HomeMy WebLinkAbout94-00978
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IJETlTION I.OR IJRonATE nnd GRANT 01' LETTERS
Es/ate "fJbS~1H j/I,I(t>snulc -Stt.'. No. ~I./- - Q'72
al.1O kllC)\"1I IIJ To:
Register of W Is for the/ d
_. /Jrl'l'USrtl. CounlY of /(11/ l>t"r /eU, ~ In the
Sar"" Srrllrity No. J.31-7? - 73!j I Commonweallh of l'enll5ylvanla
The pelltlon of thc ullllerslgncd rcsl,cctfully represents Ihal:
Your petllloncr(s), who Is/nrc I K years of ngc or older an the execut ol!-
In the Insl will of thc nbove decl'dcnt, datcd . J ',) / - I '1~ 0
nnd codlell(s) dated -
named
,19_
tuott rele\'onl drcllmr.tant:c~, (". renunciation. death of (',ccuIOf, ('te,)
Ilecendent wns domiciled at denth In (j(fl/bcrla/ld y, Pennsylvania, wllh
I. /5 last family or principal residence nt .3' r,o-
If" I
Ubi !oUed, number amJ l11undpalll)')
~fiJf),ll' then 9 t ~ars o~e, d . IrJ .. c:JS-
at . t/~ Il/J/. '/8 '1', l.x r
Except as follows, decedent did nOI marry, was not dlvor't and did nol have a child born or adopted
after execution of Ihe witl offcred for probate: was notlhe vicllm of a killing and was never adjudicated
incompetent:
Dccendcnt at dealh owncd property wllh cstlmatcd values as follows:
(If domiciled In Po.) All personal property
(If not domiciled In I'a.) Personal property In I'cnnsylvanla
(If nol domiciled In I'a.) l'ersonalpropcrlY In County
Vallie of real estate In Pennsylvnnln
situated ns follows:
,19
9r./-.
,.,( ..// P tJ CJ -
-
s
s
s
s
-
NA-
WHEREFORE, petltloner(s) rcspectfU~UeSI(S) th~robule of tbe lasl will and codlcll(s)
prcsented hcrewlth lInd the grant of lellcrs f;lnl('/l ,-c...l
)
(tC\tomtIlIIU)'; admlmuratiol1 c.I.a.; administration d.b.D.C.I.II.)
theron.
'J~.s.<";LiL/ ~(rt5(,{(> :J ,e.
r
The pelilloner(s) nbove'llIl1ncd swear(s) or affirm(s) thatlhe statements In Ihc forcgolng pctltlon arc
true nud correcttll thc !Jcst of thc knowlcdgc and bellcf of pelllloner(s) and thaI as pcrsonal rcprescn-
tnlivc(s) of thc abovc dcccdenl pctltioner(s) will weiland truly admlnislcr thc estatc according 10 law.
Sworn 10 or nfnrrued and subscrlbcd t'~/d 'f4 ~-:r;7<'h ~/ '"
before mc thi, 7TH dj!Y of I' i'
~~~~~~ ~q' ~
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14 - ~Lj.f-~
OATH 01' PERSONAL REIJRESENTATIVE
COMMONWEALTH OJ.' Pl<:NNSYLVANIA } tiS
COUNTY OJ.' CUMBERLAND
I.
i
I.
No. 21 - 94 - 978
Eslale of
JOSEPH M. KOSTElAC. SR.
I Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW NOVEMBER 21. 19~. In conslderallon of the petition on
the reverse side hercof, satlsfaclory proof having becn presenled before me,
IT IS DECREED that the InSlrumcnt(s) dalrd MARCH 21. 1990
described therein be admlllcd to probale and nJed of record as the lasl will of
JOSEPH M. KOSTElAC. SR.
TESTAMENTARY
JOSEPH M KOSTElAC, JR.
and Lellers
are hercby granled to
FEES
Probale, Lellers. Elc. ......... S 60.00
Short CcrtlOeales(5 ) ..... ..... S 15.00
Renunciation -. . . . . . . . . . . . . . ., $ 1 n . no
, JCP S 5.00
TOTAL ~ S 90,00
Flied ..... .~Qy~.rm~. .~1,. .1.m.........
'~1/~;f2tJt'~J 170~_~ato~.
/1. 'p' ~O:~III: MARY~: ~
(--<t nU t te ~...,t:tLt!(1.-t. - (/ .;
/f'o .7- 7- am/lk 105(('!c,C ..Cht'ry
A1T RNBV (Sup. CI. 1.0. No.)
" J3/!r fU' n(J!(tl LJ,., 70 ;J;( /?Iof
ADDRBSS
//~ -.13~-..Ff'fl,
PHONB
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Ma11ed letters and order to attorney on 11-21-94.
tlIOI_IU AlV ....
l'U: fOO ttllS
tf::nmlCAn II DOl
WAIlNING, IT IS ILI.EGAL 10 AL lEll lIilS COPY Oil
TO DUPLICATE BV 1'I101051AI all Pftl)10nnAPII.
DE~1'~~~~~~N" lldA'i~r.Wrl(h~~t8~os
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
CERT, NO. 2383221
h -/-1'- ty-
O.I.ull..IIIlt>lt....C....'.u11OJl
Name of Decedent
Sex
Raca
Marital Slatua
Informa I
Name and ddress 01
Funeral Es bllshment
ParI I:
Inlarval Betwean
Onsat and Death
(a)
.0
(c
(d)
Part II: Other Slgnlllcant Conditions
Manner of Death:
Natural g----Homicide 0
Accldenl 0 Pending Investlgallon 0
Suicide 0 Could not be Determined 0
N.m.,,' Till. 01 c~"m -q j4~i.pL .
Address---Lr tL ~ ~ ~ ,,~ ~/'t~j/(
This Is to certify that the Information here given Is correctly copied from an original cartlllcate 01
death duly iliad with me as Local Reglslrar. The original certificale will be forwarded to the Slate
Vital Records Of lice for permanent filing.
Describe how Injury occurred:
(M.D" Q:g" Coroner, M,E.)
/0 - .1/- ty
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21 - 94 - 978
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21 - 94 - 978
., Joseph M. Kostelac, Sr., designate my four (4) sons as the
Executors of my Estate and determine that they equally divide my
Estate among them.
Witness
Slgnatu~~/W4iO::J/!V.a-d>
Date~-2/- /99'd
.~~
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21 - 94 - 978
j
REGISTER OF WILLS OF COUNTY
OATH OF SUBSCRIBING WITNESS
----
codicil
(each) a subscrlblns wltnes he will presented herewith, (each) b
law, depose(s) and say(s) that
u y quallned accordlns to
present and saw
thc tes'" , slsn the same and th
request of tcstat In esence and (In the p
other subscribing wltnes os)'(.
slsned as a witness atthc
nce of each other) (In the prescncc of the
Sworn to or
mc thl
med and subscribed before
day of
19_
(Address)
Register
(Name)
(Address)
REGISTER OF WILLS OF CUMBERLAND COUNTY
OATH OF NON-SUBSCRIBING WITNESS
{l.IlL UIW(;:'U...ICE. t... /(illTUA-C,
,
(eacb) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
THEY ARE familiar with the slsnature of JOSEPH M, KOSTELAC. S&,
~IlIUtll
will
Sf2.
C2m,',//e /11. {(oS TEul C -(!llft,"R (I
testa' OR
presented herewith and
~1I111t)1
bellcves the signature on the will Is In tbe handwriting or
of (llilCl~l<lWXX~tXs't~l\l9XXIll\'(~Xll) the
that
THFV
JOSEPH M. KOSTELAC, SR.
to the best of THE I R knowledge and belicf./), 11/ l ("
Sworn to or affirmed and subscribed before Li!/U t t c-vJNtela i!. -' Cll~ I C,J'tJ--,
mc this 7TH day of -/J (NfJJ"e) rfl ' J. /}
N VE BER 9 .y31j /!t.I1f/UJUtl iLfl/. 1//Jtt;'" rhex;.,
,~,_ / ,/ (Address) / v ff
RegIster ~~ G~ ;;-~~ .--L,
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(A ddress)
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.. 01' I " 94 - 978
RENUNCIATION
In Re Bltate of
']""{i ~ -(..f) /,
I
I"/' //0'/1--</",,- )r,
I
deceased.
To the Reallter of Willi of
c v' I......J}~I-/u ".1
County, Pennsylvania.
The undcrslllned
S' 0" S
of
the above decedent, hereby renounce(l) the r1llht to administer thc estate and respectfully ask(l) that Letters
f(5/all1t~rlonl
,
be ISlued to J'OSEI'If Ill. 1(05 7Z.LI/-C I ..:fie.
...-
WITNBStJ~;tefd"- -&A.-~tft~ day of ~ ttJ--: ,19JL1:
t"11''''~~!> G, j.AwlfiJtf t.,
y...S ret--A (. ~-. ,ft"l)
(?VG-efJr2 A. KlIs~ $A...
r4~1 C::;7~ L,
(Sllnolure)
Lawrence L. Koatelac. Sr.
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(Address)"
Notarial S.al
Mlnha.' J. Hanft, Not=P.llbI1o
Carlllla BOlO, Cumbfri Cau
MV Commllllon 1:'1llrll I ti, ~8
MambOf,
~,<-"-It. ~u,,~.dr-.
(Sllnolure)
Eugene A. KO~felac. Sr.
63<[ 1St) pNA/tJI
STEEL/OM Pltf /17113
'(Address)
SEAL:
-..Jee af/ll (? ne L
WITNESS for Thomas Kostelac only
(Sllnolure)
Thomas M. Kostelac
hand
(Address)
this
day of
. 1994
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21 - 94 - 978
--
RENUNCIA TION
Estate 01 JOSt.f'H }JJ. k'oS/{ L-Ac- ~. No.
also known as
. Docoasod
Thaundarslgnad. -yi-/()IJJIt5. fJL..)<o.C,Tf..LAG (:;CN) 01
IRelatlonshlp) (Capacity)
tha abova Docadanl, hareby renouncels) Iho righl 10 administer ,he est ale and respoctfully roquo.llsll"a'
Lanar. 7lf;rAMf:.ArT/VLY ba Issued 10 ::::J(J$t:.fH M. I<osnl-Ik- .::::r~.
Wilnall
At V
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ISlgnaturel
(Addrassl
ISlgnaturel
(Address I
Sworn to or atlirmed and subsc"bed
batora me Ihl. /1- day 01
Alp{/. .194Jt.
~tfl6 .j,/tl'~~ltttd~~
Notary Public .d /~/l5
My Commission ewpire.: ~ I - Fir o. -/ -/,
........-...............,...........,......
NOTE: Rcnuncinlion. eucutod llUlllido thu Ollll:u uf RCU"IV' tlf
WIlli at. ,.,qu".d in lIonld count"," lu bu l1olttll,.,d,
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RGoil'!n of 'dills
CERTIFICATION OF NOTICE UNDER RULE 5.6/a)
'95 JAN 25 P 2 :59
Name of Decedent: J~ M. &stel.<r. sr.
Date of Death: 10~
CltJl r\' . ' , 'uOlJfl
Cumbuflund Co., PA
Will No.
Admin. No. 21-94-0078
To the Register:
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court ~ules was served on'or mailed to
the following beneficiaries of the above-captioned estate on
1/251135 :
Name
Address
.~ M. I'alt:elac. Jr.
2li6 Hillcn'5t R::a1, Qrrp Hill. PA 170ll
El.1:lE!E A. I'alt:elac, sr.
639 S. Frmt strnet:, stmltm, PA 17113
2li6 HiUc:rest R::a1, Carp Hill, PA 170ll
'l!Dta9 M. I'alt:elac, sr.
Iawra1::e L. &stel.<r, Sr.
323 9..,="""- triw, SlimmJlst:a,n, PA 17011
Notice has now been given to all persons entitled thereto under
Rule 5.6 (a) except NA
Date: 1/251'35
6.1I~d1.~((utl/lL~ -C.L~.JI.Lr---
Signature
Name cmd.lle &steJac.aerry, EB:jUire
Address 2315 M3i;JDlia triw
Ibrrlst:urg, PA 17104
Telephone/717) 235-1699
Capacity:
Personal Representative
Counsel for personal
representative
x
20, If lint 191, grtaf.r lhan lint 18, Inl., the dln.r.nc. on lIn. 20. This 11th, OVERPAYMENT.
mo
21. If lint 18lt grlol., Ihan Lint 19, .nler thl dln.,.ne. on lint 21. Thl, 11th, TAX DUE.
A. Ent., thllnl.,..t on thl balanc. dUI on lIn. 21A.
B, Enler Ih. 10101 01 L1n. 21 ond 21A on L1n. 21B. Thl. h Ih. BALANCE DUE.
Mah ChIck Payobl. tOI RIgllt" .f Will., Aglnt
IE sua. TO ANSWn AU QUUllONS ON aEYns. SID. AND It) RlCHICK MATH ',. . "',"'W~t.~y;.~
Under penaltl.. of perjury. I dlclor. thot , hav. Ixamlned Ihlt ,,'u,n, Including accompanying Ichedul.. and .tol.m.nll, and 10 the bill of my ~nowl.dg. and blll,f,
II h truI, corrld and compl,t.. I dldor. .hot all ,.01 .,Iot, hot b.,n rlport.a at 'ruI mo,h, .,alul. Declaration of pr.par., oth.r than ,hI perlonal rtpr."nlollve I,
ba..d on olllnlo,mollo" of which ,. or., hat on ~nowl.dg..
ONA Ul 0 H' N IIll' 'lUNG urUIN "'DDU i D...n
. 2315 Hnr.noUn Drivc. Itnrriaburr., PA 17104 Jan. 25. 1995
ION'" UU O' "'DDUU D"'U
II!Y.1500 IX. (7.91)
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
YEAR
NUMIER
L::'
*'
'OR DAnl O' DIATH AnlR 12t31/91 CHICK HIRa
:.'o~::~U~:~DIT II CLAIMID 0
fiLl HUMII.
2194-0978
COUNTY CODE
N' OMPL A
IS
51
III
..
COMMONW!ALTH O' PeNNSYLVANIA
OE'AIITMfNT 0' lfYINUI
.m, 210601
HAUISlUIO.'... '7 2I.060t
N' AN. IL.... . II ....NDMI
K08telac J08C H.
IOCI....LlleU.1TY NUMIU
323 SOmcr8et Avcnuc
Shireman8town. PA 17011
c_
1 INIIAL
o
179-10-13 I 10 2
I" """KAIIII 'UIVIVINQ SI'OUII" HAIII llAu. 'III' AND ""IOOU INlllAij
N/A
"'MouNr IlellvlD tUllNilluetloNSI
N/A
03.
05.
..Q. B,
R.malnd.r Return
(lor dol.. 01 d.olh prior 10 12.13.B21
fed.ral Edat. Tall. R.turn R.qulr.d
ii
82
ex 1. Original R.lurn 0 2, Suppl.mental R.turn
o .. lImlt.d Estat. 0 .0. Future Inl"'" Comproml..
(lor dolo. 01 dealh oh.r 12.12.B21
~ 6. D.Cld.nt DI.d Te'lat. 0 7. Deced.nt Malnlaln.d 0 living Tru..
IAttoch copy 01 Will) (Attoch copy 01 TIUII)
AlL COaaUPONDINCI AND CONPIDIN11AL TAX INPOIlMATlON SHOULD II DlalCTlD TO. ; _ ,
MPl n II A.
2315 Hlll\nOUa Drive
I!nrrinLurr.. PA 17104
'\. J .~.
Tolal Numb" of Safe D.po.it 8ax..
" u,,--;.t.-'" ,
Camille K08telac-Cherrv
UUPHON NUMIII
717 234-5941
E8 .
(II -0-
(21 -0-
131 -0-
(A I -0-
(51 ~?l.R'I7. 71
(61 -0-
(71 -0-
(B I $23.897.71
(91 5.842.79
(101 -0-
z
s
!
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1. R.al E.lol. (Sch.dul. AI
2. Sloch ond Bond. (Schedul. BI
3. Clollly H.ld SlockJPartn.nhlp Int.r'lI (Sch.dul. Cl
.. Mortgag.. and NollI Rec.lvabl. (Sch.dule 01
5. Ca.h. Ban~ D.poslts & Mlsc.lloneou. Penonal Property
(Sch.dul. EI
6. Jolnlly Own.d Prop.rty ISch.dul. FI
7. Tron"." (Sch.dul. 0) (Sch.dul. II
8. Total Gran An.ts (Iotalllnll 1.7)
9. Fun"al Exp.n.... Admlnlslrative Casts, Mlscelloneou.
Exp.n... (Schedul. HI
10. Deb", Mortgog. 1I0bIlIU.., lI.n'ISch.dul. I)
11. T 0101 D.dudlon. (Iolollln.. 9 & 101
12. N.t Valu. of E.ta'. (L1n. 8 mlnu. lIn. 11)
13. Chorltabl. and Govtrnmenlal Beque.ts (Schedule J)
1... N.t Valu. Sub.d to Tax line 12 mlnu. lIn. 131
15. Spou.ol Tran,f.,. (for dat.. 0' d.ath ah" 6.30.9A)
5.. In..rudlon. 'or Af,pUeobl. PerClntage on Reven.
Sid.. (Indud. valu.. rom Schedul. K or Sch.dule M.)
16. Amount of lIn. U toxabl. ot 6% rat.
Ilnclud. valu.. from Schedule K or Sch.dul. M,)
17. Amount of lIn. U taxable 01 15% ral.
(Include valu.. from Sch.dul. K ar Sch.dul. M,)
18. Principal tall. du.(Add tax from line. 15, 16 and 17.)
19. Credits Spou.al Pov.rty Credit Prior Paym.nts
-0- + -0-
Olscounl
+ $54. 17
Inl.,e.,
-0-
(15) -0-
(16) SI8.054.92
(17) -0
(III ~, R4? 7'1
(12) SIR n",. O?
.
113) -0-
(lA) SI8,054.'I2
x._- -O-
x .06_ S 1.083.30
x .15 - g
(lB) $ 1,083.30
(19) $ 54.17
(201 -0-
1211 S \,029.13
(21AI -0-
(21BI $ I .021).13
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the u.. ef .... .,.u... Th. rat.. a. pre.crlb.d by the .tatut. will b..
. ,'" (.111 will ... appllcabl. for ..tat.. of d.c.d.nt. dying on or aft.r 7/1/94 and bafor. 1/1/96
. 2'" (.11) wNl ... appllcabl. for ..tat.. of d.c....nt. dying on or aft.r 1/1/96 and It.fore 1/1/97
. 1'" (.'1) wlU ... appllcabl. for ..tot.. of d.c.d.nt. dyIng on or aft.r 1/1/97 and b.fore 1/1/98
. S,.vael "......n occurring on or aft.r 1/1/98 will b. .xempt from Inh.rltanc. tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
.V PLACING A CHECK MARK (....) IN THE APPROPRIATE BLOCKS.
1. DI~ Mee.r.nt make a tronsf.r and:
a. retain the use or Income of the property tronsferred, .......................................................
b, r.toln ,h. rlgh"o d.slgna'. who shall use Ih. property 'ransf.rr.d or lIs Incom., .......,.......
c. refQln a reversionary Intere.t; or .........................................................,.........................
d, r.celv. th. promise lor lIIe of el,her paymenls, benellts or care' .......................................
2. If de.tI1 occurred on or belore December 12, 1982, did decedent within 'wo years preceding
d.alh 'ransfer property wlthou' receiving adequate consldera,lon' II death occurr.d alter
D.c.mb.r 12. 1982. did dec.den"ransfer property within one year 01 dea,h without receiving
adequate consideration' .......... ............. .... ... ............ .... ...., ...... ..... ...., ... t. t ..... ..... t....... ..... ...
3. Old dlCedent own an 'In trult for' bank account at his or her d.ath.......................................
IS 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Il\I.ltOIlI.P""
~
COMMONW..lIH 0' PfNNSYlVANIA
IHHllnANCI TAX .,ruIN
II.IDIHT Dle'DINT
PI.al. Print or l' .
MBER
E OF
2194-0978
.Joseph M. Koste1ac, Sr.
CAli ,,.,,,ty leI"tly.ew".d with the 11th' II Survlvorthlp mu" b, dl,cI...d on Schldul, PI
VALUE AT
DATI Of DEATH
ITlM
NUMBER
DESCRIPTION
$ 1,359.66
9,996.22
11 ,048.40
Checking account
1.
Certificate of Deposit
2.
Ravinlls account
3.
805.00
633.43
Deposit Dec. 10, 1994 - Retirement check
4.
Deposit Dec. 21, 1994 - Nursing 1I0me Refund
5.
55.00
Miscellaneous personal property
6.
S 23,897.71
TOTAL Alia .nter on /In. 5. R.co
(Ano,h addlllonal 8 ~" K II" ,h..11 if mar. 'pac. I, "..d.d,)
....,~._~-;----~,..~_:'.~"'._'
. . '. .'
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.
..
1I'#lIl1lhI7.111
.
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
PI.a.. Print or T .
COMMONWfAlfH 0' PfNNSYlVAtllA
INHUITANCr TAX UTU.N
.'IIDINT DfCfDfNr
ESTATE OF
Joseph M, Kostelac, Sr.
ITEM
NUMBER
2194~0978
DESCRIPTION
AMOUNT
A. Fun.ral Exp.n.."
I.
$5,273.66 - funeral home
145.03 - caterer
116.50 - caterer
$5,535.19
B, Admlnl.tratlv. CO.t.,
~
4.
C,
1.
2.
3.
4.
5.
6.
7.
B.
1,
Penonol R.pr...nlotlve Commllllon,
Social S.curlty Numb.r of Penonol R.pre,enlotlve,
Veor Commllllon, paid
-0-
2.
Allorney Fee.
-0-
3.
Family Exemption
Clolmon'
Addrell of Clolmon' a' decedenl" death
S'reel Addrell
City
Slole
Zip Code
Relatlon,hlp
-0-
Probale Fee,
90.00
- Filing fees $90.00
MI.nllan.ou. Exp.n..1I
Federal Express - Renunciation form
Cumberland Legal Journal.-- Publication Fee
13.00
40.00
72.20
92.40
Sentinel - Publication fee
Medical expenses
TOTAL (AI,o enler on line 9, Recapitulation)
(If mar. .pae. I. n..d.d, In..'' additional .h..t. of .am. 01...)
S 5,842.79
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(OMMOHW'AUH 0' "NNlYtY'Ht"
INM'I.,ANCI ,.... .nUIN
IIIIDlNt DlClDlN'
SCHEDULE J
BENEFICIARIES
~
ESTATE Of
fiLl NUMBIR
Joseph M. Kostelac. Sr.
2194-0978
ITEM
NUMBER
NAME AND ADDRESS Of BENEfiCIARY
RELAnONSHIP
AMOUNT OR
SHARE Of ESfATI
A, Taxable Sequellsl
\,
Joseph M~ lCostelsA', Jr. "II OJ :J.n I
J./,j, IkftSf K/J.J Ca~ H1 r,.. I",'
EU'&3Q '~~;:;D~t$t'6f(;eIW(l, PA 1'1-113
ThOm;.~~' f~11d~'f ~ CMtpIbII, 1,4- /JfJI/
Lawrence ~ Kostelac. ~r.
1~ fP,.u5t.f GtI .9l((lfrtW1SlvWrl, PA 1:Jo/
Son
one quarter share
2.
Son
one quarter ahare
3.
Son
one quarter share
4.
Ron
one quarter share
..
f'
ITEM
NUMBER
NAME AND ADDRESS Of BENEFICIARY
AMOUNT OR
SHARE Of ESTATE
a. Charitable and Oovtrnm.ntal aeque'lIl
\,
N/A
-0-
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (AI.o onlor on IIno 13, locopllulollon)
(If more .poco I. noodod, In.ort additional .hoot. of .omo .1.0)
s -0-
... ow_. ~_........ .... ..., _
_._,------ -- - - - -- --- -_..- - - .-.--- -- - - - -.--.- -------..
-... -_. ...~ ~..._- - - -----
~:~?-eft ;::;::; ~~:-::~i ",.',
Df-. '.-.'~..~.'..:.'.i'A.....c.;A....'...O.2,.,.2...'..754. ' ,COMMONWEALTHO. F PENNSYLVANIA .
. ..< ",' . , ,DIPARTMINT O. .IVINUI .
r.:~[;;;;i,;,,;,;;;' ';OP;ICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATETAX
.
RECEIVED FROM:
&
ACN
ASSESSMENT P:'
CONTROL ...
NUMBER
AMOUNT
KOBTELAB-CHERRY CAMILLE M
e31~ MAGNOLIA DR
101
.1,029.13
HARRIBBURG PA 17104
ESTATE INfORMATION.
m II MER
II el-1994-097B
m NAME Of DECEDENT IIA$TI
~ KOBTELAC JOBEPH M
II DATE Of PAYMENT
B PO$TMARK DATE
COUNTY
'OlDHfI'~
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BBN
(fIR$TI
BR
179-10-13:51
(Mil
CUMBERLAND
DATE Of DEATH
SEAL
RECEIVED BY
.I,oe9.13
m TOTAL AMOUNT PAID
REMARKS
JOBEPH M.KOBTELAC,JR.
REGISTER OF WILLS
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/ CD''''ONWULTH OF PENN.nYANll
DEPlRTHENT OF REVENUE
BUREAU OF INDIYIDUAL TAMES
DEPT. IID6Gl
HARRISBURG, Pl 1111.-0'01
NOTICE OF INHERITANCE TAX
APPRAISE"ENT. ALLDWAHCE DR DISALLOWANCE
OF DEDUCTIONS AND ASSESS"ENT OF TAX
ACN 101
DATE 04-03-95
I)
L ..I. /
(I V
FILE NO.
DATI! OF DEATH 10-25-94 COUNTY CUMBERLAND
NOTE, TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SUB"IT THE UPPER PORTION OF THIS FOR" WITH YOUR TAX
PAY"ENT TO THE REGISTER OF WILLS. "AKE CHECK PAYABLE TO "REOISTER OF WILLS. AGENT"
REMIT PAYMENT TO:
CAMILLE KOSTElAC-CHERRV
2315 MAGNDLIA DR
HARRISBURG PA 17104
REGISTER DF WILLS
CUMBERL~D COURT
CARLISl~ ~A lW013
;'. : \)1
(;
A.ount.:-R...ltted
'~
...
HOUSE
:0
:nOI
d' t'')
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FDR YOUR RECORDll ....
iiEV:is4Tiif-"Fji-iiZ":94Y-iioi"icinoP-YNHEiiifAifcE-i"AitiiPPRA-iiiiifEii:r;-;.r.rOWAifcE~iiFin--~-~----mm
DISALLOWANCE OF DEDUCTIDNS AND ASSESSMENT D1b ~AX u ~) '.
JDSEPH M FILE NO. 21 94-0978 ACN)' 1'01 0 DATI! ~C04-03-95
.-"
APPROVED DEDUCTIONS AND EXEMPTIONS:
t 5.842.79
9. Funeral EMPan.../Ad.. Cal I/Hlle. Ewpan... (Schedule HJ (9)
10. Debts'Hartgag. Liabillti../Llana (Schedul. I) CI0) .00
11. Tot.l Deductions Ill)
12. Hat V.lu. of Tax R.turn (12)
15. Charitable/Covern-ant.l Sequa.t. (Sch.dule J) (13)
14. Nat V.lu. of Eat.t. Subject to Tax (14)
NOTE: If.n ......m.nt w.. i..u.d pr.viou.ly, lin.. 1ft, 15 .nd'Dr 16, 17 .nd 18 will
reflect figur.. th.t includ. the tDt.l of Abh r.turn. .......d to d.t..
ASSESSHENT OF TAX:
15. AltOunt of Lln. 14 at Spou..l ,..t. US)
16. A.ount of Lin. 14 taxabl. at Lin..l/CI... A rat. (16)
17. AMOUnt of Lin. 14 taKable .t Coll.teral/CI... 8 rat. (17)
18. Principal Ta~ Du.
TAX CREDITS:
PAY"ENT
DATE
01-25-95
ESTATE OF KDSTELAC
TAX RETURN WAS, I X I ACCEPTED AS FILED
RESERVATION CONCERNINO FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL
1. R.a1 E.t.te (Schadu1. A) el)
2. Stock. and Bond. (Schedu1. B) (2)
3. C1o..1~ H.ld stock/Partner.hip Int.r..t (Schadu1. C) (3)
4. Mortgage./Not.. Rec.ivabl. ISch.du1e D) 14)
S. Ca.h/Bank D.podt./Hho. Per.on.l Prop.d~ ISch.dul. E) 15)
6. Jolnt1~ Owned Prop.rt~ ISchedu1. f) 16)
7. Tran.fera ISch.du1. 0) 17)
I. Total A...t.
RECEIPT
NU"BER
AA022754
DISCOUNT
INTEREST
1+1
1-'
54.16
PAVHENT MUST BE MADE BV 07-26-95M.
I CHANGED
.00
,00
,00
,00
23 .897,71
.00
.00
leI
.00
18.054.92
.00
X .03_
X .06_
X .15_
llll
A"OUNT PAID
1.029.13
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
23.897.71
~.8~~ 7Q
18.054.92
.00
18.054.92
,00
1,083,30
.00
1.083.30
1,083,29
,01
.00
.01
IF TOTAL DUE IS LESS THAN .1. NO PAY"ENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI. YOU "AY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS,)
~
~
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RESERVATION. Elt,t.. 0' decedent. d~lnt on O~ befar. D~eeb.r It, 1'12 -- l' ~v 'utur. Int.r..t In thl ..tat. .1 'tln.f.tred
In po.....lon or enJoy.ent to Cl... . (co11,t,r.l) beneflcl.rl.. of the dlcldlnt .,t., thl Ixplr.ilon of enw ..._t. 'or
II'. ar for w..r., the Co-.onw..lth hereby I.pr...lv r...rv.. thl right to appral.. ~ ...... 'tln.f.r lnn.rlt~. Tlx..
It the l.wful Cl... . (col1,t,r..' r.t. on eny luch future Int.r..t.
PUIlPOIl 01'
NOTICEI To fulfill the r.qulr.-.ntt of Slctlon 11~a of thl l~rltenc. end E,t,t, Tlx Act, Act 22 0' 1'91. 12 P.I.
Seatson 2140.
PAVNENT. Detach the top portion of thl, Motle. and .~It with your ply..nt to thl AI,I"" 0' Will, prlntld on the r.v.r.. Ilde.
..H..... check Dr ltOMIy order plYlblt tOI REGISTER OF MILLS, AOENT
All p.~t. r.celVld shell '.r,t be applied to Iny Inter..t which ..y bt due with Iny r...lnd.r ~111d to thl tax.
At'~D (CA), A r.fund 0' . t.x credit, which w.. net r.que.t.d on the ,.x A.turn, ..y b. r.que.ted by cO__l.'lng en "Appllc.tlon
for A.fund 0' P.nn,ylvenl. Inherltenc. end E.t.t. '.x" (AEY.1J1J). Appllc.tlon. .r. .v.ll.bl. .t the Dfflc.
of the Aeal.t.r of ~lll., eny 0' the 2J A.venue Dl.trlot O"lc.., or by c.lllng the .peel.1 2'-hour
en.werlno ..rYlc. ~r. 'or 'or.. ord.rlng. In P.nn.ylvenl. l-IOD-J62-20lD, out. Ide Penn.ylvenl. end
wlthln loc.1 H.rrl.burg .r.. (717) 111-1094, 'DO' (711) 712-225' (He.rlng 1.,.lr.d onlyJ.
DIJ[CTIDNlI Any p.rty ln lnt.r..t not ..tl.fled with the .ppr.I..-.nt, .11ow~. or dl..llowanc. 0' deductlon., or ......eent
of t.x (Includlng dl.count or Int.r..tJ .. .hown on thl. Notlc. au.t obJ.ct within .lxty (60J d.v. 0' r.u.lpt a'
thlt MoUe. bYI
--wrltten prot.,t to the PA a'Plrt.ent of R.v.nu., lo.rd of App.II., a.pt. 211021, H.rrl.burg, PA 17121-1011, OR
--'I.ctlon to h.v. the ..tt.r d.tar.lnad .t audit of thl account of thl par.an.l r.pr".nt.tlvl, OR
w-app..l to the Orphan.' Court.
AatUH
IITAATlV!
CDRRrCTIDHI,
'eGtu.1 .rror. dl.cov.r.d on thl. ........nt .hould bl .ddr....d In writing tal PA DIP'rtlent of R.venue,
lur.au 0' IndlvldUll 'axa.. ATTHI Po.t A......ant A,vlew unit, D.pt. 210'01, Harrl.burg, PA 1112.-0601
Phone C717J 717-'IOS. Sal p,,, J of thl bookl.t "In.tructlon. for Inherltancl T.x Return for. A..ldlnt
OIe.dlnt" (REY-II01) for In axplanatlon of ~lnl.tratlv.lY corr.ctlbl. .rror..
If anv t.. due I, p.ld wlthln thraa (J) c'land.r aonth. aft.r thl d.c.dant'. death, . flv. p.rcent (IX) dl.count of
the t.. p.ld I. .llow.d.
Int.r..t I. ch.rged beglnnlng with flr.t d.v of d.llnquency, or nlne C') eonth. and one (1) dlY froe the det. of
de.th, to thl d.t, of PIV.ant. Tlx.. whlch bee... delinquent blforl Janulry 1, 191' ~.r Int.t..t .t thl r.t. a'
.Ix (6~) p.rc~t Plr annu. cllcul.t.d .t . dilly rat. of .0001'4. All t.xe. which bee... delinquent on and .ft.r
January I, 1912 will b.ar Intara.t .t . r.t. which will v.ry froe cII.ndlr ya.r to calendlr v..r with thlt r.t.
announced by the PA Deplrt.."t 0' Ravanua. The applh:lbll Intlr..t r.tll for 19n through 1995 .r..
DISCDI.",
INTER!I'I
2!! Int.r..t A.t. O.Uy Inl.rllt F.ctor !!!!' Int.r..t A.t. 011111' Int.r..t Factor
1911 10. .000141 19.7 .. .oauo
19U U. .0aOOI 19.'-1991 11. .000301
19'4 11. .000301 199' OX .0002..,
191' U. .000n6 1995-1994 7X .000192
if.. U. .000214 1"5 OX .000241
ulntarllt II c.lculatad .. followlI
INTERERT . BALANCE OF TAX UNPAID X NU"IER OF DAYS DELINQUENT X DAILY INTERERT FACTOR
"-Any Notic. I..uact .fllr the tall blOOM. dlllnllUWtl will raUlet M Intarllt calcul.tlon to flft"" CU. din
bevond the data of thl ......-.nt. If p'v-.nl I. .ade .ft.r thl Int.r..t coaputatlon d.t. .hown on thl
NoUcI, additional Int.rltt ....t be c.lcul.ted.
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rAl'Cutlw Olr(.'(lor
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STATUS REPORT UNDER RULE 6.12
Name of Decedent: JoSeph (Yl. Kost-el 0..0 I 'sr:
Date of Death: 'O-~5-q~
Will No.-11i~ - ooq1-g Admin. No. ;//- qt.J - OQ1g
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State ~ether administration of the estate is complete:
Yes V" No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
J, If the answer to No. 1 is Yes, state the following:
a. Did the personal r~~sentative file a final
account with the Court? Yes No~.
b.' The separate Orphans' Court No. (if any) for
the personal representative's account is:
, c. Did the personal representative ~t~ an
account informally to the parties in interest? Yes~ No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Date: I/-II-IN
&idiLl-Ufth-~ - ~ t'J"
Signature ~
Camille.. ~osfelcc - Cherf'
Name (Please type or print
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