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HomeMy WebLinkAbout01-0572 I ! ~ ~ ! , : i , i i f ! , '~ \ \. \.~\~ \ (' .. ~ l ----~,' .<f t/, 51 r- ~ ~ ~ ~ a'2 ~ r-- @.J. ~ - ~ ( '-.U , \ - <\-. - ~ ~ ~ -- "::::S .- ~ -- --' ~ - l- -- tA ~ j ~ .- -- ~ - - G ('!) -- - S ~ - <:) ~ ~ t"'- o -- () -- ~ 2 \1.! -- -S -J - t; \i V1 - ....1 ..J ~ .J "', ~ t... 1: ~ 1"';/ Cj 1"') :J ~ ..... 0 f';' .r-! ~~ .:) r'" .,.., COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21 _ (!) (- S ? tiJ...,. 01115453 03-30-2001 REV-1543 EX AFP 109-ool EST. OF MARY PANAGOS 5.5. NO. 195-36-5514 DATE OF DEATH 04-08-2000 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS [X] CHECKING o TRUST o CERTIF. TIM PANAGOS 100 EKING ST SHIPPENSBURG PA 17257 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ORRSTOWN BANK has provided the Department with the infomation listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions may be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1 06712 Date 1 0 - 30 - 1 984 Established x 1,388.25 50.000 694.13 .06 41. 65 TAXPAYER RESPONSE To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x NOTE: If tax payments are made within three (3) months of the decedent's date of death, you may deduct a 57. discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Tax PART m A. fhe above information and tax due is correct. . You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. [CHECK ] ONE BLOCK ONLY B. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent.s representative. C. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. x If you indicate a different tax rate, please state your relationship to decedent: PART ~ TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due TAX ON JOINT/TRUST ACCOUNTS OF 1 2 3 4 5 6 7 8 x PART ~ DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I $ I TOTAL (Enter on Line 5 of Tax Computation) correct and Under penalties of perjury, I declare that the facts I complete to the best of my knowledge and belief. TAXPAYER SIGNA fDJ"f,IAI ATIl GENERAL INFORMATION I, FAILURE TO RESPOND WIll RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on information submitted by the financial institution. 2. Inheritance tax becomes delinquent nine months after the decedent's date of death. 3. A joint account is taxable even though the decedent's name was added as a matter of convenience. 4. Accounts (including those held between husband and wife) which the decedent put in joint names within one year prior to death are fully taxable as transfers. 5. Accounts established jointly between husband and wife more than one year prior to death are not taxable. 6. Accounts held by a decedent "in trust for" another or others are taxable fully. REPORTING INSTRUCTIONS - PART 1 TAXPAYER RESPONSE 1. BLOCK A - If the information and computation in the notice are correct and deductions are not being claimed, place an "X" in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and submit them with your check for the amount of tax to the Register of Wills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-1548 EX) upon receipt of the return from the Register of Wills. 2. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance Tax Return filed by the decedent's representative, place an "X" in block "B" of Part 1 of the "Taxpayer Response" section. Sign one copy and return ~o the PA Department of Revenue, Bureau of Individual Taxes, Dept 280601, Harrisburg, PA 17128-0601 in the envelope provided. 3. BLOCK C - If the notice information is incorrect and/or deductions are being claimed, check block "C" and complete Parts 2 and 3 according to the instructions below. Sign two copies and submit them with your check for the amount of tax payable to the Register of Wills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-1548 EX) upon receipt of the return from the Register of Wills. TAX RETURN PART 2 TAX COMPUTATION LINE 1. Enter NOTE: the date the account originally was established or titled in the manner existing at date of death. For a decedent dying after 12/12/82: Accounts which the decedent put in joint names within one (1) year of death are taxable fully as transfers. However, there is an exclusion not to exceed $3,000 per transferee regardless of the value of the account or the number of accounts held. If a double asterisk (**) appears before your first name in the address portion of this notice, the $3,000 exclusion already has been deducted from the account balance as reported by the financial institution. 2. Enter the total balance of the account including interest accrued to the date of death. 3. The percent of the account that is taxable for each survivor is determined as follows: A. The percent taxable for joint assets established more than one year prior to the decedent's death: 1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 PERCENT TAXABLE JOINT OWNERS SURVIVING JOINT OWNERS Example: A joint asset registered in the name of the decedent and two other persons. 1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) = .167 X 100 16.7% (TAXABLE FOR EACH SURVIVOR) B. The percent taxable for assets created within one year of the decedent's death or accounts owned by the decedent but held in trust for another individual(s) (trust beneficiaries): 1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT OWNERS OR TRUST BENEFICIARIES X 100 PERCENT TAXABLE Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by the decedent. 1 DIVIDED BY 2 (SURVIVORS) = .50 X 100 50% (TAXABLE FOR EACH SURVIVOR) 4. The amount subject to tax (line 4) is determined by multiplying the account balance (line 2) by the percent taxable (line 3). 5. Enter the total of the debts and deductions listed in Part 3. 6. The amount taxable (line 6) is determined by SUbtracting the debts and deductions (line 5) from the amount subject to tax (line 4). 7. Enter the appropriate tax rate (line 7) as determined below. *The tax rate Imposed on the net value of transfers from a deceased ChIld twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0%. The lineal class of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children whether or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the natural parents and their descendents, whether or not they have been adopted by others, adopted descendents and their descendants and step-descendants. "Siblings" are defined as individuals who have at least one parent in common with the decedent, whether by blood or adoption. The "Collateral" class of heirs includes all other beneficiaries. Date of Death Spouse lineal Sibling Collateral 07/01/94 to 12/31/94 3% 6% 15% 15% 01/01/95 to 06/30/00 0% 6% 15% 15% 07101/00 to present 0% 4.5%l! 12% 15% CLAIMED DEDUCTIONS PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: A. You legally are responsible for payment, or the estate SUbject to administration by a personal representative is insufficient to pay the deductible items. B. You actually paid the debts after death of the decedent and can furnish proof of payment. C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, use plain paper 8 1/2" x 11". Proof of payment may be requested by the PA Department of Revenue. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT No.AA 496737 REV-1162 EX (11-96) RECEIVED FROM: I ACN ASSESSMENT CONTROL NUMBER AMOUNT F'C\r'!!-"\GO':::; TIM J 01 1 15<:. ::i:J $4 1 . ~/5 100 EAST ~ING STREET SHjPPENSBURG. PA 17257 FOLD HERE FOLD HERE -- ESTATE INFORMATION: FILE NUMBER 21 0.., c::()()"1 ~". f)'5"'l E: E:iSN 195-36--5514 NAME OF DECEDENT (LAST) PA~;Jf~GOE\ f"lflf'<Y DATE OF PAYMENT (J ./ 18 / r.2()() 1 (FIRST) (Mil .' 'I, POSTMARK DATE tJ /,' 1 t, .... E!()() 1 , - . COUNTY C lJf"1E~E Hi-. t:)f\JD .- '~.;. 1 .. 6.:-} . -: REGISTER OF WILLS RECEIVED BY . /'l l((,-'~~:, - c: /21--<-- 1"lt:'ll<'y L. LLlrJ,{' I REGISTER Ot' ~.JILL_~; J:l-l(~ , ~10-,6;-.;t- ~__.__.L______ "':': - TOTAL AMOUNT PAID - - DATE OF DEATH iJ. / ()8 / t:(l(J(} REMARKS DiE.D< if ,:::007 SEAL / t ~;);; 7 -0 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE <:J!' ,; BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 NOTICE OF INHERITANCE TAX APPRAISEKENTL ALLONANCE OR DISALLONANCE OF DEDUCTIONs, AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS c....-. REY-1548 EX AFP <12-00> TIM PANAGOS 100 EKING ST SHIPPENSBURG PA 17257 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 09-03-2001 PANAGOS 04-08-2000 21 01-0572 CUMBERLAND 195-36-5514 01115453 MARIA Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ Rifv:i5~8-E)f-AFP--(i2-:00)------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 09-03-2001 ESTATE OF PANAGOS MARIA DATE OF DEATH 04-08-2000 COUNTY CUMBERLAND FILE NO. 21 01-0572 TAX RETURN WAS: S.S/D.C. NO. 195-36-5514 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01115453 FINANCIAL INSTITUTION: ORRSTOWN BANK ACCOUNT NO. 106712 TYPE OF ACCOUNT: () SAVINGS (X> CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 10-30-1984 X 1.388.25 0.500 694.13 .00 694.13 .06 41. 65 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due X TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-16-2001 AA496737 .00 41.65 BALANCE OF UNPAID INTEREST/PENALTY AS OF 06-17-2001 TOTAL TAX CREDIT 41. 65 BALANCE OF TAX DUE .00 INTEREST AND PEN. 1.64 TOTAL DUE 1.64 . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. · ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU I1AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORI1 FOR INSTRUCTIONS. ) PURPOSE OF NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 9140). PAYMENT: Detach the top portion reverse side. -- Make check or money of this Notice and submit with your payment to the Register of Wills printad on the order payable to: REGISTER OF WIllS, AGENT. REFUND (CR): A refund of a tax credit, which was not requested on the tax return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices or by calling the special 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and or speaking needs: 1-800-447-3020 (TT only). OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --electing to have the matter determined at the audit of the account of the personal representative, OR --appeal to the Orphans' Court ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5X) discount of the tax paid is allowed. PENALTY: The 15X tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6X) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on or after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2001 are: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 1982 20X .000548 1992 9X .000247 1983 16X .000438 1993-1994 7X .000192 1984 llX .000301 1995-1998 9X .000247 1985 13X .000356 1999 7X .000192 1986 lOX .000274 2000 8X .000219 1987 9X .000247 2001 9X .000247 1988-1991 llX .000301 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. 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W ... eI) .... :) :E 0 ILl ::c: D:: I- /'I) ClI 0::: r-l Z eI) :) Cl cC ...I 0 r-- ...I U r-l ILl 1-1 ...I 3: 0 IIQ U<[ cC u. a.. )- 0 Q cC % D. 0::: <[ W W ...I ...I :II: I- 0::: eI) U eI) W 1-1 ILl 1-1 1Q ...I :z: (!) :E 0::: U W :) <[ 0::: U U III :II: cC :E COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT PANAGOS TIM J 100 EAST KING STREET SHIPPENSBURG, PA 17257 ___nn_ fold ESTATE INFORMATION: SSN: 195-36-5514 FILE NUMBER: 21-2001- 0572 DECEDENT NAME: PANAGOS MARY DATE OF PAYMENT: 09/20/2001 POSTMARK DATE: 09/19/2001 COUNTY: CUMBERLAND DATE OF DEATH: 04/08/2000 NO. CD 000282 ACN ASSESSMENT CONTROL NUMBER AMOUNT 01115453 I $1.64 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: TIM PANAGOS CHECK# 2093 SEAL INITIALS: SK RECEIVED BY: $1.64 MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS j h--- {} 3 7 - & COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT sf. ~ ~~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1607 EX AFP <12-001 '01 TIM PANAGOS 100 EKING ST SHIPPENSBURG NOV 26 All :46 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11-19-2001 PANAGOS 04-08-2000 21 01-0572 CUMBERLAND 01115453 MARIA ReCDrC8'j of ReGister of \11/;113 Allount Rellitted Ci_-IJ.7257 Cumber/ana ,j,,;;urt I PA MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV =i6cfj-ix-AFP--fi'2=ooY------...--iiilHERITANCE--fAx-sTAfEME-tif-oF"-ACfcoDiff--.-..------------------ --- ESTATE OF PANAGOS MARIA FILE NO.21 01-0572 ACN 01115453 DATE 11-19-2001 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-03-2001 P R I NC I PAL TAX DU E : ........................................................................................................................................................................................................................... 41.65 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-16-2001 AA496737 .00 41.65 09-19-2001 CDOO0282 1. 64- 1.64 TOTAL TAX CREDIT 41.65 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 II IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRl, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. l PAYMENT: Detach the tDP pDrtiDn Df this NDtice and submit with YDur payment made payable tD the name and address printed Dn the reverse side. If RESIDENT DECEDENT make check Dr mDney Drder payable tD: REGISTER OF WILLS, AGENT. If NON-RESIDENT DECEDENT make check Dr mDney Drder payable tD: COMMONWEALTH OF PENNSYLVANIA. REFUND (CR): A refund Df a tax credit, which was nDt requested Dn the Tax Return, may be requested by cDmpleting an "ApplicatiDn fDr Refund Df Pennsylvania Inheritance and Estate Tax" (REV-13l3). ApplicatiDns are available at the Office Df the Register Df Wills, any Df the 23 Revenue District Offices Dr frDm the Department's 24-hDur answering service fDr fDrms Drdering: 1-800-362-2050; services fDr taxpayers with special hearing and I Dr speaking needs: 1-800-447-3020 (TT Dnly). REPLY TO: QuestiDns regarding errDrs cDntained Dn this nDtice shDuld be addressed tD: PA Department Df Revenue, Bureau Df Individual Taxes, ATTN: PDSt Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, phDne (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar mDnths after the decedent's death, a five percent (5%) discDunt Df the tax paid is allDwed. PENALTY: The 15% tax amnesty nDn-participatiDn penalty is cDmputed Dn the tDtal Df the tax and interest assessed, and nDt paid befDre January 18, 1996, the first day after the end Df the tax amnesty periDd. INTEREST: Interest is charged beginning with first day Df delinquency, Dr nine (9) mDnths and Dne (1) day frDm the date Df death, tD the date Df payment. Taxes which became delinquent befDre January 1, 1982 bear interest at the rate Df six (6%) percent per annum calculated at a daily rate Df .000164. All taxes which became delinquent Dn and after January 1, 1982 will bear interest at a rate which will vary frDm calendar year tD calendar year with that rate annDunced by the PA Department Df Revenue. The applicable interest rates fDr 1982 thrDugh 2001 are: Year Interest Rate Daily Interest FactDr Year Interest Rate Daily Interest FactDr 1982 20% .000548 1992 9% .000247 1983 16% .000438 1993-1994 77. .000192 1984 11% .000301 1995-1998 9% .000247 1985 13% .000356 1999 77. .000192 1986 10% .000274 2000 8% .000219 1987 9% .000247 2001 9% .000247 1988-1991 11% .000301 --Interest is calculated as fDllDws: INTEREST = BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any NDtice issued after the tax becDmes delinquent will reflect an interest calculatiDn tD fifteen (15) days beYDnd the date Df the assessment. If payment is made after the interest cDmputatiDn date shDwn Dn the NDtice, additiDnal interest must be calculated. j- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: ---- ' t;1--S\~ K, Date of Death: ~V\, Will No. Z \ .- 0 L-- -OS 72- Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration 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 on Name Address M ~~ \~ lt1<f2- '-.r\. ~(J~ "'.,(.... lA. "-Q.... I NDfT~S\t~",- J~ <?'f-'J3 (Z-YOb M\.....~ fro )LJ\..~)~\) ~~ Z-Zt) ~~ ~~ '-e.rn~Jt1.S...{~ '70'ts. 700 ~<"~-\ S\-.) l52-~~u ) PI\- (~4--=S ~6... "'- "-8 _ "So~ l. ~\~ Notice has now been given to all persons entitled thereto under Rule 5.6(a) except~-4=-- Date: ~ / 2--( J 6"""L-- :1~~ Signature ~c. or\l ~ Nam, ,t l-f'!'-~ ...~"" S~\~ Address ~L..\ 1- ~ ~el\ ~. Co ~V'-{ JY..- D 2l:q~ Telephone ( ) ~ I - C; > ~ - 4( 8';:- Capacity: .....-/ Personal Representative _Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA REV-1162 EX0 1-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG,PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 019755 GLEASON THOMAS P 49 W ORANGE ST SUITE 3 SHIPPENSBURG, PA 17257 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold __________ -------- 101 $3,404.07 ESTATE INFORMATION: SSN: FILE NUMBER: 2101 -0572 DECEDENT NAME: PANAGOS MARIA DATE OF PAYMENT: 10/06/2014 POSTMARK DATE: 10/06/2014 COUNTY: CUMBERLAND DATE OF DEATH: 04/08/2000 TOTAL AMOUNT PAID: $3,404.07 REMARKS: CHECK# 1549 INITIALS: DMB SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS REGISTER OF WILLS 1505610105 REV-1500 EX(02-11)(R) f X17 OFFICIAL USE ONLY PA Department of Revenue pennsyLvania Bureau of Individual Taxes ... ° County Code Year File Number PO BOX 28o6o1 INHERITANCE TAX RETURN nl n r Harrisburg,PA x7128-0601 RESIDENT DECEDENT 1 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 04/08/2000 03/20/1939 Decedent's Last Name Suffix Decedent's First Name MI Panagos Maria (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW (� 1.Original Return p 2.Supplemental Return O 3. Remainder Return(Date of Death Prior to 12-13-82) O 4.Limited Estate O 4a. Future Interest Compromise(date of O 5. Federal Estate Tax Return Required death after 12-12-82) O 6.Decedent Died Testate O 7. Decedent Maintained a Living Trust U 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) O 9. Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death O 11. Election to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Thomas P Gleason, Esquire (717) 532-3270 REGISTER OF WILLS USE ONLY First Line of Address 49 West Orange Street Second Line of Address n o C F� Q Suite 3 � �� r-{� - ES ,.- City or Post Office State ZIP Code f'1 DAT FIL , , . r ._t CD Shippensburg PA 17257Gy I'a W ._a Correspondent's e-mail address:tomgleason@tomgleasonlaw.com r'• ^i Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to theest of my K30vledg�an lief, it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which reparer has any knpvoie SIGNATURE 02RSO ONSIBLE FOR FILING RETURN DA� t©!3/7.01 ADDRESS - tUCS V al�j P!� C-7 Z S `1 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 1505610105 1505610105 J .1 1505610205 REV-1500 EX(FI) Decedent's Social Security Number Decedent's Name: Maria Panagos RECAPITULATION 1. Real Estate(Schedule A). .. ..... ........ .......... ........ .. . ........ 1. 0.00 2. Stocks and Bonds(Schedule B) . . . ... ... ........... . .. ..... ... ........ 2. 0.00 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ... . . 3. 0.00 4. Mortgages and Notes Receivable Schedule D 4. ` 0.00 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).. ... . . 5. 0.00 6. Jointly Owned Property(Schedule F) O Separate Billing Requested .... ... 6. 51,000.00 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) C=:) Separate Billing Requested........ 7. 0.00 8. Total Gross Assets total Lines 1 through 7 8. 51,000.00 9. Funeral Expenses and Administrative Costs(Schedule H)..... ..... ... ...... 9. 14,108.50 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)... ... ..... ... . 10. 3,737.65 11. Total Deductions(total Lines 9 and 10)..... ......... ... ...... . .. ... .... 11. 17,846.15 12. Net Value of Estate(Line 8 minus Line 11) ...... ... ..... ... ...... ....... 12. ' 33,153.85 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) . ....... ........... . .... 13. 0.00 14. Net Value Subject to Tax(Line 12 minus Line 13) ...... ...... .. . ..... .. . . 14. 33,153.85 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X.0 0 0.00 15 0.00 16. Amount of Line 14 taxable at lineal rate X.0 6 33,153.85 16. 1,989.23 17. Amount of Line 14 taxable T 0 00 17. 0.00 at sibling rate X.12 18. Amount of Line 14 taxable M at collateral rate X.15 0.00 18 0.00 19. TAX DUE .. ... ..... . ..... ...... ........ ......... .................. 19. 1,989.23 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 L 1505610205 1505610205 J REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Maria Panagos STREETADDRESS 100 East King Street CITY STATE ZIP Shippensburg PA 17257 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 1,989.23 2. Credits/Payments A.Prior Payments _ 0.00 B.Discount v 0.00 Total Credits(A+B) (2) 0.00 3. Interest (3) 1,414.84 4, If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 3,404.07 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred.......................................................................................... ❑ N b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ ■ c. retain a reversionary interest.............................................................................................................................. ❑ 0 d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ ■ 2. If death occurred after Dec.12,1982,did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................................. ❑ N 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑ 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation? ........................................................................................................................ ❑ 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. For dates of death on or after July 1,1994,and before Jan.1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)].A sibling is defined, under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. REV-15o9 EX+(oi-io) pennsylvania SCHEDULE F DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Maria Panagos If an asset became jointly owned within one year of the decedent's date of death,it must be reported on Schedule G. SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A•Efthimeos J. Panagos 100 East King Street,2nd Floor Son Shippensburg, PA 17257 B. C. JOINTLY OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED FOR JOINTLY HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 02123198 100 East King Street,Shippensburg,PA 17257(Parcel 33-34-2415-096) 102,000.00 50% 51,000.00 TOTAL(Also enter on Line 6, Recapitulation) $ 51,000.00 If more space is needed, use additional sheets of paper of the same size. 5ss5� � T H I S D E E D ;) )!n } MADE this ��� day of February, in the year nineteen hundred ninety eight 998); BETWEEN, MARY- PANAGOS, widow and single woman, of Shippensburg, Pennsylvania, hereinafter called Grantor, AND, MARY PANAGOS and EFTHIMEOS J. PANAGOS, as joint tenants with right of survivorship, of Shippensburg, Pennsylvania, hereinafter called Grantees, WITNESSETH, that in consideration of the sum of One ($1.00) Dollar, in hand paid, the receipt whereof, is hereby acknowledged, the said Grantor does hereby grant and convey, in fee simple, to the said Grantees, their heirs-and assigns: ALL that certain lot of ground with the buildings and improvements thereon erected, situate on the corner of King and Penn Streets, in the Borough of Shippnsburg, Cumberland County, Pennsylvania, bounded and limited as follows to wit: ON the North by East King Street; on the East by the property formerly of D.W. Allison, now or formerly of A.R. Burkhart; on the South by property formerly of Frank S. Gates, now or formerly of Harry Jacobs, formerly part of this same lot; and on the West by South Penn Street; said lot having a frontage on King Street aforesaid of 32 feet 2 inches from the Burkhart line to the edge of the brick building at Penn Street with an additional 8 feet for pavement to curb line on King Street, along Penn Street to the south end of the said brick building, a distance of 70 feet 3 inches. HAVING thereon erected a three-story brick building, containing store and apartments. TOGETHER with the right to extend the cornice of any building now erected or hereafter to be erected on the above described lot, one foot over the line of the South and thereof and also the right to use of an alleyway three feet ten inches in width at the south end of said brick building, in common with the occupiers and owners of the now or formerly Harry Jacobs property above referred to, to be maintained jointly as set forth in deed from Frank E. Hollar, et ux, dated June 11, 1929, to Roy E. Martin, et ux, said deed being recorded in Cumberland County, Deed Records in Deed Book "A", Volume 11, Page 170. BEING that same real estate that Robert B. Failor, Sheriff, by deed dated June 19, 1974 and recorded in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Deed Book "S", Volume 25 at Page 489, conveyed to John Panagos and Mary Panagos, husband and wife. Said John Panagos died on December 24, 1997, thereby vesting full and complete title to Mary Panagos. THIS IS A CONVEYANCE FROM MOTHER TO MOTHER AND SON AND IS THEREFORE, TRANSFER TAX EXEI•(PT. AND the said Grantors will warrant specially the property hereby conveyed. IN WITNESS WHEREOF, the Grantors have hereunto set their hands and seals the day and year first above written. Sealed and delivered in the presence of: (SEAL) Mary Flanagors ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA: :SS COUNTY OF CUMBERLAND On this *&day of February, 1998, before me a notary public, the undersigned officer, personally appeared, Mary Panagos, widow and single woman, known to me (or satisfactorily proven) to be the person whose name is subscribed to the foregoing instrument, and acknowledged the foregoing deed to be her act and deed and desired to be recorded as sus-h. Witness my hand and official seal, the day and year aforesaid...,. NOTARIAL SEAL DAWN MARIE SNOOP.NOTARY PUBLIC �'-' -•" Notary Public Shippensburg.CumberlendCounty,PA My Commission Expires My Commission Expires February B.2000 ;,+[;=' ��,J�,,1•� I hereby certify that th Grantees precise address is: Itr, Attorney for Grantees .:' � ;,,rs :��.�,.r• Ind. . •.r,:.•• �1. Previous editions are obsolete form HUD-1(3/86)ref Handbook 4305.2 A. Settlement Statement U.S.Department of Housing and Urban Development B.lyp e of Loan OMB Approval No.2502-0265 1. ❑FHA 2. [3FmHA 3. ❑Conv.Unins. 6.File Number 7.Loan Number 8.Mortgage Insurance Case Number 4. OVA 5. Conv.lns. KAUFFMANPROP Is orm is umis o give you a s a amen o ac ua se amen cos s. oun s pai o an y e se amen agen ares own. C.Note: Items marked"(p.o.c.)"were paid outside the closing;they are shown here for information purposes and are not inGuded in the totals. TitleExpress Seftlement System WARNING:It is a crime to knowingly make false statements to the United States on this or any other similar form.Penalties upon conviction can include a fine and Imprisonment.For details see:Title 18 U.S.Code Section 1001 and Section 1010. Printed 09/05/2014 at 13:32 KSB D.NAME OF BORROWER: Kauffman Rentals,LLC ADDRESS: 20 Quigley Road Newbur-g.PA 17240 E.NAME OF SELLER: Efthimeos J.Panagos ADDRESS: 100 East King Street 2nd Fir Shippensburg,PA 17257 F.NAME OF LENDER: ADDRESS: G.PROPERTY ADDRESS: 100 East King Street,Shippensburg,PA 17257 Shippensburg Borough H.SETTLEMENT AGENT: Law Office of Thomas P.Gleason PLACE OF SETTLEMENT: 49 West Oran a Street Shippensburg.PA 17257 I.SETTLEMENT DATE: 09/0 512 01 4 J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: 100.GROSS AMOUNT DUE FROM BORROWER 400.GROSS AMOUNT DUE TO SELLER 101. Contract sales price 102 000.00 401. Contract sales pdoe 102 000.00 102. Personal Property 402. Personal Property 103. Settlement charges to borrower line 1400 4,300.12 403. 104. 404. 105. 405. Adjustments for items paid bV seller in advance Adjustments for items paid bv seller in advance 106. Cit ttown taxes 406. Ci /town taxes 107. County taxes 09/05114to12/31114 379.88 407. County taxes 09/05/14to12/31/14 379.88 108. School Taxes 408. School Taxes 109. 409. 110. 410. 111. 411. 112. 412. 120.GROSS AMOUNT DUE FROM BORROWER 1 106 680.00 420.GROSS AMOUNT DUE TO SELLER 102 379.88 200.AMOUNTS PAID BY OR ON BEHALF OF BORROWER 500.REDUCTIONS IN AMOUNT DUE TO SELLER 201. Deposit or earnest money 2,000.00 501. Excess Deposit see instructions 202. Principal amount of new loans 502. Settlement charges to seller line 1400 11 400.16 203. Existing loans taken subiect to 503. Existin loans taken sub"ect to 204. 504. Payoff of First Mortgage Loan 205. 505. 206. Seller Held Mortgage 82 000.00 506. Seller Held Mortgage 82 000.00 207. 507. 208. 508. 209. 509. Adjustments for items unpaid bv seller Adjustments for items unpaid bv seller 210. Ci /town taxes 510. Cit /town taxes 211. County taxes 511. County taxes 212. School Taxes 07/01/14 to 09/05114 461.12 512. School Taxes 07/01/14 to 09/05/14 461.12 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220.TOTAL PAID BY/FOR BORROWER 84 461.12 520.TOTAL REDUCTION AMOUNT DUE SELLER 93 861.28 300.CASH AT SETTLEMENT FROM OR TO BORROWER 600.CASH AT SETTLEMENT TO OR FROM SELLER 301. Gross amount due from borrower line 120 106 680.00 601. Gross amount due to seller line 420 102 379.88 302. Less amounts paid by/for borrower line 220 84 461.12 602. Less reduction amount due seller line 520 93 861.28 303.CASH FROM BORROWER 22 218.88 603.CASH TO SELLER 8,518.601 SUBSTITUTE FORM 1099 SELLER STATEMENT: The information contained herein is important tax information and is being furnished to the Internal Revenue Service. If you are required to file a return, a negligence penalty or other sanction will be imposed on you if this item is required to be reported and the IRS determines that it has not been reported. The Contract Sales Price described on line 401 above constitutes the Gross Proceeds of this transaction. You are required by law to provide the settlement agent(Fed.Tax ID No:47-1037484)with your correct taxpayer Identification number.If you do not provide your correct taxpayer identification number,you may be subject to civil or criminal penalties imposed by law.Under penalties of perjury,1 certify that the number shown on this statement is my correct taxpayer identificatlon number. TIN: - / - - SELLER(S)SIGNATURE(S): / SELLER(S)NEW MAILING ADDRESS: SELLER(S)PHONE NUMBERS: (H) (W) Previous editions are obsolete forth HUD-1(3/86)ref Handbook 4305.2 U.S.DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT File Number:KAUFFMANPROP PAGE 2 SETTLEMENT STATEMENT TitleEx ress Settlement System Printed 09/05/2014 at 13:32 KSS L. SETTLEMENT CHARGES PAID FROM PAID FROM 700. TOTAL SALES/BROKER'S COMMISSION based on price$102,000.00 6.000=6,120.00 BORROWER'S SELLER'S Division of commission line 700 as follows: FUNDS AT FUNDS AT 701. $ 6,120.00 to Sailhamer Real Estate Inc. SETTLEMENT SETTLEMENT 702. $ to 703. Commission paid at Settlement 6,120.00 800.ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Origination Fee % 802. Loan Discount % 803. Appraisal Fee 804. Credit Report 805. Lender's Inspection Fee 806. Mortgage Application Fee 807. Assumption Fee 808. 809. 810. 811. 900.ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From to /day 902. Mortgage Insurance Premium for to 903. Hazard Insurance Premium for to 904. 905. 1000.RESERVES DEPOSITED WITH LENDER FOR 1001. Hazard Insurance mo. $ /mo 1002. Mortgage Insurance mo. /mo 1003. City Property Tax mo. /mo 1004. County Property Tax mo. /mo 1005. School Taxes mo. /mo 1009. Aaareoate Analysis Ad•ustment 1 0.001 0.00 1100.TITLE CHARGES 1101. Settlement or dosing fee to Thomas P.Gleason 500.00 1102. Abstract or title search to Thomas P.Gleason 110.00 1103. Title examination 1104. Title insurance binder 1105. Deed Preparation to Thomas P.Gleason 80.00 1106. Notary Fees 1107. Attorney's fees includes above items No: 1108. Title Insurance includes above items No: 1109. Lender's Coverage 1110. Owner's Coverage 102 000.00 - 1111. 1112. 1113. 1200.GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees Deed$79.00 •Mortgage 79.00 •Release 158.00 1202. City/County tax/stamps Deed$1,020.00 Mortgage$ 1,020.00 1203. State Taxistam s Deed$1,020.00 Mortgage 1,020.00 1204. 1205. 1300.ADDITIONAL SETTLEMENT CHARGES 1301. 2014 County/Bora taxes to Shippensburg Borough Tax Office P.O.C. 1 185.12 Seller 1302. 2014-15 School taxes to Shippensburg Borough Tax Office 2,512.12 1303. Tax Cert Reimbursement to Thomas P.Gleason 20.00 1304. Final Water/sewer-Acct#100280 to Shippensburg Borough 160.16 1305. Inheritance Tax Escrow to Thomas P.Gleason 4,000.00 1400.TOTAL SETTLEMENT CHARGES enter on lines 103 Section J and 502 Section K 4,300.12 11 400.16 HUD CERTIFICATION OF BUYER AND SELLER 1 have carefully reviewed the HUD-1 Settlement tement and to the best of my knowledge and belief.it is a true and accurate statement of all receipts and disbursements made on my account or by m in this transaction.I fu er rtify at ave received a copy of the HUD-1 Settlement Statement u man en VIFFi mens a s WARNING:IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this UNITED STATES ON THIS OR ANY SIMILAR FORM.PENALTIES UPON CONVICTION transaction. I have caused or 11 se the tun to be di u ed in accordance with this statement CAN INCLUDE A FINE AND IMPRISONMENT.FOR DETAILS SEE TITLE 18: U.S.CODE SECTION 1001 AND SECTION 1010. --S. SETTLEMENT AGENT: DATE: C1270i, REV-1511 EX-f-(08-13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Maria Panagos Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Fogelsanger Bricker Funeral Home 6,123.00 2. Father Pulcini honorarium for funeral service 100.00 3. Father Daskalakis for honorarium for funeral service 100.00 4. Father Kearse for honorarium for funeral service 100.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: 2,000.00 Name(s)of Personal Representative(s) Efthimeos J. Panagos Street Address_.100_East King_Street......-_.........._-._._______........_, _......___ _._. __„ _ city Shippensburg._... -- — ..._ _......... — --. —. —. __ —...state PA ZIP 17257..__...._.... Year(s)Commission Paid:_2014 _ _ _ _ _ 2. Attorney Fees: 2,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.) 3,500.00 Claimant Efthimeos J. Panagos Street Address_100 East King Street City Ship ep nsburg__- _._... __State_ PA ZIP 17257 Relationship of Claimant to Decedent Son 4. Probate Fees: 185.50 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. TOTAL(Also enter on Line 9, Recapitulation) $ 14,108.50 If more space is needed,use additional sheets of paper of the same size. REV-1512 EX+(12-12) Ipennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Maria Panagos Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. CP02 for medical supplies 85.00 2. Capital Blue Cross PA Blue Shield 82.65 3. Real Estate Commission for sale of 100 East King Street,Shippensburg 3,060.00 4. Transfer taxes on 100 East King Street,Shippensburg 510.00 TOTAL(Also enter on Line 10, Recapitulation) $ 3,737.65 If more space is needed,insert additional sheets of the same size. r rr. REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: MARIA PANAGOS RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under Sec.9116(a)(1.2).] 1. IEfthimeos J.Panagos, 100 East King Street,Shippensburg,PA 17257 ;lineal son � 50%#! y �daughter � `_ 50% 2.; lVasiliki F.Hronis, 1239 4th Avenue,Chambersburg,PA 17202 lineal - - g i _ - 4 6 J a I [ 1. L_.—_j ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: VII B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 3 I F ; F �I I t' f TOTAL OF PART A— ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. If more space is needed,use additional sheets of paper of the same size. Reset PETITION FOR GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY,PENNSYLVANIA Petitioner(s) named below, who is/are 18 years of age or older, apply(ies) for Letters as specified below, and in support thereof aver(s)the following and respectfully request(s)the grant of Letters in the appropriate form: Decedent's Information Name: Maria Panagos File No: IQ ! —0 1 G-7Z a/k/a: (Assigned by Register) a/k/a: a/k/a: Social Security No: Date of Death: April 8,2000 Age at death: 61 Decedent was domiciled at death in Cumberland County, Pennsylvania (state)with his/her last principal residence at 100 East King Street,Shipvensburg,PA 17257 Shippensburg Borough Cumberland Street address,Post Office and Zip Code City,Township or Borough County Decedent died at 100 East King Street,Shippensburg, 17257 Shippensburg Borough Cumberland PA Street address,Post Office and Zip Code City,Township or Borough County State Estimate of value of decedent's property at death: If domiciled in Pennsylvania............................ All personal property $ If not domiciled in Pennsylvania. ....................... Personal property in Pennsylvania $ If not domiciled in Pennsylvania. ....................... Personal property in County $ Value of real estate in Pennsylvania......................................................... $ 51,000.00 TOTAL ESTIMATED VALUE. ... $ 51 000.00 Real estate in Pennsylvania situated at: 100 East King Street,Shippensburg,PA 17257 Shippensburg Borough Cumberland (41tach additional sheets,ifnecessary.) Street address,Post Office and Zip Code City,Township or Borough County A. Petition for Probate and Grant of Letters Testamentary Petitioner(s)aver(s)he/she/they is/are the Executor(s)named in the last Will of the Decedent,dated and Codicil(s) thereto dated State relevant circumstances(e.g.renunciation,death of executor,etc.) Except as follows: after the execution of the instrument(s)offered for probate Decedent did not marry,was not divorced,was not a party to a pending divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa.C.S. §3323(g),and did not have a child born or adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. 0 NO EXCEPTIONS 0 EXCEPTIONS B. Petition for Grant of Letters of Administration (Ifapplicable) c.t.a.,d.b.n.,d.b.n.c.t.a.,pendente lite,durante absentia,durante minoritate If Administration,c.t a. or d.b.n.c.t a.,enter date of Will in Section A above and complete list of heirs. Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa.C.S.§3323(g)and was neither the victim of a killing nor ever adjudicated an incapacitated person. a NO EXCEPTIONS Q EXCEPTIONS Petitioner(s),after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse(if any)and heirs(attach additional sheets,if necessary): r.a Name Relationshi ,Address C'7 Efthimeos J.Panagos Son 100 East King Street a C- = - Shi ensbur PA 17257M ---i �'' C7 Vasiliki F.Hronis Daughter 1239 4th Avenue =- PA 1720 _ r> =3 tI= C'? CA) r- M Form RW-02 rev.10/1112011 Page I of 2 Oath of Personal Representative Official Use Only COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF CUMBERLAND } Petitioner(s)Printed Name Petitioner(s)Printed Address Efthimeos J.Panagos 100 East King Street Shippensburg,PA 17257 The Petitioner(s)above-named swear(s)or affirm(s)the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s)and that;as Personal Itepresentative(s)of the Decedgnt,the Petitioner(s)will well and truly administer the estate according to law. Sworn to affirmed and i�bscribed before Date /D " 3 l`� me this day.of q Date By:r Date For rh eg ster Date BOND Required: 0 YES E) NO To the Register of Wills: FEES: I Please enter my appearance by my signature below: Letters. . . . . . . . . . . . . . . . . . . . . . $ 113 5 Attorney Signature: ( )Short Certificate(s). . . . . . ( i )Renunciation(s).. . . . . . . . ( )Codicil(s). . . . . . . . . . . . . _ ( )Affidavit(s).. . . . . . . . . . . Bond.. . . . . . .. . . . . . . . . . . . . . . . Printed Name: Thomas P.Gleason Commission. . .. . . . . . . . . . . . . . . Supreme Court Other . . . . . . . . ID Number: 82259 { v . . . . . . . /5 cn:) G-) C-) (J 1'5 Firm Name: Law Office of Thomas Weason . . . . . . . . Address: 49 West Orange Street; RENUNCIATION REGISTER OF WILLS CUMBERLAND COUNTY,PENNSYLVANIA e� a c' u? o cn ;�D Estate of Maria Panagos , DecRstl _.p 1, Vasiliki F. Hronis , in my,,,oap- city/re�ioripi4 s (Print Name) Daughter of the above Decedent, hereby renounce the righTto administer the Estate of the Decedent and respectfully request that Letters be issued to Efthimeos J. Panagos September 12, 2014 (Date) (Signature) (Street Address) 011 41nd eS PA L7—goo a (City,State,Zip) Executed in Register's Office Executed out of Register's Office Sworn to or affirmed and subscribed Before the undersigned personally appeared the before me this day party executing this renunciation and certified of that he or she executed the renunciation for the purpo es stated wit ' on this ��`� day of (� Deputy for Register of Wills Nota Pub is My Commission Expires: all� 1(,, (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission:) COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL Form RW-06 rev. 10.13.06 Kelly S.Baker,Notary Public Shippensburg Boro,Cumberland County My Commission Expires Feb.7,2016 EMBER; P6119SYLVANIX A$ 901ATION OF NOTARIES REGISTER OF WILLS CERTIFICATE OF CUMBERLAND COUNTY GRANT OF LETTERS PENNSYLVANIA ADMINISTRATION ®F CU ' No. 2001- 00572 PA No. 21- 01- 0572 J Estate Of: MARIA PANAGOS C D (First,Middle,Last) Late Of: SHIPPENSBURG BOROUGH CUMBERLAND COUNTY N Deceased 1750 Social Security No: WHEREAS, MARIA PANAGOS (First,Middle,Lest) late of SHIPPENSBURG BOROUGH CUMBERLAND COUNTY died on the 8th day of April 2000 and, WHEREAS, the grant of Letters of Administration is required for the administration of the estate. THEREFORE, I, LISA M. GRAYSON, ESQ. , Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, have this day granted Letters of Administration to: EFTHIMEOS J PANAGOS who has duly qualified as ADMINISTRATOR (RIX) of the estate of the above named decedent and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURTHOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 6th day of October 2014. • (jo . 6&Xj - lf) h �� Registe 5-T ls LLL -1 (:7) U- = E p Q De ury EL. LL— C��7 . "'".. p CO Ul C:7 Q- U LU N C- C) C'1 C> CD C.� LLJ Uj d C N **NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) Cumberland County - Register Of Wi11s One Courtr�ouse Square Carlisle, PA 17013 Phone : (717) 240-6345 � � � `�' t^��t a Date : Ol/05/2015 � � � �'? + c;� -� 2 u� ; GLEASON THOMAS p f�'� �= �' �-n 49 WEST ORANGE ST .�'� � �� � '�' SUITE 3 ��� :, � ,.�y `� SHIPPENSBURG, PA 17257 ' `��' `�' � :r;� _., _,1 r_.: r , �--•l �:..► 1' � CJ'1 G . W RE : Estate of PANAGOS MARIA File Number: 2001-00572 Dear Sir/Madam: This notice is to serve as a reminder that the Certificate of Notice under Rule 5 . 6 (a) is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS ' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET NO. 1 , for decedents dying on or after July l, 1992, the personal representative or his councel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5 . 7, shall file with the Register of Wills or Clerk of the Orphans ' Court his/her Certification of Notice. This filing is due by: Ol/16/2015 Please feel free to contact this office with any questions you may have . If you have already filed your certificate, please disregard this notice . Sinc r , Lisa M. Grayson, q, Clerk of the Orphans ' Court cc : File Personal Representative (s) � � CERTIFICATION OF NOTICE UNDER Pa. O.C. Rule 5.6(a) REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: Maria Panagos Date of Death: Apri18, 2000 File Number: 2001-00572 Date Letters Granted: October 6, 2014 To the Register: I certify that Notice of Estate Administration required by Pa. O.C. Rule 5.6(a)of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on October 8 2014 , Name: Address: Efthimeos J. Panagos 100 East King Str, 2nd Floor, Shippensburg, PA 17257 Vasiliki F. Hronis 1239 4th Avenue, Chambersburg, PA 1�202 (Ifmore space is needed, attach separate sheet.) Notice has now been given to all persons entitled thereto under Pa.O.C. Rule 5.6(a)except: n/a 7 \ Date October 8, 2014 " Signature of Person Filing this Form Capacity: ❑Personal Representative �Counsel i,,,_ aa Thomas P. Gleason, Esquire � � N c:;M Name ofPerson Filing this Form � i,.� � �' '� `'= � 49 West Orange Street, Suite 3 ca - I.i, ` ' � �"~- ''"' Address t t_ 9.�.. �. : t'"; c� s: � Shippensburg, PA 17257 ..� t�� �..: � �� :_� ; c.� h--- a ='� c;;; 717-532-3270 t� �> � � � � Telephone C7 �ry � Cx;, ,,.;. /, � Lt.! � tri � ,�� � � � � Form RW-0$`Y'ev. 10./3.06 V�\ V NOTICE OF INHERITANCE TAX pennsyLvania BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE �10 ! DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (11-14) PO BOX 280601 n F7D CIFFICE OF HARRISBURG PARFWAP-Oiff R E C 1 T__R1 L L S DATE 02-16-2015 ESTATE OF PANAGOS MARIA ?U15FEB 17 F'M 1 11 DATE OF DEATH 04-08-2000 FILE NUMBER 21 01-0572 CLEF COUNTY CUMBERLAND GLEAS", p�J§IR:-' (THOMAS P 101 ACN STE APPEAL DATE: 04-17-2015 49 6kANG'E ST (See reverse side under Objections) SHIPPENSBURG PA 17257 Amount Remittedl MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS I COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS 4- R-�:-li4-7--Ei--A-F�--C-1-1--i-4-)-;�-T-I-Ci--O-F-i-N-H-Ei-l-T-A�E-E--Ti-X--A��-R-A-Ii-E-M-E�i-,--AEE-O-Wi�-C-E-6i--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: PANAGOS MARIA FILE NO. :21 01-0572 ACN: 101 DATE: 02-16-2015 TAX RETURN WAS: ) ACCEPTED AS FILED f X) CHANGED SEE ATTACHED NOTICE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) .00 NOTE: To ensure proper 2. Stocks and Bonds (Schedule B) (2) .00 credit to your account, 00 submit the upper portion 3. Closely Held Stock/Partnership Interest (Schedule C) (3) . - of this form with your 4. Mortgages/Notes Receivable (Schedule D) (4) .00 tax payment. 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) .00 6. Jointly Owned Property (Schedule F) (6) 51,000.00 7. Transfers (Schedule G) (7) .00 B. Total Assets (a) 51 ,000.00 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10,608,50 10. Debts/Mortgage Liabilities/Liens (Schedule 1) (10) 167.65 11. Total Deductions (11) 10,7'76.15 12. Net Value of Tax Return (12) 40,223.85 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00 14. Net Value of Estate Subject to Tax (14) 40,223.85 NOTE: If an assessment was issued previously, Lines 14, 15, 16, 17, 18 and/or 19 will reflect figures that include the total of all returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at spousal rate (15) .00 X 00 = .00 16. Amount of Line 14 taxable at lineal rate (16) 4n .?2i_R5 x 06 = 2,413.43 17. Amount of Line 14 at sibling rate (17) .0 0, X 00 = .00 18. Amount of Line 14 taxable at collateral rate (18) .00 x 15 = .00 19. Principal Tax Due (19)= 2,413.43, TAX CREDITS: PAYMENT RECEIPT DISCOUNT AMOUNT PAID DATE NUMBER INTEREST/PEN PAID 10-06-2014 CDO19755 990.64- 3,404.07 BALANCE OF UNPAID INTEREST/PENALTY AS OF 10-07-2014 TOTAL TAX PAYMENT 2,413.43 BALANCE OF TAX DUE .00 INTEREST AND PEN. 726.52 TOTAL DUE 726.52 IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU MAY BE DUE FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS. REV-1470 EX(01-10) .. pennsylvania INHERITANCE TAX i" DEPARTMENT OF REVENUE EXPLANATION BUREAU OF INDIVIDUAL TAXES OF CHANGES PO Box 280601 HARRISBURG.PA 7128-060 DECEDENTS NAME FILE NUMBER Maria Panagos 2101-0572 REVIEWED BY ACN Joseph -Agent#94 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES H B-3 Family exemption can only be claimed against assets subject to will or intestacy. 1 3, 4 Selling expenses are not allowable deductions when the real estate was jointly owned by right of survivorship. Row Page 1 Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone : (717) 240-6345 _ . a1g, 6 Date : 3/16/2015 C u ' GLEASON THOMAS P 49 WEST ORANGE ST SUITE 3 SHIPPENSBURG, PA 17257 RE : Estate of PANAGOS MARIA File Number: 2001-00572 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6 . 12 is due on the below listed date . As per the AMENDMENTS TO SUPREME COURT ORPHANS ' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1 , 1992 , the personal representative or his counsel , within two (2) years of the decedent ' s death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/08/2015 Please feel free to contact this office with any questions you may have . If you have already filed your Status Report, please disregard this notice . Sincerel , Lisa M. Grayson, Esq. Clerk of the Orphans ' Court Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY,PENNSYLVANIA Name of Decedent: Maria Panagos Date of Death: April 8, 2000 File Number:2001-0572 Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: . . . . . . . . . . . . . . . . . . . . 0-,' Yes 0 No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is YES, state the following: a. Did the personal representative file a final account with the Court? . . . . . . . 0Yes ONo b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0Yes n No d. Copies of receipts, releases,joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date March 23, 2015 Sig;'&4e of Person Filing this Form U_ aha cv Capacity: Personal Representative Counsel Uj ._..j Thomas P. Gleason, Esquire C.. A Name of Person Filing this Form r— ;a , 49 West Orange Street, Suite 3 D t N --fi r i;i Address cr� Shippensburg, PA 17257 ' CDUJ w c�: 717-532-3270 ' C-11 Telephone Form RW-10 rev.10.13.06 Pa. O.C. //Rule 6.12 STATUS REPORT REGISTER OF WILLS OF Ul 1(4 Mb COUNTY, PENNSYLVANIA Name of Decedent: Lk SOP Date of Death: -�-Ad -Ay 1 S File Number: _6035_0 Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: . . . . . . . . . . . . . . . . . . . EAS ❑No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is YES, state the following: a. Did the personal representative 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 state an account informally to the parties in interest? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [ Yes ❑No d. Copies of receipts, releases,joinders and approvals of fon-nal or informal accounts may be filed With Liie Clerk of the Orphans' Court and may be attached to this report. Date Signature of Person Filing this Form Capacity: ersonal Representative ❑Counsel 1?a ne of Person Filing this Form O Address ' E V s„. f i L_ c Telephone r,- L».I '. .,f a r1__ SrW-/ ei. 10.13.06 + �s COMMONWEALTH OF PENNSYLVANIA REV-1162 EXI11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG,PA 17128.0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 020573 GLEASON THOMAS P 49 WEST ORANGE ST SUITE 3 SHIPPENSBURG, PA 17257 ACN ASSESSMENT AMOUNT CONTROL NUMBER ------- fold __________ -------- 101 $606.53 ESTATE INFORMATION: SSN: FILE NUMBER: 2101 -0572 DECEDENT NAME: PANAGOS MARIA DATE OF PAYMENT: 04/24/2015 POSTMARK DATE: 04/24/2015 COUNTY: CUMBERLAND DATE OF DEATH: 04/08/2000 TOTAL AMOUNT PAID: $606.53 REMARKS: CHECK# 1907 INITIALS: DMB SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG,PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 020574 PANAGOS TRINA RAMON 100 E KINGT ST SHIPPENSBURG, PA 17257 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold 101 $129.99 ESTATE INFORMATION: SSN: FILE NUMBER: 2101 -0572 DECEDENT NAME: PANAGOS MARIA DATE OF PAYMENT: 04/24/2015 POSTMARK DATE: 04/24/2015 COUNTY: CUMBERLAND DATE OF DEATH: 04/08/2000 TOTAL AMOUNT PAID: $129.99 REMARKS: RECEIPT TO ATTY CHECK# 1 141 INITIALS: DMB SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG,PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 020573 GLEASON THOMAS P 49 WEST ORANGE ST SUITE 3 SHIPPENSBURG, PA 17257 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- told __________ -------- 101 $606.53 ESTATE INFORMATION: SSN: 195-36-5514 FILE NUMBER: 2101 -0572 DECEDENT NAME: PANAGOS MARIA DATE OF PAYMENT: 04/24/2015 POSTMARK DATE: 04/24/2015 COUNTY: CUMBERLAND DATE OF DEATH: 04/08/2000 TOTAL AMOUNT PAID: $606.53 REMARKS: CHECK# 1907 INITIALS: DMB SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG,PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 020574 PANAGOS TRINA RAMON 100 E KINGT ST SHIPPENSBURG, PA 17257 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold __________ -------- 101 $129.99 ESTATE INFORMATION: SSN: 195-36-5514 FILE NUMBER: 2101 -0572 DECEDENT NAME: PANAGOS MARIA DATE OF PAYMENT: 04/24/2015 POSTMARK DATE: 04/24/2015 COUNTY: CUMBERLAND DATE OF DEATH: 04/08/2000 TOTAL AMOUNT PAID: $129.99 REMARKS: RECEIPT TO ATTY CHECK# 1 141 INITIALS: DMB SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS REGISTER OF WILLS