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HomeMy WebLinkAbout04-0305PETITION FOR PROBATE and GRANT OF LETTERS also know~ ~s,J-' TO: Deceased. Social Security No. /qq-3z - z'qaa Register of Wills for the County of Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut ~,~ in the last wilt of the above decedent, dated I~ - Il - al ~ and codicil(s) dated in the named , 19__ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in {].ot _wx~o~ ~ ctvx "c~ County, Pennsylvania, with h he~ las~ family or principal residence at /l/c/ /'/eoa. a~:esb, r~., p;4 )?o,5-o- ~-J (list street, number and muncipality) Decendent, then ~ 3 years of age, died ~o/~A cl ~A'5 + at (~ ~ ~ 0 ,~ . tl/I , c~-[ lilt~ IM, ' Except as follows, decedent did not marry, was not divorced and did not have a child born o~Jadopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: /~,OUO. Oo .~'T'©'P WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters (testamentary; administration c.t.a.~llal~'-inistratiop d.b.n.c.t. _a~, theron. -- '~ ~:!'~ ~ ~ ~ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ COUNTY OF ~.~vm~-'~ ,,- 1 o ~ cJ _ ss The petitioner(s) above-named swear(s) or affirm(s) that 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 represen- tative(s) of the above decedent petitioner(s) willed truly'~dminister the estate accordigg to law. Sworn to or affirmed and subscribed ~ ~ ~i~O~ ~~ ~' before m~ this ~ day or /~ .... ~ ~ ~' No. 2.1- Oq- 3m~' DECREE OF PROBATE AND GRANT OF LETTERS , Deceased AND NOW the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated described therein be a~mitted to proba]~'g,nd filed of record ~ the last will of ~d Letters ~'~ (t O~Z~ ~aa~,~ 9 ~_.~. & 7 . 0 ~e hereby granted to .~'[L~O .~. ~ , c>QO()%t ~ ,, in consideration of the petition on ~ FEES (3o~ Probate, Letters, Etc .......... $ Short Certificates( ) .......... Renunciation .... ............ $. .-3e_(~ $. 10 oo TOTAL Filed . .~.. :..~..o.. ~ ..,~..o. <.~.,.~ ............... Register of Wi~~)'~- ~X 7(~-- ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE RENUNCIATION the above d~edent, hereby renounces) the right to adm~mster the estate and respectfully ~k(s) that Letters / WITNESS hand this day of ., 2(}__ (Address) {/(S~gnature) (S~gnature) (Address) hzs,~s to cerufy }hat the znformanon here g~ven ~s correctly cop~ed from an original cemficate of death duly filed w~th me ks Local Registrar The ong~n_al certificate wdl be forwarded to the State Vital Re,cords Office for per. manent fihng WARNING: It Is illegal to duplicate this copy by photostat or photograph. Fee for th~s ceroficate, $2 O0 P 9496074 No , 2 -o, -3o5 Local Registrar Date Angela Ba~l, Cumberland ,,. 11,~4 West l:'ot.aJerhorn Road M,-'=~i'WrdLcslmlrg, PA 170S0 Pau~ Dietrich Female , 199 -- 38 -- 2466 Flampd_ ,~ 1114 West Powderhom 2003 0 ~g~ ~.o ~0 LAST WILL AND TESTAMENT OF ANGELA D1ETRICH BAILEY Dated t~i/bvv~/~ [! , 1998 LAST WILL AND TESTAMENT OF ANGELA DIETRICH BAILEY I, Angela Dietrich Bailey, a resident of the Commonwealth of Pennsylvama, make, pubhsh and declare th~s to be my Last Will and Testament, revoking all wills and codicils at any time heretofore made by me FIRST I d~rect that the expenses of my last illness and funeral, the expenses of the admlmstrat~on of my estate, and all estate, Inheritance and s~mllar taxes payable w~th respect to property ~ncluded ~n my estate, whether or not passing under this will, and any ~nterest or penalties thereon, shall be prod out of my residuary estate, w~thout apportionment and w~th no right of reimbursement fi.om any recip~ent of any such property SECOND I give all the rest, residue and remainder of my property and estate, both real and personal, of whatever kind and wherever located, that I own or to which I shall be ~n any manner entitled at the t~me of my death (collectively referred to as my "residuary estate"), as follows (a) If my husband Darnel Brian Barley survives me, to my husband outright (b) If my husband does not survive me, then to those of my chddren (Llam Darnel Bailey and Mmhaela Dmna Barley and any other chddren which I hereafter may have) who survive me and to the ~ssue who survive me of those of my chddren who shall not survive me, per st~rpes (c) If my husband does not survive me and there shall be no ~ssue of m~ne then hying, I give my residuary estate to those who would take from me as if 1 were then to die w~thout a will, unmamed and the absolute owner of my residuary estate, and a resident of the Commonwealth of Pennsylvama THIRD If any property of my estate vests ~n absolute ownership in a minor or incompetent, my Executor, at any time and without court authorization, may d~stribute the wliole or any part of such property to the beneficmry, or use the whole or any part for the health, education, mmntenance and support of the beneficiary, or distribute the whole or any part to a guardian, committee or other legal representative of the beneficiary, or to a custodmn for the beneficiary under any gtfls to m~nors or transfers to minors act, or to the person or persons w~th whom the beneficiary resides to use for the beneficiary The receipt of the person to whom the distribution is so made shall release my Executor from any liablhty w~th respect thereto, even though my Executor may be such person If such beneficiary is a minor, my Executor may defer the distribution of the whole or any part of such property until the beneficmry attains the age of twenty-one (21) years, and may hold the same as a separate fund for the beneficiary w~th all of the powers described m Article FIFTH hereof If the beneficiary dies before attaining said age, any balance shall be paid and distributed to the estate of the beneficiary FOURTH I appoint my sister Paula Dietrich Malachlas to be my Executor If my sister Paula Dietrich Malachlas shall fail to qualify for any reason as my Executor, or having quahfied shall die, resign or cease to act for any reason as my Executor, I appmnt my brother-in- law Mark Allen Bailey as my Executor I direct that no Executor shall be required to file or fur- nlsh any bond, surety or other security in any jurisdiction FIFTH I grant to my Executor all powers conferred upon executors wherever my Executor may act I also grant to my Executor power to retain, sell at pubhc or private sale, exchange, grant options on, invest and reinvest, and otherwise deal with any kind of property, real or personal, for cash or on credit, to borrow money and encumber or pledge any property to secure loans, to divide and distribute property in cash or in kind, to exercise all powers of an absolute owner of property, to compromise and release claims with or w~thout consideration, and to employ attorneys, accountants and other persons for services or advice The term "Executor" wherever used herein shall mean the executors, executor, executrix or admlmstrator m office from time to time SIXTH I direct that for purposes of this will a beneficiary shall be deemed to predecease me unless such beneficiary survives me by more than thirty days The terms "child" and "children", as used in this will, include not only the child and children (whether now or hereafter bom) of the person designated, but also the legally adopted child and children of such person The term "issue" includes not only the children and other ~ssue (whether now or hereafter born) of the person designated, but also the legally adopted children and issue of such person SEVENTH If my husband shall not survive me, I appoint my sister Paula D~etnch Malachlas to be the Guardian of the person and property of any children of mine who have not attained the age of majority If my sister Paula Dietrich Malachias shall fall or cease to act as Guardian, I appoint my sister-m-law Joan Bailey Irwin as Guardian No Guardian shall be required to file or furnish any bond, surety or other security in any jurisdiction IN WITNESS WHEREOF, I, Angela Dietrich Bailey, sign my/name and pubhsh and declare this instrument as my last will and testament this // day of ./~/d~i/&m~7, 1998 la lJietrlch Barley' ~.) The foregoing instrument was signed, published and declared by Angela Dietrich Bailey, the above-named Testatrix, to be her last will and testament in our presence, all being I, the understgned officer, do hereby certify that I am, on the date of this certificate, a person with the power described in T~tle 10 U S C 1044a of the grade, branch of service, and organization stated below in the active serwce of the Umted States Armed Forces, and that by statute no seal ~s required on th~s certificate, under authority granted to me by Title 10USC 1044a Name of Officer and Position SSN, Grade and Branch of Serwce Command or Organization present at the same time, and we, at her request and ~n her presence and ~n the presence of each other, have subscmbed our names as w~tnesses on the date above wmtten having an address at hawng an address at ACKNOWLEDGMENT AND AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA, COUNTY OF MONTGOMERY, SS We, Angela Dietrich Bailey and ' ' ~_ _/~ _~_~'~-~d~_ , the Testatrix and the witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix, Angela Dietrich Bailey, signed and executed said instrument as her last will and testamem in the presence and hearing of the witnesses, and that she had signed willingly, and that she executed it as her free and voluntary act and deed for the purposes therein expressed, and that each of the witnesses at the request of the Testatrix, in the presence and hearing of the Testatrix and each other, signed the will as witness, and that to the best of his or her knowledge the Testatrix was at the time at least eighteen years of age, of sound mind and under no constraint, duress, fraud or undue influence Witness Witness Subscribed, sworn to and acknowledged before me by the said Angela Dietrich Bailey, Testat/l~ and subscribed and sworn to before me by the above-named w~tnesses, this // day of ~'/~'7'.) , 1998 NOTARIAL SEAL Christie L Underkoffler, Notary Camp Hill, Cumberland Coun~ ~Y Commission ~p~ros Ju.~ 24, 2002 Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 07/01/2004 BAILEY DANIEL BRIAN 1114 W POWDERHORN ROAD MECHANICSBURG, PA 17050 RE: Estate of BAILEY ANGELA DIETRICH File Number: 2004-00305 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) in the above captioned estate. 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 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 will become delinquent on 07/10/2004 Your prompt attention to this matter will be appreciated. Thank You. CC: File Counsel Judge ~ ~%A~ER S~S T~TRASBAuGH Clerk of the Orphans' Court COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 004118 FREY ROBERT G 5 S HANOVER STREET CARLISLE, PA 17013 ford ESTATE INFORMATION: SSN: 174-05-3824 FILE NUMBER: 2104-0373 DECEDENT NAME: MALLIOS CONSTANTINOS N DATE OF PAYMENT: 07/06/2004 POSTMARK DATE: 06/07/2004 COUNTY: CUMBERLAND DATE OF DEATH: 04/09/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $35,983.23 REMARKS: TOTAL AMOUNT PAID: 935,983.23 SEAL CHECK# 1003 INITIALS' JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Same of Decedent: A~e~!O~ .~ ~>~L}e-)C~I Date of Death: ~~f / ~ ~00 ~ ~11 No. To the Register: Admin. No. '--~i/- 0~- 0.~ Off I certify that notice of (beneficial interest) estate administration reouired b,, Rule 5 ~'-~ ........... " --a j, .utaj ~jne tJrpnans court Kules was served on or mailed to the following beneficiaries of the above-captioned estate on /'r[~z74,~ ~.~ O? ZOE)t(/.. Name Address Notice has now been given to all persons entitled thereto under Rule 5.6(a)except Date: Teleph°ne (71~ -'~ q 3"-~ Capacity: .~ Personal Representative Counsel for personal representative COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE Harrisburg District Office; Lobby, Strawberry Square, Harrisburg, PA 17128-0101 Phone: (717) 783-1405 FAX: (717) 783-4447 Web: www.revenue.state.pa.us DECEMBER 10, 2004 ESTATE OF: ANGELA D. BAILEY DATE OF DEATH: 08-10-2003 FILE NUMBER: 21 04-0305/2004-37 (Please remit top portion with your payment) DANIEL B. BAILEY 1114 W POWDERHORN RD MECHANICSBURG, PA 17050 Dear DANIEL B. BAILEY: A review of our records has disclosed that you are responsible for the settlement of the above estate, or that you represent the responsible party. This is to advise you that the above estate is in a delinquent status: According to our records, as of this date, the estate still is not settled. The Inheritance and Estate Tax Act, mandates the filing of a tax return and payment of all outstanding liabilities by a personal representative of the estate or a transferee within nine months of the decedent's death. The Department's records show that this estate remains open because: AN INHERITANCE TAX RETURN HAS NOT BEEN FILED. If the return has been filed it is important that you contact us immediately. If this estate was opened for the purpose of a lawsuit, please contact this office in writing with the term and docket number of the lawsuit so that we may postpone any further action. We are extending a thirty day courtesy period from the date of this letter to permit you to file the return. If you fail to do so, the Department of Revenue will make a formal demand on you or your client and, if necessary, institute legal action. MAKE CHECKS PAYABLE TO: REGISTER OF WILLS~ AGENT Any questions regarding this estate, please CONTACT: TOM ItOOPER (717) 783-1405 lA Sincerely, A1 District Administrator EV-1500 EX (6-00} ~.~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 ~oo Z uJ Z 0 W n~ 0 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST,AND MIDDLE INITIAL) DATE OF ~DEATH (M¢-,DI~-YEAR) q DATE OF BIRTH (MM-D,D-YEAR) (IF APPLItABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INfflAL) [~1. Original Return l~4. Limited Estate [~6. Decedent Died Testate (Attach copy of Will) E~9. Litigation Proceeds Received F-J2. Supplemental Return I---] 4a, Future Interest Compromise (date of death after 12-12-82) E~7. Decedent Maintained a Living Trust (Attach copy of Trust) ] 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-%95) 8. ~0, 12. 13. 14. 17. x FIRM NAME (IfApplicable) ../,, TELEPHONE NUMBER }l ;',A L~:E O~LY FILE NUMBER COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ] 3, Remainder Return (date of death prior to 12-13-82) [~5. Federal Estate Tax Return Required 8, Total Number of Safe Deposit Boxes r~11. Election to tax under Sec. 9113(A) (Attach Sch O) COMPLETE MAILING ADDRESS Real Estate (Schedule A) (1) /~/OVl P Stocks and Bonds (Schedule B) (2) Closely Held Corporation, Partnership or Sole-Proprietorship (3) Mortgages & Notes Receivable (Schedule D) Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) Jointly Owned Property (Schedule F) (6) 4/8Y1 ---]Separate Billing Requested Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) Total Gross Assets (total Lines 1-7) Funeral Expenses & Administrative Costs (Schedule H) Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) Total Deductions (total Lines 9 & 10) Net Value of Estate (Line 8 minus Line 11) (4), /'~/O~4 6- (10) Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) q3 Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES Amount of Line 14 taxable at the spousal tax,/~) rate, or transfers under Sec, 9116 (a)(1.2) Amount of Line 14 taxable at lineal rate Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. [] 170 0 11) (13) (14¢/~-'~/SO 7' OZ / ~;~/So -'~ x.O __ (15) //'~0 ~t ¢' x .0 __ (16) KOi4 ~., x .12 (17) ~'/'O ~ ~. x .15 (18) ¢9) Decedent's Complete Address: STATE PA CiTY I z,P I ") O5'-O Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty Total Credits ( A + B + C ) (2) Total Interest/Penalty ( D + E ) (3) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANOE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT (1) -~" 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; .......................................................................................... [] ~' b. retain the right to designate who shall use the property transferred or its income; ............................................ [] c. retain a reversionary interest; or .......................................................................................................................... d. receive the promise for life of either payments, benefits or care? ...................................................................... [] [] 2. If death occurred ~fter December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. [] 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? ........................................................................................................................ [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on a nformation of which preparer has any knowledge. SlGNATURE'~;~ON RESPON,~BCE F ,(:~G ~ '~. ~ ~ ADDRESS ~-- -- ~'" SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE .% 05- /°,4 / DATE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate-imposed on the net value of transfers to or for the use of the surviving spouse is 0% [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 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 twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive paren or a stepparent of the child is 0% [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%, except as noted in 72 P.S. §9116(1.2) [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% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as a~ individual who has at least one parent in common with the decedent, whether by blood or adoption. ANGELA D. BAILEY & DANIEL B. BAILEY 1114 W. POWDERHORN RD. MECHANtCSBURG, PA 17060-2008 I,,,ith,,lll ...... ll,,ll.,ll,,,ll,,,I,l,,lt,hl,,hl,,hl, REV-15~8 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION TOTAL (Also enter on line 5, Recapitulation) VALUE AT DATE Of DEATH (If more space is needed, insert additional sheets of the same size) 8 Market Plaza Way · Mechanicsburg, PA 17055 Phone: 697.4696 September 2, 2003 Daniel B. Bailey 1 114 West Powderhom Road Mechaniesburg, PA 17050 FUNERAL HOME Michael J. Malpezzi Owner The Funeral Service for Angela Dietrich Bailey We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please feel free to contact us if you have any questions in regard to this statement. THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT, AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. 1. PROFESSIONAL SERVICES Services of Funeral Director/Staff FUNERAL HOME SERVICE CHARGES SELECTED MERCHANDISE: Oak Rental Casket Solid Marble Um $760.00 Register, Folders, Ackn. $450.00 200 Additional Folders $85.00 $46.00 THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE THAT YOU HAVE SELECTED $4601.00 AT THE TIME FUNERAL ARRANGEMENTS WERE MADE, WE ADVANCED CERTAIN PAYMENTS TO OTHERS AS AN ACCOMMODATION. THE FOLLOWING IS AN ACCOUNTING FOR THOSE CHARGES. CASH ADVANCES Opening Grave Newspaper Notices - Local Newspaper Notices - Out-of-town Organist Certified Copies of the Death Certificate TOTAL CASH ADVANCES AND SPECIAL CHARGES $3260.00 $3260.00 $180.00 $136.90 $84.00 $75.00 $50.00 $525.90 SUB-TOTAL INITIAL PAYMENT / DISCOUNT / CREDITS TOTAL AMOUNT DUE $5126.90 $5126.90 The righl choice for the long term ® American Fund PO BClX 2560 Nm'folk VA ~1-2560 MML INVESTORS SERVICES, INC. 3949 S ATHERTON ST STATE COLLEGE PA 16801-8308 h.ll,lI.M,II.,,,,lll,,I.,Ihlh,,M.h,lld..hll Dealer copy of Quarterly Statement January 1 - June ~0, 2004 // CB&T CUST IRAROU.OVER \ / ANGELA D BAILEY/DEC'n ~ 1114 W POVVDERHORN RD ~ MECHANI-C~URG PA 17~50-~ Rep name DREIBELBIS Rep number 122524 Dealer/branch number 255/506 loll Want to receive this statement online? For more account information m I~r~ml ~- Iaaa.- ap.at. Ea~m ~ ~F $harekolder Seryices - 8111421-6180 Dealer Services - 8011421-6900, ext.4 Website - emericanfaads.cem American FundsLinee - 8601325-3590 Summary Fund A~oo~t Type& ~f~re~ he~ Capilal Income Bailder-A 12 63~23040 eqeity-inceme 0 Y~r-~ate ~dends ~d ~pi~ g~s (Capital I,com, Bailder-a 12 63923040 $35.68 $0.00 $0~ Transactions Tax ID# 199-38-2466 CaplaJ Ineome Bulder - Cimm A Feed mmkef 12 kCCOl~ ~ 63923040 rrad~a~ ~ 01101104 Beginning share balance 05119104 Income Dividend 6 4641'$0104 To iagSfS~ 30104 Ending share balance Dividends and capital gains reinvested $35-EL8. $48.4 t 79.477 ~ 80.214 -60.214 ~ DaEF ~ Since the fund declares dividends daily, lhe amount of your income dividend depends on lhe number of days be~:.'~n lhe day you paid for your shares and the day lhe dividend was paid. The righl choice for the tong term ® American FunOS PO Bax2~80 Na~a~k VA 23S01-2280 MML INVESTORS SERVICES, INC. 3949 S ATHERTON ST STATE COLLEGE PA 16801-8308 I,,,11,11,,I,,I,I1,,,,,,111,,I,,,11,11,,,I,,I,I1,,,11,,,,I,1,1 16~r Dealer copy of Quarterly Statement January 1 - Sq~em~ 30, 2004 Shareholder DANIEL B BAILEY 1114 W POWDERHORN RD MECHANICSBURG PA 17050-2006 Rep name DREIBELBIS Rep number 122524 Dealer/branch number 255F-F-F-F-F-F-F-F-F-F~ Page lof3 Get a jump on tax planning Annu~ fee For more account information -, Penmld maMmee - 8 a.ai. - 8 p.m. Eaaiem gale M-F Shareholder Services - 8001421-0180 Dealer Services - 8gO1421-gJoq, ext.4 Webeite - americaafunds.com American FnndsLinen - 8001325-3590 Summary DA]~-I. B BAILEY The Growlh Fund of America-A New PerspecfJve Fand-A Fundamental Investors-A CB&T CUST IRA DANIEL B BAILEY OS 174193663 growth 741.533 $25.66 $1g. Sg2.g2 07 191Hag61 growth 634.019 $24.61 $15,763.41 lO 207729315 growth-and-income 646.t14 S2g.g2 $11,9g0.18 62 63851664 growth 59.730 S53.336.41 T~l Your investment portfolio m Growtk ~ mm, Growth-and-income 32.4~ c~a Equity-income 6.94~ About the pie chart at left COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* BUREAU OF INDIVlDUAI,:tt~.X~ INHERITANCE TAX DII/ISION. ...... PO BOX Z80601 HARRISBURG PA 171Z8-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REY-IU7 EX AFP 112-041 II: it? DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-14-2005 BAILEY 08-10-2003 21 04-0305 CUMBERLAND 101 ANGELA D DANIEL il8:Alli.lt'l'( 1114 W POWDERHORN RD MECHANICSBURG PA 17050 Allount Re..itted 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 ..... REV :r!1"'f.EX..AFp..r~1---6!".NOTicE.OF.iliHEf(I.fANCE.Y'AX.A.t5'PRA.fSEM€N'~.A[towANcE.oR.....--....... ... DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BAILEY ANGELA D FILE NO. 21 04-0305 ACN 101 DATE 03-14-2005 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 22.263.93 .00 .00 (8) NOTE: To insure proper credit to your account, submit the upper portion of this forll with your tax paYllent. 22,263.93 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/GovernllBntal Bequests; Non-elected 9113 Trusts 14. Net Value of Estate Subiect to Tax (9) (10) 5,756.90 .00 (11) (12) (13) (14) 5.756.90 16,507.03 .00 16,507.03 (Schedule J) I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ~ returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. AIIount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due C T: NOTE: 16,507.00 X .00 X .00 X .00 X 00 = 045 = 12 = 15 = (19)= .00 .00 .00 .00 .00 DATE NUMBER + INTEREST/PEN PAID (-) AMOUNT PAID ~ TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 .00 .00 .00 . IF PAID AFTER DATE INDICATED, 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 MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) Name of Decedent: ~ .wt1TNo.: Ar'1~;~, No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' COUli Rules, 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: Yes g No 0 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:R1 b. The separate Orphans' Comt No. (if any) for the personal representative's account is: 1!Ij;<! c. Did the personal ~resentative state an account inii,' arm ally to the parties in interest? Yes fC:l No 0 5 I '" i . ,bV( 17 ~. v c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to sort. e~7 ,zi( /70 S'O Date: L' C",:, ('') ,t <irame /11 y [;v. POI.)h4:~ 0v'V/ JJ1G.YI!f;I"'(}Sbu"," "\ P;if Address ,J ('.j I-- V 7(7 - 71S~-- l20Y' Telephone No. LLJ c,~ L;~ 1: CO) C~. u__ C:'c" 0.:' ' (~"' C.:-, LLI 0- 0._ u c. C-.) ,/ cr,: U';:::i ut::__' 0= C)~C" [) Capacity: ~ Personal Representative o Counsel for personal representative -^) '''' c:.~ (.;.;.;..' C"-A CPf Cumberland County - Register Of wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 7/13/2005 BAILEY DANIEL BRIAN 1114 W POWDERHORN ROAD MECHANICSBURG, PA 17050 RE: Estate of BAILEY ANGELA DIETRICH File Number: 2004-00305 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. 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: 8/10/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~.. f'~P4/.tB-~ GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Counsel Judge v-R