect the income therefrom, and shall pay the set income to or
for the benefit of the surviving Grantor in convenient installments at least quarter-annually_
Upon the surviving Grantor's death, any accrued, undistributed income shall be distributed to said
surviving Grantor's estate. The remaining pnncipa] shall be added to and become part of the Credit
Shelter Trust and shall be held and administered and disposed of in accordance with the plan of
distribution for the Credit Shelter Trust as provided in Sections 3.04 and 4.03, after provision has first
been made for the payment of any estate, inheritance, transfer, succession, or other death taxes, payable
by reason of the inclusion of the value of the Trust property in said surviving Grantor's estatc.
The Trustee(s) of the Quahfied Terminable Interest Trust are hereby authorized, in the Trustee(s) sole
discretion, to determine whether to elect (under Section 2056(b)(7) of the Intema] Revenue Code) to
qualify all or a speCific portion of the Qualified Terminable Interest Trust created herein for the federal
estate tax marital deduction, The Trustee(s) of the Qualified Terminab]e Interest Trust, in exerclsmg such
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discretion, shall attempt to minimize, or eliminate if possible, the federal estate tax payable by the estate
of the decedent spouse's estatc.
However, If the Trustee(s) of the Qualified Terminable Interest Trust determinc that it is in the best
interest of the persons who may receive any assets after the decedent spouse's death and after the
surviving Grantor's death to pay some federal estate tax in the decedent spouse's estate, taking into
consideration any other tax that is to be paid because of the decedent spouse's death and the surviving
Grantor's death, and any income tax liability that may be affected by the clection, the Trustee(s) of the
Qualified Terminable Interest Trust may elect to take a marital deduction that does not reduce the tax to
zero if the payment of the tax will not jeopardize the ability of the Qualified Terminable Interest Trust to
provide the surviving spouse with the level of support and maintenance contemplated by this Declaration
of Trust. The decision of thc Qualified Terminable Interest Trustee(s) to make this election shall be final
and binding on all persons.
The Trustee(s) of the Qualified Terminable Interest Trust is (are) authorizcd and empowered to invest,
reinvest, transfer, and convey any and all property held in this Qualified Terminable Interest Trust. This
includes all power now or hereafter conferred upon Trustees by applicable state law, and also those
powers appropriate to the orderly and effective administration of the Trust.
The Trustee(s) shall make a written accounting to the surviving Grantor at least annually and shall make a
written accounting to all remainder Beneficiaries at the time that all assets of this Qualified Terminable
Interest Trust are distributed.
Section 3.06 - Power to Appoint Agents
The surviVing spouse shall have the right to retain an accountant and / or an attorney at law for
professional services on behalf of the Trust Estate or Estates herein. The surviving spouse shall not be
responsible for the acts of such agents beyond his or her obligation to use reasonable care in the selection
of such agents.
Section 3.07 - Maximum Marital Deduction
Except as otherwise expressly stated herein, the tcrm "Maximum Marital Deduction" shall not be
construed as a direction by thc deceased Settlor to exercise any election respecting the deduction of Estate
administration expenses, the detcrmination of the Estate tax valuation date, or any other tax election
which may be available under any tax laws, only in such manner as will result in a larger allowable Estate
tax marital deduction than if the contrary election had been made,
Section 3.08 - Trust Income After The First Death
Following the death of either Settlor and until the death of the surviving Settlor, the Trustee shall, at least
annually, pay to or apply for the benefit of the surviving Settlor all of the nct income from the Trust
Estate.
Section 3.09 - Simultaneous Death
If the Settlors should die under circumstances which would render it doubtful as to which Settlor died
first, it shall be conclusively presumed for the purposes of this Trust that John C. Darcy died first. If any
other Beneficiary and a Settlor should dic under such circumstances, it shall be conclusively presumed
that the Beneficiary predeceased such Settlor.
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Section 3.10 - Last Expenses
Upon the death of each of the Settlors, the Trustee of this Trust may, in its discretion, pay any part of or
all of the funeral and burial expenses, probate claims, administration expenses, and any estate,
inheritance, succession, or other death taxes, which are payable as a result of the death of each of the
Settlors, out of that portJOn of the Trust Estate constituting the deceased Settlor's separate Trust Share.
The Trustee may make any such payments directly to the creditors or taxing authority in question, or may
remit funds to the personal representative of the Estate of the deceased spouse for such payments.
ARTICLE FOUR
Administration/distribution of Survivor's Trust
Section 4.01 - Common Pot Trust
At the death of the Surviving Settlor, the Trustee shall not create a Common Pot Trust. All of the Trust
Estate that has not been distributed under prior Articles of the Trust Agreement shall be held,
administered, divided, and distrIbuted according to the provisions that follow.
Section 4.02 - Second Death
On the death of the last Settlor to die (the "Surviving Settlor"), the Trustee shall distnbute the principal of
the Trust and any accmed or undistributed income from the principal of the Tmst in such a manner and to
such persons, including the Estate or the Creditors, as directed in this Tmst Agreement.
Section 4.03 - Payment of The Second Death Expenses
On the death of the Surviving Settlor, the Trustee shall pay from that portion of the Trust Estate
constituting the deceased Settlor's separate Tmst Share the expenses of the surviving Settlor's last illness,
funeral, burial, and any inherItance, estate, or death taxes that may be due by reason of the Surviving
Settlor's death, unless the Trustee in his or her absolute discretion determines that other adequate
provisions have been made for the payment of such expenses and taxes.
Section 4.04 - Trnst Income and Principal Distribution Upon The Death of The Surviving Trustor ~l/
1. The Trustee shall apply and distribute the net income and principal of each of the shares of th~
resulting Trust Estate, after giving effect to the section of this Trust Agreement entitled "Specia
Directives" to the follOWIng Beneficiaries in the indicated fractional shares: I
~~
'N~
Joseph M. Darcy
Gerald l)IY.' Darcy
p.
1/2
1/2
2.
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otherWIse stated in this Agreement. If the minor should die before attaining the age of majority,
the properly shall then be paid and dIstributed to the estate of the minor.
3 _ If all of the Settlor's Beneficiaries and their children should fail to survIve the final distribution of
the Trust Estate, all of the Trust Estate not disposed of as hereinabove provided shall be
distributed as provided for in this Trust Agreement.
Section 4.05 - Principle of Representation
Unless indicated dIfferently in this Trust Agreement or in the "Special Directives" section that follows, in
the event any of the named Beneficiaries should predecease both Settlors, all of that person's share of the
Trust Estate is to be divided equally among the deceased Beneficiary's children or issue per stlrpes_ In
the event the predeceased Beneficiary leaves no surviving children or issue, then all of that person's share
of the Trust Estate shall be divided equally among the remaining Beneficiaries per stirpes.
If a Beneficiary of the Settlors survives both Settlors, but should fail to survive to collect his or her share
at distribution, that share shall pass to the surviving issue of that deceased Beneficiary per stirpes and with
right of representation.
ARTICLE FIVE
Trustee Powers & Provisions
Section 5.01 - Non-Income Producing Property
During thc joint lives of the Settlors, the Trustee is authorized to retain in the Trust, for so long as the
Trustee may deem advisable, any property received by the Trustee from the Settlors, whether or not such
property IS of the character permitted by law for the investment of Trust funds.
Section 5.02 - Trustee Powers
The Trustee shall have all powers conferred upon a Trustee by law for the orderly administration of the
Trust Estate. If any property is distributed outright under the provision of this Trust Agreement to a
person who is a minor, distribution may be made under the Pennsylvania Uniform Transfer to Minors Act
("P A UTMA"), The Trustee is further authorized to sign, deliver, and/or receive any documents necessary
to carry out the powers contained within this Section.
The Trustee of any trust created under this Trust Agreement (including any substitute or successor
Trustee) will have and be subject to all of the powers, duties, and responsibilities granted or imposed by
the Pennsylvania Consolidated Statutes (20 Pa. C.S. Section 101 et seq_) as such Statute may proVIde at
the time of administration of the Trust, except to the extent that the same are inconsistent with the
proVISIOns of this Agreement.
Section 5.03 - Specific Powers of Trustee
In addition, the Trustee will have the following specific powers:
I, Trust Estate: The Trustee may leave invested any property coming into its hands hereunder m
any form of investment even though the investment may not be of the character of investments
permitted by law to trustees, without liability for loss or depreciation in value. The Trustee may
sell, exchange, or otherwise dispose of and reinvest property which may at any tIme be a part of
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,
the Trust Estate upon such terms and conditions as the Trustee may dcem advisable, The Tmstee
may invest and reinvest the Trust Assets from time to time in any property, real, personal, or
mixed, mcluding without limitation, securities of domestic and foreign corporations and
investment trusts or companies, bonds, debentures, preferred stocks, conunon stocks, mortgages,
mortgage participation, and interests in conunon trust funds, all with complete discretion to
convert realty into personalty or personalty into realty or otherwIse change the character of thc
Tmst Estate, even though such investment (by reason of its character, amount, proportion to the
total Tmst Estate, or otherwise) would not be considered appropriate for a fiduciary apart from
this provision and even though such investment caused part or all of the total Trust Estate to be
investcd in investments of one type or of one business or company.
2. Holding Property: The Trustee may hold property in the Tmstce's name, as trustee, or in the
name of a nommee without disclosing the Tmst.
3, Release of Powcr: If the Trustee deems it to be in the best intcrest of the Trust and its
Beneficiaries, the Trustee, by written instrument signed by such Tmstee, wi]] have the power and
authority to release, dIsclaim, or restrict the scope of any power or discretion granted in this Trust
Agreement or implied by law.
4. Agents, Employees: The Trustee may employ one or more agents to perform any act of
administration, whether or not discretionary, including attorneys, auditors, investment managers,
or others, as the Trustee shall deem necessary or advisable. The Trustee may compensate agents
and other employees and may delegate to them any and all discretions and powers.
5. Leases: The Trustee may lease any Trust Assets generally or for oil, gas, and mineral
development, even though the lease term may extend beyond the term of the Trust of which the
property is a part. The Trustee may enter into any covenants and agreements relating to the
property so leased or concerning any improvements which may then or thereafter be erected on
such property,
6. Common Funds: The Tmstee may hold any of the Trust Assets in a common fund with propcrty
fi-om other trust estates and may make investments jointly with any other trust, the property of
which is included in the common fund.
7. Securities: With respect to securities held in the Trust Estate, the Trustee may exercise all the
rights, powers, and privileges of an owner, including but not limited to, the power to vote, give
proxies, and to pay assessments and other sums deemed by the Trustee necessary for the
protection of the Trust Estate. In addition, the Trustee may participate in voting trusts,
foreclosures, reorganizations, consolidations, mcrgers, and liquidations, and in connectIOn
therewith, to deposit securities with and transfer title to any protective or other committee under
such terms as the Trustee may deem advisable. In addition, the Tmstee may exercise or sell stock
subseription or conversion rights and may aeeept and retain as an investment any securitics or
other property received through the exercise of any of the foregomg powers, regardless of any
limitations elsewhere in this instrument relative to investments by the Trustee.
8, Purehases from Estate: The Trustee may purchase property of any kind from the Executor or
Administrator of our Estates_
9, Lending: The Trustee may make loans, secured or unsecured, to the Executor or Administrator
of our Estates, to any Beneficiary of the Trust, or to the Trustee. Further, the Trustee may usc
Trust Assets to guarantee obligations of any income Beneficiary of the Trust (unless such
Beneficiary is serving as Trustee).
REVOCABLE LIVING TRUST AGREEMENT
Page 12
10. Distributions to or for Beneficiaries: The Trustee may make any distribution contemplated by
this Trust Agreement (1) to the Beneficiary; (2) if the Beneficiary is under a legal disability or if
the Trustee determines that the Beneficiary is unable to properly manage his or her affairs, to a
person furnishing support, maintenance, or education for the Beneficiary or with whom the
Beneficiary is residing for expenditures on the Beneficiary's behalf; or (3) if the Beneficiary is a
minor, to a trustee of an existing trust established exclusively for the benefit of such minor,
whether created by this Trust Agreement or otherwise, or to a custodian for the Beneflciary, as
selected by the Trustee, under the Pennsylvania Uniform Transfer to Minors Act. Alternatively,
the Trustee may apply all or a part of the distribution for the Beneficiary's benefit. Any
distribution under this paragraph will be a full discharge of the Trustee with respect thereto. On
any partial or final distribution of the Tmst Assets, the Trustee may apportion and allocate the
assets of the Tmst Estate in cash or in kind, or partly in cash and partly in kind, or in undivided
interests in the manner deemed advisable at the discretion of the Trustee and to sell any property
deemed necessary by the Trustee to make the distribution. The Tmstee may distribute gifts of up
to $] 0,000.00 per year per donee out ofprincipa] and/or interest.
11. Insurance: The Tmstee may purchase new life insurance, pay the premiums on existing life
insurance on the life of any Tmst Beneficiary, purchase annuities (either commercial or private)
from any corporation, trust, or individual, and may procure and pay the premiums on other
insurance of the kinds, forms, and amounts deemed advisable by the Trustee to protect the
Trustee and the Tmst Estate,
12. Borrowing: 111e Trustee may borrow money from the Trust Estate and others. To secure the
repayment thereof, the Trustee may mortgage, pledge, or otherwise encumber part or all of the
Trust Assets, and in connection with the acquisition of any property, the Trustee may assume a
liability or may acquire property subject to a liability.
13. Repairs: The Tmstee may make ordinary and extraordinary repairs and alterations to buildings
or other Trust Assets_
]4. Reserves: The Trustee may establish such reserves out of income for taxes, assessments, repair,
and maintenance as the Trustee considers appropriate.
15. Continuation of Business: The Trustee may continue any business or businesses in which the
Trust has an interest at the time of the Sett]ors' death for so long as the Trustee may, in its sole
discretion, consider necessary or desirable, whether or not the business is conducted by the
Settlors at the time of their death individually, as a partnership, or as a corporation wholly owned
or controlled by them, with full authority to sell, settle, and discontinue any of them when and
upon such terms and conditions as the Trustee may, in its sole discretion, consider necessary or
desirable_
16_ Retain Property for Personal Use: The Trustee may retain a residence or other property for the
persona] use of a Beneficiary and allow a Beneficiary to use or occupy the retained property free
of rent and maintenance expenses.
17. Dealings with Third Parties: The Trustee may deal wlth any person or entity regardless of
relationship or identity of any Trustee to or with that person or entity. The Trustee may hold or
invest any pari of or all of the Trust Estate in common or undivided interests WIth that person or
entity.
18. Partitions, Divlslons, Distributions: The Trustee WIll have the power to make all partitIons,
divisions, and distnbutions contemplated by this Trust Agreement. Any partitions, divislOns, or
REVOCABLE LIVING TRUST AGREEMENT
Page 13
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other distributions may be made in cash, in kind, or partly in cash and partly in kind, in any
manner that the Trustee deems appropriate (including composing shares differently). The Trustec
may determine the value of any property, which valuation will be binding on all Beneficiaries,
No adjustments are required to compensate for any partitions, divisions, or distributions having
unequal consequences to the Beneficiaries.
19. Claims, Controversies: The Trustee may maintain and defend any claim or controversy by or
against the Trust without the joinder or consent of any Beneficiary. The Trustee may commence
or defend at the expense of the Trust any litigation with respect to the Trust or any property of thc
Trust Estate as the Trustee may deem advisable. The Trustee may employ, for reasonable
compensation, such counsel as the Trustee shall deem advisable for that purpose.
20. Merger of Trusts: If at any time the Trustee of any trust created hereunder shall also be acting as
trustee of any other trust created by trust instrument or by trust dcclaration for the benefit of the
same beneficiary or beneficiaries and upon substantially the same terms and conditions, the
Trustee is authorized and empowered, if in the Trustee's discretion such action is in the best
interest of the Beneficiary or Beneficiaries, to transfer and merge all of the assets then held under
such trust created pursuant to this Trust Agreement to and with such other trust and thereupon to
terminate the trust created pursuant to this Trust Agreement. The Trustee is further authorized to
accept the assets of any other trust which may be transferred to any trust created hereunder and to
administer and distribute such assets and properties so transferred in accordance with the
provisions of this Agreement.
21. Termination of Small Trust: Any corporate Trustee which is serving as the sole Trustee of any
Trust or any Share thereof may at any time terminate such Trust or Share if, in the Trustee's sole
judgment, the continued management of such Trust or Share is no longer economical because of
the small size of such Trust or Share and if such action will be deemed to be in the best interests
of the Beneficiary or Beneficiaries. In case of such termination, the Trustee will distribute
forthwith the share of the Trust Estate so terminated to the income Beneficiary, per stirpes_ Upon
such distribution, such Trust or Share will terminate and the Trustee will not be hable or
responsible to any person or persons whomsoever for its action. The Trustee will not be hable for
failing or refusing at any time to terminate any Trust or a Share thereof as authorized by this
paragraph.
22. Power to Determine Income and Principal: Dividends payable in stock of the issuing
corporation, stock sphts, and capital gains will be treated as principal. Except as herein otherwise
specifically provided, the Trustee will have full power and authority to determine the manner in
which expenses are to be borne and in which receipts are to be credited as between principal and
income. The Trustee has the power to determine what will constitute principal or income and
may withhold from income such reserves for depreciation or depletion as the Trustee may deem
fair and equitable. In determining such matters, the Trustee may give consideration to the
provisions of the Pennsylvania Statutes (or its successor statutes) relating to such matters, but it
will not be bound by such provisions,
23. Generation-Skipping Taxes and Payment: If the Trustee considers any distribution or
termination of an interest or power hereunder as a distribution or termination subject to a
generatIOn-skipping tax, the Trustee is authorized:
24. To augment any taxable distribution by an amount which the Trustee estimates to be sufficient to
pay such tax and charge the same to the particular trust to which the tax related without
adjustment of thc relative mterests of the Beneficiaries;
REVOCABLE LIVING TRUST AGREEMENT
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a. To pay such tax, in the case of a taxable termination, from the particular trust to which
the tax relates without adjustment of the relative interests of the Beneficiaries. If such tax
is imposed in part by reason of the Trust Assets, the Trustee will pay only the portion of
such tax attributable to the taxable termination hereunder takir:g into consideration
deductions, exemptions, credits, and other factors which the Trustee deems advisable;
and
b. To postpone final termination of any particular trust and to withhold any portion or all of
the Trust Estate until the Trustee is satisfied that the Trustee no longer has any liability to
pay any generation-skipping tax with reference to such trust or its termination.
Section 5.04 - Special Provision for S Corporation Stock
Notwithstanding what is otherwise provided in this Trust Agreement, if at any time the Trust contains any
stock of a corporation which elects or has elected treatment as an "S Corporation" as defined by Section
1361(a)(I) of the Internal Revenue Code (or any corresponding successor statute), such stock will be
segregated from the other assets of such and treated as a separate trust. The Trustee will further divide the
separate trust into shares for each Beneficiary and such shares will be distributed outright or held in trust
as herein provided. In addition, all other provisions of this Trust Agreement will apply to each share held
in trust (and constituting a separate trust) except that the Trustee will distribute all of the income from
each separate trust to its Beneficiary in convenient installments at least annually. It is the Settlors' intent
that each separate trust will be recognized as a "Qualified Subchapter S Trust" ("QSST") under Section
1361(d)(2) of the Internal Revenue Code (or any corresponding successor statute). Notwithstanding any
provisions of this Trust Agreement to the contrary, the Trustee's powers and discretions with respect to
the administration of each separate trust (including methods of accounting, bookkeeping, making
distributions, and characterizing receipts and expenses) will not be exercised or exercisable except in a
manner consIstent with allowing each separate trust to be treated as a QSST as above described,
ARTICLE SIX
Trustee Powers with a Probate Estate
Section 6.01 - Coordination with Settlor's Probate Estate
I. At any time during the continuance of this Trust, including subsequent to the death of either
Settlor, the Trustees may, in their sole and uncontrolled discretion, distribute to the deceased
Settlor's Probate Estate cash and / or other property as a Beneficiary of the Trust.
2, All other provisions to the contrary notwithstanding, under no circumstances shall any restricted
proceeds, as hereinafter defined, be either directly or indirectly: (i) distributed to or for the benefit
of the Settlor's Executors or the Settlor's Probate Estate; or (ii) used to pay any other obligations
of thc Settlor's Estate. The term "Restricted Proceeds" means:
a_ All qua!rfied plans, individual retirement accounts, or similar benefits which are received
or receivable by any Trustee hereunder, and which are paid solely to a Beneficiary other
than the Executor of the Settlor's Gross Estate for Federal Estate Tax purposes; and
b. All proceeds of insurance on the Settlor's !rfe which, ifpaid to a Beneficiary other than
the Settlor's Estate, would be exempt from inheritance or SImilar death taxes under
applicable state death laws_
REVOCABLE LIVING TRUST AGREEMENT
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Section 6.02 - Direction to Minimize Taxes
In the admmlstratlOn of the Trust hereunder, its Fiduciarics shall exercise all available tax relatcd
elections, options, and choices in such a manner as they, in their sole but reasonable judgment (where
appropnate, receiving advice of tax counsel), believe will achieve the overall minimum in total combined
present and reasonably anticipated future administrative expenses and taxcs of all kinds, This applies not
only to said Trust, but also to its Beneficiaries, to the other Trusts hereunder and their Beneficiaries, and
to the Settlor's Probate Estate_
Without lImitation on the generality of the foregoing direction (which shall to that extent supercede the
usual fiduciary duty of impartiality), such Fiduciaries shall not be accountable to any person interested in
this Trust or to Settlor's Estate for the manner in which they shall carry out this direction to minimize
overall taxes and expenses (including any decision they may make not to incur the expense of a detailed
analysis of alternative choices). Even though their decisions in this regard may result in increased taxes
or decreased distrIbutions to the Trust, to the Estate, or to one or more Beneficiaries, the Fiduciaries shall
not be obligated for compensation readjustments or reimbursements which arise by reason of the manner
in which the Fiduciaries carry out this direction.
Section 6.03 - Judgment and Discretion of Trustee
In the absence of proof of bad faith, all questions of construction or interpretation of any trusts created by
this Trust Agreement will be finally and conclusively determined solely by the Trustee, according to the
Trustee's best judgment and without recourse to any court. Each determination by the Trustee is binding
on the Beneficiaries and prospective Beneficiaries hereunder, both in being and unborn, as well as all
other persons, firms, or corporations. The Trustee, when exercising any discretionary power relating to
the distribution or accumulation of principal or income or to the termination of any trust, will be
responsible only for lack of good faith m the exercise of such power. Each determination may be relied
upon to the same extent as if it were a final and binding judicial determination. In the event of a conflict
between the provisions of this Trust Agreement and those of the Pennsylvania Statutes, the provisions of
this Agreement will control.
ARTICLE SEVEN
Resolution of Conflict
Section 7.01 - Resolution of Conflict
Any controversy between the Trustee or Trustees and any other Trustee or Trustees, or between any other
parties to this Trust, including Beneficiaries, involving the construction or application of any of the terms,
provisions, or condItions of this Trust shall, on the written request of either or any disagreeing party
served on the other or others, shall be submitted to arbitration. The parties to such arbitration shall each
appomt one person to hear and determine the dispute and, if they are unable to agree, then the two persons
so chosen shall select a third impartial arbitrator whose decision shall be final and conclusive upon both
parties. The cost of arbitration shall be borne by the losing party or in such proportion as the arbitrator(s)
shall decide_ Such arbitration shall comply with the commercial arbitration rules of the American
ArbItration Association, 140 West 5 I st Street, New Yark, NY 10200_
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Section 7.02 - Incontestability
The beneficial provisions of this Trust Agreement are intended to be in lieu of any other rights, claims, or
interests o[ whatsoever nature, whether statutory or otherwise, except bona fide pre-death debts, which
any Beneficiary hereunder may have in Settlor's Estate or in 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, or any properties of this Trust, other than
pursuant to the express terms hereof, or directly or indirectly contests, disputes, or calls into question,
before any court, the validity of this Trust Agreement, then:
I. Such Beneficiary shan thereby absolutely forfeit any and all beneficial interests of whatsoever
kind and nature which such Beneficiary or his or her heirs might otherwise have under this Trust
Agreement and the interests of the other Beneficiaries hereunder shall thereupon be appropriately
and proportionately increased; and
2. All of the provisions of this Trust Agreement, 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
3. Such claiming, electing, or contesting Beneficiary, if then acting as a trustee hereunder, shall
automatically cease to be a Trustec and shall thereafter be ineligible either to select, rcmove, or
become a Trustee hereunder.
Section 7.03 - Specific Omissions
Any and all persons and entities, except those persons and entities specifically named herein, have been
intentionally omitted from thIs Trust Agreement. If any person or entity shall successfully challenge any
term or condition of this Trust Agreement, then, to that person or entity shall be given the sum of one
dollar ($ I .00) in lieu and in place of any other benefit, grant, or interest which that person or interest may
have m the Trust Estate.
Section 7.U4 - Benefits Confidential
The Settlors further declare that it is their desire and intent that the provisions of this Trust Agreement are
to remain confidential as to all parties. The Settlors direct that only the information concernmg the
benefits paid to any particular Beneficiary shall be revealed to such individual and that no individual shall
have a right to infornlation concerning the benefits being paid to any other Beneficiary.
ARTICLE EIGHT
General Provisions
Section 8.01 - Distribution in Kind or in Cash
On any dIvision of the assets of the Trust Estate into shares or partial shares, and on any final or partial
distributIOn of the assets of the Tmst Estate, the Trustee, at his or her absolute discretion, may divide and
distribute undIvIded interests of such assets on a pro rata or non-pro rata basis, or may sell any part of or
all of such assets and may make diVIsions or distributions in cash or partly in cash and partly in kind. The
decision of the Tl1lstee, either prior to or on any division or distribution of such assets, as to what
constItutes a proper dIVIsion of such assets o[the Tmst Estate, shall be bmding on all persons interested in
any trust provlded [or in thIS Trust Agreement.
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Section 8.02 - Spendthrift Provision
Neither the principal nor the income of the trust shall be liable for the debts of a Beneficiary. Except as
otherwise expressly provided in this Agreement, no Beneficiary of any trust shall have any right, power,
or authority to alienate, encumber, or hypothecate his or her intcrest in the principal or income of this
Tnlst in any manner, nor shall the interests of any Beneficiary be subject to the claims of his or her
creditors or liable to attachment, execution, or other process of law. The limitations herein shall not
restrict the exercise of any power of appointment or the right to disclaIm.
Section 8.03 - Definition of Children
Thc terms "Child" and "Children" as used in this Agreement mean the lawful issue of a Settlor or of the
Settlors together. This definition also includes children legally adoDted by a Settlor or by the Settlors
together.
Section 8.04 - Handicapped Beneficiaries
Any Beneficiary who is determined by a court of competent jurisdiction to be incompetent shall not have
any discretionary rights of a Beneficiary with respect to this Trust, or to their share or portion thereof.
The Trustee shall hold and maintain such incompetent Beneficiary's share of the Trust estate and shall, in
the TlUstec's sole discretion, provide for such Beneficiary as that TlUstee would provide for a minor.
Notwithstanding the foregoing, any Beneficiary who is diagnosed for the purposes of governmental
benefits (as hereinafter delineated) as being not competent or as being disabled, and who shall be entitled
to governmental support and benefits by reason of such incompetency or disability, shall cease to be a
Beneficiary of this Trust. Likewise, they shall cease to be a Beneficiary if any share or portion of the
principal or income of the Trust shall become subject to the claims of any governmental agency for costs
or benefits, fees, or charges.
The portion of the Trust Estate which, absent the provisions of this section, would have been the share of
such incompetent or handicapped person shall be retained in trust for as long as that individual lives. The
Trustee, at his or her sole dIscretion, shall utilize such funds for the maintenance of that individual. If
such indiVIdual recovers from his or her incompetency or disability and is no longer eligible for aid from
any governmental agency, including costs or benefits, fees, or charges, such individual shall be reinstated
as a Beneficiary after 60 days from such recovery and the allocation and distribution provisions as stated
herein shall apply to that portIOn of the Trust Estate which is held by the Trustee subject to the foregoing
provisions of thIS section. If said handicapped Beneficiary is no longer living and shall leave children
then living, the deceased child's share shall pass to those children per stirpes. If there are no children, the
share shall be allocated proportionately among the remaining Beneficiaries.
ARTICLE NINE
Successor Trustee Appointments
Section 9.01 - Trustees
All Trustees are to serve without bond. The following will act as Trustces of any Trusts created by thIS
TlUst Agreement, in the following order of succession:
First:
The undersigned, John C. Darcy and / or He/en F. Darcy.
Second:
The Surviving Spouse.
REVOCABLE LIVING TRUST AGREEMENT
Page 18
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Third:
Fourth:
At the death or Incapacity of the Survivmg Spouse, Joseph M. Darcy shall serve
as FIr"t Successor Tmstce, ~
Gerald 4 Darcy shall serve as Second Successor Tmstee, t
Last:
Section 9.02 - Allocation and Distribution of The Trust Assets
The Tmstees shall allocate, hold, administer, and distribute the Tmst Assets a
I. Upon the death of the first Settlor, the Tmstee shall make any separate distributions that
have been specified by the deceased Settlor. The Tmstee shall also take into
consideration the appropriate provisions of this Article.
2. Upon the death of the Surviving Spouse, the Trustee shall hold, administer, and distribute
the Tmst Assets in the manner hereinafter prescribed.
Section 9.03 - Personal Property Distribution
Notwithstanding any provision of this Trust Agreement to the contrary, the Trustee must abide by any
memorandum by the Settlors, particularly that contained in the section entitled "Special Directives"
incorporated into thIS Trust Instrument, directing the disposition of Trust Assets of every kind including,
but not limited to, furniture, appliances, furnishings, pictures, china, silverware, glass, books, Jewelry,
wearing apparel, and all poliCIes of fire, burglary, property damage, and other insurance on or in
connection with the use of property. Otherwise, any personal and household effects of the Settlors shall
be distributed with the remaining assets of the Trust Estate.
Section 9.04 - Liability of Trustee
The Tmstee will not be responsible or liable for any loss which may occur by reason of depreciation in
value of the properties at any time belonging to the Trust Estate nor for any other loss which may occur,
except that the Trustee will be liable for each Trustee's own negligence, neglect, default, or willful wrong.
The Trustee WIll not be liable or responsible for the acts, omissions, or defaults of any agent or other
person to whom duties may be properly delegated hereunder (except officers or regular employees of the
Tmstee) if such agent or person was appointed with due care. The Trustee may receive reimbursement
from the Tmst Estate for any liability, whether in contract or in tort, incurred in the administration of the
Tmst Estate in accordance with the provisions hereof, and the Tmstee may contract in such form that such
Trustee will be exempt fi.om such personal liability and that such liability will be limited to the Tmst
Assets.
Section 9.05 - Successor Trustees
Any Successor Tmstee shall have all the power, rights, discretion, and obligations conferred on a Tmstee
by this Trust Agreement. All rights, titles, and interest in the property af the Trust shall immediately vest
in the successor Trustee at the time of appointment. The prior Tnlstee shall, without warranty, transfer to
the Successor Trustee the eXlstmg Trust property. No Successor Tmstee shall be under any duty to
examllle, verify, questlOIl, or audit the books, records, accounts, or transaction of any preceding Tmstee;
and no Successor Trustee shall be liable for any loss or expense from or occasioned by anything done or
REVOCABLE LIVING TRUST AGREEMENT
Page 19
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neglected to be done by any predecessor Trustee. A Successor Trus~ee shall be liable only for his or her
own acts and defaults.
ARTICLE TEN
Rule Against Perpetuities
Section 10.01 - Perpetuities Savings Clause
Notwithstanding any other provision of this instrument, the Trusts created hereunder shall terminate not
later than twenty-one (21) years after the death of the last survivor of all Settlors and any other
Beneficiary or Beneficiaries named or defined in this Trust living on the date of the death of the first
Settlor to die. The Trustee shall distribute remaining Trust principal and all accrued or undistributed net
income hereunder to the Beneficiary or Beneficiaries, If there ;s more than one Beneficiary, the
distribution shall be in the proportion in which they are Beneficiaries: if no proportion is designated, then
the distribution shall be in equal shares to such Beneficiaries.
ARTICLE ELEVEN
General Provisions
Section 11.01 - Governing Law
It is not intended that the laws of only one particular state shall necessarily govern all questions pertaining
to all of the Trust hereunder.
I, The validity of the Trust hereunder, as well as the validity of the particular provisions of that
Trust, shall be governed by the laws of the state which has sufficient connection with the Trust to
support such validity_
2. The meaning and effect of the tenns of this Trust Agreement shall be governed by the laws of the
Commonwealth of Pennsylvania.
3. The administration of this Trust shall be governed by the laws of the state in which the principle
officc of the Trustee then having custody of the Trust's principal assets and records is located.
The foregoing shall apply even though the situs of some Tmst Assets or the home of the Settlor, a
Trustee, or a Beneficiary may at some time or times be elsewhere.
Section 11.02 - Invalidity of Any Provision
If a court finds that any provision of this Trust Agreement is void, invalid, or unenforceable, the
remaining provisions of this Agreement will continue to be fully effective_
Section 11.03 - Headings
The use ofheadmgs in connection with the various articles and sections of this Trust Agreement is solely
for convenience and the headings are to be given no meaning or significance whatsoever in construmg the
terms and prOVIsions of this Agreement.
REVOCABLE LIVING TRUST AGREEMENT
Page 20
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Section 11.04 - Internal Revenue Code Terminology
As used herein, the words "Gross Estate," "Adjusted Gross Estate," "Taxable Estate," "Unified CTedlt,"
"State Death Tax Credit," "Maximum Marital Deduction," "Marital Deduction," and any other word or
words which fTOm the context in which it or they are used refer to the Internal Revenue Code shall be
assigned the same meaning as words have for the purposes of applying the Internal Revenue Code to a
deceased Settlor's Estate. Reference to sections of the Internal Revenue Code and to the Internal
Revenue Code shall refer to the Internal Revenue Code amended to the date of such Settlor's death.
REVOCABLE LIVING TRUST AGREEMENT
Page 21
''0
SPECIAL DIRECTIVES
OF
JOHN C. DARCY
1, JOHN C. DARCY a resident of the County of Cumberland, Commonwealth of Pennsylvania,
being of lawful age, and of sound and disposing mind and memory, and not acting under duress, fraud, or
undue influence, hereby make, publish and declare this to be my Special Directive, and I incorporate THE
JOHN C. DARCY AND HELEN F. DARCY REVOCABLE LIVING TRUST AGREEMENT.
FIRST
The natural objects of my affection are:
1.
My Wife -
Helen F. Darcy
2.
My Children -
Joseph M. Darcy
Gerald ~. Darcy
r
SECOND
THIRD
f
In the event GERALD * DARCY should predecease me, then his share of the Trust Estate is to
be given to JOSEPH M. DARCY. In the event JOSEPH M. DARCY should predecease me, then his
share of the Trust Estate is to be given to ~A:R&Y. In :he event JOSEPH M. DARCY and
f1~qlII n~"LAFf\ULA D~CY predecease me, then theirlls~~~.,x,~)the Trust Estate shall be given to GERALD M.
DARCY. (bt\ /1i\' q~) !1 Ill? I A ffjOLA i}MCV
-r6(l,v4 p,q([.c,/
FOURTH
In the event all of my named beneficiaries and their children and issue predecease me, all of the
trust estate is to be distributed to my heirs at law.
FIFTH
I direct that if a beneficiary is indebted to me then his/her share of thc Trust Estate will be
reduced by a prorated formula amount which shall be distributed equally to the other Beneficiaries.
REVOCABLE LIVING TRUST AGREEMENT
Page 22
.,
SIXTH
I direct that BARBARA C. DARCY and W,L. FORSBERG shall each be given the sum of
$ I 00.000_00.
SEVENTH
I direct that, before any distribution of the assets of the Trust Estate to the named Beneficiaries,
certam specific distributions, if any, shall be made from the assets as set forth on the list attached hereto
and marked "Exhibit A."
EIGHTH
I hereby acknowledge and accept the "Special Directives," if any, of my spouse,
REVOCABLE LIVING TRUST AGREEMENT
Pagc 23
"
.'
SPECIAL DIRECTIVES
OF
HELEN F. DARCY
I, HELEN F. DARCY, a resident of the County of Cumberland, Commonwealth of Pennsylvania,
being of lawful age, and of sound and disposing mind and memory, and not acting under duress, fraud, or
undue influence, hereby make, publish and declare this to be my Special Directive, and I incorporate THE
JOHN C. DARCY AND HELEN F, DARCY REVOCABLE LIVING TRUST AGREEMENT.
FIRST
The natural objects of my affection are:
1.
My Husband -
John C. Darcy
2.
My Children -
Joseph M. Darcy
Gerald ~ Darcy
r
SECOND
THIRD
In the event GERALD ~ DARCY should predecease me, then his share of the Trust Estate is to
be given to JOSEPH M. DARCY. In the event JOSEPH M. DARCY should predecease me, then his
share of the Trust Estate is to be given to PAULA DARCY. In the event JOSEPH M. DARCY and
!JArl fJ.. fAoJlPAULA. DARCY predecease me, then their share of the Trust Estate shall be given to GERALD M.
DARCY. ( ~Z'1: '" I),),^" ) 11 A R I A r A Ol- A
\..; j( /( /v,^ O/:-,./Z c ~'I
FOURTH /
In the event all of my named beneficiaries and their children and issue predecease me, all of the
trust estate is to be distributed to my heirs at law.
FIFTH
I direct that if a beneficiary is indebted to me then his/her share of the Trust Estate will be
reduced by a prorated formula amount which shall be distributed equally to the other Beneficiaries.
REVOCABLE LIVING TRUST AGREEMENT
Pagc 24
"
SIXTH
I direct that BARBARA C. DARCY and W.L. FORSBERG shall each be given the sum of
$100,000.00.
SEVENTH
r direct that, before any distribution of the assets of the Trust Estate to the named Beneficiaries,
certain specific distributions, if any, shall be made from the assets as set forth on the list attached hereto
and marked "Exhibit A."
EIGHTH
r hereby acknowledge and accept the "Special Directives," if any, of my spousc_
REVOCABLE LIVING TRUST AGREEMENT
Page 25
...
"
DATED to be effective this
7 f- day of __~-
'").--vc '--
'~ D~" \#- D
HELEN F, DARCY
/ ft ~ f- () t''p~
HE EN F. DARCY
COMMONWEAL TII OF PENNSYL V ANLA
COUNTY OF CUMBERLAND
This instrument was acknowledged before me on the date herein set forth by JOHN C. DARCY
"Selllo, ,oJ Co-Tell,l" 10 "My wh;ch w;lne" my h~J ",1 O'~ffi". . .
Notary Public, wewllbauftRe~\l~~ry Pub1ic
City of Philadelpl,ia. Pfiii.ae ph~O C~~Y
~ My COlOmis5\on Expires Apr, '
Member, PennsylVania AsSOCiation of Notanes
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
V
Notary Public, Commonwealth of Pennsylvania
. DARCY
This instrument was acknowledged before me on the date herein set forth by HELP
as Settlor and Co-Trustee to certifY which witness my hand and seal 0 office.
NOlanal Seal
William M. Hankins, Notary Public
City of Philadelphia. Philadelphia County
My CommissIOn Expires Apr. 30, 2006
Member, PennSylvania Association of Notaries
REVOCABLE LIVING TRUST AGREEMENT
Page 26
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THE JOHN C. DARCY AND HELEN F. DARCY
REVOCABLE LIVING TRUST AGREEMENT
Declaration of Intent
The undersigned hereby declare that, as Trustee of THE JOHN C. DARCY AND HELEN F.
DARCY REVOCABLE LIVING TRUST, they are acqUIring and will hold in the name JOHN C.
DARCY and HELEN F _ DARCY, but without further reference to their fiduciary capacity, all items listed
on the attached schedule(s) hereto and incorporated herein as amended, from time to time, as well as
household furnishings, automobiles, jewelry, bank accounts, securities, bonds, clothing and other personal
property of any k111d in their name or in either of their names and henceforth such assets shall and will
belong to said Trust and not to them individually; and they further declare that, except to the extent of
interest provided to them under the terms and provisions of said Trust, they have no personal interest in
any of the above itemized personal properties, it being intended and this Declaration constitutes an
affirmation of Trust ownership and an assignment to this Trust and shall be binding on their heirs,
administrators, executors and assigns_
T~WHERE~F~Z Ed"'ign'd h,v, "~u,,d <hi, iO:.lrumont thE ..~ r:,y of
;J /r1IJll.~/!e!/
/;.roW C:15ARCY / //
/. I
,/ Settlor/Trustee !.//
leI ~ c"fL 0 DJ--L7
HE EN F. DARCY
Settlor/Trustee
COMMONWEAl,TH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
BEFORE ME, the undersigned authority, on this day personally appeared JOHN C. DARCY and
HELEN F_ DARCY, known to me to be the persons whose names are subscribed to the foregoing
instrument, and acknowledged to me that they executed the same for the purposes and consideration
there111 expressed and in the capacity therein stated.
/
SUBSCRIBED AND SWORN this ], j
doyof h/ ../
(J/
/I.
Notary P
" oI11l1WJlWftlaltt\\ of P.eillil~yl nia
H' k n< .Notary Fom'
Winiam. M. ~l:" I Philadelphia County
City of Phl13delp E ire> Apr. 30. 2()()6
My CommlS",or: JXp N lanes
- ASSOCiation ot 0
Member. pennsytval1la