The URL can be used to link to this page

Home My WebLink About06-23-06 L Susan E. Lederer June 22, 2006 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, P A 17013 RE: Violet M. Rodenhiser Social Security Number: 176-34-7808 I ('(.S~C2~ To Whom It May Concern: Enclosed for filing with your office is one (1) completed Form REV -1500 with date of death valuations, in duplicate, together with the following attachments for the above decedent: 1. Two (2) copies of the Violet M. Rodenhiser Living Trust; 2. One (1) Estate Information Sheet; 3. One (1) check for $6,863.29 (additional tax due); and, 4. One (1) check for $15.00 (filing fee). One (1) additional photocopy of the front-page of the completed REV -1500 form has been provided. Please time/date stamp these copies as received and return them to me in the envelope provided. Ifthere are any questions or further requirements regarding this return, please do not hesitate to contact me. Sincerely, I 'Y1--< A ~ ~ ?~ ~l 1\ \J ~\.../~-------.' cf--<<'--c.'~~'----L~ Susan E. Lederer, Esquire Enclosures ::. ; 4811 ]onestown Road. Suite 226 . Harrisburg. PA 17109 . Phone 717.652.7323 . Fax 717.652.7340 . susan(nledcrerlaw.coln www.lcdererlaw.coln COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRISBURG, P'" 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT LEDERER SUSAN E 4811 JONESTOWN RD SUITE 226 HARRISBURG, PA 17109 -------- fold ESTATE INFORMATION: SSN: 176-34-7808 FILE NUMBER: 2106-0568 DECEDENT NAME: RODENHISER VIOLET M DATE OF PAYMENT: 06/23/2006 POSTMARK DATE: 06/22/2006 COUNTY: CUMBERLAND DATE OF DEATH: 11/09/2005 NO. CD 006880 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $6,863.29 I I I I I I I I TOTAL AMOUNT PAID: REMARI<S: CH ECK# 651 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS $6,863.29 GLENDA FARNER STRASBAUGH REGISTER OF WILLS ~>; ~~ G3/U:E1S31:J S.lHfJll:J 1TII Sdsn 900(: ,(renuer =Iv td3 @ 'Mel reJaptJJ JO uO/le/ofll e aq Aew asnsfIIV '@ Hew AJfJOfJd 6ufpuas Uf asn JOJ A/a/os papflloJd Sf pue @ aOfMas fF1JSOd 's'n al/J JO AJjadoJd al/J Sf 6Uf6e>foed Sfl/.l z_ E o u U; Co en :s ~ ~ ~ I IT' tr I"- ru fTl ...D CJ I"- M CJ CJ CJ CJ CJ M CJ ...D CJ CJ I"- .. E I~ "'0 0, ~ 0 o ,....., ~ r-- ,....., ;:: <r: ~ ~ ti oj) (1) \0 I-< ;::N ;::l ":;N~ (1)...... =.~ t: 00 ;::l ~ "TC/l:r: ~I':il ?~. ." y. .....',..;...._~....................... !II ! . . "00#" ..m tf$ ~ L.: ~ "- - (J.) a ~ I <l) VJ ;::l o ..r::: t: ;::l c U <l) c~("") VJ 5 ;::l ........ _ .... 0"0 ;::: UO r:/) {'-- ~ <l)"""" "CVJ.A" 4-.1::;::l"" o ell 00... l-< -..r::: ~ 2E3t:~ VJ..o ;::l VJ ..... cj 0''''' b1)l=iU"'i:: <l);::l ell ~u........U ... ~ .c: ~ .!2 8 .!2 C4 ~ g ~ .l2 oS gj ~ 'lJ '" .l!! .!!! l:l. E 8 ... o l- ~ l ~ ~ REV _1500 t:X + (6-00t REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT C ir~J NUMBER __J~ 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 TH1$-SECTIONMI.l$TSE COJ\llFU2E:reP,ALL;ICOBBE$~p"'D NAME I Susan E. Lederer rlRM NAME(~ appli';'ble) .---- ----. ---I 4811 Jonestown Rd. ~aw Offices of Susan E. Lederer _ _ ',' Suite 226 rr-ELEPHONE NUMBER--~-----------I Harrisburg, PA 17109 I 717/652-7323 I _._=-=.'~-'=~===--------'====--~--=-=------==------'==-=-----==--~~=--=------ 1. Real Estate (Schedule A) (1) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 _..__._...------':Ii\FlRISBURG, PA 17128-0601 I- Z UJ o UJ o UJ o -1 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) I Rodenhiser, Violet M h5ATE OF DEATH (MM-DD-YEA~-T-DATE OF BIRTH(MM-DD-YEAR) I . 1 ! 111,)9/2005 ' 03/23/1910 rAPPLlCASLElSUR\iIVING SPOUSE'S NAME ( LAST, FIR~)T AND MIDDLE INITIAL) .. .-. -- --+~1~'original Return- UJ 1 ~ ~ VI ! 0 4. Limited Estate olf~ ~~g 0 Oo..lD ~ 0 -~ o ~ o Supplemental Return 6. Decedent Died Testate (Attach copy of Will) 9. Litigation Proceeds Received '1- VlZ UJUJ ":0 ":z 00 00.. 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship z o >= ~ :> l- e:: <( o UJ ..: 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) ()FnCJ\L USE G\ll.-1 1 FILE NUMBER 1 21 05 COUNTY CODE YEAR SOCIAL SECURITY NUMBER 176-34-7808 --- r-THIS RETURN MUST BE FILED IN'DUPLICATE WIT;:ITHE ___~___ REgiSTER OF:_'JVJ-'_-_L.~____ I SOCIAL SECURITY NUMBER o 3. Remainder Return (date of death prior to 12=13-82)- o o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) 1 COMPLETE MAILING ADDRESS None OH::jC!AL USE: ONLY (2) None (3) None ---- (4) None (5) 3,328.22 .--,-----~~--_.- (6) None ------ (7) 202,298.92 (8) 205,627.14 --------. (9) 4,624.13 (10) 47,485.46 (11 ) 52,109.59 153,517.55 1,000.00 152,517.55 (12) (13) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) -"---'." --.-.-'.---'-- z 152,517.55 .045 (16) 0 16.Amount of Line 14 taxable at lineal rate x >= -~---"----- <( I- :> 0.. 17. Amount of Line 14 taxable at sibling rate x .12 (17) ::!l 0 --~---,--------._-- 0 ~ i 18. Amount of Line 14 taxable at collateral rate x .15 (18) I- ------.-----.. 19. Tax Due (19) 6,863.29 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 6,863.29 >> BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH<< Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 88 Linda Drive I----~ CITY I STATE PA I I ZIP 17055 - ---. Mechanicsburg Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 6,863.29 Total Credits (A + 8 + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is thEOVERPA YMENT. 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 A. Enter the interest on the tax due. (3) (4) 0.00 8. Enter the total of Line 5 + 5A. This is theBALANCE DUE (5) (5A) (58) 6,863.29 6,863.29 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS 8Y PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;............................................................................. ~ D ~: ~::::~ ~h~e~;~~i~~~~s:~~e~~s~~~. .~~~~I. .~.~.~. ~.~~. ~~~~~_~~. .~~~.~.~~~~.~e.d. .o.~ .i~~. i.~.C.O.~~~..............................~~::::::::::: ~~.'.'. B ~ d. receive the promise for life of either payments, benefits or care?........................................................... D ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?........................................................................................ .n..................... D ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?........ D ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?............................._............................._.............................n.................... ~ D IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ..-- ..-- ---- Under penalties of perjury, I declare that I have examined this return. including accompanying schedules and statements. and to the best of my knowledge and belief. it is true. correct and complete. Declaration preparer other th~.".th"-personal representative is based on all information of which preparer hasany knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS B~ _~n__ _ C. adL. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS Margar. et A. "imm. e.lreic}; ~. . I.' , I /J Ii u 'J1L.<-cL SIGN RE 0 REPARE-R OTHER THAN REPRESENTATIVE . ADDRESS Susa E. Le er DATE 88 Linda Drive Mechan~csburg, PA 17055 G I ~II of_____ DATE 2000 Creek Road N{:\Vpgrt, PA 17074 4811 Jonestown Rd. Suite 226 Harrisburg, P A 17109 ~l;;L I/O b DATE b! )/1 O(~ ~~<:'-' --',- For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)]. The statutedoes not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116 1.2) [72 P.S. 99116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116 (a) (1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ----. ------_.,--- -~ I FILE NUMBER 21 - 05 - ESTATE OF Rodenhiser, Violet M 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. VALUE AT DATE OF DEATH 102.09 ITEM NUMBER 1 DESCRIPTION Patient Account at Thomwald Homes, titled to Violet M. Rodenhiser 2 Homesteader Life Company (prepaid funeral) 3,226.13 TOTAL (Also enter on Line 5, Recapitulation) 3,328.22 SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rodenhiser, Violet M This schedule must be completed and filed if the answer to ~ of questions 1 through 4 on page 2 is yes. 'I - - . DESCRIPTION OF PROPERTY It;ATE OF DEATH 'I % OF 11----1 --- Include the name of the transferee, their relationship to decedent and the date of transfer.: E OF DECO'S EXCLUSION i TAXABLE VALUE I Attach a copy of the deed for real estate IVALU ASSET : (IF APPLICABLE) . ! INTEREST: 'I' AnnuitY:-Contract No. LAR0025572, held at American , -- 47,270.34:1' 100% 47,270.34 National Insurance Company, Violet M. Rodenhiser, , Trustee of the Violet M. Rodenhiser Living Trust, owner, , Violet M. Rodenhiser Living Trust, beneficiary ! I 153,530.001 100% I I 4,498.58: 100% 1 ITEM NUMBER 2 House and Lot located at 88 Linda Drive, Mechanicsburg, Pennsylvania, titled Violet M. Rodenhiser, Trustee of the Violet M. Rodenhiser Living Trust (deeded to Barbara A. Bell on January 25, 2005), value used is assessed value at time of transfer 3 Checking Account held at Sovereign Bank, Account No. 2471703755, titled to Violet M. Rodenhiser, Trustee of the Violet M. Rodenhiser Living Trust (accrued interest $0.09) I n'-IFILE NiiMBER nL___~l - 05 - i 3,000.001 150,530.00 4,498.58 I I .n..nn_~ TOTAL (Also enter on line 7, Recapitulation) 202,298.92 *' SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS i -~-- I FILE NUMBER i 21 - 05 _ COMMONWEALTH OF PENNSYLVANIA , INHERITANCE TAX RETURN ~I RESIDENT DECEDENT ..-...--- --. ESTATE OF Rodenhiser, Violet M ITEM NUMBER A. B. Debts of decedent must be reported on Schedule I. --~-- DESCRIPTION AMOUNT FUNERAL EXPENSES: Hollinger Crematory 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): 2. Street Address City State Year(s) Commission paid Attorney's Fees Law Offices of Susan E. Lederer Zip 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Other Administrative Costs Filing Fee for PA Inheritance Tax Return 2 Accountants fee for preparation of Federal and State Income Tax Returns TOTAL (Also enter on line 9, Recapitulation) 3,226.13 1,200.00 15.00 183.00 4,624.13 . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ~-- -......-. ESTATE OF Rodenhiser, Violet M 'I FILE NUMBER 21 - 05 - ---'_.'-~""._-'----'- --- Include unreimbursed medical expenses. ITEM NUMBER I Thomwald Homes (nursing home bill) DESCRIPTION 2 Pharmerica bill 3 Pharmerica bill 4 Pharmerica bill 5 Law Offices of Susan E. Lederer (legal services provided before death) 6 U.S. Treasury (Federal Income Tax) 7 P A Department of Revenue (State Income Tax) TOTAL (Also enter on Line 10, Recapitulation) AMOUNT 41,846.10 106.19 1.07 4.60 1,087.50 3,494.00 946.00 47,485.46 REV-1513 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER 21 - 05 - RELATiONSHIP T()-I~MOUNT O~ SHARE DECEDENT I Do Not Lis1'Irustee(sL---l _OF E~!~E__ Rodenhiser, Violet M NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) Barbara A. Bell 88 Linda Drive Mechanicsburg, PA 17055 Daughter : House and Lot located at 88 Linda Drive, , Mechanicsburg, P A & 50% of residue 2 Margaret A. Himmelreich 2000 Creek Road Newport, PA 17074 Daughter ! 50% of residue Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover she~ 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 St. Pauls United Church of Christ, 626 Williams Grove Rd, Mechanicsburg, PA 17055 1,000.00 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEEr 1,000.00 Sep 30 05 12:15p Thornwald Home Thornwald Home 442 Walnut Bottom Road Carlisle, PA 17013 Barbara A. Bell 88 Linda Drive Mechanicsburg, PA 17055 _~" ,.'. .' 717249~906, . -,~(.) ~\.J L> L~_ t, ) rl- -\.-ll j-y-\ \ p.3 S A V I N G S S TAT E MEN T Statement Number Page 1 1 Date From 09/01/05 Date Thru 09/30/05 Violet M. Rodenhiser ]\1edicare ID Nr 176347808A Medicaid ID Nr Admission Date 10/17/03 Resident ID Nr 524 --~-------------~------------------------------ Date Ty Tran Refer Fn Code ---------------------------------------------------------~---------------------- 102.09 Description Balance Forward Balance Deposits Disbursed Sc l~~l\J lL 6:) rJ:~,~< ~\.-I ~- ~HOMESTEADERS LIFE COMPANl' P.o. Box 175b I Des Moi-.es, IA 50306-1756 800.477.3633 SEPTEMBER 13. 2005 BARBARA A BELL 88 LINDA DR MECHANICSBURG PA 17050 RE: CERTIFICATE NUMBER - 1202371963 DEAR BARBARA A BELL CONGRATULATIONS ON YOUR DECISION TO PLAN AHEAD FOR FUNERAL ARRANGEMENTS THROUGH HOLLINGER FUNERAL HOME. YOU JOIN THOUSANDS NATION WIDE WHO HAVE CHOSEN THIS SENSIBLE WAY TO MEET AN INEVITABLE NEED. ENCLOSED IS THE HOMESTEADERS LIFE INSURANCE CERTIFICATE THAT COVERS THE FUNERAL ARRANGEMENTS YOU SELECTED. PLEASE PUT THIS CERTIFICATE AND RELATED INFORMATION WITH ~OUR OTHER IMPORTANT PAPERS. THANK YOU FOR THE CONFIDENCE YOU HAVE PLACED IN HOMESTEADERS LIFE COMPANY AND HOLLINGER FUNERAL HOME. SINCERELY, CUSTOMER SERVICE ENCLOSURES HOl\1ESTEADERS LIFE COl\1PANY A IVIUTUAL COJVIPANY This Certificate is not a contract. It is only a statement of the insurance provided by the Group Policy shown on the Ce;:-tificate Schedule. The Group Policy is the only contract. In the event of any questions, the terms of the Group Policy will govern. The principal provisions of the Group Policy which apply to this Certificate are shown on the following pages. HOMESTEADERS LIFE COMPANY agrees to pay the face amount of the Insured's coverage under the Group Policy, as evidenced by this Certificate, to the beneficiary upon receipt of proof of the Insured's death. Payment is subject to the provisions, terms and conditions elf the Group Policy. This Certificate is issued in consideration of the enrollment form and the payment of all required premiums. PLEASE READ YOUR CERTIFICATE CAREFULLY RIGHT TO CANCEL You may cancel this Certificate b)' delivering or mailing a written notice or sending a telegram to HOMESTEADERS LIFE COMPANY, P.O. Box 1756, Des Moines, Iowa 50306, or to our agent and by returning the Certificate before midnight of the thirtieth (30) day after you receive it. Notice given by mail and return of the Certificate by mail are effective on being postmarked, properly addressed, and postage prepaid. We will refund to you all premiums and policy fees paid within ten days after we receive notice of cancellation and the retnrned Certificate. Return of this Certificate voids the coverage for this Certificate as provided under the Group Policy from the beginning. The parties will be in the same position as if no Certificate had been issued. Signed for the Company at its Home Office 5700 }Vestown Parkway, West Des Moines, Iowa 50266 700~~ Secretary fb-f/~ President GROUP PERMANENT LIFE INSURANCE CERTIFICATE. ANNUAL DIVIDENDS. Definitions of frequently used words and terms are on page 5. The index is on page 2. G-93S-MO Page 1 CERTIFICATE SCHEDULE GROUP POLICY NUMBER CERTIFICATE NUMBER I SSUE DATE INSURED AGE AT ISSUE CLASSIFICATION OWNER GPOl 1202371963 SEPTEMBER 12, 2005 VIOLET M RODENHISER 95 STANDARD BARBARA A BELL IRREVOCABLY ASSIGNED BENEFICIARY - as stated in the enrollment form unless changed In accordance with the provisions of the group pol icy PLAN INITIAL FACE AMOUNT SINGLE PREMIUM SINGLE PREMIUM WHOLE LIFE $3,226.13 $3,210.00 We may, on any cer~ificate anniversary during the 1 ifetime o~ the insured, increase the face amount, as determined by us. Any increase in the face ~mount wi I I be added to the face amount of the last anniversary to determine the death benefit. Any increase in the face amount is not guaranteed. At no time wi 11 the face amount be decreased. No additional premium wi 1 1 be charged for any increase in the face amount. G-93-11 PAGE 3 ENROLLMENT FOR GROUP INSURANCE TO ~ HOMESTEADERS Uft: COMPANY P.O. BOX 1756/DES MOII--JES, IOWA 50306/800-477-3633 , '-" ... '" .,- ','- 1'" ..-~ . GRO ENR01.tME FO .' PRQPOSEDINSURED (Please Print) t~- Last First Initial Sex Birthdate (M/D~/) Age SS No. ,.. ./;' r'; i~/ Residence -No. and Street City or Town State Phone No. APPU~.ANT!OWu~ER (If Other than Proposed Insured) last ::-.-; .-~;:' ;.: Initial Address ,,'/:--::(,,/.. City State Zip SS No. Relationship to Insured BENEFICIA.RY ",!,.,,":, ;:/:'.':,./~:-",-;"";~~. " (After paymem under any assignments, remaining proceeds are to be paid to the estate ot the insured unless a beneficiary is specified above.) Relationship to Insured R ~ C1 SINGLE PAYMENT PLAN E I 0 Certificate Q Premium U 0 Rider E 0 MULTIPLE PAYMENT PLAN S . Years r Premium E Payable D $ . ,~->,' " , Face Amount $ ::>.~;;-.;.F ~~:i' B E N E F I T S Years Premium PSjlsble Less than 5 years In lieu of the death benefit described, we may issue a certificate providing an immediate death benefit equal to the face amount if the insured signs the enrollment form and the following questions are answered "no." OPTIONAL HEALTH HISTORY (Multiple Payment Plans) 1. Is the insured now bedridden, or currently admitted to or been advised to enter a hospital, nursina home. hosoice Proaram or any extended care facil'ity; or been -diagnosed a~ ha~ina - or b~en treated for AIDS or ARC? 0 YES d NO 2. Within the past five years has the insured been diaqnosed or treated for any of the following ailments? - Heart Disease Liver Disease Alcohol Abuse Circulatory Disease Kidney Disease Drug Abuse Stroke Anemia Nervous Disorder lung Disease Cancer Diabetes Payment Method 0 Monthly 0 Annually 0 Semiannually 0 Quarterly I 0 Multiple Bill - (List other policies for C-O-M or MB) o Direct Bill 0 Check-O-Matic (See Reverse) Face Ami. $ Premium $ DEATH BENEFITS ON THE MULTIPLE PAYMENT PLAN ARE LIMITED AS FOllOWS: 5 years or greater 1 st Year 2nd Year i st Year 2nd Year 3rd Year 50% of Face Amt. Face Am!. 35% of Face AmI. 70% of Face Am!. Face Am!. If death by accident during the limited period, the face amount is payable. DYES 0 NO Dividends [JPurchase Additional Insurance o Accumulate at Interest o Paid in Cash o Reduce Premium Replacement-Will the proposed certificate replace any existing life insurance or annuity contracts? DYes [,.LNo (If '')/ es," complete replacement papers) DECLARA TIONS- To the best of my knowledge and belief, all statements and answers on this enrollment form an complete and true. It is agreed that no insurance shall take effect until the premium has been paid and a certificate ha been issued while the insured is living. I certify, if I am applying for insurance on behalf of the insured, that \ have a insurable interest in the pr0l56s'eirrnsured's life, and have full authority to use his/her Tt.)nds as premiums 00 the insuranc applied for. I have paid $ .3?,i()' '~;,;./ "\(IIith this enrollment form. :~;;?,;', ")~<:. ,f:~,"7,< ,..': -' c~.. " --'...",~,..'-;,;~, ...~.-......"....,.-~.~~.~.~ .. /- , t.- ,<' .,'''' Signed at ,/ . "'" '. Date " C '. City State . Signature of Applicant/Owner (If other than Proposed Insured) <: _.:;./r, ...,f~___.-,,-- " .. .... ~1,;;,~;._i~....--''-'''';'_.-.- Signature of Proposed Insured Agent's Statement: By my signature I certify that, to the best of my knowledge, all information contained in this enrollme forrpis correct, was recorded accurately, and confirm this enrollment form was signed in my presence. ~-1--/; _ ,j':; l-__-__[Jl.s~curityoPtic Agent Number Prod. Code Ivlkt. Code 0 Mvantage O~ Copies: White - Homesteaders; White - Homesteaders; Pink - Provider; Canary - Owner .~: """ ~ . /" .. _~:,(',~,,'-;-",'e-' Agent's Signature GP.'i99-PA DEFINITIONS \VE, us, OUR means Homesteaders Life Company. YOU, YOUR means the owner of this Certificate. INSURED means the person whose life is insured by the Group Policy evidenced by a Certificate and as shown in the Schedule of Insurance. OWNER means the person(s) shown as Owner in the Enrollment Form unless changed. You may transfer Ownership or change the Beneficiary. BENEFICIARY means the person or organization named to receive the proceeds of this Certificate. A Beneficiary has no rights in the Certificate before the death of the Insured. CURRENT AGE meanS the Insured's age compmed as of the Insured's last birthday. WR_ITTEN F_EQLTEST means a request signed by You on a form provided by lJs. \\le '.vill accept a request not on Our form if it contains the necessary information FACE AMO UNT means the amount stated in the Certificate Schedule. EFFECTIVE DATE means the issue date shown on the Certificate Schedule. The Certificate Anniversary, Certificate Year, and Certificate Months are computed from this date. PROCEEDS means the amount We will pay by the terms of the Certificate as provided under the Group Policy when it is surrendered by You or matures, or when the Iusured dies. It includes the dividends left at interest and any paid up additional insurance bought by dividends, less any loan with interest. IN FORCE means the time during which the Insured's life is covered. MISREPRESENTATION means an omission of a fact or an untrue statement which caused Us to take action different from what Our action would have been had We known the truth. CONTEST means to claim that the Group Policy is not in force with respect to a Certificate, or to deny payment of a claim because the Certificate is not in force, or to claim that misrepresentation has been made. CASH VALUE means the sum of the guaranteed value of the Insured's Certificate plus the dividends left at interest and the current value of any paid up additional insurance, less any loan with interest. GENERAL PROVISIONS INCONTEST - ABILITY: We consider statements made by You and the Insured to be representations and not warranties. A copy of the enrollment form shall be attached to the certificate when issued. No statement will be used to defend a claim unless it is contained in the enrollment form and a copy has been provided to the Insured or the Insured's legalrepresentative. We will not contest an Insured's coverage under the Group Policy after it has been in force during the Insured's lifetime for two years from the Effective Date. G-GC1,C:J)K PAYMENT OF PROCEEDS: G-9~C;-PA We are not liable for any payment made by Us before such request is received at Our Home Office. We \vill pay the proceeds: . to the beneficiary, or . to You if living, if there is no surviving beneficiary; or . to the estate of the Insured if no one described immediately above files a claim within 60 days after the death of the Insured. We may rely on an affidavit to determine the existence or death of any of the above. If there are two or more persons named to receive payments, We will make payment in equal shares to the survivors unless We are directed otherwise. POLICY LOANS: LOAN VALUE: REPAYMENT: LOAN INTEREST: r n"r. LOAN PROVISIONS You may ask for a loan. The Certificate is assigned to Us while there is a loan and is the sole security for such loan. We have the right to defer a loan for up to six months. Loans requested to pay premiums on any Policy with this company will not be deferred. Vie will deduct the loan with interest from the proceeds payable at the Insured's death, maturity, or surrender. If a loan exceeds the loan value, the coverage described in the Certificate as provided under the Group Policy will terminate. We will mail notice to both You and the assignee, if any, to the last address known to Us 31 days before the coverage as described in the Certificate as provided under the Group Policy will terminate. The loan value is the sum of: . an amount ""hich \vith interest will equal the cash value on the next Cenificare Anniversary; plus . the dividends left at interest and the current value of any paid up additions; LESS . any loan with interest. You may repay the loan in full or in part at any time prior to: . maturity of the coverage under the Group Policy; or . death of the Insured. Loan interest is 8% a year. It is due at the end of each year on the Certificate anniversary. Interest not paid is added to the loan; interest is then due on the total amount. SURRENDER OPTION: G_O':lC' CASH OPTION You may surrender the coverage under the Group Policy evidenced by the Certificate and We will pay the cash value. The value will be the net single premium at the Insured's current age for the face amount of this Policy. The same mortality table and interest assumptions described in the paragraph titled "Basis of Values" will be used. The amount We will pay win be the cash value plus any dividends left at interest and the current value of any paid up additional insurance, less any loan with interest. We have the right to defer payment for up to six months. We wiIi pay interest at 2l'2% a year from the date We receive your request if payment is postponed for 31 days or more. .HOMESTEADERS LIFE COMPANY ASSIGNMENT OF OWNERSHIP (IRREVOCABLE) p.o. Box 17S6 I Des Moines, 1/'150306-1756 [ 800-477-3633 1. IRREVOCABLE ASSIGNMENT TO FUNERAL HOME/MORTUARY. The undersigned (Note: This form does not assign d12ath benefits to the fUf)f'ral home.) - ," ,....... .> - transfers, and delivers to;,7.~,T,.c~C-'F//'::!."-<')';"f'/'~'(. ~. /~,< '!'...., '-,.-/.L_~ hereby irrevocably assigns, (Insured Name) Said assignment shall be contingent upon the Funeral Home/Mortuary assigning ownership rights to the Trustees of the Funeral Assurance T~ust in accordance with paragraph 2 below. I retain the right to change the beneficiary/assignee of the policy/certificate to the funeral home of my choice. Notwithstanding the foregoing, the undersigned shall retain physical custody of the policy/certificate of insurance. . the (Funeral Home/Mortuary) ownership rights under the policy/certificate insuring the life of ~. :' l;~ <~)CJ~~.r-/\/ /:i'. ; ..:l ~r I UNDERSTAND THAT, BY ASSIGN!NG MY OW~~ERSH:r RIGHTS TO THE FUNERAL HOME/MORTUARY, I CAN NOT SURRENDER MY POLICY/CERTIFICATE FOR THE CASH VALUE OR RECEIVE ANY REFUND FOR ANY PREMIUMS PAID AFTER THE 30 DAY RIGHT-TO-CANCEl PROVISION DESCRIBED IN THE POUCY/CERTlfICATE. X (#",.'"./-..;,..4.....,,_ Signature of Policy/Certificate Owner ;;:>:2; '<::;""i::<<' Date ~ -'~ --'BOTfl--SELT10NS~U5TBrCrrMPLETfD 2. IRREVOCABLE ASSIGNMENT TO TRUSTEES OF FUNERAL ASSURANCE TRUST. In accordance with paragraph 1 above and as a representative of the Funeral Home/Mortuary listed above, the undersigned hereby irrevocably assigns, transfers, and delivers to the Trustees of the Funeral Assurance Trust, as Nominee, under the Trust Agreement dated April 1, 1995, (conformed copy of which appears on the reverse side hereof), the ownership rights under the policy/certificate insuring the life of the insured as specified above. This Assignment shall be irrevocable and will not hI" altered, amended, revoked, or terminated, in whole or in part, by the undersigned. The undersigned hereby renounces for himself allY interest, either vested or contingent, including any reversionary right or possibility of reverter in and to the policy!certificate assigned to Trustees, and any power to determine o~ control, by alteration, amendment, revocation, or termination, or otherwise, the beneficial ownership or control of the policy/certificate. .. , ~ , /" ~. (;,/a/,,,..,,;,,;l;'1~/". L:.A:'- Signature of Funeral Home/Mortuary'Representative .',.... ./. ./ '~)5<..~://~..~~-:S- Date Policy/Certificate t~umber (to be filled in by Homesteaders Life Compan)'} ACCEPTANCE. The Trustees of the Funeral Assurance Trust have agreed pursuant to the terms of said Trust to accept ownership of the policy/certificate assigned herein. The Trustee shall be deemed to have accepted this assignment upon receipt by said Trustees of a properly executed assignment in the Home Office of Homesteaders Life Company and upon issuance of the policy/certifica~e assigned hereunder. Blue/Homesteaders Life Company White/Homesteaders Life Company Pink/Funeral Establi5hment Canary/Ow ner H245-FLEX Rev 2/02 t0HLC, 2001, All rights reserved. I~o use or rpnrnr!lIr\,nn ",;tl,^,.. .... - PRENEED fUNERAL AGREEMENT AND ASSIGNMENT EXHIBIT 1 - STATEMENT Of FUNERAL MERCHANDISE AND FUNERAL SERVICES NOTE: THIS ~GREEMENT IS TO. BE FUNDED BY THE ASSIGNMENT OF INSURANCE BENEFITS FOR THE BENEFIT OF ;/, ,:<j -'} / -...L!.~-';,,:j' (Funeral Recipient/Insured) IN AGREEMENT WITH AND ASSIGNMENT TO --- ,-""" : j :" )',<' - <~. .-:- ',- .....' , , (Address) /. ':. /-<>~<,<;~/,_:.;~{"'--../' .:~,;:< ~;t: ~,-,- .-J ,~ ,-",'/; ,,~ ," 7;,., (Phone) NON-GUARANTEED CASH ADVANCES $ {~,[) (".c:) Escort ",,~,"'" ,tej," :'f<ii.-Jfi,,," $ ,0'''- c./u Grave Opening and Closing $';' /i't",,,', 'C'" Memorial Cards/Book.:,;?:"(/' "..j $';;';/ ,L.;' Clothing (Specify) $ ,/,,,':j c.1'.'l Monument/Marker $ Engraving.-<". , $ O~!~r(~f~,~i[Y) ;~~?,-'r,j j::f-()f'~! $ .C ~-,-.,-Iv_~...(", ,;~:f-;r,<:::'. $ We charge you for our service~",W.Bb~mg:---"-,-,,,~, . TOTAL NON(.GUARANTEED CASH ADVANCES) --''''''''''''<=-.....-."'''...-------~~..-.....--''-~''-~.,-.-..............-..--.~. TOTAL GUARANTEED;AND NON-GUARANTEED FUNERAL PRICE _ ~__,__.....,....,,",_..__~~ .,._ __._..._..--'.......~.,.....<-F"- GUARANTEED PROfESSIONAL SERVICES Services of Fnneral Director and Staff $ Embalming (See Agreement and Below*) $ ,,'."_. "C' l, :i Other Preparation < ,'.. ,-". ,,> i"! "'v.' $ Visitation '1.-/ Days at $ /Day $ Funeral Ceremony /Me?:lo:r:~Ct.L::;~!:y!c:e $ Other Use of Facilities and Staff (Specify) ......._c "-c-"--- ~ " ....,..~ $ Transfer of Remains to Funeral Home $ ~~ If beyond a mile radius, which is our service area, t.~ere vvill be a charge of $_ per Irlile one way. Family Car(s) _at $ each $ Limousine Hearse $ Cremation ,-~/" $ c?,~(';S. ':':'''' Forwarding/Receiving Remains $ Other Services/Facilities/Equipment (Specify) $ 1$ <', '~" ,"" .~. G'" .---~ --', ....,-~ "., ~,;.'-~ ,-<-", / '.....;:.. . TOIALGUARANHfP SERVt(!;S Death Ce:rtific~tes /(5 Flowers ~;" ,: ''; /,.. n" Music Honorariums., Obituaries j>if;":( ,()" , ' Hairdresser Shipping Container Other (Specify) S;:' at $ (Funeral Provider Name) GUARANTEED MERCHANDISE Casket Manufacturer Model Name Model Number L Exterior Description Interior Description Outer Burial Container Model Name I Model Number I Manufacturer Constructed of Othe!,; Guaranteed Merchandise (Specify) 0j~'~'~~j ~':~:::~)~JL~t;~i~:, (. ~-Z~'/)~:'~:./; ~<~~-c $ $ ,.-;::: $ t.'" $ 1$ - -' -' t ..~r(.L-';',:.~C :} TOT At GUARANTEED MERCHANDISE -:1 .:; ~ ~~l.- ":/', -' $ $ 'N $ $ $ $ $ $ $ :;~:;;-: ,.y~ .L../~ /<--_r, ,i~ .-...,: -- ;'~(:~ 1$ __.T' ". - ... ','-. C' ';7C,../~- or- I I ..-; - 11 "'" $ .. i"~\__.A1 !"1 . .'--"";.".-.......... *REQUIRED PURCHASES-Charges are only for those items that you selected or that are required. If we are required by law or by a cemetery or crematory to use any items, we will explain the reasons in writing below. EXHIBIT 1 ABOVE AND THE PRENEED FUNERAL AGREEMENT AND ASSIGNMENT ON THE REVERSE SIDE SHALL CONSTITUTE THE TERMS AND CONDITIONS OF THIS AGREEMENT. AGREEMENT AND ASSIG!'JMENT BY: AG~~EM.E.NT AND1JTt!;lANCfBY:~; X -.:"'~'--"-'-'~"T~~_; "">,~_.!-_.,~ ?~::/?//{.:~\.;, X -\.r__/l~(,l~-t ~ -j(_jj?,~~-:;~~-t.I--' ..~i-~.<~} (?!gnatur~ of Purchaser) V 1''''' ~ -' , ',' -"f-.,7.',',,;c' .,' - . >,'j'. --) :...~" ~.,..,."".~..-_. --'-. ----. (Date) f\<'~ -~; ...J I~; ) (Mqress) "/':/:~:~':C';;:~~~',,.:~/ /j (Phone) -",;;,,"~'/' (City, State) (Zip) - .- . ,:/(. ,{, (S~atur~ of P!~)'ider'5 Authorized,~er:resenta~!Ye)_ :;)i.~;/~ //...1 _/::J!--~<~(.7;-' ;;--7~t;~:.".// L .P'{/~1f::;. / 7/,/".- (/ (Date) .' .,- 'C; \ Y~~")::3 .: (Location) IPhone) ",-'/-. .., "'''''.r! /../<-T'-_.-i _ ':.?',.' _.,,,z~/: .-,"...... (City, State) (Zip) HOME SALES ONLY: You, the Buyer, may cancel this transaction at any time prior to the third business day after the date of this transaction. See the attached Notice of Cancellation form for an explanation of this ::ight. P001-A Rev. 03/10/95 @HLC, 1995, All rights reserved. No use or reproduction without express permission. Copies: Original- Homesteaders Life Companv: Pink - PrnviilPT' r"n~ru _ P"T~hOCOT SC\'-.iCl\..llL G-j '1~ /-J\ I r::;;:~ ;0... ~/JI' "\\~~ AMERICAN NATIONAL AMERICAN NATIONAL INSURANCE COMPANY LIFE INSURANCE AND ANNUITY CLAIMS DEPARTMENT P. O. BOX 1840, GALVESTON, TX 77553-1840 BUS: 1-800-615-7372 FAX: 409-766-6994 April 20, 2006 SUSAN LEDERER ATTORNEY AT LAW 4811 JONESTOWN ROAD - STE 226 HARRISBURG PA 17109 Re: Claim: C633626 - Violet Rodenhiser - Certificate LAR0025572 Dear Ms. Lederer: This letter is in response to your April 10, 2006. According to our records (LAR0025572) is a non-qualified annuity. Violet Rodenhiser was the annuitant and the owner on this contract. The contract was issued 4/3/1996. The values as of the date of death of 11/9/2005 are as follows. Cash value: $47,270.34 Death Benefit: $46,781.81 Cost Basis: $20,000.00 Records reflect the beneficiary to be Violet M. Rodenhiser Living Trust dated 4/3/96. If you have any questions you may contact us at 1-800-615-7372. When calling please refer to claim C633626. Sincerely, /1 _. '=j , ~ n ','. l. ,.r (DdLWv L -t{ij1k;1VYj EDITH S. FERGUSON /1 / \..J -~) \~, I ( _ 5/\~_c\\-,~.(j:/ct-~z v--, ~ TAX PARCEL NO. 38-14-0852-004 ',;:: : ~',-" S.S nr>r>A Vt5t:!l ~~. e J t I '--TI ~ .' 1'7 f I D .,,~ "11 -.". f) -- - .' "" ;- 'n , h ~ "1 d ~ .JL it-iS e..f~.~f{;jf~ -UK t- f llIdU~ '--'.1e ..J..JL J. -ay OJ:: year of our Lord two thousand and five (2005), ,January, In the R f) i'M' 0 ,() 11 .-.-- .......' ij/ r r ~ v ; ..-' \lIOLET lVi.. RODENHI:::.ER, a widoitJ not since remcTried, by and t~bl-c)ugrl Bp_F~B~~P~.;.Z:~ ?.;.. BELL 2.I1C} 11P.;.F~GAF~ET "P... ~ HIlvn~IELP_EICH I her daughters and attorneys-in-facc, pursuant to a Power of }::_ttorr1e~T recc,yclecl on 1',1o'\]e:mJJer 4, 2004 lD thE: Fl.ec()rder cjf Deeds in and for Cumberland County to Deed Book 7121 Page 39331 GPJiJ:1TOE I and Bl'J=!.Bl'YJi_ .!A. BELL, rn.arr i ec3~ \A:Clman 1 r2~J D 1\IfTlP"G' ---'............--'-.. -,-.i-....l..i-J/ T"'-T..i .-,J YVfCi'lessetlll That the Grantor, for and in consideration of the sum of ONE ($1.00) DOLL~~I lawful money of the united States of l'.merical unto her well and truly paid bvthe Grantee at or before the sealing and delivery hereof~ ihe re~eipt whereof lS her2by acknowledged, has grantedl bargained and soldl released and confirmedl and by these presents does grantl bargain and selll release and confirm unto the Granteel her heirs and asslgns. ALL TEAT CERTAIN tract or land situatel lying and being in Silver Spring Tovvnship I Cumberland County I Pennsylvania, being more particularly described in accordance with a survey plan of lands of Violet M. Rodenhiser, prepared by Johnson, Mirmiran & Thompson, dravJing No. 604-500, dated September 161 20041 revised September 20, 20041 more particularly bounded and ~escribed as follows, to wit: BEGINNING at a point In the center of Linda Drive (T-59 5) and being a corner COffiITlOD co lands of now or formerly Larry L. "Vogelsong; THENCE South 78 degrees 00 minutes 00 seconds East a distance of 233.03 feet ~o a set rebar and capl on line of lands OI: DO\tJ Dr fo~merl~/ L&rr-1 L ~ ~]ogelsorlg 6.Dct 2. C(Jr:'-lE:r CCJInrnorJ. -co ;J~~ .t, :...~; :":;'~II -:-;~,~7(j lands of now or forillerlv Lawrence D. and Betty L. Hodges and passlng over a set rebar and cap located 20.00 feet from the beginning of this course; THENCE along lands of now or formerly Lawrence D. and Bet~y L. Eodges South 12 degrees 04 minutes 4S seconds East for a distance of 62.92 feet to a point in the base of a 17" Oak tree and passing over a nail and ~aD locaced 5.00 feet from the terminus of this course, being- a corner common to lands of now or formerly Lawrence D. and Betty L. Hodges; THENCE continuing along the same, South 77 degrees, 5S minutes 15 seconds West for a distance or 258.40 feet to a point in the center of LiDda Drive (T-595) passing Q\Ter 2. set reb2cr SLEd cap located 5.00 feet from the beginning of this course and crosslng a round % inch rebar located 25.00 fee~ from the terminus of this course; THENCE chrough the center of Linda Drive iT-595) North 12 deqrees 04 minutes 45 seconds West or a distance of 178.40 feet to a point being the point and place of BEGI~TI~ING. SAID PROPERTY contains 0.72 acres more or less. BEING THE SAME PREMISES which VIOLET M EODENHISER, TRUSTEE, of the Violet M. Eodenhiser Living Trust, dated April 3, 1996, by and through BARBARA A. BELL and ~~YGARET A. HI1TI1ELREICH, her daughters, and attornevs-in-fact, pursuant to a Power of Attornev recorded November 4, 2004 in the Recorder or Deeds Office of - Cumberland Co'~nty, Pennsylvania in Book 712, Page 3933, by deed dated October 5, 2004 and recorded November 4, 2004 in the Office of the Eecorder of Deeds in and for Cumberland County, to Deed Book 266, Page 410, granted and conveyed to Violet M. Rodenhiser, a widow not since remarried, the Grantor herein. TOGETHER TI/Ili th all and singtllar the building, imlJrc,-vemen"ts I ways, streets, alleys, passages, wacers, water-courses, rights, Libert j PC'., pri ,.rileges, hereditaments and appurtenances whatsoever thereunto belonging, cn- in any wise appertaining, and the reversions and remainders, rents, issues and profits thereof, and all the estate, right, title, interest, property, claim and demand whatsoe'Jer of the Eaid Grantors in la\tJ, equi ty, or otherwise howsoever, of, In, and to the same and every part chereof. TO }-L""cVE ?~'m TO HOLD the said lot or piece of ground above described, with the messuage or tenement chereon erected, hereditaments and premises hereby granted, or mentioned and intended so to be, with the appurtenances, unto the Grantee, her heirs, pErsonal representatives and assignst to and for the only ~rO~Pr uce and Qcnoof roT rhp ~Yan.pc her heirs, '_,Jersonal .!..-'- ,l.-'-- '-'~ -- "' --- - -- -- -- -..-'- -----t ~EpresenLatlves and ~sslgns, fGrevs~. "' , ~\;.~.\"_:-._~_.,1... -,_t'l~,,_j-'~.'. ~~::D7 '"- -/ ~ ~ p~~D the Grantor, for herself, her heirs, personal representatives and assigns, does covenant, promise and agree, LO and wich the Grantees; her heirs, personal representatives and asslgns, by these presents, that she, the Grantor, her helrs, personal representatives and assigns, all and singular the hereditaments and premises hereby granted or mentioned and intended so to be, wiLh the appurtenances, unLO the Grantee, her heirs, personal representatives and assiqns, against her, the Grantor, her heirs, personal representatives and assigns, and against all and every person and persons whomsoever la.\JJrully claiming or to claim the same or any part thereof; bv, from or under him, her: them or any of them~ ~hall and will, -- Subj eet 2,5 a for e s a i (3. , Wp"RRJ'J\JT...3.Dst I.Q):.s..YsX_DEE.END_.______---...----- 11'1 lvittleSs W 11 ere of, the I:;rantors have hereunto set their hands and seals. Dated the dav and vear first above -",\iY i L. t eli . Sealed and Delivered in the Presence of: Irj ( /:: i /'. ~. ..-~;,'! .:) .____~/L [/(..1 L.-L.~-'V~'~- I I /y' / /{i!-i-i/:.'!--{~ .:;::> I, j,-.!~f"f.-.-v;4v~ ~~'-. (! -'---" . , (~~L(' (SEp_L) v'7J:TNESS FOP. VIOLET M. P.oDENHEISEP. by h~~ atto~ney-in-fac~1 BARBAP~ A. BELL VIOLET M. RODENHISER, by her 0tto~Dey-in-fact, B~RB~Rs A. BELL. ;,/ i ,,// / "I' .n, .".' J../ .,OJ ,'.' ...:;) J; / ' ....- 1,__,.// ,1Afi-- 't.-L ,i---j-,-'-o.{-----. fi.~~/L,,~-J./--.. WITNESS FOP. VIOLET H. RODENHEISEH ~~Rg~~E;t~~r~~~~~~;~~~~' '-,./l,-1~. ., -;', / j~.l \_.-Jl~..,'I'?~) /.;?:~...:; ~_!(~u~)__.,..~.J' ( C~ 7\ -L ) 1/ (.'/)/'J ~~J!.-,.......~ I 'J/.r, _~" ~ ....... L-J.-..t""_ VIOLET M. RODENIiEISEH, by her . t ~/ , r . l~~,~.r...-_L_B.~_r.T _~_ aL orneY-ln-IocL: ~~~ - - -' HIL1MELP.EICR :-.>:""') :",-',\",r:.E";;~.' c';; .'J IJJ' ~ ..(.vj .~- v- ...., ,{ ,/0 17'] l7 d ~ ..., .<- .i~,-,Jt,ilOM, ~egel:renl COMPjONw~ALTE OF PEN~SYLV~~IA S8 COuLqTY OF DAUPHIN On this, the 25~h day of January, 2005, before me, a Notary Public in and for the Commonwealth of Pennsylvania, the undersigned officer, personally appeared BARBAK~ A. BELL and H_2:~Ri:;J.2ET P.. HHll'1ELREICH known to me (or satisfe,ctorilv proven) to be the persons whose names are subscribed to the within- . instrument, as attorney-in-fact for their mother, VIOLET l'1. EODENHISER, and acknowledged that they executed the same for--,':he____.. .-------- -~-----_._---_.--~. --""-- --~ -- p'.:i~pG-sestfierein contained. IN WITIE:::S w-::SEREOF, I hereunto set mv hand cLn,j official ,-..,.~-.I ;:::'CCL.L. /l . /J . AI j/ .' '~>v~1 <;~/? <-?:flj!}1i.A.l"'/ I l, I 'I Y/ I "I P ,I ,.,/i " f v ./, /, / i) :i/~ , '.1 / v ~\I.dXary 2:)MhIOi.iV,'=rL~:I c';- I';::~ rJ;::;':LYtJ'Il? ~UD~lC i Notarial Seal Amy M. Maya, Notary Public Lower Paxton Twp., Dauphin County My Commission EXDires Jan. 29, }008 Memberl Pennsytvania Assod::tion of NC?a:le5. l/' Certificate of Residence v ~ . I hereby certify that the preClse residence of the Grantees herein is as follows: Barbara Bell 88 Linda Drive Hechanicsburg, P}~ 17055 I \ ;1 , ~=:- /~i~'-'~/~____;;.....:;-..-~,.-.. Attorney ......'\ ~L----',--<...-..,- for Grantees r, J...__:' ... 'J '.J:"- 2'81}1 ::-i~5.73 RE\'- \[U \:.:; tf,-~\ll) ,~5C:O/~[IEF:'S USE ONL) :] r,l. Gr~9 S{3~e Tax Paid 't"\;..n;"" REALTY TRANSFER TAX k~:;$>>- Book l\lulTll1el C~OMrv\O!'\l\NE.ll.,L TH OF PEI\!NSY'..-\Ill,I>JIA STATEMENT OF VALUE DEPARTI,IEI'T OF REVEI'JUiO Page l\lumber BUREAU OF II,DIVIDUAL TAXES DEPT ::>80603 See Dale Recorded HARRISBURG. P~. 17128.0603 Reverse for Instructions CDmplele each section and file ',n duplicate With Recorder of Deeds when (1) the iull valuelcDnsideraliDn is nDt set foril1 in the deed, (e) when 111e deed IS WI1I10ul consideration, or by gift, or (3) a ta,; exemption IS claimed. A Slalement Df Value is nol required if 11,8 transfer is wholly e"empt from la>: t'3sed on (1) lamil)' relationship or (2) publiC ulililv easement If more space IS needed, allach additional sheet(s). A CORRESPONDENT - All inquiries may be directed to the following person: I'Jame Telephone I~umber: Susan E Lederer Streel Address .1(,11 Jonestown Road Ste.226 B TRANSFER DATA Cit\, /I,rea Code ( 7 1 7 ) 65') 7 3 ') 3 Slale Zip COdE Harrisburq Pp, DatE of Acceptance of Document 17109 'Co rantor( 5 l/Lessor( 5) Grantee( s )/Lessee(s) Barbara ,A, Bell Street Address Violet M. Rodenhiser (see attached) Street ,t.,ddress 88 Linda Drive City se Linda Drive Stak c..lp Code City Stak :::Ip Code fVlecllamcsburQ P.i\ C PROPERTY LOCATION 17055 Mechanicsburq Pa 17055 :', Streel Address City, Township, Borough S8 Linda Drive County Silver SorinQ School District Tax Parcel \~umber Cumborlancl Cumberland Vallev 38-14-0852-004 D VALUATION DATA 1. Actual Cash ConsideratIon 12. Other Consideration 1 00 + 5. Common Level Ralio Factor 3. Total Consideration -0- 1 00 4. County ,L.ssessed Value 6. Fair 1v'larKet Value E 153 530.00 EXEMPTION DATA 1.00 153.530.00 1 a. Amount of S>,emption Claimed 1 b. Percentage of Interes! Conveyed 10000 100% :-" -.. .-..J ~ Check Appropriate Box Below for Exemption Claimed o o o o o Will or intestate succession (Name of u2ceoen1j (Estale File "UmDer) ~:; Transfer tD Industrial Development AJeney. c:; Transfer to a trust. (Atl8ch complels copy of trust agreem"'nt idanlifying all benefiCiaries.) (1;~'J<:::::, . (.f,__.).) '---.," Transf",; b",twe",n principal and agent (,",ttach cDmplete copy of agency/straw party agreement.) Transfers to th", Commonwealth, the United States and Instrumentaliiies by gift, dedication, condemnatiDn or in lieu Df cDncemr\ation. (If cDndemnation or in lieu of cond",mnation, attach copy Df resolution.) o Transfer from mortgagDr to a holder of a mDrtgage in default. IJlortgage BDDk l'<Jumber o Corrective Dr confirmatory deed. (Attach complete copy of the prior de::d being corrected Dr confirmed,) o StafDlary carporate consolidation, merger Dr division (Attacr, copy of articll:'s.) , Page jjumber fVl ~ Other (PI",ase ,":plain exemptior, claiMed, if other than listed above,) Property transferred from Violet IVI Rodenhiser Livina Trust toViolet fv'l. Rodenhiser on r~ovember 4.2004 (within one Continued on a Separate Paoe Under penaltiEs of law1 I de:::!arE that I haVE:: E:X?minEd this Stalernent, including accompanying information, and IO thE best of my knowledge and belief, it IE true, correct and compiete. 3ionaiure cf Corr8spDnoent or rEsponsibltS Par1:,; - , -1 \o"~, P"'-I .. .. _/y"-../ ',,.../'_ '" . .-L--'_- , UZ1E: ------ .---------, /2-';-: J 0] I:"'" _5-~'\ULd~t~ ,~'G-.)<t~ 'l--l. '3 Sovereign Bank ESTATE OF SOCIAL SECURITY #: DATE OF DEATH: Violet M Rodenhiser 176-34-7808 November 9,2005 Account #: 2471703755 Type: Checking Open date: 5/30/1996 In the name of: Violet M Rodenhiser Living Trust, Violet M Rodenhiser ttee Date of Death Balance: $4,498.49 Int.(YTD) from 1/1/2005 to 10/21/2005 $1.81 Accrued interest to date of death: $0.09 Other Info: Account #: 2335253817 Type: CD Open date: 9/13/1983 In the name of: Violet M Rodenhiser Living Trust, Violet M Rodenhiser ttee Date of Death Balance: Int.(YTD) from to Accrued interest to date of death: Other Info: closed 8/1 7/05 for $2,517.00 Page 1 of 1 · c' ~,jO,~eI~ 'gI1 Bank ~'ucn'~i~ is C()flf;.-it"'12 ".J It\:.t.... '~r tx,N)1t.l:l' r.'(,':l' rbe:ren.: .. ., "~~'. ,0, ." tJ.... .,,~,L. ','I;.' L.( 0 J .I. ..,. .', ," 6" b. -'. Court Ordered Processing / MA 1 MB3 02-10 P.O. Box 841005 Boston, MA 02284 April 18, 2006 Susan E. Lederer Law Offices 4811 Jonestown Rd., Ste. 226 Harrisburg, P A 171 09 RE: Estate of: Violet M. Rodenhiser Date of Death: November 9,2005 Dear Ms. Lederer: Per your request, enclosed please find the account infom1ation as of date of death for the above-named decedent. Please note the balances do not include accrued interest. If you should have any further questions, please do not hesitate to call. Very truly yours, I, +~) r: ~) /\1 -', 'I, ~ rrf-fJLLL.t/\.l/''-_'--/ --..."" Linda Spavento OAG Team Leader (617) 533-1789 (617) 533-1931-fax 11e. CViO~e,t M. QOde.KRiSe.ll U()[Kg TiLust ARTICLE I TiLOKStye./L [K 1iust For good and valuable consideration, the Trustor, Violet M. Rodenhiser of Mechanicsburg, Pennsylvania, County of Cumberland, hereby transfers, conveys, and delivers to the Trustees and iheir successors the property listed in Schedule "A" or supplemental schedules annexed hereto and incorporated herein by reference, to have and to hold the same, and any cash, securities, or other property which the Trustees may, pursuant to any of the provisions hereof, at any time hereafter hold or acquire, all of such property being hereinafter referred to collectively as the "Trust Estate" for the uses and purposes and upon the terms and conditions herein set fDIth. ARTICLE II DiSpoSitioK DU/LiKg tRe, litye. oty t~e, TiLustO/L During the life of the Trustor, the Trustees shall hold, manage, invest, and re-invest the Trust Estate, and shall collect the income thereof and shall dispose of the net income and principal as follows: A. The Trustees shall pay to the Trustor all of the net income of this Trust, in monthly or other convenient installments, but at least annually. The Trustees may, in their discretion, payor apply for the benefit of the Trustor, in addition to the income payments herein provided for, such amounts of the principal of the Trust Estate, up to the whole thereof, as the Trustees may from time to time deem necessary or advisable for the use and benefit of the Trustor. ARTICLE III t)[SpoSitioK OK De.otR Oty tRe. 1iustO/L A. Upon the death of the Trustor, the property of the trust, and including also any other portions added ther.eto from the estate of the Trustor or other sources, along with the undistributed income shall be held in trust and shall be administered and disposed of as follows: B. St. PnuPs United Church of Christ of Mechanicsburg, Pennsylvania shall receive a one time g:ift of One Thousand ($1,000) Dollars, Barbara A. Bell, (daughter shall receive the dollar amount for the appraised value of the trustor's garage, contents of said garage, plus a 50% share of the balance of the trust estate), Margaret A. Himmelreich, (daughter shall rece:ive a 50% share of the balance of the trust estate). It is the expressed intent of the trustor that George W. Rodenhiser shall be specifically excluded from being 9nih"ah V Iv) R.,:Pa!l~ / a beneficiary of any trust created herein. Individual beneficiaries will receive their portion of the trust estate as follows: at the age of Eighteen (18) . C. If any of the beneficiaries in Article ill, paragraph B, who are individuals, shall be deceased, then the Trustees shall divide the shares or part for the: deceased beneficiary into as many equal shares as may be necessary to provide one part or share for the then living descendants of the deceased beneficiary, they taking per stirpes; and as thusly divided, each said share or part shaH be held as a separate trust for the benefit of the person or persons for whom it was set aside and shall be held, administered, and distributed as follows: 1. The Trustees may use and expend or apply so much or all of, first, the income, and second, the principal of the trusts hereby created for the benefit of a beneficiary hereof, and said amounts shall be used as the Trustees determine necessary or advisable and in such reasonable manner as the Trustees see fit, to provide for the health, reasonable comfort, education, support, and maintenance of the beneficiary for whom such trust shall have been created. Provided, however, that in determining said amounts the Trustees shall first take into account the needs" assets, and other available sources of income and support of a beneficiary thereof. Providled, further, however, the said powers of encroachments upon the beneficiary's share shall be limited to the respective shares held for the respective beneficiary. 2. As and when a beneficiary shall meet the requirements designated in paragraph B, above, the Trustees shall distribute to said respective beneficiary the share of the Trust estate for him or her, free and clear of trust. 3. In the event a beneficiary is for any reason unable or unwilling to take any portion of his share of the Trust Estate pursuant to the above paragraphs of this Article III, then such portion shall be distributed to his or her living descendants equally, they taking per stirpes, and if there be no such descendants, then such funds shall be equally divided between such beneficiary's then-living brothers aIld sisters, and if there be no brother or sister then living, then such funds shall be divided equally between the descendants of such beneficiary's brothers and sisters, they taking per stirpes., and if there be no descendants of such beneficiary's brothers or sisters then living, then the Trustees shall add that portion of the property of that beneficiary to the other portions of the other living beneficiaries, and if there are no other living beneficiaries then: distribution shall be made according to the Pennsylvania law of intestate succession, as in force on the date of the signing of this Trust Agreement. Notwithstanding anything contained to the contrary in this paragraph, if, under fthe provisions of this subparagraph 3., of paragraph c., Article III, any person who does not yet meet the requirements designated in paragraph B, above, shall become entitled to a share of the Trust Estate, such share shall not be distributed to such beneficiary, but shall be retained in trust for said beneficiary's benefit, and shall be held, administered, and disposed of according to subparagraphs 1., 2., and 3., of paragraph c., Article III. !7niliah ~ :Pay" 2 4. If under the terms of this Article III, upon the death of any beneficiary, any other person for whom a share or portion is being held in trust shall become entitled to an additional share or portion, such additional share or portion shall not be delivered free of trust, but shall be added to the principal of the share or portion held in trust for such person and shall go as and with the same. 5. At the death of the Trustor, the Trustees shall distribute all of the Trustor's personal effects or other assets, including any contents of the Trustor's residence, to the persons named in one or more letters of instructions, entitled "Disposition of Personal Effects" referring to Article III., Subparagraph c., of this Trust Agreement, dated and signed by the Trustor and located among the Trustor's important papers at the time of his or her death. In the event that the Trustor has inadvertently named two or more persons to take a particular item, then the most recently dated letter of instruction shall control. 6. If any beneficiary named in paragraph B, above, is an organization, and such organization does not exist at the time of the death of the Trustor, then, if the organization was a charitable institution, the share designated for that charitable organization shall be distributed to another organization, chosen by the trustees, who has similar pUlposes and functions as the charitable organization that no longer exists. If the organization was not a charitable institution then the share designated for such organization shall be added back to the balance of the trust estate and divided to the other beneficiaries named in paragraph B, above. 7. A trustee in its discretion may terminate. and distribute any trust hereunder if the trustee determines that the costs of continuance thereof will substantially impair accomplishment of the purposes of the trust. The trustee shall terminate and forthwith distribute any trust created hereby, or by exercise of a power of appointment hereunder. Distribution under this section shall be made to the persons then entitled to receive or have the benefit of the income from the trust in the proportions in which they are entitled thereto, or if their interests are indefinite, then in equal shares. D. Whenever used herein, the term "issue", "child", "children", and "descendants": include adopted issue, adopted child, adopted children and adopted descendants, as well as natural issue, natural child, natural children, and natural descendants, and include descendants of adopted issue, adopted child,. adopted children, and adopted descendants. Provided, however, adopted issue who are also natural issue shall take their share of the Trust Estate only in one capacity, such capacity being the one which grants to such issue the larger share. Where applicable, the masculine includes the feminine, and vice versa, and the neuter includes the masculine or feminine, and vice versa. Where applicable, the singular includes the plural and vice versa. \/ MJP Jnihah ' I!P.. ge :] ARTICLE IV Spe-\{d-tivl1tt Pn.oLrlSiol-t No beneficiary of this trust, other than a Trustor, shall have any right to alienate, encumber or hypothecate his/her interest in the trust to claims of his/her creditors, or to render such interest liable to attachment, execution, or other process of law. The income of this trust shall not be pledged, assigned, transferred, sold or accelerated, anticipated or encumbered in any manner whatsoever by any beneficifuy, nor shall any income of the trust be in any manner subject or liable in the hands of the Trustees for the debts, contracts: or encroachments of any beneficiary or be subject to any assignments or any other voluntary or involuntary alienation or disposition whatsoever. If the creditor of any beneficiary, other than a Trustor, who is entitled to any distributions from a trust established under this instrument shall attempt by any means to subject to the satisfaction of his claim such beneficiary's interest ill distribution, then, notwithstanding any other provision herein, until the release of the writ of attachment or garnishment or other process, the distribution set aside for such beneficiary shall be disposed of as follows: 1. Distribution to Beneficiary. The Trustees shall pay to or apply for the benefit of such beneficiary such sums as the Trustees shall determine to be necessary for the reasonable health, education (including study at institutions of higher learning) and support of the beneficiary according to his or her accustomed mode of life. 2. Disposition of Excess. The portion of the distribution that the Trustees shall determine to be in excess of the amount necessary for such health, education (including study at institutions of higher learning) and support shall be added to and become principal of the trust share of such beneficiary and will be paid to said beneficiary or subsequent heirs in a manner to maximize the benefit to the beneficiary without compromise of the intent of this trust to provide Em inheritance to the heirs. ARTICLE V I\{Lra~id PJlOLri.sio~ If any provisions of this trust are held to be invalid, none of the other provisions shall be thereby rendered invalid or inoperative as long as the remaining Trust Agreement does not frustrate the intents of the Trustor, but tends to accomplish his or her overall objectives. ARTICLE VI PeJLpe-tuitie-s Sal)'il-tgs Q~alJ.St In any event, and anything to the contrary herein contained notwithstanding, the trusts Ymllah II /1j ~aye 4 created in this agreement shall terminate upon the day next preceding the e^-1Jiration of twenty- one (21) years after the death of the Trustor and their issue now living, in the event these trusts shall not have previously terminated in accordance with the terms hereof. In the event of termination of these trusts as provided for in this paragraph, the Trustees shall distribute theTrust Estate as it shall then be constituted, together with any new income, to the beneficiaries then entitled to the income from the Trust Estate in the same proportions in which they are entitled to such income. ARTICLE VII lILlAste-e-S A. The follovring people will act as Trustees in the following order of succession: FIRST: Violet M. Rodenhiser SECOND: At the death of the Trustor, the following, shall serve as successor Trustees, in the orde~r listed: Barbara A. Bell and Margaret A. Himmelreich, acting together, and then either Balrbara A. Bell or Margaret A. Himmelreich, acting alone. The executor for the heirs is Barbara A. Bell, who may speak on behalf of any minor beneficiaries. THIRD: Trustee(s) chosen by a majority of the beneficiaries, with a parent or legal guardian voting for minor beneficiaries; provided, however, that the issue of any deceased child shall have collectively only one vote. B. A majority of the trustees, whether individual or corporate, shall have the power to make any decision, undertake any action, or execute any documents affecting the Trusts created herein. In the event of a difference of opinion among the Trustees, the decision of a majority of them shall prevail, but the dissenting or nonassenting trustees shall not be responsible for any action taken by the majority pursuant to such decisions. If only two individual Trustees are in office, they must act unanimously. If an individual and a corporate Trustee are in office, the determination of the Individual Trustees shall be binding. C. Any Trustees may from time to time delegate to one or more of the remaining Trustees any powers, duties, or discretions. Every such delegation shall be made by a writing delivered to the delegate or delegates, and shall remain effective for the time therein specified or until earlier revocation by a writing similarly delivered. Every one dealing with the Trustees shall be absolutely protected in relying upon the certificate of any Trustees as to who are the Trustee(s) for the time being acting, and as to the extent of their authority by reason of any delegation or otherwise. D. No Trustees named above need give bond in any jurisdiction. If a fiduciary's bond gniHah V 11 gge 5 may not be dispensed with, the Trustor requests that the bond be accepted without surety and in the lowest possible amount. In the absence of breach of trust, no Trustees shall ever be required to qualify before, be appointed by, or account to any court, or obtain the order or approval of any court in the exercise of any power or discretion herein given. The Trustees are entitled to ordinary and reasonable compensation for services rendered in the administration and distribution of the estate. ARTICLE VIII POlti~1tS at; tRt Tiwstte-S A. The Trustees shall have full power to do everything in adrnjnistering these trusts that they deem for the best interests of the beneficiaries (whether or not it be authorized or appropriate for fiduciaries but for this broad grant of authority), including power: 1. To acquire by purchase or otherwise, and to retain so long as they deem advisable, any kind of realty or personal property, or undivided interests therein, including common and preferred stocks, bonds, or other unsecured obligations, options, warrants, interests in investment trusts and discretionary common trust funds, all without diversification as to kind or amount, without being limited to investments authorized by law for the investment of trust funds, and power to hold or take title to property in the name of a nominee. 2. To sell for cash or on credit, at private or public sale, exchange, hypothecate, sell short, or otherwise dispose of any real or personal property. 3. To make distributions, including distributions to themselves as Trustees, in kind or in money or partly in each, even if shares be composed differently; for such purposes, the valuation of the Trustees shall be given effect if reasonably made. 4. If, in the Trustees' discretion, any beneficiary (whether a minor or of legal age) is incapable of making proper disposition of any sum of income or principal that is payable or appointed to said beneficiary under the terms of this Trust Agreement, the Trustees may apply said sum to or on behalf of the beneficiary by anyone with whom th~l bene:ficiary resides, or by payments in discharge of the beneficiary's bills or debts, including bills for premiums on any insurance policies, or by paying an allowance to a beneficiary directly. The~ foregoing payments shall be made without regard to other resources of the beneficiary, or the duty of any person to support the beneficiary and without the intervention of any guardian or like fiduciary; provided, however, that the Trustees shall ensure and see to the application of the fW1ds for the benefit of the beneficiary, so that the funds will not be used by any adult person, or any other person for a purpose other than the direct benefit of the beneficiary, and particularly so that said funds will not be diverted for the purpose of support and education of said beneficiary. 5. To determine whether and to what extent receipts should be deemed income -v;t1 r9 !7niliafs I '7-'ay" 6 or principal, whether or to what extent expenditures should be charged against principal or income, and what other adjustments should be made between principal and income, provided such adjustments do not conflict with well-settled rules for the determination of principal and income questions. 6. To delegate powers to agents including accountants, investment counsel, appraisers, legal counsel, and other experts, remunerate them and pay their expenses; to employ custodians of the Trust assets, bookkeepers, clerks, and other assistants and pay them out of income or principal. 7. To renew, assign, alter, extend, compromise, release, with or without consideration, or submit to arbitration or litigation, obligations or claims held by or asserted against the Trustor, the Trustees, or the Trust Assets. 8. To borrow money from others for the payment of taxes, debts, or expenses, or for any other purpose which, in the opinion of the Trustees, will facilitate the administration of these trusts, and pledge or mortgage property as security for such loans; and, if money is borrowed from any Trustees, individually, to pay interest thereon at the then-prevailing rate of interest. 9. To lease, or grant options to lease, for periods to begin presently or in the future, without regard to statutory restrictions or the probable duration of any trust; to erect or alter buildings or otherwise improve and manage property; demolish buildings; make ordinary and extraordinary repairs; grant easements and charges; make partywall contracts; dedicate roads, subdivide; adjust boundary lines; partition and convey property or give money for equity of partition; to be either a general or limited partner. 10. To enter into transactions with any other trust in which the Trustor or the beneficiaries of the Trust Agreement, or any of them, have beneficial interests, even though any Trustee of such other trust is also a Trustee under this Trust Agreement. 11. To exercise all the foregoing powers alone or in conjunction with others, ~ven though any of the Trustees are personally interested in the property that is involved, notwithstanding any rwes of law relating to divided loyalty or self-dealing. 12. The Trustees may engage in the practice of writing options on all recognized exchanges and buy and sell, on margin or otherwise (including "short" sales), securities of every nature, limited partnerships, and commodities. 13. The Trustees may make gift transactions. However, no Trustee, other than the Trustor acting as Trustee, shall have the power to make gifts, other than to the spouse of the Trustor, if any, in excess of the amount excluded from gift tax under section 2503 (b) of the Internal Revenue Code of 1986, as amended, or any successor thereto. No Trustees, other than the Trustor acting as Trustee, shall be authorized to make gifts to charities except in satisfaction gmlials Y ;t1 ~aJo 7 of a written pledge of the Trustor. No Trustee, other than the Trustor acting as Trustee, shall be authorized to make gifts to any person who is not a descendant of the Trustor or a beneficiary under this Trust or of the Last Will and Testament of the Trustor, or the spouse of such descendant or beneficiary. B. Any Trustee may decline to act or may resign as Trustee at any time by delivering a written resignation to the beneficiaries of a trust then subsisting. C. From the income of the trusts hereby created, or, if that be insufficient, from the principal thereof, the Trustees shall pay and discharge all expenses incurred in the administration of the Trusts. D. No successor Trustees shall be liable for any misfeasance of any prior Trustees. ARTICLE IX De~egat(OVt OtJ ..AutR01Llt~ During physical or mental incapacitation, the Trustor herein appoints the successor trustees, during said period of incapacitation. The successor trustees will act as Trustee, Guardian, Executor, or in any other legal capacity, whether appointed orally or in writing, and supervise all matters in which the Trustor had the right to act if he or she had not become incapacitated. Incapacitation shall be established either by a court of competent jurisdiction or by a written statement filed with the Trustees and signed in good faith by two (2) physicians unrelated to the Trustor or the beneficiaries. During any period of incapacity or incompetency of the Trustor the Trust is irrevocable and unamendable in regard to its operation or disposition for the affected Trustor. If the Trustor regains competency, the trust wilt again become amendable and revocable. ARTICLE X ~ciciltlOVlS to 1iust A. It is understood that the Trustor or any other person may grant, and the Trustees may receive, as part of this Trust, additional real and personal property, by assignment, transfer, deed, or other conveyance, or by any other means, testamentary or inter vivos, for inclusion in the Trust herein created. Any such property so received by the Trustees shall become a part of the Trust and shall become subject to the terms of this Agreement. B. It is specifically the intention of the Trustor that all real and personal properties now owned by the Trustor are to be a part of this Trust; provided further, that all future real and personal properties acquired by the Trustor are to be a part of at to automatically become a part of this Trust at the time acquired by the Trustor. gmficrh"L ;f);f fag" ~ ARTICLE XI PClJLtles DeD~l~g CW[t~ Tiuste-es No purchaser, and no issuer of any stock, bond or other instrument evidencing a deposit of money or property, or other person dealing with the Trustees hereunder with respect to any property hereunder as purchaser, lessee, party to a contract or lease, or in any capacity whatsoever, shall be under any obligation whatsoever to see to the disbursing of money paid to the Trustees or to the due execution of this Trust, in any particular, but such persons shall be absolutely free in dealing with the Trustees on the same basis as though the Truste'e(s) were the absolute owner of the said property, without any conditions, restrictions, or qualifi cations whatso ever. ARTICLE XII QeJjotCltlo~ CH\.d .AlVtt~dM.e-Kt A. As long as the Trustor is alive, the right is reserved to amend, modify, revoke, or remove from this Trust any and all property, in whole or in part, including the principal, and the present or-,past undisbursed income from such principal. On the death of the Trustor, the remainder of the Trust Estate, and the trusts created hereinafter, may not be amended, revoked, or terminated, other than lby disposition of the trust property to the beneficiaries according to the terms stated herein. B. While the Trustor is alive, full authority is retained, in his/her discretion, to sell, convey, or mortgage property, without disclosing their capacity as Trustees of this Trust Agreement; any such sale or conveyance of property in accordance with this provision, shall be considered as, and shall cause, a partial revocation of the Trust with respect to the property so conveyed or sold, and shall be sufficient to remove said property from the Trust. ARTICLE XIII CVesttd IKttJLest at Btl1ttitiCl/litS The interest of the beneficiaries is a present vested interest which shall continue until this Trust is revoked or terminated other than by death. gnili~ V f1 (Q 9 ARTICLE XIV GOLJtJuti~g Law- This Agreement shall be construed and regulated by the laws of the State of Pennsylvania. ARTICLE XV Cotostllop~it m~~e-ss Should a catastrophic illness occur to the Trustor while living, 1he successor trustees shall manage the Trust Estate to the greatest advantage to the beneficiaries. Catastrophic illness shall be defmed as an illness that renders the Trustor incompetent or not capable of caring for himself or herself such that full-time care lis required, and it is reasonably anticipated that such care shall be needed for a period of six months or longer. Upon the implementation of the provisions of this article, other provisions not withstanding, the Trust shall become an "income only" Trust, in which none of the corpus of the Trust shall be distributed to the Trustor during the time of the catas1IOpmc illness, but will be held for the benefit of the Trustor, in anticipation of their recovery from the catastrophic illness. ARTICLE XVI r~ Te..!l!lOlltM.. In the event that any beneficiary under this trust shall, singly or in conjunction with any other person or persons, contest in any court the validity of this trust or of a deceased Co-Trustor's Last Will or shall seek to obtain an adjudication in any proceeding in any court that this trust or any of its provisions, or that such Will or any of its provisions, is void, or seek otherwise to void, nullify, or set aside this trust or any of its provisions, then the right of that person to take any interest given to him by this trust shall be determined as it would have been determined had the person predeceased the execution of this Trust Agreement. The Trustees are authorized to defend, at the expense of the trust estate, any contest or other attack of any nature on this trust or any of its provisions. gnihah VM ~a7~ JO ARTICLE XVII JtttO)Ul.t~ Qe.plLest~tO:tio~ The attorney of record for the preparation of this trust is John C. Stambulis, of Heritage Assurance Group. If assistance or instruction concerning this trust is required, the Trustor requests that the Trustee(s) call John C. Stambulis, or another attorney knowledgeable in Estate Planning. ARTICLE XVIII PlltpOJLtd r~ Du.p~(c,o:tt This Trust Agreement has been prepared in duplicate, each copy of which has been executed as an original. One of these executed copies is in the possession of the Trustor, and the other is deposited for safekeeping with the Trustor's Attorney, John C. Stambulis. Either copy may be used as the original without the other; if only one copy of this Trust Agreement can be found, then it shall be considered as the original, and the missing copy will be presumed inadvertently lost. Any clarifications or instructions concerning this Trust Agreement may be obtained by calling the above-mentioned attorney, who is requested to do everything necessary to implement the provisions of this Trust. Yni/1ah V It? @:oogc }} In Witness Whereof, the Trustor has executed the foregoing Trust Agreement, dated the day of '-/. 3 , 19~. Trustor: 0~~cf~ Violet M. Rodenhiser Trustee(s): Violet M. Rodenhiser GJ~i0cV-- 0?~ Certificate of Acknowledgement of Notary Public State of Pennsylvania) :88. County of Cumberland) On this 3d day of Ill/-i/ , A.D. 19 9& , appeaIed before me Violet M. Rodenhiser, as Grantors, and Vi et M. Rodenhiser, as Trustee(s), personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed in this instrument, and acknowledged that he/she executed it. otary Public My Commission Expires NOTARiAL SfAL [),lJ\lENE A Wii";';:itJi, NOLlli' Public "(:' , my Mrr' Commissioo E~ires No\l.18, 1996 NOTARY SEAL: !JniJiaf, \/: !vi;f faj'Q 12 ~7Ae Violel!Jl{ YCodeIllriser Bivin!! tru sl TRUST AMENDMENT AGREEMENT This Amendment Agreement is made conceming The Violet M. Rodenhiser Living Trust at the city of ......-<c..'v...:u..,c..\I'loIJ ~ounty of C.lH'.... \oo!(" \........J. , in the State of Po-. , by Violet M. Rodenhiser, whose address is 5?~ l. \ 'ttQ.. 0""'1 Ire. , in the city of Mft..,~l~ b..,,.. , in the State of. , (hereinafter called the "Trustor"). i WITNESSETH: The parties hereto are the parties of a certain Trust Agreement dated LJ - 3 -'1 (::, . Under the terms of said Trust Agrieement, specifically Article XII, Trustor reserved the right to revoke, amend, alter or terminate such Trust. Now Therefore, in consideration of the premises herein, the "(rustor hereby amends and modifies said Trust Agreement as follows: A r-t--\"'C.. \ ~ :Ill - (6) S..lr.p",...d~ ~~d-- Ch,-f"c.'-'\ cG- C\o..(\~) V\I\.!!c.\..-.....\~ bY" I Pc... - S I} o~c/e, ~o...,....'oo...ro. A. 'G,...11 ~n.u"'k.+<<' +c. b-e'1\<.re>'l dc.::.l(--s ~r ~ o......~-et:l..J.f'S~ v-' ~ 'O....,.......~ c.Y\. ~5'1 ce I f''''''fle.r+y ~-\ 8 ~ k,'t'\d-."': 0,.., I l"'--c.,~~:P...~ \ 0.- C\. t\.~ Y\. k-.::, 0 ~. +-'r-.t.. ~ 0- r-o...lf C'-.. \ re. o.c:ly '0 ~ l..~ -Tb \2, ""-"I"" b Go- .-.-.. A.~ -e.. (\ GJo-rbo...ro- Cl.~' I I J AV"~'r-..,\-e.(' '-'(~ ~ So.yo S~ 0 ~ 'b......\ ~ 0;" e~--t-....- ~c....(""I:!+- 14. H;~\"'.e..-c.,\..'\\ dv-~Y\..W wi-IY-..Q,. 5<:>10 ShLr{. o~ 'oc.-\o-~ c~ .e~+c. All other terms of the Trust are ratified by the Trustor. . Gec.~ e..." R..o~\-....~ ..5\........\\ .\9<. eJ-C I '-I ~d- ~V'Y\.. ~ ~~~ IN WITNESS WHEREOF, the lparties hereto execute this Amendment of Trust this .3 day of ~r.,-{ l \ 1 g~:&.. , 6J 1/~ hvz. c7fJ~ Violet M. Rodenhiser Ce:rtificate of Aclmowledgement of Notary Public State of Pennsylvania) :55. County of Cumberland ) On this J 0 day of A-b II! I A.D. 19~, appeared before me Violet M. Rodenhiser, personally known to me (or proJed to me on the basis of satisfactory evidence) to be the person whose e is subscribed in this instrum.ent, and acknowledged that he/she executed it. Residing in C Lt /YJ j if fLU, d G- otary Public My Commission Expires NOTARY SEAL: 1 NOIAAlAL SEAl DARLENE A. Vrii~R i1ijlar,. PuiJlic ~ ~=i~~i;!~~UE~i~~'~~~e~r996 lKe. O(lO~e.t M. Qode.\\~iSe.! U~i\\g l"iu.st DECLARATION OF INTENT The undersigned. Violet M. Rodenhiser, as Grantor, and Violet M. Rodenhiser, as Trustee(s), of The Violet M. Rodenhiser Living Trust, declare that all proper1y listed in the Schedule of Trust Property, hereby incorporated by reference, as amended from time to time, and all other property transferred to the The Violet M. Rodenhiser Living Trust shall belong to The Violet M. Rodenhiser Living Trust, and all such assets shall belong to the Trust and not to Violet M. Rodenhiser individually. Except to the extent of interest provided in the Trust document and this Declaration, Violet M. Rodenhiser has no personal interest in any such properties. It is the intention of Violet M. Rodenhiser that this Declaration shall constitute confirmation of trust ownership and shall be binding on the heirs, successors, executors, administrators, and assigns of Violet M. Rodenhiser. IN WITNESS WHEREOF, the undersigned have executed this instrument the 3 day of ~'fC"I\ ,199(,.. ~7r?a.L Cfj ~ Violet M. Rodenhiser, Grantor U~;hJeU- d~ Violet M. Rodenhiser, Trustee(s) Certificate of Aclmowledgement of Notary Public State of Pennsylvania :ss. County of Cumberland ) On this J ~ day of rl ! , A.D. 19~, appeared before me Violet M. Rodenhiser, as Grantor, and Violet M. Rodenhi er, as Trustee(s), personally knO'Wll to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed in this instrument, and acknowledged that he/she executed it. Residing iDU'fl. t er-/al1 d U ~ Notary Public My Commission Expires (SEAL ) NOTARiAL SEAl lJ.\Rl_El~ t. WH.;,GtR, it-llar)' Pljbl~ C,)I"':"'i0 n;~~. :'.'Jl(:~,~;'tti'lo;j I..::nurrty My CCJi)ln~!;)Sllti, ~~')if2S Nov. ie, 1S96