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HomeMy WebLinkAbout12-08-05 CHARLES E. SHIELDS, III ATTORNEY-AT-LAW 6 CWUSER ROAD Corner ofTrindle ond Clouser Roads MECHANICSBURG, PA 17055 GEORGE M. HOUCK TELEPHONE (717) 766-0209 (1912-1991) FAX (717) 795-7473 December 8, 2005 Register of Wills Cumberland County Court House I Court Square Carlisle, PA 17013 Re: Estate of Glenn G. Voneida No. 21-05-00317 Dear Register of Wills: Please find enclosed for filing 2 copies of the Inheritance Tax Return for the Glenn G. Voneida Estate as well as Check No. 5623, in the amount of$45.00 for additional probate, Check No. 5624 in the amount of$15.00 for the filing fee and Check No. 5625 in the amount of $697.83 for Inheritance Tax due. Thank you for your kind attention to this matter. Very truly yours, ~~~~ Charles E. Shields, III Attorney-At-Law CES/mjj Enclosures COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 006077 VONEIDA PHYLLIS E 1604 MCCORMICK ROAD MECHANICSBURG, PA 17055 ACN ASSESSMENT AMOUNT CONTROL NUMBER nn_n_ fold _______n_ .__nn_ 101 I $697.83 ESTATE INFORMATION: SSN: 213-20-5756 I FILE NUMBER: 2105-0317 I DECEDENT NAME: VONEIDA GLENN G I DATE OF PAYMENT: 12/08/2005 I POSTMARK DATE: 1 2/08/2005 I COUNTY: CUMBERLAND I DATE OF DEATH: 03/09/2005 I I TOTAL AMOUNT PAID: $697.83 REMARKS: P VONEIDA CHECK# 5625 INITIALS: VZ SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WillS REGISTER OF WILLS R:E\l-1500 EX (6-00) REV-1500 OFFICiAL lJSE ONt Y COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RETURN FILE NUMBER DEPT. 280601 .2.1 DS- ~.Q.~~L HARRISBURG, PA 17128.0601 RESIDENT DECEDENT - -- COUNTY CODE YEAR .NUMBER DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER I- VONElt>A, G-Lt:NN G, .2 1.3 -.:lO - S7Sfc z w DATE OF OEATH (MM.DD.YEAR) DATE OF BIRTH (MM.DO.YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE C W 03 -09- :looS /tJ -/7 - /'123 REGISTER OF WILLS (,) W (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, ANO MIDDLE INITIAL) SOCIAL SECURITY NUMBER C /1M' E /J) .+, PHy L.L. /$ E. /{dp -;(.0 -57tJ't w .1ZJ 1. Original Return o 2. Supplemental Return o 3. Remainder Return (date of death prior 10 12-13-82) ... ~:$U) o 4. Limited Estate D 4a. Future Interest Compromise (date af death after 12-12-82) D 5. Federal Estate Tax Return Required 00"- w"O ",00 [ZJ 6. Decedent Died Testate (AltachcopyofWiII) D 7. Decedent Maintained a Living Trust (AtlachcopyofTrust) ~ 8. Total Number of Safe Deposit Boxes 0..... .... .. o 9. Litigation Proceeds Received o 10. Spousal Poverty Credit (date ofdealh between 12-31-91 andH-95) D 11. Election to tax under Sec. 9113(A) (Attach SGh 0) .. .... z COMPLETE MAILING ADDRESS w NAME {'II.II-/lL~S 0/(/ELLJS ff c e. z ~ C. L/J /I Sb7t ,(Ii). 0 .. FIRM NAME (If AppIicabI&) .. /1//,-4- w fr/€ C/I/fAl/CS .8 UA"~ "d/f /7os~ .. .. TELEPHONE NUMBER 0 7/7- 71~- p;z.of 0 '" 1. Real Estate (Schedule A) (1) 0 '.. . FFICIAE'U5E ON~ n ::':5 CJ ,--j (J (2) l' :U', 17(",;z~ '-':CJ Gl --')C) 2. StocI<s and Bonds (Schedule B) I --~;_._- 7 ;.,-2:] 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) - 0 - CO r,l ~. " l:::J 4. Mortgages & Notes Receivable (Schedule D) (4) - C> - ~ ."':.' j, -, '. -n --'-> :Q 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) -0 - is _. CJ I"l"l Z (Schedule E) U1 -,-j ,:-J 0 - C> - I .c- -'-1 !;;: 6. Jointly Owned Property (Schedule F) (6) o Separate. Billing Requested ~ J7? I ...I (7) 62(,.19 ~ 7. Inter-VIVOs Transfers & Miscellaneous Non~Probate Property . , I- (Schedule G or L) 'I a: c( 6. Total Gross Assets (total Unes 1-7) t (8) ~o7. 60~. LfS- (,) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) I f, .( Of. f?(g w a:: 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 1- .:!. ;;;'r.. 95 11. Total Deductions (total Un.. 9 & 1D) (11) t f3. 'fu.9'1 12. Net Value of Estate (line 8 minus Line 11) (12) ~ ;; 9 'I.. / 3~. 61 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to lax has not been (13) - 0- made (Schedule J) 1 :J.9i 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 13 !U,q SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES Z 15. Amount of Line 14 taxable at the spousal tax f ?1S', l.:<(". If{ 0 x.oL (15) -()- !cc rate, or transfers under Sec. 9116 (a)(1.2) l- x .0!i2 (16) I (p 'l7. 1'3 IS. 507.'15 I-' 16. Amount of Line 14 taxable allineal rate . ~ 0 _0- a.. 17. Amount of Line 14 taxable at sibling rate x .12 (17) :!! 0 tJ x .15 (18) _t) - (,) 18. Amount of Line 14 taxable at collateral rate >< 19. Tax Due (19) ~tD97.i'3 j:'!: 20.0 ::HECK HERE F ~f)u ......RE ~EQUESTING..), REFUND OF -I.N OVERPAYMENr .------ .-- ~{!,f.fCJf!-'lt77t)tJ./-:-_. ~[._p~__t/c/1!.~!D.A I--€~€?Y/l/ 6c__.2i~o.r..-:.:'3J.Z G/({)S9 "f55E 1S ; . - '-'. ',...- -, .--,.-.... - _..~._-_._.,.. _.._._-~-- -,--, '--.-- -'._.._~_._,......_--- --------- . T./l.-f: (5duLc.L ~/~t_b.a3..s:..._ _.____________ __ __J/-IY,v/{/7y (Sw~) ~ /3~ '1S?, J'f_ _____ _ .,. ':17J; '2", If( 7;.f8l!' IT~ _tuG"RE j?/t/,/) .L>IA!J!f'ci'ZY 7;0 ,;eI/bda} - ..----- --.---- ..--,-, --..--- . ----..'- ._--, .-...-.-- ._ __ "fA/./) ~/./)_~L,.<7~S~ /.J&84-71ff: - ---.--.- __- _.._- -- - --_~_~;---~T~~~----t7%-~u. _ _ __ _ (~Ec~~E _~s:) _ . StHlF]) lB. _:.~-_~__..-;l,<JIlM,fri~@1--~~J-.ri,=2~--~ __~_~___ _.___ _ -~~_~_;.=~;=-_;-----. _____________. /#'~G~ez!',_~ s:t{~.z€lLC.__.________ _ ________ __ ________N... 7?L-Set..lfL/!lm._frlL_ /./~_._~______.________________ ___ ._____.~/jl/f/NjJ~~eIVE;::qtJ/,,4/< Ie. =_==--==~~?J--iz~;~~~-=--===~-__==._._______________________~=~==== _.___.. _'=_ '/3). ~~ (j( _ {f)E'I)t1fJ.lZ~/'ILIJtJ.~t:tI.ffP5'HfX)__.___.__.__.___ --------- ----- -. ~L 5;. sz;z.fj$'.__=_~ff.L_ = 1$_ _ _$.Y.(?)L[;c!:L..E_721t<'..@_-r:~)j__~7if::_____ . _--_---=_;;~=--~_~9/s;so?-i;::=~--~af~.:; 1-;z~ti___-;2~~~~~~_!~I_=_-=_===_=~_.'-_ -,"--'--"-- . ._-----. __~__ _m".___...____u _.._.._._. __ _ _.__". __.______.__..,_____~_. - ------ ,,-----.-- ._--~---.. --~-_..._-,,-- u__..~___ _____ "".,...,..,,.,'. SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF V. IV J; '1M FILE NUMBER ~ ;. I r;c.evAl G: ;2(- oS - 3/7 All property joinUy-owned _ right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. IYI& ~J( ILl J.ypM .H.t-r i'1~ - 'I7/J~Z 'linE!> /N 7lI&' IY-fAfE,S 8~ GL&'iYN (;. ~AI~//)/1 "AILJ P/lYLL/S E: YtJiYEI[)A/ ,f5 rc/V~/V7"S /N &7..H4'/IY: ,.,.) brut cloulh/l &uR. &//.,6k e~~ ~..2'~ /2#~/ZbO '1 eu s,'p. -#- 3?/;Rt? r KFo ~ ~ r ~S;/t?t?, '17 @ 7?-?>tJ rtt'r sh.U~ = .;7'/, !'S7J, #1 fA.) JUl'. ':;;'1-. t ]). P,P. :zh.....l/-. ~ ", - (. 'I. 73 c,) merr; II L-~I\d, Ea....!:: j)"iI' 0 .,,;,t q:>,.. "'it""Am lIMa Cl1slt 33} 0::15. ~ u.n;t", (B) 'i.- pt.r u,,:+ '" <l3~ ()2$.3o J). ) A-ec.r. 1); v'- deneJ D" I-t-e.K c. .::. "I~.'fe - -y;,TA-t. -" 'f 57, "IS:l.,S1 1Jececl~l\t ha.cl cmc-h..lf {y(}, ') ',nter-est- theR;n as -ru,11Y1.t '. ~ '57, q5 ;;;, Sf 7 ~ = ~~Y 97~,~~ <t In eo 11/ 111M . ;),,8'( '771&.. ;z(P , (.see mar'-// Lync;/, dafa }elfer MId e..,.,eJosu..ru of July /'I, ;;1.005' a;tf-acht.ol hereto ). TOTAL (Also enter on line 2, Recapitulallon) $ ;I, F, Cj](,.. J,fe (If more space is needed, insert additional sheets of the same size) JUL-14-2005 14:39 P.02/17 Global Private Client Group 211 Senate Avenufd: Suite SO I P,O. [lo. 0810 Call1l) Hill. Pe,m.yIV'\llia 17UOJ-08JO ~ ..rrUl Lynch 7179754600 Main 800 937 0735 Toll Free FAX 717975466:) July 14, 2005 Charles E. Shields ill Attorney-At-Law 6 Clouser Road " Mechanicsburg, P A' 17055 RE: Estate of Glenn G. Voneida Dear Mr. Shields, Per your request, following is a list of the assets held long in Mr, And Mrs. Voneida' s joint account as of close of business 3/09/2005. Account # & Title: 872-47062 Glenn G. Voneida and Phyllis E. Voneida TIC Description: CMA Account - checking, money market and investments Date Opened: 4/01/1996 Assets held long as of close of business 3/0912005: ?rice per Share Total Value Descriotion Ouantity COB 3/09/05 COB 3/09/05 Great Southern Bank 25,000 99.40 $24,850.00 Callable CD 4,50% 12/16/2009 Cusip # 39120VKFO Accmed.Int.~:__$..6A.7.3_ ML Bank Deposit 33025.30 1.00 $33,025.30 Program and cash Accrued Dividend: $12.48 Total: S57.952.51 'f11C information set ,tbnh hcrc:in was obtained from sources wTI1ch 'We believe reliaole, but we do not guarantee its accuracy. ~either lhe informahon. rtot nny opinion eXJftned.. con.,lilule! a ";QI\CltM1<m b'l ui> uf tM l1un)~ \'1\" :;.a.\c of any l'~U'rh\es (JI' C'ommoditie$_ Printed in USA. JUL-14-200S 14:40 P.03/17 ~ Merrill Lynch I am also enclosing monthly statements for February and March 2005. As per our phone conversation, I will follow-up with valuations for Mr. Voneida's IRA Account and Merrill Lynch Retirement Power Annuity next week, " Please do not hesitate to contact me with any questions or if you require additional information, Thank you. Sincerely, 8~' ~tt~ Lori S. Hoffeditz Registered Clieni Associate Enclosures .-- ..~------_.- I11c inthrmahM set forth herein was obtained from ~OUroc.'i -,vhich 'lit' btljeve n:tiablt:, nut \V(. do not guaran~ jts ~umcy. Neither The lntemn.tion, nor any opinion exprcued. conslinne$ .a iiolicnauon by us. of the: purchNe or sllle ufany securities or commodities. Priutt(J in USA. JUL-14-201215 14:4121 P.04/17 <HELP> for explanation. P205 Corp HP " MLNY/CLOSE/MIO/YTM P8.'~le 1 / 1 GREAT SOUTHERN GSBC 4 '2 1209 QS?P?j'39 45T' 1<4 '7(j,'4 h"1 1"1 NY ..' ,,- '-'- . ~.::.. . ,f ~, . _J-...I, .~. Source _ HI 99.40 ON 3/ 9/05 Pa II ge 11111!2 to .-0 Pl,r'i ad 00 Dai ly AVE 99.398 i'1ark~Mi d/Last LOW 99.40 ON 3/ 9/05 I DR-TE Price YIELD 1-'-Ofiir-'- Pr ice VIELD I DATr-'~rice . YIELD I i IF i I I 'T I , lw 'i C; I 99 40 4.541 I I I _I, _..... , I I I I I I I I I I I I I , I I j , i i , , I I I I i I I , , i ! I I I I I i I i I I I I I , , I i I , , I , , I , ! --.--.--+- I I I I I I I i ! I , Australia 61 :l"","JriioT"---. Brazil 55lt :)04a 45lfd-'---~,,,"'-i.44 20 aJO 7500 ---'I$;O=".'-';-9204IQ Hong Kong 852 2977 6000 "opon 81 33101 _0 Sin_. 65 6212 10m U.S. 1 2123182000 COP\ll"ight z 'I~ ~.P, G:199-307-1) 14-Jul-OS 12 140107 JUL-14-2005 14:41 P.05/17 39120VKFO Corp VA P21)t, Corp YA " I MElJ:rOr1lERM CD PR~/Y:rELD SC~ I ( 6/16/04) , S~~~7(l8 DAYS AMOUNT GSBC 4 '2 12/16/09 ( 86.:30 6/15/08 31 95.55 , SETTlEMEN-T DATE ... ""15 '0'3 30 31.'.47 r ",~ i ( 8/1b;08 -'1 ge: r:;c J" ..J. ... ._1 9/15/08 30 g~' 4'7 ........ ! YIELD (CD comooundJ , 10/15/08 31 9';.55 APY YIELD I 11/1S/08 31 qc C'I; .' _..1. ,~I,.; CORPORATE EQUIVALENT YIELD 1"" 1" 8 30 9i'."I7 _,;/ o/U , EURO-BOND EQUIVALENT YIELD 1 /lr~/09 31 gr ,-.., _::J .J~ DPorrrD~ E~~IV YTrl n N/A liEllol!iIli4Ei!! 7/'1" tn :30 g-' 4" I "'. ....t...... v _'... I ~. ....tl.. L _ ~b/dj ...i..' [" :'/' I" iWi 31 95.55 .J J...:], -' 4/1Ij/1I9 31 g~), S5 ppT,-r 99.4 5/15/0g 28 05'0 .,I,.\"c. D ..:1 ,"rl VI"I D 4.540268 S/15/09 :31 95,55 I....." t. _ APV YLD 4.281479 ""lHi '0'3 30 92. "f? I,. I, '" 8"6/0':] ':1" c 5 c:c l I. .. _ ..~ ,~_ . .....J.J NUI'lEER OF BONDS .. '3/16/0'3 30 :J2,47 PRINCIPAl.. 24850,00 10./15/09 31 %.S5 .., ACCRUED 64.73 i 11/15/09 '1 ':15,5!; ,J. TOTAL 2<1914. 73 --\--..-., - ---~'1-'?""-1-h-/.fiS-. :'0 92.~7 I '_.' .._,.' .. .~ Run CSHF <Go> to see more flows. AIl.l....\iQ ~I 2 ~777 8600 "'Qzi 1 51111 304B 4500 Elr"'" 44 ZO 7330 7500 119"""",,, 49 69 920410 Hong Kong 8SZ 2377 GOOO J"""" 81 3 3201 "00 SinvClf'Ol"9 65 6212 1000 U.S. I 212 31B 2000 COto"~l zooe BI___9 ~.P. G'99~ 7-0 14-Jul-05 12'09:04 ~""~.('~. SCHEDULE G INTER-VIVOS TRANSFERS & COMMONWEAlTH OF PENNSVLVANIA MISC. NON-PROBATE PROPERTY !NHERlTANCE TAX RETURN RESIO NT DECEDENT ESTATEOF . rrJ,t/~/j)!f,GLElVN' Go, FILE NUMBER .;2.;-05'- 317 . This schedule must be compieted and filed if 1I1e answer to any of questions l111roU<Jh 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY . %OF ITEM lMCl.UOETHEK.lUEOl'1l\E~ERa:,l)IE\R?B.A1lOMSH\PTCtlECE1)OOAN01\-lE OATEO'FTflIINSfT:R DATE OF OEATH DECO'S EXCLUSI~ TAXABLE VALUE ATTACH A COP'V'OFTHEDEED FOR REAL ESTATE. NUMBER VALUE OF ASSET INTEREST IFAPPlICAfl.f 1. ]:,f,( ~ f7:l-771()(p ui 41tU1U.,.,j /)WllU'sh,~ uf GLEI'II'I G-. V/)4IGlD,4- allJJ~nrl/ ';YAC~. 11'f, ~61" 3S' / PO 7", ~ -o- N/!. ~~tf: :1S' (see k fMlf/ etJt'd Idler <UtlI' dPo/; /lfAkn.. .f ttppf,elt"lf ~!; Zai~ 6y /Jlen-//I . L.yI1CI" 5o/1f1k;Jf~I1~t:I Jy ~RlJse/J ~/;ul6I r!tile<<l"h'p/1 shed AhchLP"J mer,.; /1 J.y".:h I?eI/rel11Mf ~wer 1'3$ '1S7,1'1 ~ ~. /DtJ!a -0 - 13~ 9FT.W 1I-/1/1tl/ty " &,/1lHrd 11= .:r l>t.z, 1>09 '22- PIiI/1&(' AN' A-I1I1/1,fAJ1t G/{;A/1 C, hhe/iI" &l1thCIIlIj',' ~~ - /Ay/b-s Eo !/(JIfelCU (set a#/eS4d Iiuc 44UI re/dd AtAfV'PIJ ;Jmr;~tt' ? 41err/// Lynd,) - TOTAL (Also enter on line 7, Recapituiation) $ J7gJ (q,H./~ (If more space IS needed, msert additional sheets of the same SIze) SCH~ D, Go erd.'e{. esT. or tI~I'IJ;IDIf, GL~IVII/ G. FILEi 11/0. .;2/-0'5-317 i . CII-LtulA-77pA! SflEe'T 7Q ~t!~IIfPAIVY I4ff _ A-eer: J)-+rA _, . t- ..-... . '-.'--- -,',.---...-, -'---C- d..,__"_ _____.... - .... ,_________ - ___,n_n,_n .. .on 'U - "---- i ~IfPfl[f@ /By JJ1E7UIU LY/1'(!/l #- J"7:<- 771'6'6. _.._.. _'" _....__...... _u _, ....__..........., I ! '19. I'M <I- .~ .1'111/ SLII! ~~t I~al:? .FA4MS", XU - I I, rr'l~, 6'0 .: cp Fr~~f ~k I:i;a;o sfrql'{S ,. JI )G 1.()lo33'l == I ~ ISS: 0 '1 . ___'0__- --- 1 .. :!9-,II. ~'!'It &..,,[ 49.~. '{L~;fs__. J< ~.:('- 6.1 == . /3/ IS1.5"_ un_: &K,f!Jl______________ --------- --- - --- ___ _____u_ B__ _,.___..____._...._________ ____n__ -.-------- -.--------'.--.-- ~-- ... _ :kK.~lkI~drl 5'.UJAoiTs_.. _~f.L't__ !ruu = LO,LI'! 4,fJ'{ ~~~rleJC __n n '_____n._ - ---,-',-._------', ---.----- .'---- - ------ __,__,,___,___ _,n"n" u . jr- .-.---- 'f -.. -. -. /III{ . H-J,JU/,$_:T.tc, 5tnd. 'fk.f.IIPLIcn.,'r.._]lf,lfl - l',(J.s r,oL . - 1 ,fA",. (!.J E.u I . ------- . ,. ., .u_ .lLdJ.M1tff{.,ffi.q(NllJm {/3~2.f67LtTlIt:,x I'I.I" - J1, '-73. l;l I I . Ml &wi. Kwtd fAt~ f1"J T-.... '-. ... ---..-.....,..---...-. ..--..-...... 1 : PorfM;oCI /J 8'tj. 915'u.rn~ '" - 1/.10 - 1- fO 3'1:z. 51 1-- -- : ML G/Db.J AlIDt. t=Und. ,. ,c'1 B. I, o~ <1./ s.fun;1.S - '*/7 '~4. 7lf )( ",58- - , . YVlL L","'{e r1p VAiPt f:Und 1,122,9SZtc.n;ts 'l( f "17, ;l.'f 3. 'If. /5. 'fo = : CI 8. . J11l- f3an/l UsA f!.A-sp W. &~ rr c:- 1,z,9lf9. Yo * I'N, '''51. 35" 5EP-08-2005 14:48 P.Ol/18 Thtl<OePalma While Group F~eri.k O. DePalma. CFM David C. White, CFM Vice President s.niot Financial Ad~sor Senior Financial Advisor (717) 975-4655 Merrill Lynch (717) 975-4610 Lori $, Hoffedltz Registered Client ASllCeiate (717) 975-4864 Global Privalll Client Group 214 Senate Avenue, Suite 501 P.O. Box 810 Camp HiD, PA 17001-0810 (800) 937-07$ (717)975~3 Fa. Tal Charles Shields From: Lori Hoffedilz (717) 975-4664 Menilllynch 872/ HA FalC (717) 795-7473 ....es: 1 a PIlone: Date: 9/08105 lie: Est of Voneida CCl o Urgent X 'or~ o lit.... eo_t o ".... Reply o "'- RtlO)'OIe . Ccm~ Please do not hesilate to call with any questions or if you require additional informlllion. Thank you. ~I"_ l1ioF__p/MIoglIdMd_.1do......,I.....,_orly......_oI...-...or__-. " ... _otthe F_ ~ nolthe_.......or lI\It_or-"""c .-...-"l",..._ _.,.....-......." rlDliIiId !hItMfI'tllfttiOft. di-.inI*In or~d 1M fal:lIin'IIe is dir::VY proI1lbiWd. Ifyaun.e ~thit"'" in error,'" b.... n 'T~ noarv..llv........ni""""lI\ItcngNl_ilolo"'....__......un"*'___, 'l11II'lkV"ll. SEP-08-2005 14:48 P.02/18 Globall'rivate Client. Gwup 214 Senate Avenue Suit. 501 P.O. Box 0810 Camp Hill. P(:nnsylvaoia 17001.0810 ~.errill Lynch 717 975 4600 Mdtn 800 9:l7 0735 Toll Fr.. fAX il7 975 4663 September 8, 2005 Charles E. Shields III Attorney-At-Law 6 Clouser Road Mechanicsburg, P A 17055 RE: Estate of Glenn G. Voneida Dear Mr. Shields, Per your request, following is a list of the assets held long in Mr. Voneida's Merrill Lynch IRA Account as of close of business 3/09/2005, Please note: a Historical Pricing Detail is attached listing the Cusip Number and High, Low and Closing Prices for each security. For your convenience, the detail follows in the same order as the securities listed below. I have also included the value of the Merrill Lynch Retirement Power AlUluity below. A~ount 1# & Title: 872-77906 Glenn G. VoneidalRA Description: IRA Account Date Opened: 4/01/1996 Beneficiary: Spouse - Phyllis E. Vondia 100% Assets held long as of 3/09/2005: - DescriDtion Ouantitv in shares Svmbol NM SLM Corp 12,000 nJa Flt% 3/01/2014 CD First Bank USA 15,000 nJa 7.20% 6/21/2005 Note: This CD matured on 6/21/2005. Tbe closing price as of close of business 3/09/2005 was $101.0339. A historical pricing print is currently unavailable.) The informlltiun set tonb hetein wai obtained ttom ~urCII which we bc!icve reliable. but we do not guaranu:c its QCGUt3Cy, Neifher fh.e int(mnal.iort; nor flnY QfliniDn ~. c,:Qnslitules a :>olicitation by Uli l)f the purch., nr !Ii. of any scwntiM ot commoditi~, ~t\ted in USA, SEP-08-200S 14:49 P.03/18 ~ Merrill Lynch American Growth Fund of 493.4200 AGRBX America Cl B American Capital World Bond 528 CWBCX Fund Cl C American Funds Income Fund 868.4 740 IFABX Of American CI B Lord Abbett Affiliated Fund 1332,8070 LAFBX CIB ML Bond Fund Core Bond 883.9750 MBHQX Portfolio CL B ML Gk,bal Allocation Fund 1064,1580 MBLOX CLB ML Large Cap Value Fund 1122.9520 MBL VX ClB ML Bank USA RASP and cash $12,949.40 . .-----~--------------~____~_~w__________________________________________________~_____.~__________________ Merrill Lynch Retirement Power Annuity: Contract # J02Z0094ZZ Contract Effective Date: 9/17/02 Owner: GlelUl G. Voneida Annuitant: Glenn G, Voneida Beneficiary; Spouse - Phyllis E, V onelia 100% Value as of3/0912005: $133,957.84 A change in ownership was completed effective March 9, 200S. Phyllis Voneida is now listed as the owner and annuitant on this contract. The infurmation set tbrth herein WWj nbt..ned fmm :-r.lluces which wt! beliave reliable. hut we do not guannbse its a.GWt8Cy, Nc1thcr the int'ormatinrr, ntn' any ""inton expml~, constitutes .3 ~()Ilcitalson by us nftfMt purchase (IT sa1e of Any ~cturitil:l5 UT cornmorJities. Printed in lJSA. SEP-08-2005 14:49 P.04/18 ~ Merrill Lynch Please give me a call with any questions or if you require additional information. Sincerely, Ci~ ~~ Lori S. Hoffeditz Registered Client Associate Enclosures -. \ The information :;<< tbnh tt~~n was obtained from sources which we believe reliable. btlt ~ do not gQJnUl~ it$ w:;curac.:y. Neither the intormlllou. nor any opinion cxpre~. ~on$titute... a wJicltaUon by us of the purehae or Site of any !;c;curiries or commodities. Printed jn USA. SEP-08-2005 14:50 P.05/18 Historical Pricing Inquiry HH752 . SUA CORP Cuslll: 78442FBV9 MaturitY: 3/1/2014 Coull'ln: 0 D~te Hi!lh Price Low Price Close Price Volume 03/09/2005 99.140 99.140 The information has been obtained from sources we believe to be reliable but we do not 9uarantee its accuracy. Past performance is not indicative of future performance. SEP-08-2005 14:50 P.06/18 tiOIIeOltz, Lon Historical Pricing Inquiry AGRaX - GROWTH FD AMER INC Cusip: 399874205 Date Bid Price Offer Price 03/09/2005 26.670 26.670 cweex - CAPITAL WORLD BD FD INC Cusip: 1-40541301 Date 8t<i Price Offer price 03/0912005 19.880 19.880 IFAIX -INCOME FD AMER IHC Cusip: 453320202 o.te Bid PrIce Offer Price 03/0912005 lB.490 18.490 LAFIX . LORD ABBETT AFFILIATED FD IN Cusip: 544001209 Date Bid PrIce Offer PrIce 03/09f2005 14.760 14.760 MBHQX . MERllllL LYNCH BD FD INC Cusip: 590907507 Date Bid~ Offer Price 03/09{2005 11.700 11.700 MBlOX . MERRILL LYNCH GLOIlAL ALLOCAT CUlip: 589939206 Date Bid Price Offer Price 03/09f2005 16,580 16.580 MBLVX - MERlllLL LYNCH LARGE CAP SER Cu.ip: 590Z1R770 Date Bid Price Offer Price 03/09f200S 15.400 15.400 The information has been obtained from sources we believe to be reliable but we do .not guarantee its accuracy. Past performance is not indicative of future performance. SEP-08-2005 14:51 P,07/18 0.... ;t z '8 ~QOl "' omCl)r- OO~~;:g~OQ ~ ~ . !l iO" ~ z ",Old!! ! (J<n :::f'O ~-C!S~(liC\!<II a~.O::l .. -gS<O '11 =3 ;o.Cl ~ i3'C ~(r'8 fe..~ a 0- .. . "!Il.",~.~ 3 ms: 0 tDl[s:!I: !:~;!:!:\ ~3~ ::l. <II . ....~3-€o CI) III f' " ",~'C 2: - ~ won -(1)(0_'::1 "'0 o;:a r- III ,.. t: ::J<<D 3 0.. '11 5'~ g) 0- 5>"''' =' tt1co-9L'< 3 ~~I~Rl ""'s ~g-- g. Q .. tn aa,9ti> .. 5(ll1(tl :: -< iil~a 2<:: 1I;n zrn -",.. ii ",Ol_ .. "';c 8 go~zo )>" ""E"C ..'" 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"" '" " '" 0 0<'" ~ 0 '" ...,0 ... ~~~~~~ i ~"l 0"- .. f " .. " ..~Clcl\\ \: t\ ! ~ ;a- t <h \ ~?\~~ a' "'% . ~ ... emodOd " i "';> ~ 'e ... lJl; 1A~W.tIl ... ."..".."..".."." '" -< c ~ '" ~ ~~~~~~ Sf. " .. ~ 0 <h'!' ",0 <h t "CItd~'"d'd>q '1 ..., '0'" ... ~ 00 '" ... ~ 0" " ,,0 . '" ... ~ ." ~i 2 .., ~ '0 ~ ~ ... 't. ~ ~ ~ .. ~ . '!l '11 ~ n' " -I i <h II> t: t <h .... .. ... ",,,, ~ ~ .... '" ... . -< .. 0'" (l) .... ... 'l\ ~ ... ... 0" '" " " '" Ii ... ... ..; ..; ... .. " \ '", '0 ,,'" 0 " 0 g: 0 " 0 " '" ... '" ... .. ,~ a- N ," i ~ 0 '" '" 0- .. REV-1511 EX+ (12.99) . '*' SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER VOMGIDIf-I GLGJtlIV G_ ;21-05" -317 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. 5E:E130l.b r u 1/ G7e.Rl- ()F S I:l.IN'i.G/2{)tJG, P-4 ~ V, L, HNJt Ii? ~, ~Z{).S-{) ~. K.4-Y LA-Alb/'S, Ft(AI~ /JIS/-t. ',8 :3 3.3. 9tJ ..3, 41',dt.€e~, FUAlE7e#i /J! .!f7'fL .5GL/NSG~tJt:, PA , , I 1/, Z~ 1- I/P4/pR/heI Uhf /lEV'. KEItH SG7he~SS ~ 7C .sz;,oo S. f/IJ.YJlttRSf IJ1 IF /11 P AVI'/-i-S , /11 /{ Ale Y, ~,,( 'Jl II 7 {,{,. {) () (5/$ P/looFS ~T'T/ftH/F1:)J B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) PHVLUS ;;;:. YPIYIi?Il)11 Social Security Number(s)/E1N Number of Personal Representative(s) II.~ - ;ze, - 57"" tu If- I V t::--n Street Address II-O'! 1It1!t!/;/l1lf1t!k DJeIYE City jJ1EIYlklVl (!S .l!JtlKG- State Pk Zip /105'S Year(s) Commission Paid: LvA-I f'S:> 2. Attorney Fees ellA-ilLES IE: Sltlb-z.L)S 1lI. of.;;1., / Of), DO 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant fJl/ViLlS E. YtlA' aM Street Address /6orj lite (!PI/Ill I t!R :JJRlJ'/F Wl'llvm City /J1Eellh//(JSGuRG- State to/! Zip 17b5r" Relationship of Claimant to Decedent Sf/Pt/S/F 4. Probate Fees 4M.d Dr; a;nJ '1>!.lAe of- Sherr c.e.rt;t,'c.aJes Jl/O;;1.,OO 5. Accountant's Fees /tIjA- 6. Tax Return Preparer's Fees /1/1,4 Add,' h'onal fltrJ6alii let 'f LJ s-, 00 7. o.,j /: h'nral short (!.erf/{,'ca1e.s T~,oo 8"- ad d/ h ',,/4i shut eerf,'';;'caie.s 18 1 2. 0" 1- hi/II? fu. Ivr in her; frulce Ia$. ;efurn , IS", t?O , /0. ///1"; ,J/selc.;me-r .s-, t7 0 1/. f'~il>tbursemcn.t f.c, Chrules E. c5/','e/dof ~ 7Jkl-o~/es. f3 I. :1.0 !psherel (! erf,'f. 1H4/1/II'fS, t:1~. (es/i",.) TOTAL (Also enter on line 9, Recapitulation) $ II, 20/. go!; (II more space is needed, insert additional sheets of the same size) V,L. Sccbold FUlIcr'al I-IOIllC 60 J N. Iligh Slreet Sclinsgrovc,l'^ J 1870 (570)374-4131 July 8,2005 Mrs. Phyllis E. Voneida 1604 McCormick Dr. Meeltaniesburg, P^ The Funeral Service for Mr. Glenn G. Voneida \Ve sincerely appreciate the confidence YOll have placed in liS .:lIld will continue to assist YOll jll every \\'(1)' we C<lI1. Please feci free to contact us ifyoll have any questions in regard to this statement. THE FOLLOWING IS AN ITEMIZED STATEMENT Or-THE SEI\VICES, r-ACII.ITIES, AUTOMOTIVE EQUIPMENT, AND MEI\CIIANDISE THAT YOU SELECTED WilEN MAKING 1'1.11> FUNEI\AL AI\I\ANGEMENTS. I. PROFESSIONAL SERVICES Services of Puncml DircclOr/SwJT . $1685.00 Embalming. $360.00 Dressing and Cosmetofogy . $S5.00 2. FACILlTIF:S AND SERVICI,S Funcrnl CeremollY, $245.00 ;), AUTOMOTIVE EQUII'MENT Vehicle to translcr remains to pUllcrallloll1c. $~5.00 r rcarse (Caskd Coach) . $175.00 Flower car or nori.ll disposition. $50.00 FUNIORAL 1I0ME SERVICJ:: CIIAllGES S2fJIJ5.mj SELECTED ~IEllCllANDJSE: Casket, 18 Ga. Steel G90 Sicrra $1-155.00 Qutcr COlltilillcr - Wilbl.'rll\clolltlccfl $1)1)5.00 Acknowledgemcllt eards. $5.0n Register Book(s) . $Ix.on Mcnwri<ll Rcconls, $2X.(lO TIm COST OF OUR SlmVICF,S, F,Qllll'~IENT, AND ~I ERCII,\NDISE $51%,00 THAT YOU 11,\ VE SEtF:CTED . . . . . . . . . . . . . Cash Ad\'llllCCS Opening Ciravc, $.'100.011 Lot and [ked . $<Hlll,OO Ncws[lnpcr Nutices - . ' S2..t2.00 Clcrg)'/M.lss OJlcring. $75.00 Ccrtilicd Copics orthe Death Ccrtilicatc . ~nllll , Flowers, $1~S.50 , I Church Sexlon. S50.00 TOTAL CASU ADV/\NCES Ai\n Sl'I':Cl,\ Is Cll,\HCES . $!..c!'..f.5fl I Tohll I Total Cost $fl(;:!O.5() I GLENN G. VONEIDA 5578 PHYLLIS E. VONEIDA Dale ~r I-a ~"'5 1604 Me CORMICK DRIVE 60-127:!!3!3 MECHANICSBURG, PA 17055-5951 04' Pay to th~V L jr,~Q~\- r-<.._ ~~\ '~1's.c-J $ Co b ~O..:J\j Order of / - .. ~~P~;-BA~& of ~~J ~~(,~~~~ ~~ Doll,,, 6J I, l'Ne B.2nk, N.A 040 ChOIce i Ccn,,,ll'A Plan f> - e V - A'~' ~~ I Fm ";::I :..- I, 1:0 :HH 2 7:>81: SO 70028 HI.II' "i)S 78 ."00001', 1',20 50." ,.\{,"r,,~,,: "e'e' ~ - ~- - --- '------ ~'''ItF" ". Jf"1,;'>o'i : STATEMENT IDATE,' ~ L1 /2 ~ , TO _ t . /1 ~ I AODAESS ,I ~'~, /' / / , -< /,l./ /7 ' A-/ .... d ' . , ~ I ; IN ACCOUNT WITH f /1 -, ~ 7i JWd ?l ~ \ ~.: " -1,/) ",,7/.. //[ j ,\,-......:: I_:g/..)' &LJ ~.P""..." Ie::- r; ,<:":15 '. ,/0' " 12_ \ . /,1/ ~ '\ ' /' tl7 z..-,.-> (7;7 /~ ;~ /~ ./ L ~5~ t-;::t; a jZ, ~ /l \ u!? /), /1. ..-J.,z<;(;1 !) r / \ I ;{.,' 10 < '0, I'L> /' ,.... 7',:j , ( / 7 ::; 2, 1<:16 , " I;,: L j ( ( 'i; a......~12. ~, :; 8101 '0, - .c:;; IZ-......<..- 6D-I27:l1313 Date I -- " '-'-' 181 6J ;::-.::: \ , ."00000:i:i:i gO,'" -- W~:"~-' """~"",, ... ,'1""" ,..":,t:..;,,..__. ~ 'li' ", " YJnnfef. - _,_ ~t l1\,. ,.,1 O~'''::) ~>. i::! ~ i APPLEBEES ~.'", Ilmil j!j(]RI10on em Ii i\ [\1\1; 1':,1-1115 ~;lJmU[IIAimA VAl UY 1<1I,11 'if! HeGlillVE, PA, lldiO I !J70) :li'll:J:i'J , HLLC:';Sl\ IL\,ll(Jl~) DAII:: 1J3i}{15 111,11:: I,':J. 1,11f:;I'.;: Ii, . .-- 1 ** fliIi DEI' I ,~{I 1 1/2 fRY SA~AO 6,48 .. \ ',' ,,' " OJ!O::; ", ~ - I IIlI. _..:: ,..... MO "n 1., Ul If) M r:-' ~u C'- I HH L~; U::ijt: I . 'FJ I,{) N I. "- , ~ IE Ii "" 1 '" r,'") -' ['- Iii :-; I'lL HU<LOT 1. ~j() \- ,"j c; I lirdlell ellx ::!tIill ? .:; ~ ~ j 0 1/) Cl r 0 1 It.~C ".i.i~; W j \.0 0 I Lt'I'" ",,'1""" I" '"J \")\1' ~, 0 ~',;",','i", i,'," ~'Il,'J ,I, ',,~) I ,...,l. _ 1 H~il';; l~:':i!{ ! . \1"j .. ~ ' 'r Cl.P- .. --;- IT' I L1ii'ILL 1.8:1 t J, _ ) -- I i/..: ~:ANll. I! r. .1't ,. .-, '\ Lf1 ~ ", ') '4 .. ""I '''\ Lf1 I ~IATUl U.O,' " ~- ;~ t: - ;. .~ j " 1 HONEY BBU :Anu {.:J~l ~ (\;\ !.. I . ~- ~ ...... .J I H REG BE'! I;j~; , .... I 111'1"'" I'jl'u" ""II' " '" ,: \"'f'" ~=:;; 'J,Li ,1.,,,U <,oj ~; ~~, r-' ~ 1= i? ru 1 .~;f: RlG BEV 1 'i'.; ~', ' ~ u - IS i illIN"Ylll1iJ ::;;liI, f ,:1'1 l", J . ~ ~.... 0 lH f-~Hi HlV J ~:,I " * \, ~ Lf1 I CHX mill UJ9 :.. an ?. .. .; ~ <( ~ w ~ J) .J A;; cO 1 ** REG BEV I ,'J;\ I 0-"" ~ "., 1 1\11' ['IX "AI" I' 4'1 f! UJ a: 0( ') ~',.", , . \ 1', u ,1~tI 1. '- ~ WZoo... .!.I-""'I< ['- ZO::Cci' 'J ) Ui. '" ~>~!!5 .:./ ') i;;; .... 1;11"c, 1011\1.: %,[]j u,ja:co........ ~ 2-''''' 1'''' 'J' . Ot/) ,.. =~ fII,; ,)", 0"'00 -i p.."" .... 'r" t I [") , 1 "1 I)'" t Z - Z 1.0 ,.J ~.~ rn (). - d , U e ~ ( ) . '_ , ..J 0 <: ~ ~ _v 1 'I > hi ' ) I I" 1 I.' ",' .. 1 I,' '.H I z..J::'", -: i,x 0 ,.", <.. ,.)7._ d..~..:J I ~~~lrl:.-'2 ~ 3" PI EM~E I'P.Y: 1 11 . ~/fi ~ ~~....~ ~o ~ \ 4L Cllld,jCL III JF : II. (I() . IIiXi IIt,IL fiN 0111 11IHill 1.!,li;;:1!1 ;;I.INfi:l Vljll 1,,:1'.\ II it lit ltnd I"U ~~l 'II III ,flU It (lUt., lIH'! ::.idlfle uredt j'tj(Jd. f'1~1 dill! t:UI1\'f:~lllt;1I1 rnlUY j I ;,t lht~ 01 f kb lit :tt l\l.:\m~ Ca 11 ~~70..Jl.; f;c,.j(; lti. tp. "':.".11181'U::,t:0Il_ltJ:i. 'lil:: > .. - -~..- , ~ . , GLENN G. VONEIDA [ PHYLLIS E. VONEIDA 5522 ~ 1604 Me CORMICK DRIVE D .:J -/-'> \: ) MECHANICSBURG, PA 17055-5951 1i0-1273/313 atc - It 041 ~ Pay to the f( Is:. ' Q r I $,.50 ,~~ Order of 3'-V, .. .--1 !; "-<,' ~ ~ P~~. , ' .. -, ~A."'Q.. ~ -Dollars 6]"""- ~~ ;:-_'-!'o ~ _~ ...... , ;;:.;:::.":... " 0~ 'PNCBAN< -,--.-- PNC Bank, N.A. 040 Choice a..-nlraIPA Plan e - ~ Fo, ~~ 'ie-,Ic - , --""-t. ~ ",' I ~~ M> 1:0:l ~:l ~ 27 :l81: 50700 28 7 ~ 411' (755 22 . ,,~ /0000005000," ....-,..,..._...... . )1:~M,,~~ ~ ~ ""'.' CONDITIONAL SALES CONTRACT: S"bj~' to !~m' ood ,cod""," ""'~ end ".~", ~ ,. . side. 1 or we. the undersigned buyer or buyers. dQ hereby agree 10 buy .rems os speCIfied. - ~ 301 N. Main Street. Muncy, PA 1nS6 . /' ^ ( r. I (570) 546-5022 ~ P...\ . l~ ([, JOU Terms:. -. OnComplelioo_ ~-L(. -t?:::7 9,. ' , ~ eu,... f i,,.., \"'_:"'V -2. If <>-"\'-"--"'- b:... "'- CREDIT \!AlANCE ,-,D/t/lfJflL)Y(?'T, (760 ]A ~ ~ P/fJ 1 L L / ~ 1/ LJ AJ LillY] fO~~::::N /6LJ 1./ Jv{cL.LJ ~ N lLJ.< ~ /( DA r Jl.- M ~f.\AJufLS (][)1?6 k1 !72lS5 l>~ - &w -.-~.~"' I' CiV \7 P.6' d?'t! f)l\! 'I [) ( ;d)f f-JIJ )~7 T HEAD " GLENN G. VONEIDA 5601 PHYLLIS E. VONEIDA ',1;04 MC CORMICK DRIVE 10- 10".. () .'5- "-IZl"'" MECHANICSBURG. PA 17055-5951 I)<lfc . 041 ',- ~>;,:, t', M~71 '. , " 0 ;"e - '1 ...,- (" O;.'~..' c::?:~ ~~.'J ::::~~ I $ /2- f,C%t _ . FOqr.._~._ ,"';1;: . ~ .....s:...:J ( ~ c.-'.- A'-,-..-:::I" X \ - 2- .A _~- - \ --- .l. '-~~ ~ '" ~ "",_0"'. --------'Ooll"rs UJ ~:;:":..":'... ~E C/ ~jPNCBAN< . e\ WR[;€.f< 'PNC B,"k, NA 040 ChOIce + 3 a.;ntral PA I ~ Plan _ '''I _~- _ _ " -fI -' .Jt; ~'I . .' "" \ ( ", For !""J^( ~\~~.-- .,.,.....".., '" f-{t(0~ ~- \J (:j->y'-~~'- oW ':0:n;\~2?=lBI: 507oo2a7~L.II' '51;0~ 0"0000l.21;1;00,1' ..(........-.....~ i ..:,1, '.~ h.." "} V .....: ',,' ---~-- GLENN G. VONEIDA Y V r ~PHYLLIS E. VONEIDA 5574 / I 1604 Me CORMICK DRIVE . . ~ MECHANICSBURG. PA 17055-59 1 I),Ho.: .1_ r.L - U .::>--- 60-12731313 H Ml '!,' P,lY to the V .-.. \:OrdCfoJ I $d OO...s>-- F C~ '~...... ~ I) A"'."." ~PNCBAN< - oil,,, '";:~"':.. PNC nilnk, N.^-. 040 Choice c....nlral PA PJan 1 Foe /~,~ V~~ w ':0'3 03 ~ 2 ?=lB.: 50700 2B 7 ~ 1.,11' 5 ~'~I., .~ooOoo 5000;:;' 0"'",......__ """"ex.'".,,,. SCHEDULE! ^< DEBTS OF DECEDENT, COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF J/~I/FI/)A CLENIV r;.. FILE NUMBER 2.(-0 S -3/7 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1. IVR/GI/IiP.e M7tE /lrl/fI'1/J/.4eV Si:7eJ//~ / Pr Y..~ ~,4. JiC .:l1.;;'.t?5' .l INIf - A'/A-NtJ,( URE, PF M,.eL/$L€ /,1, F , :1,0 .z 9. 00 ~. /Y E/G/f 1ipR f!/M!.E ;J;f(~ltfJ1AeY S;-5,tf1"l(!~ ~r Y~,e; P'A ? <15 1- GUIS-rW/ IE: PAm/LV ~M(!71CG , ~r t'!NtL./St.~ ;11,.(- I' .z I. bS- TOTAL (Also enter on line 10, Recapitulation) $ d, J :U, fe, qs- (If more space is needed, insert additional sheets of the same size) ttf~ .. NeigttJorCare. BILL FOR SERVICES PAGE: 3 of 3 '% ,~,-~.. CUSTOMER NAME BILLING DATE ACCDUNT NO. '.' ". . :J.f19 CONCORD RD. GLENN VONEIDA 02/28/05 21-23136 YORK, PA 17403 . NCPDP#: 3972634 fACILITY . PRIMARY PHYSICIAN PHONE: 8B8,565-6708 MCHS CARLISLE #21 ". . HOURS: M-F B:30 AM . 5:00 PM GUISTWITE, DARRYL'" DATE RX# TRANS I NDC CAT. OESCRlPTtON I PHYSICIAN Cry. I $ AMOUNT 12/17/04 R5771502 CREDIT 51079023320 RX CIPROfLOXACIN 500MG TABLET GUISTUITE 7 .~6.21 DAYS SUPPLY: 7 12/17/04 R577304B CREDIT 51079023320 RX CIPROfLOXACIN 500MG TABLET GUISTWITE 2 -15.20 DAYS SUPPLY: 1 .' \ /'JFC . 'WhenYovThinkjo4f;... I , \ Staffing Associates , Think TFC! ,---- - [ -:. _m ! -"-' 1 YoM( '3 -d ]_~S g-S .-/' ~ (}.' lE DISREGARD THIS MESSAGE. T E TOTAL UE IS OW IF YOU ~P PAST D E ,y PROMPTL YI FOR YOUR CONVE IENCE, N IGHB RCARE ACCEP S -::,- .:J- ::-- ~ICAN EXPRESS. L-~' ~/J. ?:>/O5 ! fF:. .. . .' , H: U~t.lIUIII 276.74 0.00 201.64 0.00 $220,19 DAVS OUTSTANDING AGED BALM-ICE 111111111111111011111110111I1110 1I11111WIID 1&1 Will ~ , r .-f' ~. ~- I ,,; " GLENN G. VONEfDA ',>, . PHYLLIS E. VONEIDA 5525 .. I 1604 MC CORMICK DRIVE -,., -j 'If MECHANICSBURG, PA 17055~5951 D..tc-....).--....-3.-a ,")- 60-1273/313 :, , POly to the 1~ .. '. 1'~ .7 '" .. I ,. (' O,,1c. of. -'--'-'2) _O~~ ~~... , <:..:c....o... A:__c"l ~ .:L, .- "_" I $ ,...1 /} _ Ss -:t .) '-.......... --t~~......"'-"""'-k.+t"s' ,,~'" ..... ^"':;. i .../ - "-". ,....~ ....'\.'\-t:;,,, "-~- .. _ ....... ".". <:::-,o;::~ ---~-" _ Dolli1r~ G:I ::::::..,;.......... ;~ ~~ PNCBAN< . ---... t J1NC Jhnlc. N.h. 040 Choice Ccmlral l'A PInn ~. Fo, -=r'v' ,\.~ '"-~j , d ...:..~ Z V c:,- . f;,. I .'" -"-;r ~ -~ ''''I-''L''---(_ ~ ':0:1 j,:I j,27:18': 50700 287j,I,II' "5525 .<'000002j,285.<' r 0__ ~. , :r \i * ., 'l ., NeighborCare'. BILL FOR SERVICES PAGE: 20f 3 Pharmacy Services CUSTOMER NAME BilLING DATE ACCDUNT NO. 3419 CONCORD RD. GLENN VONEIDA 02/28/05 YORK, PA 17403 21-23136 NCPDP#: 3972634 FACILITY PHONE: B8B-5B5,B70B PRIMARY PHYSICIAN. HOURS: M,F 8:30 AM, 5:00 PM MCHS CARLISLE #21 GUISTWITE, DARRYL ,. " , . . . . , DAYS SUPPLY: 3D 02/11/05 R5B01472 COPAY 51D790B0157 RX METOPROLOL TARTRATE 50MG TABLET GUISTIJITE 30 2 DAYS SUPPLY: 30 02/12/05 R57B5D18 COPAY 51079025520 RX METOPROLOL TARTRATE (SUB.FOR:LOPRESSOR) GUISTUITE 60 3 25MG TA8LET (RP:METOPROLOL TARTRATE (LOPRESSOR SUB)) DAYS SUPPLY: 30 02/16/05 R5804538 COPAY 51D79D75657 RX CARBIDOPA & LEVODOPA 25MG/1DDMG TABLET GUISTUITE 3D 7 (RP: SINEMET) DAYS SUPPLY; 30 02/16/D5 R5804885 COPAY 004060357D5 RX HYOROCODONE UI ACETAMINOPHEN 5MG/5DDMG GUISTUITE 15 1 . TABLET (RP:VICODIN) DAYS SUPPLY: 2 02/21/05 R579D700 COPAY 63323004401 RX CYANOCOBALAMIN (VITAMIN B-12) 25X1ML GUISTUITE 1 1 1000MCG/ML VIAL DAYS SUPPLY: 26 02/22/D5 R5808295 COPAY 49502067260 RX DUO-NEB (IPRATROPIUM AND ALBUTEROL) GUISTUITE 90 2e VIAL-NE8. DAYS SUPPLY: 5 02/22/05 R5BOB2BO COPAY 000693060B6 RX ZITHROMAX (AZITHROMYCIN) 250MG TABLET GUISTUITE c , DAYS SUPPLY: 3 02/23/05 R5B09D26 COPAY 00832121301 RX JANTOVEN (UARFARIN SODIUM) 2.5MG TABLET GUISTUITE 30 i (RP:COUMADIN) DAYS SUPPLY: 30 IF YOU PAYME T HAS A READY BEE SENT, PLEASE DISREGARD THIS MESSAGE. T E TOTAL UEIS OW PAST D E. PRO ECT YO R CREDIT RE ORD ND PAY PROMPTLY! F'OR YOUR CONVE IENCE, N IGHB RCARI ACCEP S VISA, STER RD, DISCOV R, AN AMERICAN EXPRESS. ,1< . r""~'''''''''''''''~~m"~1 :}.vu,l=lat.: RETURNS _"'~III-""'''.''~--r ""'W".-t:":"';r~"I",''''''..:r''''~''__1 ,..,: t')"111'HJ:::t " I I I ~: I OAYS OUTSTANDING ~ AGED BALANCE 111111 ~lIIl11m 1111111II11 an 01110 111I om 1110 lID lall f- . . , - IF PAYING BY MASTERCARD, DISCOVER, VISA OR AMERICAN EXPRESS, Fill OUT BEL( CHECK CARD USING FOR PAYMENT @ NeighborCare'. D 8STEACARD . ~SCOVEA I VI~] 9SA r(~KAN! 0 F.XP.1'IU AMERICAN EX ~ Pha,macy S."ic., CARD NUMBER AMOUNT 3419 CONCORD RD. YORK, PA 17403 SIGNATURE EXP. DATE NCPDP#: 3972634 ru CARDHOLDER NAME CUSTOMER NAME DUE DATE ... UJ TEMP,RETURN SERVICE REQUESTED GLENN VONEIDA 03/20/0: ... ... In ACCOUNT NO. In BILLING DATE AMOUNT DUE , '" PHONE: Bll8-565-6708 HOURS: M-F B:30 AM ' 5:00 PM .... 21,23136 02128/05 <:J o Please check box if below address is incorrect or insurance See Last Page <:J <:J informalion has changed. and mdicatechange(s) on reverse side . PLEASE OETACH AND RETURN THIS PDRTlON WITH YDUR PAYMEN "" 30713'1000ZFVWXOOQ706 Q ADDRESSEE: MAKB CHIiCKfi PAYABLII TOI ,.... ~ ru Q 1",111",111""1,1..1,1"1,1,1.1",11,,,,,1111..,,1..11",11 1."11\,\"",111",1,1,1,1\",11",1\"""111,,,1\,,,1.,1,\1 UJ GLENN VONEIDA NEIGHBORCARE PHARMACY SERVICES, INC. W8900 C/O PHYLlSS VONEIDA PO BOX 7777 604 MCCORMICK DRIVE PHILADELPHIA, PA 19175-0001 " MECHANICSBURG, PA 17055-5961 45100000021-2313600000003185760000000000220190 If~ NeighborCare' BILL FOR SERVICES PAGE: 1 of 3 t!- ~. '=~. ,,,"<- CUSTOMER NAME BIlliNG DATE ACCDUNT NO, d; 3419 CONCORD RD. GLENN VONEIDA 02128/05 21-23136 " YORK, PA 17403 , " NCPDP#: 3972634 FACILITY PRIMARY PHYSICIAN "':'" PHONE: B88-665-6708 MCHS CARLISLE #21 HOURS: M,F B:30 AM ' 5:00 PM .. GUISTWITE, DARRYL " '. . . . . . . , . . 02/16/05 CK55D9 GP PAYMENT. THANK YOU! -258.19 12/17/04 R5773048 COPAY 51079023320 RX CIPROFLOXACIN SOOMG TABLET GUISTWITE 2 2.85 DAYS, SUPPLY: 1 02/D6/05 R5797261 COPAY DODD2411533 RX ZYPREXA 5MG TABLET GUISTWlTE 30 92.22 DAYS SUPPLY: 30 02/06/05 R57B1572 COPAY DOB32121301 RX JANTOVEN (WARFARIN SODIUM) 2.5MG TABLET GUISTWITE 30 7.34 (RP:COUMADIN) MYS SUPPLY: 30 02/08/05 R5799259 COPAY ODB32121301 RX JANTOVEN (WARFARIN SODIUM) 2.5MG TABLET GUISTWITE 15 4,D5 (RP:COUMADIN) DAYS SU~PLY: 3D "- ,02/08/05 R579926D COPAY , 00B32121401 RX JANTOVEN (WARFARIN SODIUM) 3MG TABLET GUISTWITE 15 4.02 (RP:COUMADIN) " DAYS SUPPLY: 30 02/09/05 R5BOO086 COPAY 58177022211 RX ISOSORBIDE MONONITRATE ER 30MG TABLET.SR GUISTWITE 30 5.83 I' (RP:IMDUR) I' DAYS SUPPLY: 30 02/09/05 RS7B3587 COPAY DOD74611411 RX DEPAKOTE SPRINKLE 125MG CAPSULE GUISTWITE 60 19'.88 , DAYS SUPPLY: 3D D2/11/~5 R5801316 COPAY 51079D25520 RX METOPROLOL TARTRATE (SU6.FOR:LOPRESSOR) GU!STIHTE 30 ' :,.::j 25MG TABLET (RP:METOPROLOL TARTRATE (LOPRESSOR SUB)) I., DAYS SUPPLY: 3D , 02/11/05 R5B01318 COPAY 63739024501 RX TRAZODONE HCL 50MG TABLET GUISTYlTE 30 2.06 IF YOU PAYME ~T HAS ~ READY BEEt SENT, PLEASE DISREGARD THIS MESSAGE. T E TOTAL [ UE IS ~OW PAST D JE. PRO ECT YO R CREDIT RE ::;ORD ND PAY PROMPTL YI FOR YOUR CONVE ~IENCE, N IGHBC RCARE ACCEP SVISA, II1ASTERC ARD, DISCO\i ER,AN P AMERICAN EXPRESS. " . r":I.''''''"'''''''''''.~1 :J,\",l.J::l~U.,; :t~II]:I~~ I,..,"!jll-~I"',"I'''-''Y''''''''''''I. :>,' 'roj~I"'''''I'.:>'':l. "'IIII![ N: it}r"111.UI I I I I OAYS OUTSTANDING ~ 1!1III1111111111I~lIl1lll11ll11lnnllmllllll!lnlllll!11 AGED BALANCE :...f:.=. ----wPAYiN~G BY MASTERCARD. DISCOVER, viSA ORAMERICANEXPF'-ESS~Fn.L.OlJT BElOW:--' STATEMENT OF PHARMACY CHARGES CHECK CARD USING FOR PAYMENT @ NeighborCare'. DO 11I0 !mAIO 1'Wl~~'rAH 0 MASTERCARD DISCOVER VISA M>AfSS AMERICAN EXPRESS ~ Phaema,yS",;", CARD NUMBER AMOUNT 3419 CONCORD RD. SIGNATURE YORK, PA 17403 EXP.QATE NCPOP#: 3972634 ru CARDHOLDER NAME CUSTOMER NAME DUE DATE a- w TEMP-RETURN SERVICE REQUESTED GLENN VONEIDA 03/20/05 a- In ACCOUNT NO. BILLING DATE In AMOUNT DUE . .. . '" PHONE: BBB-565-6708 HOURS: M-F 8:30 AM ' S:OO PM .... 21-23136 02/28/05 See Last Page c c o Please check box if below address is incorreclor insurance c mformatlonhaschanged,andlndrcalechange(s)onreverseside. PLEASE DETACH ANO RETURN THIS PDRTlDN WITH YDUR PAYMENT '" 30713'1 GQOZFVoNXOOO706 CI ADDRESSEE: MAKE CHECKS PAVABLE TO: 61S25~6" l!l W CI 1."111."111",,1.1,,1.1,,1.1.101.,,11,.,,,1111,,..1,,11.,,11 1".111,1.....111,..1,1,1.11.,.11..,11...,..111,.,11,..1,,1,11 w GLENN VONEIDA NEIGHBORCARE PHARMACY SERVICES, INC, WB900 C/O PHYLlSS VONEIDA PO BOX 7777 604 MCCORMICK DRIVE PHILADELPHIA, PA 1917S-0001 MECHANICSBURG, PA 17055,5961 45100000021-2313600000003185760000000000220190 ?;:. r*""~~j1C';r~"" """~-- ~'-::; flICR'eManorCare Statement '-:':" { . .- '..," .... .". '. -, .~.~.v r' MANOR CARE CARLISLE 372 ,~~ 940 WALNUT BOTTOM ROAD 'iI: CARLISLE, PA 17013 ,_i. (717)-249-0085 "d'--;:' "..:' -'{ PRIVATE . PHYLISS VONEIDA - FDR GLENN VONEIDA ROOM 135 -B .~ 604 MCCORMICK ORIVE ,'. . ME C HANI C S au R G. P A 17055 Please Return This Portion With Your Payment =-r ..-..---. DATE OF SERVICE RENDeRED I CHARGES I CREDITS SERVICE - 3/01/05 BALANCE FORWARO 5,868,50 3/09/05 51801 INTERMIT INCONT-DLY FEE (QTY 9) 40,50 03/0W5 53201 NTRTNL/ENTRL SERV GRP 3 (QTY 9) 36.00 '3~705 REV LAST MO RC 5,518.00 0~!01-03/09105 ROOM CHARGE 1,602,00 "r:';" 1 .,.' , -J. PAYMENT DUE UPON RECEIPT 'n. .&..,./ .-----.. . r7 . .. .. - -..-- ~'029.00 AMOUNT DUE . ! I . . JAlflJ/:; ~ (65 i-I '1-/0 S- i) "w- ~ .!:l S 7 (' '_..'_' / ;::l "'" ~"-,,,' ~..: GLENN G. VONEIDA ~t;,.' PHYLLIS E. VONEIDA 5536 ij>", 1604 Me CORMICK DRIVE Y ~":. MECHANICS BURG, PA 17055-5951 Dol. V -i - c, S- "l-I273';l~ b.,. Pay to the m" ~;...._Ord.rDI '^' ....,......- ~ ~ - I $t.:002 0...2. ~ ~ - '/"",; .. 1.' .... ,'. ., . ~ "'.u...... .'-!-!i. --, ~ ':J::; ~ ,,--"--,,-- _\ ",-, ..-..........' ..,. ..........- \J ' ~~ ....... h. > D II A =-- ":;" QPNCBAN< 0 ." OJ --- i. PNC B.nk. N.A. 040 Choice ii':." . ~a1PA Plan , _ ~tor. : --IJJ;"z; On.: ~~V'~. 'k,~ ~~" 1.0 3 ~.j I. 2? 381: 50 ?oo 28 ? 1....11. 553 b "'DODO 20 2 '100." i;:............. .:...... ~' _ NeighborCare'" BILL FOR SERVICES PAGE: 1 of 1 ~ Pnormocy Serv;ces CUSTOMER NAME BILLING DATE ACCOUNT ND . 3419'CONCORD RD, GLE . YORK, PA 17403 NN VONEIDA 03/31105 21-23136 NCPDP#: 3972634 PHONE: 888,565-670B FACILITY PRIMARY PHYSICIAN HOURS: M-F 8:30 AM _ 5:00 PM MCHS CARLISLE #21 GUISTWITE, DARRYL OATE RX# TRANS, I 'ROC' CAT.;,"- -' ,<.' DESCRIPTION" '.' PHYSlCIAK OTY. $AMOUNT 03/28/05 CI<5525 GP PAYMENT. THANK YOU! -212.B5 03/07/05 R5816352 COPAY 51079025520 RX METOPROlOl TARTRATE (SU8.FOR:lOPRESSOR) GUISHIITE 30 2.22 25MG TABLET (RP:METOPROLOL TARTRATE (LOPRESSOR SUB)) DAYS SUPPLY; 30 03/08/05 R5816487 COPAY 00002411533 RX ZYPREXA 5MG TABLET GUISTWITE 30 92.14 DAYS SUPPLY: 30 03/08/05 R5817966 COPAY ooD06D0436B RX MEPHYTON **** 5MG TABLET GUISTWITE 2 1.23 DAYS SUPPL V: 1 02/06/05 R5781572 CREDIT 00832121301 RX JANTOVEN (WARFARIN SODIUM) 2.5MG TA8lET GUISTWITE 30 -7.34 (RP:COUMAOIN) DAYS SUPPLY: 30 2')V J" 1-' $q~. L/- \i 3. ~1 cc ". IF YOU PA~ME~ HAS A READY BEE SENT, PLEASE DISREGARD THIS MESSAGE. TIjiE TOTAL PAST 0 E. PRO ECTYO R CREDIT RECORD NO PAY PROMPTLY! FOR YOUR CONVE IENCE, N ACCEP S VISA, ASTER ARD, DISCOVER, AN AMERICAN EXPRESS, .. . ;. . . ., : . ' , 220.19 0.00 0.00 ,212.85 O,O~I 88.25 I 0,00 I $95.59 DAYS OUTSTANDING AGED 8AlANCE 88.25 1l1l111111i 1111111111I11: IIUII lIillllll 11111 III 11111 11111 ~ 11111111111I GLENN G. VONEIDA 5537 PHYLLIS E. VONEIDA .." ;.,,- " 1604 Me CORMICK DRIVE I)at~ r - .' to. ......,:::.:... ') l'O-Il.n~~~ MECHANICS BURG, PA 17055-5951 ct' -' " ,- P;lY to tho: ,1" _'" ~Q-.......)) ~:~~.~ I ...D -). 7'"-) Ordl:T or -- Q ,~ -. ,,,':,~:" '/.1. '"' ...,--, ..J.. ~==>(. _.__a --t)olbn 6J "~--".~' ~ ~_~--" 0 ....-\) _ '-~~ ,--...>-, - . ,- ~~PNCBAN<. Choice l'NC Bank, N.A (MO ) . . Ccnlul PI\ I I.lll j?(-' _ ~~ /~ r-... . ,"';r, .';., /~.-.. ~'''''.'' ..... fo' c.~'" '__" ()::f,Q.s..-~)-=-t(r"-~""'- ......- f ' ~-.".:;. 1:0:llo:l~273BI: 50700 287 lol.II' -'5537 ."00000003'.5,. -~ /-- ~ Guistwite Family Practice 522 S. PITT ST. CARLISLE, PA 17D13 TAX ID. #23-2104174 (717) 243,1516 Statement Date 03/03/05 GLENN G. VONEIDA Ac ' C/O PHYLISS VONEIDA count Number 604 MCCORMICK DRIVE 2820 (1) MECHANICSBURG PA 17055 :~~}S':Date Description Charge Credit Balance Date ".~ GLENN G. VONEIDA ( 2820.0 ( 2820.0) 01/22/05 NURSING HOME EST PATIENT L 75.00 02/09/05 Ins Pmt-MEDICARE 24.28 $21.65 was applied to your de uctible 02/09/05 Adjustment 23.00 02/21/05 Ins Pmt-CAPITAL BLUE CR03S 6.07 $21.65 was applied to your de uctible 21.65 01/22/05 TOTA FOR GLENN G. VONEIDA 21.65 _ _____"" __ _un __ _n_ GLENN G. VONEIDA PHYLLIS E. VONEIDA 5521 1604 Me CORMICK DRIVE -_-~ I __-. _ __ MECHANICSBURG PA 17055~5951 Dat~ ._.' _ I . . -<:.) 60-1273/313 I [)4\ Pay to the ,t P'" - :-- ,...-, ~ " . ~ . r,.'" 1'"- _Order of ...- -U....1_~:'IJ-; "'-~~ { .:~'(".......~ j -^..<;....,\...~.,. I $ :1-1 ~ /' C ",. . c,,, ---' ,. """ '.'., . l (" . ,S- - /-~".'Ii'--^::3 ~ .......:: r~ ,., ~'''''~~ .. "'-~ +~ -- -""-- -- Doll -9- ~....,.~ ~ ..3 6 - iHS W ".''''~',K' 0_PNCBAN< PNC Dank. N.A 040 Choice G...ntral PA Plan 1 " I . . ' (:-" I "- hlr -----( (r\--'C . ~ ~_ ~/ 0\.-........~~-"" M> ':oHH2738': 50700 2871.L,u' 55n /OoODOUnl;5.,' """"O.A-T.-R" J ~.,.J.( " . . ~_\.'" - --\ "-:' -( ,') - '" :::, .. '''-> .) r Total Due Current 31,60 Days 61,90 Days 91 -120 Days Over 120 Days ~. , , 21. 6 5 2 1. 65 0 . 00 0 . 0 0 0 . 0 co. 00 21. 6 5 (::J Please pay this "'\ r amount! REV"""'''.". SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATEOF 0 j) GLe7VAI (;. FILE NUMBER tJ /lE/ .4 / .2../ - tJ S' -.3 17 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 1. TAXABLE DISTRIBUTIONS (include outnght spousal dlstnbutions) 1. LIFE' IN-rEI(EST IN (!k!EJJrr SHEZ:r€7? SPl7u Sc: V,SUI'1I/l1i!D T/?/lST /AI ;::::/1-J"t1/( "r 5fJtptl!e" fJHYL-L/S Au p~ A?~E'r.s. Gr. YNIBDA- H/f5 ,tPFE7V j)1S'CL/f/A1ED. jk,~T.S 7IJl /f,fJ/E ~ 7?l/l /115' AF7lA?El) 7Z> 'T,e;tSnFE A.f!E LIST€V ~III StH6Zll3. (SEE l)1S'f!L/f//lft:7( k7T/fWEi:>) A- (!(!NlIJ!Al6 7/) MM' ;:IF 777'/5 ~/Kh.?N- NEIfi77f //'1 4J~/YE'e'T/t?h W/i7I rN'E tJ,PFR/I-7ltNY t?P oR/SCaf/A/ae>.. 7h'G' , Ia=-.J" l])tll: /S S'E//VG' V/ST/a'8h t"c7J 'PFR ~,o/(lIL/ k'E: /p rtJt{R7~ /K ;:b?UlJII$ : ( .)&-€ &N'r/VI{A-7?II;V ~~7) ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same slzel Selle;), J: / t'C1I7/NttYJ) ,JEST. tJj:' tWY,€I.l)4/ G?€/Y/lI C. FILE ~ 2/-/J S"-3/7 ----,,'- -\--- _.ee.ell'(&!'!r_L~.LJ~'?S n ...__.~aI(jJ'#/;O ...w~ .-7.j. ~L:.,J2~€ ---- _ L /.$-Lf~_ G&I/ftJYt€# 4j/~. ))/f/.{G/YTB(l .5ZJ% I -----" n u __ .:IlI~{!JI4-If'I.C:,f$tR,6/- ~A. /7PSS' ___ n___~4-T".4~t!ilL_~ _t2~E_______ ....G/!/!tJIJJ2J~ff-,-C'7( ,;<'0 Z, __. .'.._ _:_.4J9.tfJ!~/fl€y _!!P.A-1->__ __n __...___ .___L-1:&ft?~!'LU'A,nn.n .... .:J/~/.{ _. ,---. -~._--- ~_.___ - ____n__.._'__ _.n_........______........_____... ...._____._ _ _~_____.__.__..._..____.. _.____ t. jJ<eztY<!, Otlt1k _..___ u._ -_.-, cL~__I1f!..lJ.L_.LM.~ ._..._-~._- _NAlYIJ/JIHAGHTfl? 020~ -.,--.-.-.----'-,. . u__-t/JJEt!fLlld/~$~l/g~,.t?4~1712SJJ. ........ -'--- i ....---.- -. --..----1-......-.---------....--.------..--.. '___.____ ._ _____.__._'_n____ - '____n __ _'0_ n'__ ____n_._ .. 5;. ,gmy$,J!tJJJ!I,.ZIl.tISl'gk llR.M-T ~OAJ 10J;,. I.. .,t;~--'2, ~fJ.ElJ.Cbf!!>.~_ f Abl/dtJ~_ . -..,....---- . - ! (0 fLC.7lJR L/HfE I 1Jl~I(A-/Vle>.Bt(fZ(;" toA 1705'0 CODICIL TO LAST WILL AND TESTAMENT OF GLENN G. VONEIDA I, GLENN G. VONEIDA currently of, Lower Allen Township, Cumberland County, Pennsylvania, being of sound and disposing mind. memory and understanding, do make, publish and declare this Codicil to my Last Will and Testament dated the 22nd day of October, 1998. I revoke the residuary distribution in Item FOURTH of my said Will, and substitute in its place the following: FOURTH: I give and devise the residue of my estate, real and personal, to my Trustee hereinafter named, IN TRUST, as follows: (a) The net income therefrom shall be paid to my spouse, PHYLLIS E. VONEIDA, for life. (b) Upon death of my spouse, or in the event my spouse predeceases me, my estate shall be distributed as follows: (i) All the rest, residue and remainder of my estate, real, personal and mixed, whatsoever and wheresoever situate, shall be divided and distributed as follows: (A.) Fifty (50%) per cent thereof to my daughter, KAREN R. DREESE. In the event, however, that she has predeceased me or has died during the term of the aforesaid trust, then her share shall be divided equally between my two (2) granddaughters named below. " (8) , , "'1 Twenty (20%) per cent thereof to my granddaughter, TAMMIE E, DREESE, j!jIT '. -'-'j , ; .--~ ~, (.:1 (C.) Twenty (20%) per cent thereof to my granddaughter, KELLY S. C001{, per, stiq)es. D) Ten (10%) per cent thereof to my great grandson ALEXANDER CRAIG <;:OOK;',- >'~' ~ ~- In the event that he is under the age of twenty two (22) years at the time of his ,',.1) inheritance, this share shall be held in trust for his benefit. This share shall be invested in good and safe investments such as high-grade corporate or government bonds, preferred stocks with priorities of payment, certificates of deposit and the like, The income therefrom and so much of the principal thereof as the Trustee, in her sole discretion shall deem appropriate may be expended for his college or other post high school education. Payments may be made directly to him or to the institution providing services as my Trustee in her sole discretion deems best in any particular instance. My Trustee in making her decisions shall consider altemative sources of funding for college or other post high school education. In the event ALEXANDER determines not to further his education, he may be given distribution of income as Trustee, in her sole and absolute discretion, deems best. However, in such case, he shall not be entitled to any part of the principal until he reaches the age of twenty two (22) years. Upon his attaining the age of twenty two (22) years, any then remaining balance of principal and any accumulated income thereon shall be distributed to him outright and free of trust. I hereby nominate, constitute and appoint my granddaughter, KELLY S. COOK as Trustee. In the even that she is unable or unwilling to serve in such capacity, I appoint my daughter, KAREN R. DREESE to act in her place and stead. IN WITNESS WHEREOF, I hereunto set my hand and seal this Iq~ day Of-# A.D. 2002. -9.e,. fv.. ,,() tf>-1\ J6 {t (SEAL) Signed, sealed, published and declared by the above-named GLENN G. VONEIDA, as and for a Codicil to his Last Will and Testament dated October 22, ] 998, in the presence of us, who, at his request and in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses. ~~ ~~~ ~ (!, ~; LAST WILL AND TEST AMENT OF GLENN G. VONEIDA I, GLENN G. VONEIDA, of the Township of Lower Allen, Cumberland County, Pennsylvania, declare this to be my last Will, hereby revoking all prior wills and codicils, FIRST: The expenses of my last illness and funeral shall be paid from my estate. SECOND: I hereby give and bequeath, absolutely and in fee simple, to my spouse, PHYLLIS E. VONEIDA, all my household furniture and furnishings, books, pictures, jewelry, silverware, automobiles, wearing apparel and all other articles of household or personal use or adornment, provided that if my spouse dies before the thirtieth (30th) day following the day of my death, this gift shall lapse or be divested and 1 make said bequest to our daughter and granddaughters, per stirpes, living at the time of my death, to be divided among them as they shall agree. If they cannot agree for any reason, then these items shall be sold at public auction, our issue being permitted to bid upon such items without specific permission of the court even though they might be a fiduciary at the time. My Executor shall represent any minor child in any division of such property and shall deliver to the person standing in the place of a parent to such minor, without bond, such portion of the minor's share as my Executor, after considering the minor's wishes, deems appropriate and shall sell the balance and pay the proceeds to my Trustees to be retained for the minor under Item SEVENTH hereof. THIRD: The gift to my spouse in this Item is intended to give my estate the marital deduction effective under the Internal Revenue Code to reduce Federal' _ C ..\ , , estate tax. Any provisions in this Will which conflict with or fail of this intention shall ti~10 reconciled or amplified as to accomplish this objective. I I , . .'-'1 . c.'; I YJ)~"""-.Jlvt; (/fh.1-e.-c:-1iV -. If my spouse, PHYLLIS E. VONEIDA, survives me, I direct that my Trustees, hereinafter named, hold, IN TRUST, an amount free of all taxes equal to the maximum marital deduction allowable to my estate for Federal estate tax purposes, reduced by the aggregate marital deduction allowable for Federal estate tax purposes for other property or interests that pass or shall have passed to my spouse otherwise than under this clause and that qualify for the said marital deduction; and further reduced by an amount, if any, needed to increase my taxable estate to the largest amount that after allowing for the unified credit and any other credits available to my estate, will result in no Federal estate tax, and pay the net income therefrom not less frequently than quarterly to my spouse for life. My spouse shall have power to appoint all or any part or parts of the principal of this Trust (Marital Deduction Trust) to herself or a class composed of our issue, to wit: our daughter and granddaughters. This power shall be exercised by her alone and in all events by specific reference thereto in her Will, or by delivery at any time or times during her lifetime of a written direction to my Trustees who shall thereupon make payment as she directs. My Trustee shall pay to her personal representatives from any unappointed principal the difference between all taxes, interest and penalties which they must pay by reason of her death and those which would be payable by them if such unappointed principal were not taxable in her estate and shall add the balance of such unappointed principal to my residuary Trust. FOURTH: I give and devise the residue of my estate, real and personal, to my Trustee hereinafter named, IN TRUST, as follows: (a) The net income therefrom shall be paid to my spouse, PHYLLIS E. VONEIDA, for life (b) Upon the death of my spouse, or in the event my spouse predeceases me, my estate shall be distributed as follows: (i) All the rest, residue and remainder of my estate, real, personal and mixed, whatsoever and wheresoever situate, shall be divided and distributed as follows: A.) Fifty-five (55%) percent thereof to my daughter, KAREN R. DREESE. In the event, however, that she has predeceased me or has died during the term of the aforesaid trust, 2 Uu~ tL".~ then her share shall be divided equally between my two (2) granddaughters named below. B.) Twenty-two and one-half (22 1/2%) per cent thereof to my granddaughter, TAMMIE DREESE, per stirpes. C.) Twenty-two and one-half (221/2%) per cent thereof to my granddaughter, KELLY COOK, per stirpes. FIFTH: Trustee may use principal of the trust under Item FOURTH and FIFTH hereof only for the benefit of my spouse. Trustee may use principal from both trust as that Trustee deems necessary: (a) To meet the expense of any accident, illness or other emergency befalling her; (b) For maintenance, and support; (c) To pay funeral expenses, including the cost of a grave marker and perpetual care of the grave. Notwithstanding the foregoing, the power to consume, invade or appropriate property for the benefit of my spouse shall be limited by ascertainable standard relating to health, education, support or maintenance within the meaning of subparagraph (a) of Section 2041 (b)( I) of the Internal Revenue Code of 1954 or any similar provision which may be in effect at the time of my death so that such power will not constitute a general power of appointment. SIXTH: I hereby nominate, constitute and appoint my hereinafter named Trustee, Guardian of any property which passes otherwise than under this will to a minor and with respect to which 1 am authorized to appoint a Guardian and have otherwise not specifically done so. Such Guardian shall have the power to use principal as well as income from time to time for the minor's education, support and welfare, or to make payment for these purposes without further responsibility to the minor or to any person taking care of the minor. 3 ft~~ ~~t"- SEVENTH: No provision of this Will is intended to exercise any power of appointment, including any power of appointment granted to me by my spouse's estate planning or other documents. EIGHTH: All taxes, interest and penalties thereon payable by reason of my death with respect to property comprising my gross estate, whether or not passing under this Will, shall be paid from the principal of my residuary estate under Item FIFfH provided however, that funds of my Trust created herein may be used to pay taxes, interest and penalties attributed to such trust assets. NINTH: No interest of any beneficiary under this Will or any codicil hereto shall be subject to anticipation or voluntary or involuntary alienation, and the personal receipt of such beneficiary shall be the sufficient and only discharge of my Executor and Trustee unless otherwise provided herein. TENTH: In addition to powers given them by law, my Executor and Trustee and their successors and any guardian acting hereunder shall have the following discretionary powers applicable to all real and personal property held by them, effective without court order and until actual distribution:( except as more particularly stated and provided in Item FIFTH above): (a) To retain all property received by them including the stock of any corporate fiduciary acting hereunder, provided such property remains productive; (b) To invest in all forms of property without restriction to investments authorized to fiduciaries, so long as such investments are productive (c) To join in any incorporation, partnership, recapitalization, merger, reorganization or voting trust plan; to delegate authority with respect thereto; to deposit investments under agreements and pay assessments; and generally to exercise all rights of investors; (d) To compromise controversies; (e) To exchange or sell for cash, property or credit, publicly or privately, or to lease, even for a term exceeding five (5) years or the duration of the trusts hereunder, without liability on the purchasers or lessees to see to application of the consideration, and to give options 4 Ye.e~~(}~~ for these purposes without obligation to repudiate them in favor of a higher offer; (f) With respect to my residuary trust under Item FIFfH hereof, to allocate items of receipt or disbursement between income and principal as they deem equitable regardless of the character given such items by law; (g) To apply income or principal to which any beneficiary is entitled directly for his or her maintenance and support should they deem such beneficiary incapable of receiving the same by reason of age, illness or any infirmity or incapacity, or to pay the same to such person as they select to disburse it, whose receipt shall be a complete acquittance therefor, without the intervention of any guardian; (h) To borrow money, including the right to borrow from any corporate fiduciary acting hereunder, and mortgage or pledge as security; (i) To hold investments in the name of a nominee; (j) To distribute in cash or kind or partly in each at valuations fixed by them; (k) To assume continuance of the status of any beneficiary with reference to marriage, divorce, illness, incapacity or other change in the absence of information deemed reliable without liability for disbursements made on such assumption; (I) To elect to value my gross estate for Federal estate tax purposes as of the date of my death or as of the alternate valuation date as allowed for such purposes, and to claim as income tax deductions expenses that would otherwise qualify as estate tax deduction and other elections allowable under law; (m) Except to the extent necessary in order that the trust under Item FOURTH hereof qualify for the marital deduction allowable under the Internal Revenue Code, it shall not be necessary to segregate investments as belonging to a particular trust or share therein and all interests may be held in undivided form in a single fund from which proportionate distributions are made based on current reappraisals; (n) To merge any similar trust established by my spouse where the terms of the same are identical; (0) To make income or principal distributions during the course of administration of my estate or trust created hereunder; (p) In the event that I am the beneficiary of a qualified terminal interest trust and the same is taxable in my estate, I direct that my Executor shall seek reimbursement from said trust for all taxes due by my estate because of the inclusion of such trust in my estate, said computation of taxes due to be computed by taking taxes owed by my estate and such property 5 ~A'f -9 t/Chf-4iltL included therein as compared to the taxes my estate would owe in the event said property were not taxable in my estate; and (q) To undertake any and all acts deemed necessary and proper by it for the proper and advantageous management of any trust and the settlement of my estate. ELEVENTH: In the event that for any reason whatsoever, any of my named beneficiaries should become a success or fiduciary, then No fiduciary who is a beneficiary of my residuary trust created in Item FIFfH hereof shall participate in the exercise of any discretionary power to use the principal thereof for the benefit of any person or to apportion or allocate items of charge or credit between principal and income of such trust. Additionally, no fiduciary named herein shall participate in any discretionary decision to invade or use the principal of any trust hereby created for hislher benefit or for the benefit of hislher issue and in addition no fiduciary named hereunder shall enter into any reciprocal arrangement with any other fiduciary to make such discretionary distributions. No fiduciary named herein shall have any power with regard to the administration of a trust created hereunder if such power would cause the trust to be includible in his or her estate for federal estate tax purposes. TWELFTH: Any person, other than my spouse, who shall have died within 1hirty (30) days of my death, shall be deemed to have predeceased me. If my spouse and I die simultaneously, or under such circumstances that the order of our deaths cannot be established by proof, my spouse shall be deemed to have survived me. Any person (other than myself) who shall have died at the same time as any then recipient of income or in a common disaster with such beneficiary, or under such circumstances that it is difficult or impossible to determine who died first, shall be deemed to have predeceased me. THIRTEENTH: I appoint my spouse, PHYLLIS E. VONEIDA, as Executrix of and as Trustee under this my Will. In the event my said spouse cannot act or continue to act as Executrix and/or Trustee for any reason, I appoint my daughter, KAREN R. DREESE, to serve in her place and stead. In the event that she also cannot act or continue to act in such position or positions, for any reason, then I appoint my granddaughters, TAMMIE DREESE and KELLY COOK to act jointly in her place and stead. No fiduciary acting hereunder shall be required to post bond or enter security in any jurisdiction. 6 L~~~ IN WITNESS WHEREOF, I have hereunto set my hand and-seal\ this .? J"d day of i>fth-iP_ ...-1998, to this and the preceding ..'t1..{,; (~) pages, and 1 have also placed my initials on each preceding page for better identification and greater security. ltl.A", :q; I/~~, ~ (SEAL) GLENN G, V6NEIDA r\ SIGNED, SEALED, PUBLISHED and DECLARED bp< the above-named Testator, GLENN G. VONEIDA, as and for his Last Will and Testament, in the presence of us, who at his request, in his presence and in the presence of each other, have hereunto subscribed our names as witnesses. '/ ~?~" ~ ~~ 42 ~\lcUL 7 In Re: Estate of Glenn G. Voneida IN THE COURT OF COMMON PLEAS OF a.k.a. Glenn Galen Voneida CUMBERLAND COUNTY, PENNSYLVANIA Deceased, Late of the Borough of Carlisle, Cumberland County, DOCKET NO. 21-05-317 Pennsylvania ~....,) '.:'~ ,~ , ORPHANS' COURT DIVISIONf~ n r-:,"1 C) REGISTER OF WILLS (J ,-, .:--'..... . , '.,'.-' , -_:.. I~i I ;'"h - \:::~) " . 'C"J -- - .-.:-\ -q _-n "("") DISCLAIMER IN ACCORDANCE WITH 20 Pa. C.S.A. ~ 6201.,,"' rTi .. i--:J .::> -i, 01 1. Glenn G. Voneida, also known as Glenn Galen Voneida, departed this earthly life on March 9, 2005, at HCR - Manor Care, in the Borough of Carlisle, Cumberland County, Pennsylvania. Decedent also had a separate mailing address at the time of 1604 McCormick Drive, Mechanicsburg, Cumberland County, Pennsylvania 17055. 2. Decedent was survived by his widow, Phyllis E. Voneida, of 1604 McCormick Drive, Mechanicsburg, Cumberland County, Pennsylvania 17055. 3. Decedent's probate estate consisted of a one-half (112) interest as a tenant in common with his said widow in securities held in a street name brokerage account at Merrill Lynch, being designated as Account No. 872-47062. The total value of said account was $57,952.51. Decedent's interest therein was valued on the date of death at $28, 976.26. 4. Decedent also owned assorted entireties property and IRA accounts and the like, none of which are directly relevant to this disclaimer. 5. The probate estate is subject to the payment of inheritance taxes, costs, fees, expenses and debts. The said probate estate is well more than sufficient to bear the payment of the same with no danger of insolvency. 6. Decedent's widow is not indigent, necessitous nor impoverished and has sufficient means and property of her own to comfortably maintain herself in the style to which she is accustomed. 7. Letters Testamentary were duly and properly granted to the said Phyllis E. Voneida by the Register of Wills in and for Cumberland County on the 5th day of April 2005. 8. Under the terms of decedent's duly probated Last Will and Testament dated the 22"" day of October 1998 and the Codicil thereto dated the 19th day of July 2002 (true and correct copies of which are attached hereto and made a part hereof), most particularly in Item IV of the said Will and I Codicil, a credit shelter residuary trust is provided for, which, inter alia, holds and administers decedent's probate assets for the benefit of his said widow for and during her natural life, providing for the payment of the net income therefrom to her. 9. Item IV additionally provides that upon the death of decedent's said widow, the balance then remaining is to be divided among decedent's daughter, granddaughters, and great grandson, all of whom survived and continue to survive decedent as follows, to wit: A) daughter, Karen R. Dreese, currently of 1544 Grandview A venue, Mechanicsburg, PA 17055, fifty (50%) percent thereof. B) granddaughter, Tammie E. Dreese, currently of 209 Rushley Road, Arnold, MD 210 12, twenty (20%) percent thereof. C) granddaughter, Kelly S. Cook, currently of 10 Victor Lane, Mechanicsburg, PA 17050, twenty (20%) percent thereof. D) great grandson, Alexander Craig Cook, currently of the same address and in care of his mother, the said Kelly S. Cook, ten (10%) percent thereof. 10. All the aforesaid four (4) residuary beneficiaries are compos mentis individuals in excess of the age of twenty-two (22) years, except for the said great grandson, Alexander Craig Cook, who is a minor. The three (3) aforesaid adult individuals have made or are in the process of making arrangements with Merrill Lynch for the holding and transfer of their respective shares or for the outright distribution thereof, as the case may be. 11. Merrill Lynch will make arrangements to hold the share of the said minor in an educational trust account with his said mother, as the named trustee thereof as per the terms of the said Last Will and Codicil. 12. Phyllis E. Voneida, has accepted no benefits from the aforesaid one-half (1/2) interest as a tenant in common of decedent, has exercised no dominion over the same, except in her capacity as Executrix, and, in the event there have been or are any automatic credits made to her benefit in said Merrill Lynch account, she has or shall disgorge all of the same back into the probate assets from whence they came, to the favor of the four (4) residuary beneficiaries. 13. Phyllis E. Voneida, in her capacity as decedent's surviving widow, and in her capacity as life tenant beneficiary of the aforesaid credit shelter residuary trust provided for in decedent's Last Will and Testament and the Codicil thereto, desires to disclaim any and all of the above referred to probate assets of decedent. The operation of which disclaimer will deem her to be legally dead for the purposes of the distribution provided for in the said Last Will and Testament and Codicil thereto and result in the distribution of the balance of the same remaining after the payment of all death taxes, costs, fees, expenses and debts unto the said four (4) residuary beneficiaries or the trustee thereof, as the case may be. 2 NOW THEREFORE, intending to be legally bound hereby, I, Phyllis E. Voneida, the unremarried widow of Glenn G. Voneida, also known as Glenn Galen Voneida, do hereby disclaim any and all interest in and to the aforesaid undivided one-half (112) interest as a tenant in common in the securities held in a street name brokerage account at Merrill Lynch, being designated as Account No. 872-47062 and any fruits thereof, to which I would otherwise have been entitled under the laws of the Commonwealth of Pennsylvania. I have hereunto set my hand and seal this ~A{ day of ~.IL.. _ , 2005. r%tAtw P~ffi r:~~~ ~- ~, Witness PHY S E. VONEIDA ~~:k #" Witness COMMONWEALTH OF PENNSYLVANIA) ) SS: COUNTY OF CUMBERLAND ) On this, the 3d(, day of ~ ,2005, before me, the undersigned officer, personally appeared PHYLLIS E, VONEIDA, who being duly swom.according to law, deposes and says that the foregoing Disclaimer is her act and deed and that she desires the same to be recorded as such. IN WITNESS WHEREOF, I have hereunto set my hand and notarial seal the day and year aforesaid. ~~~4J Notary Public My commission expires: (SEAL) ~~...:~,;", \'-':_'i~:'li -:':r.~ ''-'''t:;:;1i,;;::'/;..'"r':l;j, ,\~:):anal Heal , <::hmlS'S 1:. :;b.::~d:_ m, i\Jotary Pl.clic 1 ) , \len'Oe T""4l., (::..~mberiand County . Vlv i:"',;.m!.'J'~SJOTl :;:~:Gres .;une 20. 2008 , 3 '--_.._.._.".__._--~..,. , :Aemrmr. :.l~"~.r';'~,,TY<~' ,', ',;>,:;',;-'!~'''' CIl\!('}t;~ri.~s