EFTA00602418

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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 the following: The sum of Eight Hundred Thousand ($800,000) Dollars pursuant to Article THIRD(A) of the Last Will and Testament of Annette Siegal dated December 16, 2010. Signed on , 2012. PEGGY SIEGAL Beneficiary EFTA00602418

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