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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. / / ,: / l~:O -.----.---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. ' ", · -~-- d., ,( D""m.., 1997, "f""",, tI. ",d,,",,,,, om"" _"Ily '-"" '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, .. 'J:-lfi~ Notar PUblic . ___ My Commission e"pire8: " NOr4illA11fAl .,. A. AUlI1" Nofory I'uWIe a...., "-'- r." 1lt~lIhIn e... '4 6 ......T. 11M.; ....., If,IOO. .. ~EK~JlQN 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. ~#:;Jl~~T~)' p I" I.; -I' JAN L, BROWN '8415 SIR THOMAS, COURT, SUITE UA HARRISSURG. Pr,:NNSYLVANIA 17109 ." 117.rf41.D,f'DO " g h. 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""''''' ( i. f. d,(C..{ d.((' I-- ) "-f,lt" 1 ,--r ) . () ;; ',.!{J,"'" =.. . . -' --........-- --.....' ~,.~~~ . . .' JAN \...BROWN ,e46 el" 11-l0t<l~e COUR1, eu\re \I~ l-II\RRI5aURG, PENN5'1I-.\IMlIPl \7\09 1\1.64,.6660 ~ 6'\'1>"'- ,\<...', \'-~"- \~,,'I>~~ "",~02",- ~ . ,,'1>\'0 ,,\,-.y,o, ~'I> "".' ~'f-~~ '\ v ,,\~c<"~ \0 ~ '1>\0<"'0 ~'i-\'I> . i..'o~ ~~" \~o ., ~'O\~ ~c<"" ",.y,o"''' ~"", '0<..0" \1 r '^\~ ,.,,""" ~~ . 0'" , \''' "", ~~ 'l \~e~ ,'\c<..c. _, ~~ <"~\'I>\e'",,o~,e<'" <W'" ~v ~" -v~.,,:p :(\ 'I>~ $. 0'" ~~ ~e<""'o ~,'I>~ 0 \, $. ~c O~'I><" ~,'I>~ 0 e~ '1>'" O~~<.. ~'I>~ ~'O<" '0<..0 y ~,,~ \O~ /,0 tn ~'O ~,c \0<" '0 ~'O '" ~'" ,0 '0 ~ ~e _'0''1>' 1 0 ",,'0 ",\c~ C 'I> ,- ,:;.~" ~;I.'OC ~c~ ...~o ~c '<;,'0\0 \'-~S, ~ ~'I>' ,C)cy;:~ \,-\1 ,:;.\C~~e ,~v ~o ,<;/I' ., \//,;.~" 'J># G J~~ ~~~~ ~~ 0" ~C~ .,,~'" ,...~ < ," 'I>~~ . ~",,<.. <" y 0'" ~1 .~,~" e \'-........, O~ ~~'I>"l ~",o<;:l- ~~ ",'" ~~ ~C ~.....<{ ~~. ~ ,0 . c~. :1.0 c<f5 ,~,', wd'''' 00'.' ~,,,,, ~ "'~" .~C ,,'0" o , ' ~i,'''' ~'O<..'o" \ ,,'Ii- 0\' c ~~ 0"''0'" ,<,0'" ' S,~,'o ~ ~~o<; c ~~<..'Q ~~~~ ~<..~ \0<" ~ ~~SS ",~~,e ~\..... ~ ,..;,,- .\,~~S .' (-{" v-~ \,-\1 '------/ "v.';~~~ '.J'.~ ~\,~e"'''' ~ s~. '\ c~ ~,6'~<; / ~'1>-~~0 ':k ~'1>-'I) \~. ."","l I. ' e:,rf':l" I ~ ~~'::i\C .~<..ro'" " ~'1>-~ . :(\~-;.~ ...",,0 ~"., L--~-- (o~ ~"l . '-: i'l ~ I" .~ t\ .....~, .~ \'--' , i r 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. ~,( ~.' ~, ~ ( \-) ~ \ ' tJ. "t ~ . ,\ .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: C /-It1(J(INC Il ,,"'--,-vr ()ill/lff'v (),}('.;l,r (jl).vi/. 7J.J7'tl,f'-3 ---- C-llf(l(('VC ,1,(~v-"li (]f'1N/<. fl..;::. 05'6).")&,;2-2-9 ~fr ill t -:r: lViv(1/l Iv,'- :roo N l! 1/ N co (f/. 2. "'I? 2-'7l-'1 2.L'I']l-73(' Ul(l/lUJ .fil;WIl(J Ird'/< . A u v v I" T ~I G z ~ S' ) . 'f 'I ,f 'I S I) .I- \) '1 J N .1' N/ 101 (J 11 (l/ll ':f 4" -rt> (/< 11'(0 '1A/i- t'vy. 0:2 nr.1(, l'c1 '( Y.ftIM~ : $ tf; 11. 'IIf 20"0. .1) 1J J/;' d"h;- III ~I' 'zl/fhr- 2;"0.JJ ZefD, )1 /0 'lS9 ~ ~ 4J (>/~ Yfll~.f 5'6' 'Ufo .)Jr Ii J ,II"~ I~!}'I ~ 7 1, 0IJN~{lJ/"(' '10/ ;{.H.Jtf: it CI!I'J~t1( . J'( I ((lI)NJrv/V, It.). :.>;I9ly ((fi 2)"QvC),0# (Attach Additional Sheets if Necessary) T9tlll, 1 7 ,lfy.1 f .- ~ 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: l i '-.. Sigllatu e : ,) 'J \ (~ ~.Dr~lU\'--. , Name Jan L, Brown Address_ 845 Sir Thomas Court #9 Harrisburg. P A 17109 If'I () fIl R 'S~ r~'" i 0 ~- ~;?: (., .. " ,0 ,-'I ,. ffl \) "-' ;-0 \.l W '1) ~ ;ii. om is ...., I ill ~I ~ ~j Telephone 717-541-5550 Capaclty:_Personal Representative X)LCounsel for Personal Representative I .," '"I '/1 . \.) ... 0(" :> 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 , , ,,'!/'-II'<'\ -' 'c "~~;''': ~'r \" ~ '" ~, . <.4,; "- t':- -. \~ ... ...... l;( <;:t.., t; '-.,J, I...:l ~ " " ~ ,,,. '" ... ~ &, ~ '-> ..) " ~ .....;:, ~ '- 0" ,\,OJ '< "l " '> t\ ::t k '<'. ~ ~ ':) \....;> 'l o ~ ,.\,.~ ~ t:. ::l \...j pi ... ::f r M, .... ., t-- -. ~ ,";1 I:~I 'I', I, I\i \ 'l:' ',> J --. '~'; i'I;1 ~,,! ,;:) f" ~,'l ,,' ~ -> t!. ~ "-.) ::0 <0 ([;; ;'~ 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,