EFTA01133359.pdf

IN THE CIRCUIT COURT IN AND FOR PALM COUNTY, FLORIDA PROBATE DIVISION IN RE: ESTATE OF File No. ANNETTE SIEGAL 50201ICP001706XXXXSB Deceased/ RECEIPT OF BENEFICIARY The undersigned, PEGGY SIEGAL, hereby acknowledges having received from the personal representative of this estate and the Trustee of the Annette Siegal Revocable Living Trust u/a/d December I, 2010, the following: The sum of One Hundred Thousand ($100,000) Dollars pursuant to Ankle THIRD(D) of the Last Will and Testament of Annette Siegal dated December 16, 2010 and subsequently Article FOURTH(A) of the Annette Siegal Revocable Living Trust Wald December 1. 2010. Signed on , 2013. PEGGY SIEGAL 22329328.1 09042013 EFTA01133359