HomeMy WebLinkAbout97-00973
"
JAN L, BROWN
a4'!f SIR THCMAfi CQUFl'r, BUITE itA
HARRISBURG, PO:NNSYL.VANIA 17109
717.8;II.e8~o
OEe 0 6 )1J9l/!J
~~-'i"~"''''~!l1lfl1!l11l'''l'''-;;!J-'-~nIH I L ,.,,--
N L BROWN . ,
JA .' COURT SUIT! W. ,
S4~sllnH0!<1A.:'NNSVL.VANIA 17109
HARRISBURtl, Po.
, 717.841...80
~
IN RE: THElRESA M 0' AGOSTINO
a/k/a TERESA M. D' AGOStiNO
IN TIlE :'OURT OF COMMON PLEAS
OF CUMBERLAND COUNTY,
PENNSYLV ANIA
ORPHANS' COURT DIVISION
NO ~I _en .-g '"'3
an alleged
incapacitated person
PRt:L1MINARY O~I)t:R 01<' COlJRT
AND NOW, this _'1!!.._ day of __/.lc!!..,-)" L'l.~I__.' 199/., the tbregoing Petition having
been presented in open Court, upon consideration thereor and on motion of Jan L. Brown, Esquire,
Counsel for the Petitioner, it is ORDt:Rt:D and I)ECRU:\) that a Citation be awarded, directed to
THERESA M. [)' AGOSTINO allda TERESA M D' AGOSTINO to show cause why she shoulcl not
be adjudged an incapacitated person and a plcnary guardian of hcr estatc and person be appointed,
returnable l~_u.1.:tIl.l{L-';'--'-'-._' 1991 at _/U:(li o'c1o(:k.l\M, prevailing time.
The time and place ofheadng on the petition for i1ppointment of a guardian of the estate and
person ofth(~ alleged incapacitated! pers?,n are fixed for _hc.~~,Li>!_iiL-' 199 J at ..10: (!()o'c1ock,
II .Ul ..C"(L L.t\..~tr'/( I .L'. ,~.
...:M.,^prevailing timc, in the Orphans' Court Division, Cumberland County Courthouse, Carlisle,
Pennsylvania. '1. jr' )'.~ (ct. ..:). /: (.u.'.:( 1.1/ 171 .' il,'l A/'. (11."/'" (/,ltc'( /0
At least /~t~~~;)~~'y~, ~~~cn '~jd~~r;;;fftle il~{a~~/~~(l~/~i~~~(";~ 'fu~~~~~( M.
0' AGOSTINO aIk/a TERESA M. D' AGOSTINO, the alleged incapacitated person, by serving her
personally with the Citation and this Order of Court and a copy of the foregoing petition together
with an explaaation of the content and terms of the petition: and at least __ days' written notice of
the petition and hearing shall also be given to the next of kin and to the following parties in interest:
_ ____---. either personally or by registered or cer~it1cd mail.
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-.----.---r----.--- J,
YOU ALSO HAVE THE RIGHT TO REQUEST TIlE COURT TO ORDER AN
INDEPENDENT EVALUATION OF YOUR ALLEGED INCAPACITIES ADDITIONALLY,
YOU I-lAVE TIlE RIGHT TO A TRIAL BY JURY ON TilE ISSUE OF YOUR ALLEGED
INCAPACITIES YOU IIAVE A RIGHT TO BE PRESENT AT TilE COURT IIEARINGS
UNLESS YOUR PHYSICAL OR MENTAL CONDITION WOULD BE IIARMED BY YOUR
PRESENCE, OR IF YOU ARE OUT OF PENNSYLV ANIA
YOU HAVE THE RIGHT TO APPEAL THE COURT'S DF.CISION REGARDING
INCAPACITY OR FUNCTIONAL LIMITATIONS AND TIlE APPOINTMENT OF GUARDIANS
BY FILING NOTICE OF APPEAL TO TIlE SUPERIOR COURT OF I'ENNSYLV ANIA WITHIN
DAYS OF THE COURT'S DECISION YOU ALSO HAVE THE RIGHT TO
PETITION THE ORPHANS' COURT OF CUMBERLAND COUNTY FOR A REVIEW
HEARING TO MODIFY OR TERMINATE THE GUARDlANSHIPS WITHIN \0 DAYS OF THE
COURT'S DECISION
YOU MUST ACT PROMPTLY IF YOU HA VB REASONS WIlY YOU THINK YOU ARE
NOT AN INCAPACITATED PERSON, AND IF YOU OBJECT TO HAVING A GUARDIAN
APPOINTED FOR YOUR PERSON AND/OR FOR YOUR PROPERTY YOU MUST TELL THE
COURT YOUR REASONS, OR HAVE YOUR ATTORNEY TELL THE COURT THE REASONS
BEFORE OR AT THE TIME OF TilE I-lEARING.
WITNESS MY HAND AND SEAL THIS _ DAY OF _, 19_,
By:
****"*****
6. The names and addresses of the person or institutions providing residential services
to THERESA M. D' AGOSTINO a/k/a TERESA M. D' AGOSTINO are as tbllows:
NONE KNOWN
7. The names and addresses of ot her service providers are liS follows:
NONE KNOWN
8. THERESA M. D'AGOSTlNO a/k/a TERESA M. l)'AGOSTlNO was never a
member ofthe Armed Selvices of the United States. THERESA M. D' AGOSTINO alk/a TERESA
M. D'AGOSTlNO is not receiving benefits n'omthe United States Veterans Administration.
9. The Petitioner asks that SALVA TORE 1. D' AGOSTINO, JR. be appointed as
Guardian ofTHERESA M. D' AGOSTINO a/k/a TERESA M. I)' AGOSTINO The proposed
guardian is related as son to THERESA M. D' AGOSTINO a/k/a TERESA M. D' AGOSTINO.
10. The proposed guardian has no interest which is adverse to the interests of THERESA
M. D'AGOSTlNO alk/a TERESA M. D'AGOSTINO
11. Petitioner believes, and therefore avers that no Court has ever assumed jurisdiction
in a proceeding to determine whether THERESA M. f)' AGOSTINO a/k/a TERESA M.
D' AGOSTINO is incapacitated.
12. Petitioner believes, and therefore avers that THERESA M. D' AGOSTlNOalk/a
TERESA M. D' AGOSTINO does not have a guardian already.
13. The reasons why this guardianship are being sought are as fbllows: THERESA M.
P' AGOSTINO a/k/a TERESA M. f)' AGOSTINO is unable to make decisions regarding financial
matters or health care/medical decisions, du(~ to scnile dementia.
14. The functional limitations and physical and mental condition of THERESA M.
D' AGOSTINO alk/a TERESA M. f)' AGOSTINO are senile dementia, not able to make competent
decisions as far as her welfare is concerned.
15. The following steps have been taken, in order to tind less rcstrictive alternatives to the
appointment ofa guardian: THERESA M. f)' AGOSTINO alk/a TERESA M. f)'AGOSTINO is not
competent to execute a power of attorney, and no power of attorney exists.
16. The Petitioner requests that the guardian be granted powers to act for THERESA M.
D' AGOSTINO alk/a TERESA M. f)' AGOSTINO in the following specitic areas: financial affairs,
COMMONWl1AL TH
COUNTY
OF PENNSYLVANIA
OF CUMBERLAND
5S:
o th' t/ /"{lb.
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'-"" 'At VA l'OllE J D' AaDSl"NO, JR, Who, ""'" d.." ''''m '''''dl,. " low, d...
...... "d~, tI,,,.,,, ...." ","h i, 'h, ('''801,. p"ltI"." ''''' "d ,,_ ,,'''' "'" o(N.
knowledge, information and belief
IN WITNESS WHEREOP, J h''''md. "'. m, .."" "d om"., "".
.!!:f-1;J 1~~ d
SALVATOR~~~
.
SWORN '0 "" """"""" &ero", m, 'hlo .!ii'l d. Y of n......,., 199,
~(\ 11(,)/Y],lln,
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Notar PUblic . ___
My Commission e"pire8:
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I yerlty that the statements made in this Petition arc true and cOl'\'ec!. I understand that -false
statements herein arc made subject to the penalties of 18 Pa.CS. t4904, relalingto unsworn
falsification to authorities.
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JAN L, BROWN
'8415 SIR THOMAS, COURT, SUITE UA
HARRISSURG. Pr,:NNSYLVANIA 17109
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Q I! Teresa M. D' Agostino n/k/a Theresa M. D' Agostino partially or totally unable to manage her
tinanc.ial resources?
A. The ability ofTeresa M. D' Agostino a/k/a Theresa M. D' Agostino to manage her financial
resources is impaired __R,j--u / / Y'"-.--------- (not at all, partially, totally) as
follows: S j\.L---'-:J..__2LL?.i!.~:ek_-~tt-,-jLr?.~tMJ--..:.iI:(I..":Ui/zJ--.-'~ ('(,'((jtCf)>4)
(J'_ it. MI ::'1~l?:-(it__J'1{II) INr:,;S1-"--__l~u..(~(L0'i.~:y.._<L...tz.!l_~~:_l'_:1:d_/;/1i ('.L_. /'
{l.~ 0(<.( /'/lv' dt-t:, /1.1'/(',--(>-1 /t/c(.'-.pv~'v' ;;>'-;'f'/,r.~.2I'rI!7:. /<~./hthc._:(~~4.t..
(J Is Teresa M. D' Agostino a/k/a Theresa M. D' Ago~tinollble to mect essential requirements for
her physical health and safety?
A The ability of Teresa M. D' Agostino a/k/a Theresa M. D' Agostino to meet essential
requirements for her physical health and safety is impaired ..lz'-iZL!-4-----~- (not at all, partially,
IOl~"Y) as followsyS 17 III :_.j:l~(f1.t.!..,.k'_1-...L-!:~~("I~yy'I;L{.f:c7fW.~h ~ ~-'-1
'm. ~I j--<kl-hr-clf ~ 1..2.-k'n.c., -'1 ()(/I_4-.4-tt/_jr - . /~-). ,r" }'-r~<')'~ /<1-1'.JtLrf./t..-rk1.
.. 'f~:tJlJ' J{( ;)anv'J~'-___~k~2):'cZL.d/4')/' z_ r~h{?P~'
(r ;\;"'// I?,.ur'>! (,/.J.,,~.-,Iti.+1'.L /.L jf"-r<I.I\_tlr:z,,,_.,,t..
Q. Can you please evaluate the present condition of !teresa M. D' Agostino alk/a Theresa M
IY Agostino with respect to incapacities of the type alleged in the Petition? In particular, could you
please comment on the nature and extent ofthe alleged incapacities and disabilities and also, insofar
as YOll are able, the mental, emotional and physical condition., her adaptive behavior, and her social
skills?
A. Based upon my education, training and experience, as well as my acquaintance with Teresa M.
D' Agostino a/kla Theresa M. D' Agostino as stated above, it is my opinion that her incapacities and
disabilities are :)1J.e:2AA f1 /<,:r::-.!-4 n~-:f.'-o:f N</tt~P ....LLf/,i J _(l/VU</~;~'--r.J-'
~ If '
lUll/.... 5-t1~__J;.'.-J/i<J_ /Jt(d'_A:-.~ dtz,J-!I()'r---- If-An::f_,-'u.l.t,dz.--1-<>:
tn-ldek
Her mental condition is _.U___'L_t)!::l.;~_l~-f/!:;.'f_l__(('(;'(:U'-I~~-~-_--._.----~~----.
, tJ {)
._______.___.___._____. ____._____..___~__ lIer emotional and physical condition are
uJi.~ I'I':..,!:_.. /'''''(:11' ;J(c{0Jl.l-l.fl:!:1-r;L:. .~_'-l f >~.(,..1'1I(" ,-__(;,4'./..J.f!.t::~'___:i:...._ .
, ()
I J .
'o.Llli~- . 'lLJ_.t..,.1II...iII(,i<;h. -./t6il.L. -~L'.z~.';L.r-.' ..k.. ....wf11t...ifJ(SYJ.?ly- '.-- ...~2...f.(1.."4'-t!i(c<-.
1'/ a. .f,.-<f"Y.}F p"t!-(t 1".(1/ .
I~r ada Ive behavlbr is______.. _________. ___~___. -~--- -. -.--- .---~.. -------------.
lIeI' social skills are
.,.___.~~_..___.___.__.___...,_ _______._~..._._~._.>..~______...._.._~..,..'~r~____
Q. What recommendations would you make concerning services necessRlY to meet the essential
rcquirements lor the physical health and safety of Tercsa M. D' Agostino a/k/a Theresa M.
I)' Agostino?
A. I would recommend that her physical hcalth and safety be protected by
tl1ln(.di~(h~Zl1.L-ri{'Fu./:L~~__L'2.JL~_..lt''''-(Hdu-,-- 'I t1 .~-
,( Q
f~~dL{-I/'" -It(,~.!._j:''1~___lJ,::j,L._/JL''<I~~1-~L--~-------
Q. What recommcndations would you make concerning managemcnt of the financial resources of
)
Teresa M. D' Agostino alk/a Theresa M. D' Agostino?
A. I would recommend ..'li.d__j!'.-!_!<JUT-!'.!..c:t__-6:r--l~:--L--:Li(<-,/~--..-
.Yl n::,(d..,.....t- L.':!L.i'-!i.,!-~_J' ('//,"n_ t';,,-=_...J"C c1-L/ J-.1;(_u:..~L____
I
h;J
Q. What recommendation would you make concerning the devclopment or regaining of the physical
or mental abilities ofTeresa M. D' Agostino a/k/a Thercsa M. D' Agostino?
A. I would recommcnd the following: _.).t_,.!"'----.2,.L...L-~4--~~y;~,._-..e."'.J?--I ,::,-h'U~...!, tlf
'-'t7wN~'!~_ll--;l:(li-/1-- hj~.'1icI-.-i,-t.2.!~I..I';7UI")cJ!&L-;y-.:i--~-!i~-'!:.,~'.,~1 C::....: d "d
<M"W___ c<.((:r~-e-',-;1M' ..;1 .c. / K- !'t< I. (( ('t'- .
Q. What types of assistance do you think are required by teresa M. D' Agostino alk/a Theresa M.
D' Agostino?
A. I believc shc nceds assistance with.k 0'2.(. )I.:Z.LL-l-a...u~ .(U.1.:7.~~-(-t4-L.HlL''7f.- .
/,:?-/~'IJ' )"1'<': ,t', ,""h.'JF!; (_A. !<I-<f,'J-'C''-f''/) /'~J".l(,"h""'''''
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and If Bny deed, passbook, certitleate or other document evidencing any such account,
bond, stock or security he found IImong my etlccts, I direct my Executor to deliver the
same to him or her or them.
THIRD:
I hereby nominate IInd IIppoint my son, SALVATORE J.
0' AGOSTINO, JR., liS Executor of this my Last Will and Testament and direct that he
need not be required to file any inventory or to render any public account of my estate and
that he aot be required to file any bond unless required by law and then in only the lowest
permissible amount and without surety if permitted by law. I hereby authorize my
Executor whenever in his opinion it shall be necessllry or advisable in the course of the
Administration of my Estate to seli at either public or private sale at such prices and upon
such terms as he shall see fit, including the acceptance of II purchase money mortgage or
other security for a portion of the purchase price, and property, real or personlll, which I
shall own at the time of my death, and to execute assignments, transfers, and conveyances
thereof as they shall deem proper to settle and compromise any claims, either in behalf of
or against my estate and to pay 1111 or any part of the expense of reducing to possession
and delivery tangible personal property to legatees or other persons entitled to receive the
same under the provisions of this Will without seeking or securing authority from, or the
advice and direction of, any court having jurisdiction of the administrlltion of my estate.
During the settlement of my estate, my said Executor shall have IInd shall exercise his
power to invest and vary investments which are conferred upon the Trustee by the laws of
the State of Rhode Islllnd.
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.3, To comprise, IIdjust IInd scule elllims or ngllillst the trust estlltc.
4, It is in my iatentioll thnt tllll sllid Trllstee shnllnpply to the bellel1t of my
said grllnddllughter such sums from principlll and/or interest liS are necessary for all
expellses Incurred in the evcnt that my said grllnddaughter pursues a t()I'Illal education;
formal education shall mean full-tim(\ enrolhllcnt in allY of the following: trude schools,
vocational schools, colleges, universities, gruduate schools, nursing sl'hools IInd medical
internships.
5. As soon as my said granddaughter shall have nuaincd the age of eighteen
(18) years, said trust shall be terminated and the rest, residue and remainder of said estate
remaiaing unapplied for the purposes aforesaid shall go to my granddaughter, outright
absolutely and forever in fee simple.
FIFTH:
I hereby give, devise and bequeath to my Executor, SALVATORE
J, 0' AGOSTINO, JR., all of my personal property including but not limited to all my
household furniture and furnishings, my personal belongings and jewelry, the automobile
which I may die seized of, and all the right, title and interest in said real property which I
may own at the time of my death to be held by him as Executor thereunder upon the same
trust with the same powers, discretions, exemptions, duties and obligations as are.
hereinafter set forth. I hereby authorize my said Exeuctor to sell such personal and real
property at either public or private sale and at such prices and upon such terms as they
shall see fit, including the acceptance of a purchase money mortgage or other security for
a portion of the purchase price and property, real or personal which I shall own at the time
of my death, and to execute assignements, transfers and conveyances thereof as he shall
deem proper.
.J'....'
an incapacitated
person
) IN THE COURT OF COMM.oN PLEAS
) .oF CUMOERLAND COUNTY,
) PENNSYLVANIA
) .oRPHANS' COURT DIVISION
)
) NO. 97.973
)
)
IN RE: THEitESA M. D'AOOSTlNO
alk/a TERESA M. D' AGOSTrNO
Description:
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CERTIFICATION OF N.OTICE lJNDER RLJLE 5..MJU
Name of Decedent :.--I!:!!;RHSA1YLJ)~^GQSIlliV
Date ofDeath:_ F~RUbJl..Y.?J!, 1998 -.--.
Will No 1997-QQ273 _.___._~_.______ Admin. No,
To the Register:
I certHy that notice ofbeneficia\ interest required by Rule 5,6(a) of the Orphans' Court Rules
was served on or mailed to the following beneficiaries of the above-captioned estate 011
April 27. 1998 :
~
Address
Salvatore J. D' Agostino. JI".
804 Acri Roa\LJ\1echJ!ni~urg. PA 17055
Notice has now been given to all persons entitled thereto under Rule 5,6(a) except none
Date:
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Sigllatu e
: ,) 'J
\ (~ ~.Dr~lU\'--.
,
Name Jan L, Brown
Address_ 845 Sir Thomas Court #9
Harrisburg. P A 17109
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Telephone 717-541-5550
Capaclty:_Personal Representative
X)LCounsel for Personal
Representative
I .," '"I '/1 .
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FilED IN DUPLICATE
WITH REGISTER OF WILLS
"EV" 1500 EX 1{1.\J~)
OIW[WENl'S NAME (LAfoT. rH~;.r, AND MlOOLE jt~ITIAl.)
D'A Ofltino. ThorOSH M.
SOCIAL SEOURITY NUMBER]0^Tf: m'OEA;~'j-I:)ATr. Of' 01 AT,',' ,"
037.01.9568 O?/?6/1998 07/1?/1911
Cmmty C\llllbor.l. and
(W ArPLlOABLEISURVIVING '''DUSE', N;':'~i';:;;;::;;;;;"T MIO -':;;;:;;'-':;;;~~;^L-)T'-;CIAL ';I'(;,,7;;;';';;;","I'R IM-;;UNT RE~;;:;V;:O("LE ;;;gTflU~T.'~~'
X '1. Original Roturn . 2. Supplmnont;1 Rotll~ ~--'-----D 3, Romaindor Roll;rn
4, Limited Estate 41, Futuro Inlorost Compromiso (for elutes of dedlh prior 10 12-13-02)
(for dntes 01 death aftor 12..12-02) D 5. Fodoral Estate Tal< Return Reql'lrod
[K] 6. Decadont Died Tostato D 7. Docedont Maintained iJ Living TfLlst 0 8. Total Numbor 01 Snlo Deposit Boxes
(AiIach co~y 01 Willi (Allach" copy 01 Trllsl)
C P ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
a 2 NAME -_.~--,- COWWEMAIUNO ADDRESS' . ~ ~.
~ 0 Salva tore .J, D' Agos t I no, .J r ,
S ~ TELEPHONF, NUMEJEn'u--- --------.
- 1 717 73?1.557
1. Re,,1 Eslale (Scheelllle AI 1
2, Stocks anelSond' (Schedllle B) (2)
3. Closoly Held Stock/Partnorship Interest (Schedule C) (3)
4, Morlgages and Noles Receivable (Schedule D) (4)
5, Cash, Sank Deposils & Miscellaneolls Porsonal Proporly (Sch. E) (5)
6, Jolnlly Owned Propo,"y (Schedllle FI (6)
7, Translors (Scheduie GIISchodulo L) (7)
8, Tolal Gross Assels (Iolal Lines 1-7)
g. F~moral Expenses, Administrative Costs. Miscollanoous
Exponsos (Schodulo H)
10. Debts, Mortgage Liabililios, Liens (Schedule I)
11, Tolal D.dllclions (Iolal Linos 9 & 10)
12, Nel Valllo 01 Eslalo (Lino 8 minu, Lino 11)
13, Cha,ilable and Govornmont.' Soquesls (Schodule JI
14, Nel Value Sub'!'.CIIO Tax (Line 12 minus Line 13)
15, Spousal T,ansfors (lor dalos 01 dealh al10r 6.30.94)
See Instruclions for Applicablo Porcontage on page 2.
(Include .....alues from Schedulo K or Schedule M,)
16, Amount of Line 14 taxable at 6% rate
(Include valuos from Schedule K or Schedulo M,)
17. Amount 01 LIne 14 taxable a115% rale
(Include valuos from Schedulo K or Schodulo M, I
18, P,'ncipallax duo (Add laxl,orn Line 15, 16 and 17,)
19. Credits/Sp Poverty Prior Paymonts Discount
+ 4,100,00 + 21J1.2/
20, "Lino 19 is greato' Ihan Line 18. onlor Iho dillorence on Line 20. Thi' is Ihe OVERPAYMENT,
IAJ 0 ~k here If you are reques~a refund of your overpay~
21. If Uno 18 is greater than Line 19, entor tho difforonce on Llno 21. This IS tho TAX DUE.
A. Enter the Intorest on tho balance dllO on Uno 21A.
B, Enle' Ihelolal of Lino 21 anel21A on Lino 21B. Thi, i' Ihe BALANCE DUE,
Make Check Pa ablo to: Ro Ister 01 WI!ls, Agent
~ ~ BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH · ·
unae;j:ienanTes of perju,y,Tdeclare thilll hill/e ol(amlnlld this ,olum, InCIl1dlng accompanying 5ctl6dllle~ Mill 9I<11811111I1t!l, nnd 10 tho bU~lt 01 my kl1owled9o and bullol, 111, true,
correct and cemplolo.l declaro Ihat all real estate has boon roperled at Iruo market valllo. Decfaratlon 01 plllparer oth.'r than tho por50r1ll1 ropfllSflntatll/ol!l based on alllnlormatlon of
whIch preparer hiS any knowledge.
CAB
~n
C R C
Kn
COM~~~tlMh!0~Jf~tVl!llMANIA
HARRIsgm~~,lIA 1~\28.0flOl
o
E
C
6
E
~
R
E
C
A
P
I
T
U
L
A
T
o
N
T
A
X
C
o
M
C
t
o
N
- <Z,
FOil DAT(!SOF DEATH AFTER 121]1/91 CHECK HERI! (\
IF A HPOlJ~fAL II '--'
r..9SEHTYQmmW1!J:~.1htlill...-L.J.......
FILE NUMBER
?197-0911
COUNTYCOO(
NUMBER
~'F.AR
Or;CEtlr:Nl'~; COMPI.I!Tf: ADDRESS
BO/. Ael'l ROlld
Moehal\lcBbul~f.~ I PA
17055
,(
:n
"1)11)
801, Acd Road
Mcchaniosbut.'
PA 170.';:)
Nono
n,018,10
None
None
.0-
2,772,6J,
None
n
.--to
(8)
94,790,91
(9)
12,751,85
(10)
1 ,611. , 77
(11)
(12)
(13)
(14)
II. ,366,62
80,424,29
80,1.21,,29
(15)
0,00 X
0,00
,
(16).
80,1,21,,29 X .06 '
1,,825,46
(17)_,
0,00X.15'
0,00
(18)
4,825,46
Interost
4,341.27
0,06-
(19)
(20)
(21)
( 21A)
(21B)___
4A4, 1 9
0,00
IJA4,1-9
.II:,
DATE
SIGNATURE OF PERSON A€SPONSIBL.f: FOR FILING RETURN
/) / <I i] () '[. v'-
-J.~ I I ( !
SIGNATURE OF ~REf'lARER
Salvatoro .I, D'Agostlno,
80/. Acrl Road
Mo-';h~;;ic_;'b-~':p,,- -PA""i. '7b5~
(I'
., j)
/ ;~ I
DATE
~,.,rwrlnhllclI994 form soltw;~ ol1ly CrSYiitoms, i7Jc,
80/, Ac rl Rond
Mo-ct;~n-j"3;'b'.;0:,-" "i'A"""i '70:;5" - -. - -. -""""...." - - - - --
Form 1500 (Rev, 7.{t-4)
" Act.... of 1994 provides for the reduction of the tax rates Imposed on the net value ot transfers to or tor
the use ot the spouse, The rates as prescrIbed by the statute will be:
. .3"10 (,03) will be applicable tor estates of decedenll dying on or after 7/1194 and before 111/96
.2"10 (,02) will be applicable for estates of decedents dying on or after 1/1/96 and betore 1/1/97
.1"10 (,01) will be applicable for estates of decedents dying on or after 111/97 and betore 1/1/98
.spousal transfers occurring on or after 111/98 will be exempt from Inheritance tax,
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A MARK (X) IN THE APPROPRIATE BLOCKS,
YES NO
1, Old decodonl mako a I,enstor and,
x
I, retaIn the use or income of the property tmnslerred,. . ' . . . . . . ' ' , .
x
b, rolaln Iho rlghllo doslgnalo who shall uso Ihe property ".nslorrod or ils Income,
c, retain 8 reversionary Interest: or . . . . . , . .
..".. ,
" ..",
d. receiIJ8 the promise lor llle of either payments, benefits Of care? .
2, If dealh occurred on or beforo December 12, 1982, did decodont within two years preceding death
transfe, property wilhoul receiving adoqualo consideration? II dealh occurrod after Oocombor 12:
1982, did decodont transtor property wilhin ono year 01 death withoul receiving adequate
consldolatlon?
,,' '...,.
3. Did decedent own an 'in trust for' bank account at his or her death?
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
x
x
x
x
""" 1&ClO (ROV, J,9~J
CopyrIght (0) 19904 form ,ottw.r. anly cpsv,temll, lnt,
/5-j!ll' 6'
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU Of INDIVIDUAL TAKES
lNHEAITANCt lAM IJJVISloN
DEPT. 28060 I
HARRISBURO, PA "'12a~0601
NOTICE Of INItERITANCE TAM
APPRAISE"ENT. ALLOWANCE OR DISALLOWANCE
Of DEDUCTIONS AND ASSESS"ENT OF TAK
10-20-1998
DAGOST! NO
02-2b-1998
21 97-0973
CUMBERLAND
101
F-...,.~o~~.;;;t,_R...l-t::@.--=~j
___.._.~n._________'_'._
MAKE CHECK PAYABLE AND REMIT PAYMENT TOl
REGISTER OF WILLS
CUM8ERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT AL.ONO THIS LINE ..... RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiEV:i!'t'-i-EX--AFP-iilij:97Y-NiirlcEnoF-YtiHERifANCE-TAirA' ppRAISEiiiN'r;-,m.-OWANcE-oli--m--mmn--
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
THERESA M FILE NO. 21 97-0973 ACN 101
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
SALVATORE J DAGOSTINO JR
804 ACRI RD
MECHANICS8URG
PA 17055
ESTATE OF
DAGOST! NO
TAK RETURN WAS I (X) ACCEPTED AS fiLED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1, R.a1 Est.t. (Schadul. A)
2. stocks .nd Bonds (Schedull B)
3. Clo..ly Held stock/Partnership Interest (Schedule Cl
4. Hartg.gee/Not.. Reoeivable (Sohedule D)
S. C.sh/Bank Deposits/Hi.o. Personal Property (Schedule E)
6. JointlY OWned Property (Schedule f)
7. Transfars (Schedule G)
8. Tot.l A...t"
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral EKp.n.../A~. Costs/Hisc. Expenses (Schedule H)
10, D.bts/Nortgag. Liabiliti.s/L!ans (Sch.du1. I)
11. Tote1 Deductions
12. Net V.1ue of rax Return
13. Ch.rlt.ble/Govern.~nt.1 eequeGtsJ Non-elected q113 Trust$
1~, Net V.1ue c1 Estat. Subjact tc Ta.
(1)
(2)
(3)
(~)
15)
(0)
(7)_
"J
(101
) CHANGED
,00
92.018,30_
,00
,00
,00
2.772,61
,00
(8)
12.751,85
1.614,77
(11)
(121
(13)
ll~)
(Sch.dul. JI
*
."_IU1 II ." U~-"l
THERESA
M
DATE 10-20-1998
NOTE I To Insure proper
credit to your aoCQunt,
.ub~lt the upper porti~n
of this forM with your
tax pay...nt.
94.790,9L
]to. ~66 62
80.424,29
,00
80.424.29
If en essessment was i.sued previously, lines 14, 15 end/or 16, 17 end 18 will
reflect figures that include the total of 6bb returns assessed to date.
ASSESSMENT OF TAXI
15. AMount of Line 14 et Spous.l rata lIS)
16. AMount of Line 1~ t.xable .t Line.l/CI... A rate (16)
17. Allaunt of line 14 taxable at Coll.taral/Cla.. 8 rat. (17)
18. Prlnclpel Tax Dua
NOTE:
TAX CREDITS:
PAYNE NT
DATE
05-26-1998
08-05-1998
RECEIP'r
MUNBER
AA270125
AA296518
DISCOUNT (+)
INTEREST/PEN PAID (-)
215,79
,00
,00 K'OO.
80,424,29 M ,06.
,00 M .15.
(18)
ANOUNT PAID
4.100,00
484 , 19
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
PAYMENT MUST BE MADE BV 11-27-1998*,
,00
4.825,46
,00
4.825,46
4,799,98
25,48
,00
25,48
. If PAID AfTER DATE INDICATED. SEE REVERSE
fOR CALCULATION Of ADDITIONAL INTEREST,
If TOTAL DUE IS LESS THAN .1. NO PAYNENT IS REQUIRED,
If TOTAL DUE IS REfLECTED AS A "CREDIT" (CR). YOU "AY BE DUE
A REfUND, SEE REVERSE SIDE Of THIS fORN fOR INSTRUCTIONS,)
Ii
\}--;
_'.-'_1
" /
'-I
(,/,
(:(./1,
ftESERVATIONI E.tat.. of deoetdttnh dvJnt on or before D.o.....r 12, IlJ81. n if IIn~ future Intl"I.t in the .,tet. 11 trlMllf,rrtid
In po.....lotl qr ."Jo~..nt t6 Cl... . (0011.ter,1) bln.flel,rle, of thl dlcldent .ft,r thl IKptr.tlon of eny ..tat. for
11f. or for y'.r., the COII8OnW..lttl hlrebY ll'Cpr...lv r...ryu the right to apprlih, and Issess transf.r Inheritanol llx"
It ttM 1aw,ul Cia.. I (ooUet.rell rnt. on "OY luch future Int.rnt.
PURl'OSE Of
HOTlI:EI
PAYMENl,
REFUND (CR) I
To fulflll thl r.quir..."ts of Slotion 2140 of the Inherltllfl(llll and Estate hK Act, Aot 21 of 1995. (72 P.S.
Slctlon 9140 I.
Det~h thl top portion ot this NoUoe and sublllt with your Pllv..nt to the Righter of Wills printed on thn r.v.r.. .Ide.
--"~. cheak or .onlY UI'd.r l)flyable to: REGISTER OF MILLS I AGENT
A refund of . tIIlM credit, which W,It. not r.quested on the Tax Return. .ay tnt reque.ted by co~letlnll IIl1 "Application
for Refund of P"nn.ylvanla InherUflnoe and Estftte TalC" (REV'\313I, Appl!cfttion. ftre availabl. ftt the Offiel.
of the Megbter of NUll, any of the 23 Revonue Dlstrld Offices, or by Clftlllng the sp.clal ?4"hour
ltR.wer'ng ..rvICl' nu.bflrs for for.s orderJnCIl In Pannsyl...ania 1~800-362.2050, outside Pennlytv.nl. lIIoct
Id thin 10(181 Hard.burll IIrea (717) 787..8094, TDDl Cl17) 77l-2252 Olear Ing I.paired Only),
OBJECTIONS, Any party In int.r..t not satIsfied with the ftPpralpe.ant, 8110wanClo or dl.allowance of d.ductlons, or ........nt
of tel( (Including dhcnunt or Intere.O 8S shown on this Notice .ust object within sll(h (60) days of receipt of
thls NotlCl' bYI
ADf1IN
ISTRAnVE
CORRECTIONS,
DISCOUNTs
PENAL TV,
INTEREST I
.-Nrltt.n prot..t to the PA O.part.ent of Revenue, Board of Appeals, nept, 281021, Hllrrls~urll, PA
*~.I.otlOfl to hive the 8atte,' det.r.in.d et audit of th'it ICClount of the p.,..onllll r.pr...,,,, ~tive,
-.ap"eal to the Orphan.' Court,
11128-1021,
OR
OR
factullll error. dhcovered on this assalitaent should b.. addressed In wrltlnll 10: PA Dlpartalilnt of R.....nlHl,
Bureau of Individual Ta"e., ATTHI Post AS."6s.nt Raylew Unit, Dept, 280601. Harrl,burg, PA 17128.0601
Phone (717) 787-6!oOS. S.a pag. S of the boo!i:18t "Instructions for Inh.r ltanCllil Tal( R.blrn for a R..ld....t
O.a.d.nt" (REV-1501) for an flICplanatlon of a~inl,tratly.ly Clorrect.bl. .rrors,
If any tal( due it paid within thr.. L\I calfmdl'r aonths aft.r tho dOCllild.nt', death_ I flvlI perc.nt (5;0 dl.oount of
the tal( paid I. allow.d.
The 151: tel( Mn8.ty non~p8rtlclr>atlon penalty Is coeputld on tha totel of the tal( Ind intere.t .......d) end not
paid b.for41 January 18. 1996, the flrflt dllY aftar the .nd of tho talC asnesty period, Thh non~p.rtio.ipatlon
p.nalty 11 app..lab1e In thfl .... aannor ami In tho tha sa.o t hiD period as you would app.al the tI!IlC end Int.rett
that hat bun .......d a, indicated on this notice.
Interelt h charpd beginning with fI'.llt day of delinquency, nr nln. (91 IIGnth. and ono ()) day fro. th. d.t. of
death, to tM det. of paYs.nL Tal(as whloh baCilli. dlilllnqulnt before January 1. 1982 b.ar Inhr..t at the rate of
.b (61:) p.re.nt per annus oalculat.d lit a dally rata of ,000164. All tlxuwhlc;h blea.e d.lInqu.nt on IN1d ilftlilr
Janu.ry I, 1982 will belllr Int"r..t at a rftte whloh will uory fr08 Clalende,. year to cal.ndar year with that r.t.
announced by the PA D.parteent of Ma....nu., Th. appllClabllil int.re.t rAtes for 1982 through 1998 ar.:
'tm Interut Rat. Dalh Int.rut Foctor !!!! Int.rest Rate [)al1y Interut r.ctor
1982 20% ,000548 1981 9% ,000247
1981 16% .0004]8 1988.1991 11% ,000101
1964 11% ,000101 19fJ;! 9% .000247
1985 U% ,0l't0556 199:'1-1'J94 n .000192
1986 101: ,000274 191)5-1998 9% ,0002to1
~-Iflt.r..t ltl Claloulat.d .. followS!
IN!EREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
nAny ~tlc. luued aft.r the talC baCiO..1i dlill.lnqy.nt will r.f!ect all Interut calculation to fift..n 1I5) daYIl
beyond the date of the ........nt, If pay.ent i. IIad. aft~.. thlt lnt_r..t coaput.tlan datlil shown on the
Notlca, additional Int.r..t ~u,t he ~alcul.t.d,
1\ i 1
: I I I
' I
'I ! I
j\\((\
~:~~"v:
" ,
....\ 11
, ,
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~, .
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"
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PAYIIlNTI
rt.bIQU the top 'p(lrtlon of thAI HoUlie ond sua-it ~Hh YOl,.lr JUly.."t .ade payable to to. n... and addr...
printed on tM ravI"" .Idt.
H RESIDENT DECEDENT .~. oheck or 1I0nlY order Ply.hI. tOI 'REGISTER OF WILLS, AGENT.
If flON~RES]DENl DECEDENT ..k. ctwlck or 1I0nlY on"r payable to I CottHONWEAL TH OF PE"'SVLVANXA.
REFUND (eM)1 A r.fund of . tal< oredit, which "lIS nllt raqu..tld on th41 'al< Return, .IY b. raqua.tld by ClOllplutlnl an
"Af'pllOIlUOfl for R.fund of p.nn.~lvenl. Inhtlrltllflol and Eltat_ 'el(" (REY-U13). Application. .r. IVIUlIblA at
the Dfflol of th_ RIghter of Willi, anY of the 23 Rlvenul DhtrJot OHio.. or trOll the n.p.rt......t'o 24-hour
Inl..lrlng ..rvlol nu.bar. for for.. order\nu: In P.nn,Ylv&nl~ 1-800-362"2050, out.lde Plnnsvlvanla
and wUhln 10cIl llarrhburg araa (117) 787-8094, TOOl (711) 77Z-22S2 IH"nring I.pair.d onh),
REPI.'1' TOI Qu.stlons regardint Irl'orl contain.d on thh notic. lihould be addrvued tOI PA nepart...nt of ReYlnue, lur..u
of Individual TeICol, AllN: POlt A.......nt R.yll" Unit, n.pt. 280601, Harrllburg, PA 17128~D601, phone
(717) 787-6505.
DISCOUNT I
1f any ta~ dUG is paid within thr.. (3) calendar Ilonths aU.r the decldent's d.ath, a fjye PI,'cent (SiD dlsoount
~f the tal< paid 1. allo..ed.
PENALTY I
'The 15% t.~ ",,'.h' nonMparUclplltlon pllnalty 11 co.puted on the total of the tal< and lnt.,...t I.....ad, and not
paid b.for'1I January 18, 1996, the firtlt da.,. "ftar the and of the tal< ...n..ty p.riod.
INTEREST I
lnt.t..t 11 Clhatgld bIIglnnlng ..ith first da.,. of d.llnquency, or nine (9) "cnths and ona (1) dly frCIII ttM data of
death, tot.,. dltl of ply..nt. TeICu which blcl"l dlllnqulnt baforl Jlnulry 1, 1982 bear lntarl.t It ttt. rat. of
.11< (6in percoot plr ,MUll oalculatld at 8 dally I'ata of .000IM. All teICa. ..hlch bac..e delinqulnt on end aftar
January 1, 1982..111 baer lntlr,.t at II rate whJch Nlll vary frOll cailndat y..r to calandar ya.r Nlth that rat.
announcld by the PA Olpert..nt of R.venu.. The appllcabl. Int.,.est rat'l for 1982 through 1999 IrOl
V..r Inte,...t R;.t. Dally Inter.st faCltor Vaar Int.r..t Rate 0.11.,. Inter..t factor
--
1982 20% .000548 1988-1991 Hi: .000301
1985 16% ,OO041f1 1992 9% .0002il'i7
19" HI: .000301 1993~1994 7% .000192
1985 13% .000356 1995-199& 91: .080247
1916 m .000274 1999 7% .0110192
1987 9X .000247
~Mlht.r..t 1. calculatad .. fol10"'1
INTEREST ~ BALANCE or TAX UNPAID X NUNBER or OAYI DELINqUENT X DAILY INTEREST rACTOR
~~A"Y Notice Issued .ftsr the ta~ hleo.., d.llnquent ..Ill refl.ct an Jnt.r..t calculatloo to fJf~1In (IS) dlw'
beyond the rl6tl of the ........nt. If pay..nt is .ade.ft.r the Intlr..t cOIlputatlon date .hQwn ~ the
Notice, addlUonal Inter..~ aurt be calClulated.
.
of the Last Wlllund Testument ofthc suid dccedent:
NOW THEREFORE, KNOW YR, thut we, till.\~!\.m:~-1L..rr.AJI,ostino, JI:JInd Jellnifer [1"
Adams, being ull of the bcnet1ciaries of thc said decedcnt and heirs under the Last Will and
Testament of the said decedcnt. und being those pcrsons entitled to inhcrit under said Last Will and
Testament do hereby, each of us, acknowledge that we have this day hud and I'eceivcd from the
aforesaid Personal Rcpresentative, in full satisfaction and paymcnt of all sum 01' sums of mOlley,
legacies, bequests, and devices as are given, devised and bequeathed to cach of us respectively by
the said Last Will and Testament, which amounts wc have I'cceived this day, and which amowlts are
In the amount set opposite our respective names in thc table and schcdule of distribution in said
state:nent attached hereto and marked Exhibit A:
AND, each of us does hereby stipulate that in order to avoid the expense and time involved
in the filing of a formal account and schedule of distribution, we each agree that no account is
necessary and we do hereby agree that we do conscnt to distribution being made without the tiling
of an accowlt and schedule \If distribution, the same to be with the same force and effect as if the had
been filed and eont1rmed by the Orphans Court Division of the Court of Common Pleas, Lancaster
County Branch,
THEREFORE. we and each of us do hereby remise, release, quitclaim and forever discharge
the said Personal Representative, Salvatol'c.-L_D' Agostino, ,lr" his heirs, executors, and
administrators and assigns, of and from the said estate and l1'om all actions, suits payments, accounts,
reckolling, claims. and demands whatsoever for 01' by reason thereof. or for any other lise, matter,