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Home My WebLink About03-0925 PETITION FOR PROBATE and GRANT OF LETTERS , s,ate os L. No. eql-OS-q ,5 also known as To: Register of Wills for the _,(~ Deceased. County of (-} or~be_c I ar, d Social Security No. ~ O °F - O 3- I q-O 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 will of the above decedent, dated ~e.ot. , '7 and codicil(s) dated I in the named , -l~ 2ool (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in 'Do ct o~i ~ County, Pennsylvania, with h i~ lastfamilyorprincipalresidenceat [2, '-t~r'i,ar Lo, ine_~ Ccx~,,~?-I-4;II;P'~t (Lo, oar ?~.!h~. Tc,~on.S~,;?) ' ' ' (list street, number and muncipality) Decendent, then ~ ~ ye,ars of age, died / 0 - 2 ~- 0 3 , ~ , at ~O. rr-i.~burct ~osf,~zo,.I ~ ~rri~bm.~. ~ . Except as follows, d~cedent d~d not marry, was not divorced and d~d not have a child born or adopted 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: WHEREFORE, petitioner(s) respectfully presented herewith and the grant of letters theron. $ ,~0¢ 000 $ $ $ !oo~ 0o0 I BO, 00o request(s) the probate of the last will and codicil(s) (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) J OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA 3 COUNTY OF ~cxe,,b~,.cla~ .~ 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) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this ,..~'~ ~,~ / No. O3 - q3,5 Estate Of DOMTNTC ~ MarCUS0 , Dece~ed DECREE OF PROBATE AND GRANT OF LETTERS AND NOW NOVEMBER '?, 2003 l,gx ,, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated 9-7-2001 described therein be admitted to probate and filed of record as the last will of and Letters TESTAMENTARY are hereby granted to DONNA M KUMPF FEES Probate, Letters, Etc .......... Sf~:~ ~. O O Short Certificates(bt) .......... $ / ~. o o TOTAL ~ $c~(aq. oO Filed .. Ii.-..-/. z .O..~ ....................... ]~' 11-7-03 ATTOI~NEY (Sup. Ct. I.D. No.) ADDRESS PHONE his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local R,egistrar. The original certificate will be forwarded t~ the State Vital Records Office for permanent 'fiiing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 ~ ~ Local Registrar No. ~ D~te Dominic L. Mzncuso COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH * VITAL RECORDS CERTIFICATE OF DEATH ,. 81 ~,. j ] 12/18/1921 ,.Harrisburg, PA "~[] E,~,*, [] ~[] [] F,.~.~ ~s~,~,~,[] ! . ~. Nu~in ~. H~risb~g ,0. White ,,.. Draft~ ,,,.PA ~pt. Of ~NrS MmU~ ~ ~,~. C~ ~. Z~ C~) ~C~'S ' "~' ~4. Wi~ ~S. 6 Bri~ ~e ~,u~ ,..~, Pennsylv~ia ,,..~.~ ~r Allen ~ Hill, PA 17011 ~*,u. --= I,,,.Nov~r 3, 2003 ._b,,.~te of H~ven C~te~ ~E ~{~'~u~c~ ~ ....... L ................................. I .... ................ I I' [ qEa ~. , -- ....... ~GNA*U.EANOTIT~%~/O ERflFlf~ ..... ' MEDIC AL EXAMlNERlCORON ER ( LAST WILL AND TESTAMENT OF DOMINIC L. MANCUSO I, DOMINIC L. MANCUSO, of 6 Briar Lane, Camp Hill, Cumberland County, Pennsylvania 1 7011, being of sound and disposing mind and memory, do hereby make, publish and declare this for and as my Last Will and Testament hereby revoking any and all Wills or Codicils by me at any time heretofore made. ITEM I- I am married to GIZELLA M. MANCUSO. I have three daughters: LINDA M. KEMP, DONNA M. KUMPF and NANCY MANCUSO, and they are described in this Will collectively as "my daughters" and individually as "my daughter." ITEM II - I give my tangible personal property and all insurances thereon to my daughter, DONNA. I have complete confidence that my daughter, DONNA, will Initials honor any written instructions that I may leave with regard to said tangible personal property. Any such property not so distributed should be sold and the proceeds added to my residuary estate and pass as hereafter described. ITEM III - All the rest, residue and remainder of my Estate, real, personal and mixed, I give, devise and bequeath in equal shares to my daughters LINDA, DONNA and NANCY, all per stirpes. ITEM IV - I name as my Executrix, my daughter, DONNA M. KUMPF. In the event she predeceases me or elects not to serve, I name my daughter, NANCY MANCUSO, as my successor-Executrix. I direct that my Executrix shall not be required to post bond in this or in any other jurisdiction. ITEM V - I give to my Executrix named in this Will or any Codicil hereto or to any substitute Executrix all of the powers now applicable by law to fiduciaries in the Commonwealth of Pennsylvania and in particular, through the Pennsylvania Probate, Estates and Fiduciaries Code, as effective and as in effect on the date hereof, during the administration and until the completion of the distribution of my estate, or any Codicil hereto. Initials ITEM VI - My Executrix is authorized and empowered to retain, for such period of time as my Executrix may determine, any assets, including the capital stock of any closely held corporation, which at any time shall come into the possession of my Executrix, whether such assets are or are not of the character approved or authorized by law for investment by fiduciaries and whether such assets do or do not represent an overconcentration in one investment. ITEM VII - No interest of any beneficiary under this Will or any Codicil hereto, shall be subject to anticipation or to voluntary or involuntary alienation. ITEM VIII - All estate, inheritance, succession and other death taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property comprising my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid out of the residue of my estate, as if such taxes were expenses of administration, without apportionment or right of reimbursement. I authorize my Executrix to pay all such taxes at such time or times as deemed advisable. Initials ~,~~ ITEM IX - Wherever the context requires, singular and plural, and masculine, feminine and neuter, shall be interchangeable. IN WITNESS WHEREOF, I have hereunto set my hand and seal this dayof -~'~/~'~/~ ~)-~t" , 2001. ~(SEAL) DOMINIC L. MANCUSO The preceding instrument, consisting of this and three (3) other typewritten pages, each identified at the bottom thereof by the initials of the Testator, was on the date thereof signed, published and declared by DOMINIC L. MANCUSO, the Testator herein named, as and for his Last Will, in the presence of us, who at his request, and in the presence of each other, have subscribed our names as witnesses hereto. WITNESSES: residing at residing at COMMONWEALTH OF PENNSYLVANIA : : COUNTY OF CUMBERLAND : SS. WE, DOMINIC L. MANCUSO '~-~__(~' ~, C~. g-~L~_?g ,,j v'. , and Li r~c.~ck~,/ ~ , k.~0-~ I the TESTATOR and WITNESSES .I whose names are s~gned to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and Testament and that he had signed willingly (or willingly directed another to sign for him), and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witness and to the best of his or her knowledge the Testator was at that time eighteen (18) years of age or older, of sound mind, and under no constraint or undue influence. DOMINIC L. MANCUSO, Testator WITNESSES: Subscribed, sworn to, and acknowledged before me by DOMINIC L. MANCUSO, the Testator, and subscribed and sworn to before me by ~f~_f j2~ ~r (_~-~u4)r). ~r., and L~r~c~'~.~ ~. Ik.~3. i I , witnesses, this r-j day of .'~D~L~-~'~-~--' , 2001. Notary Public J NOTARIAL SEAL · BARBAFIA J. KOCHER, Notary Public Oamp Hill J~oro, Cumberland Counly ,, My Commission Expires Oct. 22, 2001. Name of Decedent: CERTIFICATION OF NOTICE UNDER RULE 5.6(a) 'T)om i n i c L. Date of Death: 6~.~ ~ · ~' ~.~ C:~ 0 0 ,,~ Will No. ~ tQ) O3~ O(_~q ~..~ Admin. No. p0~ _/{JO. 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 .Ix]OV. "Tj ~ O0._-.B · Name Address Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: ~'~ DE' Signature Name Address Telephone ('1 ,-~) 6/3 ~- ~ Capacity: ~'~, Personal Representative Counsel for personal representative JRD/June 30, 1992/17858 In Re: Estate of DOMINIC L MANCUSO Late of LOWER ALLEN TOWNSHIP Estate No.: 21-03-925 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 21-2003-925 NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 5.6(e), SUPREME COURT ORPHANS' COURT RULE Personal Representative: DONNA M KUMPS Counsel for Personal Representative: Date of Grant of Original Letters: 11-07-2003 Date of Delinquency Notice: 02-17-2004 The undersigned, Glenda Famer-Strasbaugh, Register of Wills, in accordance with Rule 5.6, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its certification required by Rule 5.6(e), Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court Orphans' Court Rules, was given by the Register of Wills on FEBRUARY 17, 2004, and that the ten (10) day notice to file the certification has expired. Accordingly, in accordance with Rule 5.6(e) the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 03-15-2004 Distribution: gu, g' f~[ls Personal Representative Counsel for Personal Representative Estate File A hearing is scheduled for ,~.w'4,( c//j ~ ~( at ~/g-/~',In Courtroom No. 3. If the Certification of Notice is filed prior t° the hearing dat~, t~e ~'~"'~ng will automatically be cancelled. ., !1t'!Iili Georg~E. ~t~e~/P.l~." } h,,llh,,I,,Ih,,Ihl,h,hh,,hhlh,,h,hh,hlh,,h,,ll DOMINIC L MANCUSO 580 PLEASANT VIEW RD LEWISBERRY PA 17339-9508 P.O. Box 67013 (717) 234-8484 (Harrisburg) Harrisburg, PA17106-7013 (800) 237-7328 (Nationwide) websJte- htlp://www, psecu.com 0Z0qXXXXXX THE FAIR MARKET VALUE, (FMV) OF YOUR IRA WILL BE REPORTED TO THE INTERNAL REVENUE SERVICE ANNUAL IRA-SUMMARY FOR CALENDAR YEAR ZOO5 PAGE 01 ~APYE = ANNUAL PERCENTAGE YIELD EARNED IRA TYPE: TRAOZTZONAL IRA BENEFICIARIES; DONNA M KUMPF - 55.000~ NANCY M SPANGENBERG - 55.000~ LINDA M KEMP - 55.000~ 01/01 SZl BEGINNING BALANCE 0.00 [1/14 11/14 SZ1 DEPOSIT 9,114.14 0.00 9,1lq.lq TRANSFER FROMOTHER INSTITUTION [1/50i11/50 SZ1 DIVIDEND 6.500~ Z7.59 0.00 9,141.75 APYE~ 6.70~ FROM 11/14/05 THROUGH 11/50/05 [Z/51 1Z/51 SZ1 DIVIDEND 6.500~ 50.47 0.00 9,19Z.Z0 APYE~ 6.70~ FROM 1Z/01/05 THROUGH 1Z/51/05 [Z/51 SZ1 ENDING BALANCE 9,192.Z0 91/01 SZZ BEGINNING BALANCE 0.00 [1/14 11/lq SZZ DEPOSIT 9,114.14 0.00 9,114.14 TRAHSFERFROHOTHER INSTITUTION /1/50 11/50 SZZ DIVIDEND 6.500~ Z7.59 0.00 9,1~1.75 APYEN 6.70~ FROM 11/14/05 THROUGH 11/50/05 /Z/51 1Z/~I-*S~Z D~f~DEND~.--SOO~ ............ 5.0,~7 0.0~ 9,19Z.Z0 APYE~ 6.70~ FROM 1Z/01/05 THROUGH 1Z/51/05 /Z/51 SZZ ENDING BALANCE 9,19Z.Z0 91/01 SZ5 BEGINNING BALANCE 0.00 [1/14 11/14 SZ5 DEPOSIT 9,114.15 0.00 9,114.15 TRANSFER FROM OTHER INSTITUTZOM [1/50 11/$0 SZ5 DIVIDEND 6.500~ Z7.59 0.00 9,141.7Z APYE~ 6.70~ FROM 11/14/05 THROUGH 11/50/05 [Z/15 1Z/15 SZ5 WITHDRAWAL 505.81- 100.76 8,657.91 DEATH ~ FEDERAL WITHHOLDING 100.76 LZ/51 1Z/51iSZ5 DIVIDEND 6.500~ q8.9q 0.00 8,686.85 APYE~ 6.70~ FROM 1Z/01/05 THROUGH 1Z/51/05 [Z/51 SZ5 ENDING BALANCE 8,686.85 )1/01 S55 BEGINNING BALANCE 25,845.50 ¢ONT/NUED ogoxoooo 5019110 PSE ' - - ILI~II I kqiliI,YgLTlllll [I I¶iTIlliliil ~][IPj~llli[gi I Iillil[Uki P.O. Box 67013 (717) 234-8484 (Harrisburg) Hmdsbu[g, PA 17106-7013 (800) 237-7~28 (Nationwide) websJte - http://www, psecu.com .............. :~:~:~:;:::::~:~'~'~:':":~:~'~'~:~ VALUE, (FMV) OF YOUR IRA MILL BE REPORTEO TO THE INTERNAL REVENUE SERVICE DOMINIC L MANCUSO ANNUAL IRA-SUMMARY FOR CALENDAR YEAR ZOO5 PAGE OZ - ~ ~~'~~~eI~:C~NTAGE yzELO EARNED :::::::::::::::::::::::::::::: :::::::::::::::::::::::::::: ::::;::::::;:::::: IRA TYPE: TRRDIT%ONAL CONT%NUED D1/$1 01/$! S§5 DIVIDEND 6.500% lqZ.68 0.00 25,988.18 APYEN 6.70~ FROM 01/01/05 THROUGH gl/Z8 OZ/Z8 555 DIVIDEND 6.500% 129.58 0.00 Z6,117.76 APYE~ 6.70~ FROM 02/01/05 THROUGH OZ/ZS/05 05/51 05/51 SS5 DIVIDEND 6.500~ lqq.18 0.00 Z6,g61.Vq APYE~ 6.70~ FROM 05/01/05 THROUGH 05/51/05 Oq/50 Oq/50 555 DIVIDEND 6.500~ lq0.50 0.00 Z6,qOZ.Zq APYE~ 6.70~ FROM 0q/01/05 THROUGH 05/51 05/5! S55 DIVIDEND 6.500% lq5.75 0.00 Z6,Sq7.99 APYE~ 6.70% FROM 05/01/05 THROUGH 05/51/05 06/50 06/50,S55 DIVIDEND 6.500~ lql.85 0.00 Z6,689.SZ APYE~ 6.70~ FROM 06/01/05 THROUGH 06/50/05 07/51 07/51 S55 DIVIDEND 6.500x lqT.Sq 0.00 Z6,857.16 APYE~ 6.70~ FROM 07/01/05 THROUGH 07/51/05 08/51 08/51 S55 DIVIDEND 6.500~ lq8.16 0.00 26,985.52 APYE~ 6.70~ FROH 08/01/05 THROUGH 08/51/05 09/50~09/50 S55 DIVIDEND 6.500~ lqq.17 0.00 g?,lZ9.q9 APYE~.~6,.~O~ FROM 09/01/05 THROUGH 09/50/05 10/51 10/51 S55 DIVIDEND 6.500% lq9.77 0.00~ZT'Z79'Z6 APYE~ 6.70~ FROM lO/O1/05 THROUGH 10/51/05 /~__ _._ ,:~ Il/lq Il/lq S55 DIVIDEND 65.15 0.00 APYE~ 6.71~ FROH 11/01/05 THROUGH 11/15/05 Il/lq Il/lq S55 NITHDRANAL 9,1Iq.lq- 0.00 18,2ZS.Z7 TRANSFER TO ANOTHER INSTITUTION ll/lfi Il/lq 555 NITHDRAHAL 9,1Iq.lq- 0.00 9,11q.15 TRANSFER TO ANOTHER INSTITUTION Il/lq Il/lq S55 NITHDRANAL 9,114.15- 0.00 0.00 TRANSFER TO ANOTHER INSTITUTION 1Z/31, S55 ENDING BALANCE 0.00 TRADITIONAL SUMMARY PREVIOUS YEAR CONTRIBUTIONS 0.00 CURRENT YEAR CONTRIBUTIONS 0.00 DISTRIBUTIONS Z7,Sq6.zg IRS HITHHOLDING 100.76 ROLLOVERS 0.00 02020000 CONNONHEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z80601 HARRISBURG, PA 17128-0601 REV-16q3 EX AFP C09-00) ZNFORHATZON NOTICE AND TAXPAYER RESPONSE FZLE NO. 21 03-0925 ACN Oq1017q5 DATE 01-25-ZO0q DONNA M KUMPF 580 PLEASANT VIEW RD ~t LEWISBERRY PA 17539-95~8*~ TYPE OF ACCOUNT EST. OF DOMINIC L MANCUSO [] SAVTNGS S.S. NO. 20q-O$-61q6 [] CHECKTNG DATE OF DEATH 10-29-2005 [] TRUST COUNTY CUMBERLAND [] CERTTF. REMTT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 PSECU has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you ware 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 fora 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 (727) 767-BSZ7. COMPLETE PART 1 BELOW # ~ ~ SEE REVERSE SiDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. O20qO$61q6 Date 07-30-2002 Established Account Balance 6,008.02 Percent Taxable X 5 0.0 0 0 Amount Subject ~:o Tax 3,004.01 Tax Rata X .045 Potential Tax Due 135.18 To insure proper credit to your account, two (Z) copies of this notice must accompany your payment to the Register of Hills. Hake check payable to: 'Register of Hills, Agent". NOTE: If tax payments ara made within three (5) months of the dacedant's data of death, you amy deduct a 5Z discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE 1'711,:,:,:~i~,:::~:::,~~;,;,~i~;,;,;~:,:,:i~:,::~,,:,~i~i~:::,:~,, ~~ :,~ ,:~,, ~ A, ~1 The above information and tax due is correct. 1. You may choose to remit payment to the Register cf Hills with two copies of this notice to obtain CHECK a discount or avoid interest, or you may check box "A" and return this notice to the Register of ONE q Hills and an official assessment will ba issued by the PA Department of Revenue. BLOCK J B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return ONLY ~ to be filed by tha dacadant's representative. C. D The above information is incorrect and/or debts and deductions were paid by you. You must complete PART [] and/or PART []below. PART If you indicate a different tax rata, please state your -I relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LTNE 1. Data Established i 2. Account Balance 2 3. Percent Taxable 3 q. Amount Sub5ac~ to Tax q S. Debts and Deductions 6. Amount Taxable 6 7. Tax Rata 7 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line $ of Tax COaputatLon) Under penalties of par.~ury~ T declare that the facts I have reported above ara true, correct and complete to the best of ay knowledge ~nd belief. HOME ( TAXPAYER S~GNATURE - TELEPHONE NUMBER ' DATE GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT ZN AN OFFICIAL TAX ASSESSMENT with applicable interest based on information submitted by the financiaI institution. Z. Inheritance tax becomes delinquent nine months after the dacadant's date of death. $. A joint account is taxable even though the decadant's name Nas added as a matter of convenience. q. Accounts [including those held between husband and wife) which the decedent put in joint names within one year prior to death arm 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 er others are taxable fully. REPORT]'NG TNSTRUCTTONS - PART I - 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 I 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 i1548 EX) upon receipt of the return from the Register of Hills. If the asset specified on this notice has been or will ba reported and tax paid with the Pennsylvania Inheritance filed by the decedent's representative, place an "X" in block "B" of Part I of the "Taxpayer Response" section. Sign one eturn to 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 g 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 Nills of the county indicated. The PA Oepartaent of Revenue will issue an official assessment (Form REV-1SqB EX) upon receipt of the return from the Register of Wills. TAX RETURN - PART Z - TAX COMPUTATION LINE 1. Enter the date the account originally was established or titled in the manner existing at date of death. NOTE: For a decedent dying after 1Z/II/BI: 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 $$,000 per transferee regardless of the value of the account or the number of accounts held. If a double asterisk (am) appears before your first name in the address portion of this notice, the $5;000 exclusion already has been deducted from the account balance as reported by the financial institution. 2. Enter the total balance of the account including interest accrued to the date of death. 5. The percent of the account that is taxable for each survivor is determined as follows: A. The percent taxable for joint assets established more than one year prior to the decedent's death: 1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE JOINT OWNERS SURVIVING JOINT OWNERS Example: A joint asset registered [n the name of the decedent and two other persons. I DIVIDED BY 3 (JOINT ONNERS) DIVIDED BY 2 (SURVZVORS)= .167 X 100 = 16.7Z (TAXABLE FOR EACH SURVIVOR) B.The percent taxable for assets created wlthln one year of the decedent's death or accounts owned by the decedent but held in trust for another individual(s) (trust beneficiaries): I DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE OWNERS OR TRUST BENEFICIARIES Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by the decedent. I OIVIOEO BY Z (SURVIVORS) = .SO X 100 = SOX (TAXABLE FOR EACH SURVIVOR) The amount subject to tax (line q) is determined by multiplying the account balance (line 2) by the percent taxable (line 5). S.Enter the total of the debts and deductions listed in Part 3. 6.The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) free the amount subject to tax (line q). 7.Enter the appropriate tax rate (line 7) as determined below. Date of Death Spouse Linea! Sibling Collateral 07/01/9fi to 12/S1/9q SX 6X 1SI 01/01/95 to 06/50/00 OX 6Z 15X lex 07/01/00 to present OX q.$X! 12X lex aTha tax rate imposed on tho nat value of transfers from a deceased ch(Id 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 The lineal class of hairs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children whether or net 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" ara defined as individuaZs 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. CLATMED OEDUCTTONS - PART 3 - DEBTS AND DEOUCTTONS CLATMEO Allowable debts and deductions ara 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, uss plain paper 8 l/Z" x 11". Proof of payment may be requested by the PA Department of Revenue. Alan Kumpf 580 Pleasant View Rd. Lewisberry, PA 17339 37 REV-1500 EX COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 _ 03 925 ~OUNTYCOOE YEAR NUMBER I-- ILl UJ W z C~ Z W n, DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Mancuso, Dominic L DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR 10/29/2003 12/18/1921 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER SOCIAL SECURITY NUMBER 204-03-6146 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS [~1. Original Return r'~4. Limited Estate ~-~6. Decedent Died Testate (^~ch copy of w~,) [9. Litigation Proceeds Received r~2. supplemental Retum --'1 4a. Future Interest Compromise (date of death after 12-12-82) [~7. Decedent Maintained a Living Trust (A~ch copy of Trust) [~10. Spousal Poverty Credit (date of dealh between 12-31-91 and 1-1-95) D3. Remainder Return (date of death prior' 1o 12-13-82) [~]5. Federal Estate Tax Retum Required ~ 8. Total Number of Safe Deposit Boxes ---11. Election to tax under Sec. 9113(A) (Atlach Sch O) THIS $~CTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONfiDENTIAL TAX INFORMAT-K?~I SHOULD BE D~,F.~" ~:D TO: NAME ~ COMPLETE MAILING ADDRESS Donna M Kumpf, Executrix t 580 Pleasant View Road FIRM NAME (~f,~caue) Lewisberry, PA 17339-9508 TELEPHONE NUMBER (717) 938-8223 1. Real Estate (Schedule A) (1) 1 19,000.00 2. Stocks and Bonds (Schedule B) (2) 62,599.~ 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 0.(~ 4. Mortgages & Notes Receivable (Schedule D) (4) 0.00 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 8,957.00 (Schedule E) 6. Jointly Owned Property (Schedule F) (6) 0.00 ]---]Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 27,342.41 (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) (8) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 13,411.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 0.00 11. Total Deductions (total Lines 9 & 10) (11) 12. Net Value of Estate (Une 8 minus Line 11) (12) 13. Charitable and Governmental BequestsJSec 9113 Trusts for which an eleclion to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 217,898.41 13,411.00 204,487.41 0.00 204,487.41 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due _ x .0 _ (15) 2044~487.~1 x .0 45 (16) _ x .12 (17) x .15 (18) (19) > > BE SURE TO ANSWER ALL QtJESTiON8 ON REVEP~,E SIDE AND RECHECK MATH < < 9,201.93 9,201.93 Decedent's Complete Address: STREET ADDRESS 6 Briar Lane C~Wcamp Hill STAIEpa I Z~P 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Pdor Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty 0.00 8,893.42 468.06 (1) Total Credits ( A + B + C ) (2) 0.00 0.00 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) 9,201.93 9,361.48 0.00 159.55 5. 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 BALANCE DUE. (5B) 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; .......................................................................................... [] [] 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 after 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 tree, correct and complete. Declaration of preparer o~er than the personal representative is based on all information of which preparer has any knowledge. 580 Pleasant View Road, Lewisberry, PA 17339-9508 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE 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 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 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% [72 RS. §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 RS. §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 an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX+ (6-98) SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Dominic L. Mancuso 21-03-925 All real property owned solely or as a tenant in c,,iii,,,on must be reported at fair market value. Fair market value is defined as the pdce at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which Is jointly-owned with right of survivorship must be dlsc~e~ on Schedule F. ITEM NUMBER DESCRIPTION 1. (Appraisal attached.) 3 bedroom, 1 1/2 bath ranch house. Address: 6 Briar Lane, Camp Hill, PA 17011 Located in: Rossmoyne Manor, Lower Allen Township, Cumberland County, PA TOTAL (Also enter on line 1, Recapitulation (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 119,000 119,000.00 REV-1503 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ~SiATEOF J~m;n;c L. SCHEDULE B STOCKS & BONDS FILE NUMBER 21-03-925 ITEM NUMBER 1. 3. All property jointly.~w~e~ with right of survivorship must be disclo__-ed_ on ,~che,~ule F. DESCRIPTION SAVINGS BONDS (SEE LIST ATTACHED) HH Bonds payable to Dominic L Mancuso or Gizella M Mancuso (deceased 7/22/02) EE Bonds payable to Dominic L Mancuso or Gizella M Mancuso (deceased 7/22/02) HH Bonds (See list attached) Payable on death to Donna M Kumpf [These are being included on Schedule B as a taxable asset, but with question as to whether these am taxable assets under Pa. Inheritance Tax.] MetLife Insurance Stock Trust certificate/Investor ID 806680254179) Value: 587.10 Copy of certificate included. TOTAL (Also enter on line 2, Recapitulation) $ (If mom space is needed, inse~t additional sheets of lhe same size) VALUE AT DATE OF DEATH 13, OO,9- I, OIZ-- Urn, oOo- 5%7--- 62,599.00 REV-1508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER DOm;nic L. M(~lqcc~5o 21-03-925 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH Penna. State Employees Credit Union Joint Savings account with Donna M Kumpf Balance $6008.02 50% Value PNC Bank Account: Joint Checking Account with Donna M Kumpf #5140041317 Balance $4400.89 50% Value Personal Property (see attached list) 1999 Ford Taurus · Blue Book Trade-in Value (attached) Cash on hand: $29.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 3004. REV-1510 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21-03-925 This schedule must be completed and filed if the answer to any of questions 1 throu( h 4 on the rever side of tb ....... ~ ......... ~ '~'~'OG OlUG UI UI~ F~F-V' I0~,~.1 ~*,UVl-~ ~)~'~_.~_ I IS yes. ITEM DESCRIPTION OF PROPERI Y NUMBER INCLUOETHENAMEOFTHETRANSFEREE, THEIRRELATIONSHiPTOOECEDENTAND DATE OF DEATH %OFDECD'S EXCLUSION TAXABLE THE DATE OF TRANSFER. ATFACHACOPYOFTHEDEEDFORREALESTATE, VALUE OFASSET IN'II:KEST (JFAPPLICABLE VALUE 1. 27342.4' 27342 Pennsylvania State Employees Credit Union · IRA - traditional Beneficiaries: Donna M Kumpf, Nancy Spangenberg, Linda M Kemp TOTAL (Also enter on line 7 Recapitulation) $ 27,342.41 tl pace is needed, inse~t additional sheets of the same size) REV-1511 EX+ (12-99~[% COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Domi i L SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER o 3-clz5 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION A. FUNERAL EXPENSES: 1. Bo Funeral expenses paid to Malpezzi Funeral Home: $7249. Flowers for funeral $284. Gingrich Memorials (Headstone) $900. Gate of Heaven Cemetery (grave opening) $700. VFW Honor Guard $ 50. Luncheon following service $150. Interpreter for deaf (for Linda Kemp, daughter) $100. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Secudt7 Number(s)/EIN Number of Personal Repmsentalive(s) Street Address Ci~j State Year(s) Commission Paid: Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Zip Street Address c~ Relationship of Claimant to Decedent State Zip Probate Fees Register of Wills: $269.00 Acceuntant's Fees Tax Return Preparer's Fees House appraisal: $275.00 Death notices advertised: Cumberland Law Journal $75.00 Carlisle sentinel: $75.00 Cost of Maintaining Property: (from 10/29/03 to 4/27/04) Utilities (Water $109.80; Sewer/trash $154.04; Electric $198.44; Basic phone service $173.07; UGI gas $606.; home insurance $22.; cable: 79.28) Repairs needed: Furnace $412.21; Plumber $199; Shed repair, window repair, paint & supplies $350.14; Carpeting/flooring $952.64, Postal/mail expenses $27. TOTAL (Also enter on line 9, R~.pitulation) AMOUNT 2 oq ' 328 -- (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Dominic L. NUMBER I 11 SCHEDULE J BENEFICIARIES NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include ou[i¥,i sp~al ~b;butions, and ~,,,=~'~s Sec. 9116 (a) (1.2)] FILE NUMBER 2_1-o3~ ?2.5 RELA~ONSHIPTODECEDENT Do Not Mst T~---* AMOUNT OR SHARE OF ESTATE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHE~- ~ NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If r~c~-e space is needed, insert additional sheets of lhe same size) $ FI Or~ ~. Central Penn Appraisals, Inc. (717) 737-4600 UNIFORM RESIDENTIAL APPRAISAL REPORT e. No. BRIARLN6 , Address 6 BRIAR LANE City CAMP HILL State PA Zip Code 17011-7903 DEED 00248 PAGE 00306 County CUMBERLAND Assessor's Parcel No. 13-25-0022-222 Tax Year 2003 R.E. Taxes $1,677.38 .__~Jec__-'_=J A_~_?nmts $ 0.00 Borrower N/A Current Owner ESTATE: DOMINIC L. MANCUSO Occupant: ~ Owner ~ Tenant [~ Vacant Leasehold Pro~ect Type ~ PUD ~ Condominium (HUe/VA only) HOA ~; NONE mo. ROSSMOYNE MANOR Map Reference HBG. ADC19 H7 Census Tract 0111.00 ..................... DateofSale INSP. 01-18-04 Oescri~mlandSamountofloancharoes/concessionstobeoaidbv~ N/A DONNA M. KUMPF JOHN So BOSWELL LocaUon Urban [] Suburban [] Rural Built up [] Over 75% [] 25-75% [] Under 25% Growth rate [] Rapid [] Stable [] Slow Property values [] Increasing [] Stable [] Declining Demand/supply [] Shortage [] In balance [] Over supply MarkeUn(] lime C~ Under 3 mos. J---I 3-6 mos. i--I Over 6 mos. Address 580 PLEASANT VIEW ROAD, LEWISBERRY, PA 17339-9508 Address 24 W. MAIN STREETr SHIREMANSTOWNr PA 17011 Predominant o~Si?~q~le family ho~l~ Present land u~e % Land u. olumge occupancy ~,~,(~) ~:) I One family 70 I [] Not likely [] Likely [] Owner ~ Low ~ 2-4 family 7 [] In process l i-]Tenant I 200+ High 100+ IMulli-family 3 I To: FULLY DEVELOPED I [] Va.. I I Predondn=, I I Commercial 10 I ICI Va . o e, 120 45 IVACANT10 I Note: Race and the racial compooltion of the neighborhood are not appraisal factors. Neighborhood boundaries and characteristics: THE SUBJECT IS LOCATED IN LOWER ALLEN TOWNSHIP; GETTYSBURG RD. TO THE NORTH, SAINT JOHNS RD. TO THE EAST, RT 76 TO THE SOUTH, AND THE TOWNSHIP LINE TO THE WEST. Factors that affect the marketability of the properties in the neighborhood (proximity to employment and amenities, employment stability, appeal to market, etc.): This suburban neighborhood has most public utilities available, relatively easy access to employment and services, and is competitive with in the general area. Most have similar amenities. No unfavorable factors were observed which would adversely effect marketability. Market activity indicates average or better acceptance in the market place. Market conditions in the subject neighborhood (including support for the above conclusions related to the bend of property values, demand/supply, and merkeUng time -- such as data on competitive properties for sale in the neighborhood, description of the prevalence of sales and financing concessions, etc.): There are no foreseeable economic trends which might significantly influence market conditions in this area. The current mortgage market offers a wide variety of conventional loans with competitive rates. As a result, the terms of financinA have little, if any, impact on sales prices. If interest rates remain reasonable, property vaiuas and marketability should be good. Current supply and demand are in balance. Marketin~ statistics, lnterast rates are ranoinG from 5-7% with 0-3 points typically being paid for origination or discount. Project Information for PUDs (If applicable) - - Is the developer/builder in control of the Home Owners' Association (HOA)? [] Yes [] No Approximate total number of units In the subject project N/A Approximate total number of units for sale in the subject project N/A Oescdbe common elements and recreational facilities:N/A Dimensions SEE LEGAL DESCRIPTION Site area 0.33 ACRES Corner Lot [] Yes [] No Specific zoning classificabon and description RESIDENTIAL USE Zoning compliance [] Legal [] Legal nonconforming (Grandfathered use) [] Illegal [] No zoning Present use Utilities Public Other Off-site improvements Type Public Private EleClTicity [] 200 AMP Street ASPHALT [] [] Gas [] Corb/gutter CONCRETE [] [] Water [] Sidewalk CONCRETE [] [] Sanitary sewer [] Street lights POLE [] [] Storm sewer [] NONE Topography LEVEL Size TYPICAL FOR AREA Shape RECTANGULAR Drainage APPEARS ADEQUATE View AVERAGE Landscaping AVERAGE Driveway Sudace ASPHALT Apparent easements NONE OBSERVED FEMA Special Flood Hazard Area [] Yes [] No FEMA Zone C Map Date 9/30/1977 FEMA Map No. 4210160002B Coraments (apparent adverse easements, enoroaclmmnts, special assessments, slide areas, illegal or legal nonconforming zoning use, etc.): Site has average There are no apparent adverse easement, encroachments, or other adverse conditions on this site. GENERAL DESCRIPTION EXTERIOR DESCRIPTION FOUNOATION BASEMENT INSULkTION No. of Units 1 Foundation CON. BLOCK Slab 0 Area Sq. R. CRAWL Roof [] No. of Stories I Extedor Walls BRICK / ALUM Crawl Space 100 % % Rnisbed N/A Ceiling AVE. [] Type (Det,/Att.) DETACHED Roof Sudace SHINGLE Basement 0 Ceiling N/A Walls AVE. [] Design (Style) RANCHER Gulters & Dwnapts. ALUMINUM Sump PUmp NONE Walls N/A Floor AVE. [] Existing/Proposed EXISTING Window Type DBL. INSULAT. Dampness NONE OBSERV. Floor N/A None [] Age (Yrs.) 46 Storm/Screens NO / YES Setltement NONE OBSERV. Outside EntTy N/A Unknown [] 20 Manufactured House NO Infestation NONE OBSERV. Rec. Rm. Other Area Sq. Ft. CRAWL 1,659 finished area above tirade contains: INTERIOR Materials/Condilion Floors CARPET - AVE. Walls DRYWALL - AVE. Trim/Rnish WOOD - AVE. Bath Floor TILE - AVE. Bath Wainscot CERAMIC - AVE. Doors LUAN - AVE. 6 Rooms; 3 Bedmom(s)i 1.5 Bath(s); HEATING 1994 Type FHA Fuel GAS ConditionGOOD COOUNG 1994 Central YES Other WALL Condition GOOD KITCHEN EQUIP. Refrigerator Range/Oven Disposal Dishwasher Fan/Hood Microwave Washer/Dn~er Additional features (special energy efficient items, etc.): See attached addenda. ATTIC None Stairs Drop Stair Scuttle Floor ,eated Finished lr659 Square Feet of Gross Livin,q Area AMENITES Fireplace(s) # Patio Deck Porch FRONT Fence Poo~ SIDE PORCH CAR STORAGE: None [] Ga'age # of cars Attached Detached Built-in Carport I CAR Driveway 2/ASPH Condition of the improvements, depreciation (physical, functional, and external), repairs needed, quality of construction, remodeling/additions, etc.: These are of average quality brick and frame / aluminum design and reflect average maintenance. Utility of floor plan is typical for a house of this age and style and should receive average acceptance in the market place. No unusual functional obsolescence or external were observed. environmental condilions (such as, but not limited to, hazardous wastes, toxic substances, etc.) present in the improvements, on the site, or in the immediate vicinity of the subject property.: There are no apparent adverse environmental conditions observed upon inspection of the or in of Freddie Mac Form 70 6/93 PAGE 1 OF 2 Fannie Mae Form 1004 6/93 Form UA2 -- 'TOTAL for Windows" appraisal software by a la mode, inc. -- 1-800-ALAMODE UNIFORM RESIDENTIAL APPRAISAL REPORT Rk, No. BRIARLN$ .............................................. .-- $ 38,000 !Comments on Cost Approach (such as, source of cost esamate, site value, flON COST-NEW-OF IMPROVEMENTS: square foot caiculaUon and for HUD, VA and FmHA, the estimated remaining ,9 Sq. Ft. @$ = $ economic life of the properly): The cost approach was considered but Sq. FL @$ = deemed inappropriate because of the subjective adjustments = warranted for physical depreciaUon due to the subject's actual _ Sq. Ft. @$ = acm. No obsolescence was observed. The estimate remaining ~ ............................. = $ economic life for the subject improvements is 40 years. dcal Functional External rovements ................................. =$ ovements ................................... =$ )ST APPROACH ............................. I SUBJECT COMPARABLE NO. 1 COMPARABLE NO. 2 COMPARABLE NO. 3 A, NE 16 PALMER DRIVE 26 PALMER DRIVE 18 ROCKAWA¥ DRIVE L. CAMP HILL CAMP HILL CAMP HILL ~.~ 0.15 miles 0.10 miles 0.07 miles INSPECTION ASMT RECORDS/MLS/AGENT/ ASMT RECORDS/MLS/AGENT/ ASMT RECORDS~ILS/AGENT/ I~A sE-r'TLEMENT DEPT. SI=--I-rLEMENT DEPT. SETTLEMENT DEPT. DESCRIPTION DESCRIPTION i +(-)$ Adjust. DESCRIPTION i +(-)$ Adjust. DESCRIPTION i +(-)$ Adjust. ~:~ CONV. " CONV. : CONV. ; ~ ~ NONE ', NONE ', NONE .: ;:~.~*~-.~. ~ .~ 09-30-03 DM 6 +500 08-22-03 DM 10 ! +1,000 04-25-03 DM 3 +2,800 AVERAGE AVERAGE i AVERAGE i AVERAGE FEE SIMPLE FEE SIMPLE i FEE SIMPLE i FEE SIMPLE 0.33 ACRES 0.31 ACRES 0.25 ACRES ' +500 0.22 ACRES ', +1,000 AVERAGE AVERAGE : AVERAGE i AVERAGE RANCHER RANCHER : RANCHER i RANCHER ' AVE. - BRK/ALU AVE. - BRWALU ; AVE. - BRK/VlN ; AVE. - BRK/V/A " AVERAGE GOOD ," -5,000 AVERAGE i GOOD i -5,000 To~iBdrmsi BathsTotaliBdrmsi Baths', TotaliBdrmsi Baths; TctaliBdrmsi Baths i 1 ,c~9 Sq. Ft. 1 ,~ 5 sci. Ft. i ~,700 1,215 Sq. FL i ~6,'Z00 1,215 Sq. It. i .,-6,70O CRAWL CRAWL i CRAWL i CRAWL : N/A N/A,: N/A ,: N/A ,, AVERAGE AVERAGE , AVERAGE : AVERAGE , GFHA/CA GFHA/CA I GFHA/CA : GFHA/CA TYP FOR AREA TYP FOR AREA ' TYP FOR AREA TYP FOR AREA 1 CARPORT 2 CARPORT ', -P,500 1 CARPORT i 1 CARPORT 2 PORCHES STOOP / PATIO : +1,500 STOOP , +2,500 STOOP / PORC : +500 WOODSTOVE NONE i +1,000 NONE i +1,000 NONE i +1,000 NONE FENCE : NONE i NONE NONE NONE : NONE : NONE : ESTIMATED SITE VALUE ESTIMATED REPROI Dwalliq 1 ~659 GaraWCarpor~ 440 Total Estimated Cost New Less Phy Depreciation Depreciated Value of I~ "As-is" Value of Site Iml INDICATED VALUE BY CO,' 6 BRIAR Address CAMP HILL Sales Price Data and/or Verific~on Source VALUE AI~USTUE~S Sales or RnencJng Concessions Location Site View Condition Above Grade Room Count Basement & Rnlehed Funotional trdlity , Efficient Items Porch, Patio, Deck, Adjusted Sails Price (including the subject property's ~ to Ole neighbortmocI, etc.): All three sales are considered to be reliable and ¥ in the final reconciliation. Time adjustments are based on appropriate research of the market the market area. It is noted that the Gross living Area for Comparable No.(s) 1,2, & 3 is significantly less than that of the subject; the sales chosen are the best available. Other comparables analyzed would have required less desirable adjustments and were not used for that reason. Comparables sales used are all closed sales. Appropriate adiustments have been made for all differences. ITEM SUBJECT COMPARABLE NO. 1 I COMPARABLE NO. 2 COMPARABLE NO. 3 Date, Rice and Data 08-23-2001 NONE KNOWN TO EXIST I NONE KNOWN TO EXIST NONE KNOWN TO EXIST Source, for prior sales$0.00 OTHER THAN ABOVE I OTHER THAN ABOVE OTHER THAN ABOVE COURT HOUSE FOR THE PAST 3 YEARS I FOR THE PAST 3 YEARS FOR THE PAST 3 YEARS Analysis of any current agreement of sale, option, or li~ng of subject property and analysis of any prior sales of subject and comparables within one year of the date of appraisal: not known to be under any option for sale or agreement of sale as of the effective date on this report. NO PRIOR SALES IN THE PAST 3 YEARS WERE FOUND. INDICATED VALUE BY SALES COMPARISON APPROACH .................................................................................................. INDICATED VALUE BY INCOME APPROACH ('d A~nr~_}C~__h!e~ Estimated Market Rent $ N/A /Mo. x Gross N/A made [] 'as is" [] sublet to the repairs, alt~ons, inspections or conditions listed below sublet to compiltion per plans & specifications. CondflJons of Appraisal: See attached addenda. Final Reconciliation: See attached addenda. The purpose of this appraisal is to estimate the maket value of the real property that is the subject of this report, based on the above conditions and the celica'don, contingent and lirniting conditions, and market value definition that are stated in the attached Freddie Mac Form 430/FNMA form 1004B (Revised I (WE) ESTIMATE THE MARKET VALUE, AS DERNED, OF THE REAL PROPERTY THAT IS THE SUBJECT OF THIS REPORT, AS OF TO BE $ 119,000 S. SUPERVISORY APPRAISER (ONLY IF REQUIRED): Signature Name Date Renor~ Signed 1-21-04 Date Report Signed State CerUfication # PACERT RL-OO1405-L State PA State Cedification # Or State License # RM-050503-A State PA Dr State License # 6/93 ). 10-29-2003 [] Did [] Did Not Inspect Property State Freddie Mac Form 70 6/93 PAGE 2 OF 2 Form UA2 -- "TOTAL for Windows" appraisal software by a la mode, inc. -- 1-800-ALAMODE Farmil Mae Form 1004 6-93 ! 8onQwer/Client Supplemental Addendum File N0. BRIARI_N6 N/A Pr~e~ Address 6 BRIAR LANE Cily CAMP HILL County CUMBERLAND State PA Zip C0de 17011-7903 Lender DONNA M. KUMPF · ,URAR: Additional Features BUILT-IN BOOKCASES IN THE FOYER; WHOLE HOUSE FAN; REPLACEMENT WINDOWS; KITCHEN REMODELED IN 2002 WITH PICKLED CABINETS, CERAMIC TILE BACKSPLASH AND NEW VINYL FLOORING; GAS WATER HEATER; WOODSTOVE AND WALL MOUNT AC IN THE FAMILY ROOM ADDITION. · URAR: Conditions of Appraisal THE EFFECTIVE DATE OF THIS REPORT IS THE ' DATE OF DEATH '. This appraisal report has been prepared with the property in 'as is" condition. No personal property has been included in this valuation. The fact that the seller is, or is not, paying any portion of the closing cost has no effect on the market value of the subject. The subject property was vacant at the time of inspection. Although the subject property was vacant at the time of inspection, all mechanical equipment appeared to be in working order. See attached appraieer's certification and statement of limiting conditions. · URAR: Final Reconciliation This eppraisai assumes a raasonabie marketing period for the subject property of three months. The IVlarket Approach reflects recent activity in the market place. In view of the age of these improvements, the Cost Approach cannot be considered an accurate indicator of value. The Income Approach is inappropriate because few single family houses ara rented in this market. Given the high quality of the available sale data, the value indicated by the Market Approach is used as the final estimated value. THiS iS A SUMMARY REPORT OF A COMPLETE APPRAISAL. APPRAISER ACKNOWLEDGEMENT APPRAISERS ACKNOWLEDGES AND AGREES, IN CONNECTION WITH ELECTRONIC SUBMISSION OF APPRAISALS, AS FOLLOWS: THE SOFTWARE UTILIZED BY THE APPRAISER TO GENERATE THE APPRAISAL PROTECTS SIGNATURE SECURITY BY MEANS OF A DIGITAL SIGNATURE SECURITY FEATURE WHICH LOCKS THE REPORT WITHIN OUR OFFICE AND CAN NOT BE ALTERED BY ANYONE OTHER THAN OUR OFFICE. APPRAISER CERTIFICATION APPRAISER STANDARDS I acknowledge and certify that (I) my appraisal of the above referenced property may be used in a federally related financial transaction subject to requirements of Title XI of the Financial Institution Reform, Recovery and Enforcement Act of 1989 (FIRREA"); (ii) the appraisal must comply with FIRREA and the applicable regulations implementing Title IX of Firrea; and (iii) the appraisal was completed in accordance with USPAP. APPRAISER COMPETENCY I certify that I am fully qualified and competent by training, knowledge, and experience to perform this appraisal. APPRAISERINDEPENDENCE I represent and certify that (I) the appraisal assignment was based not based on a requested minimum valuation, a specific valuation, or the approval of a loan; (ii) my employment was not conditioned upon the appraisal producing a specific value or value within a given range; (iii) my futura employment is not dependent upon an appraisal producing a specific value; (iv) my employment, compensation, and future employment ara not based upon whether a loan application was approved; (v) neither me nor any person with an ownership interest in the company employing me, is related to or has any ownership or other financial interest in, either the builder/devaloper, seller, buyer, mortgage broker, or real estate broker/salesperson (or any person related to any of them) involved in the transaction for which this appraisal was requested, or with the most recent sale or refinancing of any property used as a comparable property in this appraisal, and (vi) I am not aware of any facts which would disqualify me from being considered an independent appraiser. APPRAISALINSTITUTE CERTIFICATION I certify that, to the best of my knowledge and belief, this report analyses, opinions and conclusions were developed, and this report has been prepared, in conformity with the requirements of the Code of professional Ethics and the Standards of Professional Appraisal Practice of the Appraisal Institute. I Certify that the use of this report is subject to the requirements of the Appraisal Institute rolaUng to review by its duly authorized representatives. Form TADD -- 'TOTAL for W'mdows' appraisal software by a la mode, inc. -- 1-800-ALAMODE (Estate of Dominic L Mancuso Personal property (in usable condition) ITEM Estimated value (using Salvation Army donation guidelines) LIVING ROOM sofa, approx 14 yrs. old 35 loveseat, ...... 35 chair, approx."" 25 end tables, 2 20 draperies (15+ yrs.) 3 lamps (15+ yrs.) 8 FAMILY ROOM sofa (approx. 6 yrs.) 35 chair 25 recliner 25 TV, (15+ yrs ) 50 Pool table, (4+yrs.) 50 Bedrooms: double bed set 60 twin bed/mattress 35 dressers (30+yrs.) 30 Blankets (3) 8 Bedspread 5 KITCHEN kitchen set 40 Dishes/glassware 10 Cookware 10 PERSONAL (in wearable condition) Jackets x 2 15 Slacks x 7 35 Shoes x 3 pr 10 Overcoat 15 Suits x 2 15 SHEDS Mower, fair 50 Snow blower, fair 125 Garden tools, fair 15 Mower, fair 100 Washer/dryer, fair 50 Refrigerator fair, (approx. 10 yrs) 50. TOTAL: $ 989. I MetUfe Policyholder Trust Statement DOMINIC L MANCUSO Account Market Value Stock Price as of Total Market 11/07/2003 Value $30.~00 " ' $587.10 The aggregate amount paid to all Trust Beneficiaries In this distribution is $84,005,793.40 RETAIN FOR YOUR RECORDS Investor ID I eo66e0254179 I \ 2003 Dividend Summary \ ~rTotal Trust Dividend per Current Rec~d Date .-~/ Interests Trust Interest Distribution 11/07/2003 lS.O000 $0.23 $4.37 Prior Year Payable Date Tax W'Rhheld Nat Distribution Distribution 12/15/2003 '$0.00 $4.37 $3.99 Trust Beneficiary Information You may purchase or sell shares of MetLife, Inc. common stock through the Trust, free of any commissions or other fees, under the MetLife Purchase and Sale Program, as amended. A copy of the brochure dasc~ibing the program is available on the Intemet at www.metlife.com by selecting Investor Relations and then the Shareholder Se~ices Information page, or by calling the number listed below. You are permitted to transfe~ your Trust Interests only in the circumstances described in the brochure. You may also instruct thet all (but not less than all) of your shares of MetLife, Inc. common stock held by the Trust be withdrawn from the Trust. Information regarding your withdrawal rights may be found in the Purchase and Sale Brochure or by calling the number listed below. An annual shareholders' meeting to elect members of the Board of Directors of MetLife, Inc. and for transaction of other business is expected to be held on April 27, 2004. The deadline for submitting shareholder proposals for consideration at this meeting was Novemb~' 28, 2003. A copy of MetLife, Inc.'s annual report and proxy statement will be available free of charge on or before March 31, 2004, along with other MetLife, Inc. and Policyholder Trust filings under federal securities laws, (i) on the Internet et www.metlife.com on the Investor Relations pertion of the website, (ii) by writing to MetLife, Inc. at the address listed below or (iii) by calling the number listed below. These and other securities filings by MetLife and the Policyholder Trust are also available on the Intemet at www.sec.gov. For Inquiries about your account, the status of your Trust Intarests, or discrepancies on this statement, contact info~mation is listed below: 0068715 I~em~:. www. matloninvestor.com~cl Genial Mall: MatLife, Inc. E-mail: Meflife~melloninvestor.com c/o Mellon Investor Services Pholte: 1-800-649-3593 P.O. Box 4412 South Hackensack, NJ 07606-2012 Why did I receive this check?. You are receiving the enclosed check because you are a Beneficiary of the MetUfe Policyholder Trust. Your Trust Interests (shares) receive dividends paid on MetLife, Inc. common stock. The Trust was established in connection with the conversion of Metropolitan Life Insurance Company from a mutual company to a company with shareholders. Owners of an eligible policy at the time of the conversion were entitled to receive shares of MetLife, Inc. common stock. If you have never updated your social secu~lf number, you may do so at your convenience. You may update your social security number on your account by calling 1-800-649-,3,5.93. You will need your Investor ID located in the upper right hand comer above. The automated system will instruct you on how to properly update your account. The automated system is available 24 hours a day, 7 days a week. The original account holder is deceased. How do I transfer the account?. In order to transfer the account, please prov'~le us with the following information to the address listed above: 1) A letter of instruction detailing the transfer you would like to complete; 2) The name, address and taxpayer ID (social security number) of the person or persons to whom the shares will be transferred; 3) A completed stock power form, signed by the legal representative and guaranteed with a medallion stamp* and, 4) A certified copy of the death certificate. You may also need an original Inheritance Tax Waiver if required by your State. *The medallion stamp may be provided by a commercial bank, trust company, securities broker/dealer, credit union or savings association participating in the medatlion stamp program. For quick and easy access to your account information log on to www.melloninvestor.com/isd *Please Deposit the Enclosed Check Immediately* Kelley Blue Boo. k Used Car Values Page 1 of 2 jKelley Blue Book 'I HI: I'RUSI ED RESOURCE ~b,com Blue Book Trade-In Report Pennsylvania · April 3, 2004 PSEC 1999 Ford Taurus LX Sedan 4D Next try one of these: Another Report New Car Pricing Engine: V6 3.0 Liter Trans: Automatic Drive: Front Wheel Drive Mileage: 35,000 Equipment Air Conditioning Power Steering Power Windows Tilt Wheel AM/FM Stereo Dual Front Air Bags Consumer Rated Condition: Good "Good" condition means that the vehicle is free of any major defects. The paint, body and interior have only minor (if any) blemishes, and there are no major mechanical problems. In states where rust is a problem, this should be very minimal, and a deduction should be made to correct it. The tires match and have substantial tread wear left. A clean title history is assumed. A "good" vehicle will need some reconditioning to be sold at retail; however major reconditioning should be deducted from the value. Most recent model cars owned by consumers fall into this category. Trade-In Value $2,735 Trade-in value represents what you might expect to receive from a dealer for this consumer owned vehicle. Keep in mind that the dealer must then absorb the cost of making the vehicle ready for sale, advertising, sales commissions, arranging financing and insurance and standing behind the vehicle for any mechanical or safety problems. http://www.kbb.com/kb/ki.dll/kw.kc.ur?pse;491832 ;&;sed+t;&39;Ford; 1999%20Taurus&6;... 4/3/2004 COHMONHEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z80601 HARRISBURG, PA 171Z8-0601 I~V-~S45 FX AFP ZNFORMATTONAND NOTICE I TAXPAYER RESPONSE ACM DATE DONNA M KUMPF 580 PLEASANT VIEW RD LEW[SBERRY PA 17339-9508 FILE NO. 21 03-0925 OqlO17q5 01-Z3-ZOOq TYPE OF ACCOUNT EST. OF DOMINIC L MANCUSO [] SAVZNeS S.S. NO. 20~-03-61~6 [] CHECKING DATE OF DEATH 10-29-2003 [] TRUST COUNTY CUMBERLAND [] CERTTF. REHZT PAYHENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PSECU has provided the Department .ith the information listed beloN ahichhas been used in calculating the potential taxdue. Their records indicate that at the deathof the above decedent, you~ere a joint o~ner/beneficiary of this account. If you feel this information is incorrect, please obtain .rittan correction from the financial institution, attach a copy to this fora and return it to the above address. This account is taxable in accordance aith the Inheritance Tax Lm4s of the Commonwealth of Pennsylvania. Questions ~ay be ansasred by calling (717) ?BT-85ZT. COMPLETE PART ! BELOW x x x SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 020~0361q6 Date 07-30-2002 Established Account Balance 6,000.02 Percent TaxabXa X 5 0.0 0 0 Amount Subject to Tax 3, OOq. 01 Tax Rate X · 0~5 Potential Tax Duo 135.18 To insure proper credit to your account, tee (Z) copies of this notice ecst accompany your payment to ~ Register of gills. Hake check payable to: "Register of Wills, Agent". HOTE: [f tax payments ars made Nithin three (3) months of the decadent's date of death, you may deduct a SZ discount of the tax due. Any inheritance tax due Nil1 become delinquent nine (9) ecnths after the date of death. PART TAXPAYER RESPONSE ! A. [--I The above information and tax due is correct. 1. You Nay choose to rHit pa~ment to ths Rsgistar of #ills Nith tNo copies of this notice to obtain a discount or avoid intsrest~ or you say check box "A" and return this notice to the Register of CHECK ~ #ills and an official assass~unt Mill bo issued by the PA Department Of Revenue. ONE BLOCK B. ~The above asset has been or .ill be reported and tax paid Nith the Psnn~Jlvania Inheritance Tax return ONLY ~ta be filed by the decedsnt's representative. C. [] The above in;oraation is~incorrect and/or debts and deductions Nero paid by you. You must co~Plata PART ~ZI and/or PART [] belo~. PART zf you indlcate a different ~ax rate, please state your relat/onship to decedent: TAX RETURN - COMPUTATTON OF TAX ON JOZNT/TRUST ACCOUNTS LINE 1. Data Established I 2. Account Balance [ 3. Percent Taxable 3 ~ q. Amoun~ Subject to Tax q S. Debts and Deductions ~ 6. A~ount Taxable 6 7. Tax Rate 7 X 8. Tax Due ~ PART DATE PAID DEBTS AND DEDUCTIONS CLAZMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on LLne S of Tax ComputatLon) $ Under penalties of perjury, T cleclare that the facts T have reported above are true, correct and comjplete to the bes~ of ay knowledge end belief. HOME (-)/-~) ~- TA TELEPHONE NUMBER ?riority 50 Plug Account Statement PNCBANK 'N(' B;utk For the period 11/0712003 to 12/0912003 DOMINIC L MANCUSO 580 PLEASANT VIEW RD LEWISBERRY PA 17539-9508 Primary account number: 51-4004-1317 Page I of 3 Number of enclosures: 5 For 24-llour banking, custemer service and interest rate information, sign-on to Account Link ,-~' by Web on pn,:bank.com or call 1-888-PNC-BANK Moving? Please contact us at 1-888-PNC-BANK Write to: Customel Selvice PO Box 609 Pittsburgh PA 15230-9738 ,~L~_~ Visit us at pncbank.com TDD terminal: 1-800-531-1648 4ave You Ever Run Out of Checks And Forgot To Order More? J' lifts Il;IS Jl;IJ)J)ellCd 1o VOll ,vlJtl klH)W wJl~lt ~111 i11¢o1'1v('11i¢11c¢ J[ c~111 he. ~¥eJJ. PN(: ll()W Il;Is I;q~l)Cll I~ vl~u ;~K;lill. It's a new F~E service called Aulomalic Check Reorder. Ali you .eed )l';lll('ll, till .~('CI)IIIII l.ink'~~ al l)nchank.c.m, or simply c~dl 1-g88-PNC-I~,~NK (1-8~,~-7G2-2265). ()utc v,.~ si~ Ul~, afler you place 'our nexl check order, we will he~ coJ)~iliiiK lhe mm)her of checks vmFvc Hsed ;md aulomalically rem ,h'~ v,,m .cxl sci ()J -hacks heJ'(n'e v(m ri)~i (mi. ~'~)~)1' IlSll~lJ check order fee, if ;q)l)licalfle, will he cJl;u'~ed h~ vlJi~r I's IJl;H sill)lo. ~t'e'Jl evelm l)(~liJ~' )'OII Ih;mi we're ;iJ)olll h) J)l~mce ~m I'('Ol'(Jol' s() vt)il f';lll Ill;IRc ;111)' cl);~l)~(.s I- vt)ill' II:IIIIC ;lll(J ;.hh ~.~ lll'.~nl;~li.n ~1' r'h:ulffe yolu' r'heck sivle. So, siffn u}) Iodav for A~llillll;llic Check Re.rdcr :uul Priority 50 Plus Interest Checking Account Summary kccotmnt ntmmber: 51-4004-1317 Account Link ~' number: 0204036146 Dominic L Mancnso 3alance Summary Beginning Deposits and balance other additions .I,tt)o.89 .IO5.2(; Checks and other deductions Average monthly balance 3,79().32 Ending balance Charges and fees It).()() transaction Summary Checks paid/ Check, Card POS Checl,: Card/Bankcard withdrawals signed transactions POS PIN transactions 6 0 () Total ATM PNC Bank Other Bank transactions ATM transactions ATM transactions 0 0 0 Interest Summary Annual Percentage Number of days Average collected Yield Earned (APYE) in interest period balance for APYE o. IOZ 33 3,790.32 Interest Earned this period .33 Please see the Activity Detail section for additional information, As of 12/09, a total of $6.33 in interest was earned tbis year. FORM953R HH BONDS (Dominic L Mancuso, POD Donna M Kumpf) NUMBER DATE FACE VALUE DEFERRED INTEREST V1581871 9/2001 5000 1875 V1581872 9/2001 5000 1875 V1581873 9/2001 5000 1875 V1581874 9/2001 5000 1875 V1581875 9/2001 5000 1875 V1581876 9/2001 5000 1875 V1581877 9/2001 5000 1875 V1581878 9/2001 5000 1875 V1581879 9/2001 5000 1875 M8104327 9/2001 1000 375 M8104328 9/2001 1000 375 M8104329 9/2001 1000 375 HH Bonds: Dominic L Mancuso or Gizella M Mancuso NUMBER DATE FACE VALUE DEFERRED INTEREST V815842 4/1991 5000 3312.50 M3931933 4/1991 1000 662.50 M3931934 4/1991 1000 662.50 M3931935 4/1991 1000 662.50 M3931936 4/1991 1000 662.50 M3931937 4/1991 1000 662.50 M3931938 4/1991 1000 662.50 M3931939 4/1991 1000 662.50 M3931940 4/1991 1000 662.50 EE BONDS (All payable Dominic L Mancuso or Gizeila M Mancuso) NUMBER DATE FACE VALUE CASH VALUE C82656084 may 1985 100 143.40 C91239712 JUN1985 100 143.40 C91246075 JUL1985 100 143.40 C94793078 AUG1985 100 143.40 C94799591 SEP 1985 100 143.40 C95966154 OCT 1985 100 143.40 C959972486 NOV1985 100 140.60 m rtl r-i Certified Fee r"'l Return Reclept Fee (Endorsement Required) [::1 Restricted Delivery Fee ~'~ (Endorsement Required) ITt $ Postmark Here Total Postage & Fees ;~ [~[~.....~.!..~.~.:.-._~~ ......... [.o.r.~:~x.i.~~~ ~. ~~_~ ................. KUNrPF DONNA M 5880 PLEASANT VIEW ROAD [] Registered [] Retum Receipt for Memhandles [] Insured Mall- [] C.O.D. Restricted Delive~j? (Exea Fee) OYes Date: 1~ / 2 ¥.~0~4- APPROVAL OF ACCOUNT, RELEASE AND INDEMNIFICATION ESTATE OF DOMIniC L. M^NCUSO, DECEASED ( .grc r¢ 1 -& The undersigned is a beneficiary under the Will of Dominic L. Mancuso and desires that the Estate be distributed without the formality of a court accounting. In consideration of the Executrix making distribution without a court accounting, and agreeing to be legally bound hereby, the undersigned does hereby: 1. Waive the filing of an account of the administration of the Estate in any court; Declare that the undersigned has examined the attached informal account of the Executrix, finds it to be true and correct in all particulars; accept and approve it with the same lbrce and effect as if it had been prepared and filed with, audited, adjudicated, and confirmed absolutely by a court of competent jurisdiction; Warrant that the beneficiaries names in the informal account are the sole parties in interest in the Estate and entitled to receive the entire distribution thereof in accordance with the said account, and that the undersigned knows of no outstanding and unsatisfied claims against the Estate; Release and discharge the Executrix, and her heirs and personal representatives, from any and all actions, liabilities, claims, and demands relating in any way to the administration of the Estate and distribution in accordance with the attached accounting; 5. Agree to refund to the Executrix any portion of the distribution of the undersigned which exceeds the amount of the undersigned's share as the Executrix finally determines; 6. Agree to indemnify and hold harmless the Executrix, and her heirs, personal representatives, successors and assigns, from and against any claims or liabilities arising from any cause whatsoever, which the Executrix may incur as a result of the administration of the Estate and its distribution in accordance with this release and indemnification agreement. APPROVAL OF ACCOUNT, RELEASE AND INDEMNIFICATION RE: ESTATE OF DOMINIC L. MANCUSO, DECEASED (~ l'¢zJ'e !a '2_1 - c~ .~ .- 72 ~) The undersigned is a beneficiary under the Will of Dominic L. Mancuso and desires that the Estate be distributed without the formality of a court accounting. In consideration of the Executrix making distribution without a court accounting, and agreeing to be legally bound hereby, the undersigned does hereby: 1. Waive the filing of an account of the administration of the Estate in any court; Declare that the undersigned has examined the attached informal account of the Executrix, finds it to be true and correct in all particulars; accept and approve it with the same force and effect as if it had been prepared and filed with, audited, adjudicated, and confirmed absolutely by a court of competent jurisdiction; Warrant that the beneficiaries names in the informal account are the sole parties in interest in the Estate and entitled to receive the entire distribution thereof in accordance with the said account, and that the undersigned knows of no outstanding and unsatisfied claims against the Estate; Release and discharge the Executrix, and her heirs and personal representatives, from any and all actions, liabilities, claims, and demands relating in any way to the administration of the Estate and distribution in accordance with the attached accounting; 5. Agree to refund to the Executrix any portion of the distribution of the undersigned which exceeds the amount of the undersigned's share as the Executrix finally determines; 6. Agree to indemnify and hold harmless the Executrix, and her heirs, personal representatives, successors and assigns, from and against any claims or liabilities arising from any cause whatsoever, which the Executrix may incur as a result of the administration of the Estate and its distribution in accordance with this release and indemnification agreement. Linda M. Kemp So¢ia s ourity ARPROYAL OF ACCOUNT, RELEASE AND INDEMNIFICATION RE: ESTATE OF DOMINIC L. MANCUSO, DECEASED (~.S ((~,~c ~ 21-6'/3 5 ) The undersigned is a beneficiary under the Will of Dominic L. Mancuso and desires that the Estate be distributed without the formality of a court accounting. In consideration of the Executrix making distribution without a court accounting, and agreeing to be legally bound hereby, the undersigned does hereby: 1. Waive the filing of an account of the administration of the Estate in any court; Declare that the undersigned has examined the attached infom~al account of the Executrix, finds it to be true and correct in all particulars; accept and approve it with the same force and effect as if it had been prepared and filed with, audited, adjudicated, and confirmed absolutely by a court of competent jurisdiction; Warrant that the beneficiaries names in the informal account are the sole parties in interest in the Estate and entitled to receive the entire distribution thereof in accordance with the said account, and that the undersigned knows of no outstanding and unsatisfied claims against the Estate; Release and discharge the Executrix, and her heirs and personal representatives, from any and all actions, liabilities, claims, and demands relating in any way to the administration of the Estate and distribution in accordance with the attached accounting; Agree to refund to the Executrix any portion of the distribution of the undersigned which exceeds the amount of the undersigned's share as the Executrix finally determines; Agree to indemnify and hold harmless the Executrix, and her heirs, personal representatives, successors and assigns, from and against any claims or liabilities arising from any cause whatsoever, which the Executrix may incur as a result of the administration of the Estate and its distribution in accordance with this release and indemnification agreement. Donna M. Kumpf Social security # 162-48-1791 INFORMAL ACCOUNTING OF ESTATE FOR DOMINIC L. MANCUSO Estate Number 21-03-925 Donna M. Kumpf, Executrix ASSETS/INCOME: HOUSE/property sale at 6 Briar Lane, Camp Hill, PA 17011 $123,000.00 Value of Personal property (furniture, household goods): $989.00 Checking/savings account 10/29/03: Cash on hand: Refund from Malpezzi funeral home (overpaid) Comcast refund Erie Ins. Refund (house insurance) AARP Refund Refund Medicare Premium Deposit (Metlife stock) Deposit Deposit Refund: Inheritance Tax overpaid HH savings bonds: EE savings bonds: HIt Savings Bonds: CAR: Valued at $8034.00 $29.00 $100.00 $23.O4 $34.00 $24.56 $117.60 $647.87 $3174.89 $68.78 $151.59 $13,000.00 $1012.44 $48,000.00 $6000.OO TOTAL ASSETS/INCOME: $204,406.77 LIABILITIES: Utilities from 10/29/03 to 6/17/04: Electric: Gas: Trash/sewer: Water: Phone: Cable: $260.49 $725.O5 $154.04 $150.03 $200.83 $79.28 Erie Insurance, extra premium Income tax paid: Inheritance tax pre-paid 1/25/04: Repairs to property: Furnace ( 1 /10/04) Carpeting (3/25/04) Painting, shed and window repair (2/29/04) Plumber: (4/3/04) Railing labor/materials: (6/17/04) $22.00 $5557.00 $8893.42 $412.21 $952.64 $350.14 $199.00 $245.00 Malpezzi Funeral Home (1 l/4/03) $7348.80 Funeral Flowers (10/30/03) $284.00 PSERS (amt. due 12/7/03) $27.96 Register of Wills Fee $269.00 Cumberland Law Journal: Advertisement $75.00 Carlisle Sentinel: Advertisement $75.00 Tag sale expenses: $150.00 Steelton Ambulance: $70.64 inheritance Tax filing fee: $15.00 Bank charges ($18 / 2 months) $36.00 Filing fees, stamps, estate expenses $66.95 Costs of house sale: --Closing costs paid for buyer as per sales agreement. --State transfer taxes paid --Attorney Fees: ($75.00 to David Stone; $250.00 to John Fenstermacher) $325.00 $3,000.00 $1,230.00 --Properly taxes paid/deducted from seller's funds at settlement $559.95 TOTAL LIABILITY: $31,734.38 ASSETS: Less Liabilities REMAINING ASSETS DISTRIBUTION OF FUNDS: ITEM: Donna Kumpf's Share Linda Kemp's Share Nancy Spangenberg's Share $204,406.77 -($31,734.38) $172,672.39 1999Ford Taurus $2000 $2000 $2000 Personal property Valuation: $329 $330 Less Escrow in a Certificate of Deposit for one year: Balance of Estate [Divided by 3 beneficiaries:] Linda Kemp's remaining share Donna Kumpf's remaining share Nancy Spangenberg's remaining share $33O $54,894.47 $54,894.46 $54,894.46 Less -(6,000) -(989) -($1000.00) $164,683.39 Balance of estate $0.00 I swear that these figures are accurate and truthful to the best of my knowledge. Donna M. Kumpf, Exe[utrix / ~,) 5/7 BUREAU OF ZNDZVZDUAL TAXES INHERTTANCE TAX DZYTSZON DEPT. 280601 HARRTSBURG, PA 17128-0601 CONHONNEALTH OF PENNSYLVANZA DEPARTHENT OF REVENUE NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTZONS AND ASSESSHENT OF TAX RE¥-lS47 EX AFP (nl-D5) DONNA H KUHPF 580 PLEASANT VIEN RD LENISBERRY PA 17339 DATE ESTATE OF DATE OF DEATH FZLE NUHBER COUNTY ACN 06-1q-ZOOq HANCUSO 10-29-2005 21 05-0925 CUHBERLAND 101 Amoun~ Ramified DOMINIC L HAKE CHECK PAYABLE AND REHZT PAYNENT TO: REGISTER OF NZLLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THZS LTNE ~ RETAIN LONER PORTZON FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTTCE OF ZNHERXTANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLONANCE OF DEDUCTZONS AND ASSESSHENT OF TAX ESTATE OF HANCUSO DOHTNIC L FZLE NO. 21 05-0925 ACN 101 DATE 06-14-200~ TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATZON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~e~e (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (2) 3. Closely Held S*ock/Par~nershlp Zn~eres~ (Schedule C) ($) q. Nor~gages/No~as Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Misc. Personal Proper~y (Schedule E) (5) 6. Jointly Owned Propmr~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al Asse~s APPROVED DEDUCTXONS AND EXENPTZONS: 9. Funeral Expenses/Ada. Cos~s/Nisc. Expanses (Schedule H) (9) 10. Dobbs/Not,gage Liabili~ies/L{ans (Schedule 1) (10) 11. To,al Deductions 12. Ne~ Value of Tax Ra~urn 119;000 O0 62;599.00 O0 O0 8;957.00 O0 27; $qZ ~1 (8) l$,qll.O0 .00 NOTE: To insure propor crodi~ ~o your account, subei~ ~ho upper portion of ~his fore wi~h your ~ax payment. 13. 14. NOTE: 217,898.41 ~F PA/D AFTER DATE INDICATED, SEE REVERSE FOR CALCULATZON OF ADDZT/ONAL /NTEREST. 19. Principal Tax Duo TAX CREDITS: DATE NUNDER 01-26-200~ CD005~i79" .. ! ~ · O0 x 00 = .00 20~,r.87-~1 x 045= 9,201.93 · 00 x 12 = .00 · 00 x 15 : .00 (19): 9,201.93 DISCOUNT ZNTEREST/PEN PAID (-) AHOUNT PAZD 8,895.~2 TOTAL TAX CREDZT I 9,353.52 BALANCE OF TAX DUEl 151.59CR ZNTEREST AND PEN. .00 TOTAL DUE 151.59CR ( ZF TOTAL DUE 1S LESS THAN $1, NO PAYNENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CRED/T" (CR), YOU HAY BE A REFUND· SEE REVERSE SZDE OF THZS FORH FOR ZNSTRUCTIONS.) ASSESSHENT OF TAX: 15. Amoun~ of Lino 14 a~ Spousal ra~o (15) 16. Amoun~ of Lino 14 ~axablo a~ Lineal/Class A ra~o (16) 17. Amoun~ of Lino 14 a~: Sibling ra~:o (17) 18. Amoun~ of Lino 14 ~axablo a~ Colla~oral/C1ess B ra~o (18) Chari~able/$ovornmon~al Bequests; Non-elected 9115 Trusts (Schodulo J) (13) . O0 No~ Value of Es;ca~:e Subjoc~ ~o Tax (14) 20~,487.ql X~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 wi11 re~lect ~igures that include the total o~ ALL returns assessed to date. (11) 13.~.11 (la) ZOO,ri87. ~1 RESERVATION: Estates of decedents dying an ar before December 12, 19BZ -- if any future interest in tho estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Coemonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes et the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYHENT: REFUND CCR): OBJECTIONS: ADHIN- ISTRATIVE CORRECTIOHS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z5 of ZOO0. (?Z P.S. Section 91q0). Detach the top portion of this Notice and submit mith your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: REGISTER OF N/ELS, AGENT A refund of a tax credit, #hich was not requested on the Tax Return, may ba requested by completing an "Application for Refund of Pennsylvania Inheritance end Estate Tax" (REV-1313). Applications ara available at the Office of the Register of #ills, any of the Z$ Revenue District Offices, or by calling the special Ii-hour ansaering service for forms ordering: 1-800-36Z-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-~7-30Z0 (TT only). Any party in interest nat satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of AppeaLs, Dept. ZBlOZ1, Harrisburg, PA 171ZB-IOZ1, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Revise Unit, Dept. 280601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. Ssa page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. if any tax due is paid within three (3) calendar months after the dacadant's death, a five percent (SX) discount of the tax paid is allowed. The 15Z 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 is charged beginning with first day of delinquency, or nine (9) months and one [1) day fram the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent par annum calculated at a daily rate of .O0016q. All taxes which became delinquent on and after January 1, 19BZ will bear interest at a rate which ail1 vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 19BZ through ZOOq ere: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ 20Z ,OOOSqB ~'6-1991 llg .000501 ~ 9Z .O00Zq7 1983 162 .000638 1992 92 .O00Zq7 ZOOZ 6Z .O0016q 198~ llZ .000301 1993-199~ 7X .OO019Z 2003 52 .000137 1985 132 ,000356 1995-1998 9Z .O00Zq7 ZO0~ qZ .000110 1986 lOX .O00Z7~ 1999 7Z .O0019Z 1987 lOZ .O0027~ 2000 7Z .00019Z --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELZNQUENT X DAZL¥ 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. If payment is made after the interest computation date shown on the Notice, additional interest must ba calculated. BUREAU OF 'rNDZVZDUAL TAXES TNHERTTANCE TAX DTVTSTON DEPT. Z8060! HARRTSBURG,, PA 171Z8-0601 DONNA H KUHPF 580 PLEASANT VIEW RD LEWISBERRY PA 17339 COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE ZNHERZTANCE TAX STATEMENT OF ACCOUNT DATE 07-Z6-Z004 ESTATE OF HANCUSO DATE OF DEATH lO-Z9-ZO03 FILE NUHBER 21 03-09Z5 COUNTY CUNBERLAND ACN 101 Amoun'l: Reei~ed RE¥-iSD7 EX AFP (01-03) DOHINIC L HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUNBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To /nsure proper credi~ ~o your account`' submi~ ~he upper portion of ~his fore wi~h your ~cax payment:. CUT ALONG THIS LXNE ~ RETAIN LOWER PORTION FOR YOUR RECORDS -~ REV-1607 EX AFP (01-03) ~M~ INHERITANCE TAX STATEHENT OF ACCOUNT ESTATE OF HANCUSO DOHINIC L FILE NO. 21 03-0925 ACN 101 DATE 07-26-2004 THZS STATEHENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NANED ESTATE. SHO#N BELO# ZSA SUHHARY OF THE PRTNCZPAL TAX DUE., APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE`' AND, ZF APPLICABLE`' A PROJECTED ZNTEREST FZgURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 06-07-2004 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYHENTS (TAX CREDITS): 9,201.93 PAYHENT DATE ol-z6-zyog, 07- 06 - 2004::~ RECEIPT NUHBER .~. CDO 0~9 ~=~ REFUND r DISCOUNT (+) INTEREST/PEN PAID (-) AHOUNT PAID ZF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( ZF TOTAL DUE ZS LESS THAN $1`' NO PAYHENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT" (CR), 460.10 .00 8,895.42 151.59- TOTAL TAX CREDIT 9,201.93 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. ) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240 -6345 Date: 9/15/2005 KUMPF DONNA M 5880 PLEASANT VIEW ROAD LEWISBERRY, PA 17339 RE: Estate of MANCUSO DOMINIC L File Number: 2003-00925 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. I, for decedents dying on or after July I, 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: 10/29/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~~-.J~ / j , j '...- GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Counsel Judge '-~ c Lt' C' E~ c_ (~- {-' c: C.: ~,.~', L:.- ii" . . f " , . Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name ofDecedent: J)o ern If) ; c..... L f'v\ Q Yl (" LA <:: 0 Date ofDeath: I 0 -.;:) q - 03 Estate No.: dO (L~ - no 9:15 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State~hether administration of the estate is complete: Yes)6J 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 141 No 0 b. The separate Orphans' Court No. (if any) for the personal representative's account is: f'J ).A c. Did the personal representative state an account informally to the parties in \ interest? Yes ~ No 0 o-(}) c. Copies of receipts, releases, joinders and approval of formal or informal \ G.~~\O/'tY accounts maybe filed with the Clerk of the Orphans' Court and may be I .>0 attached to this report. Date: /0 I;;), ID? I . C"l \.D c/-;. (YlK-wy1 !VI KLUn p f w m d j ~Jo y /JeuJ lu~h ItOtD , n ~ g~ 8 / g L 2.3 Telephone No. (\ K ) (NUt a- ,- Signature ~UDY\V)n. Name ,SII Address .- ~.~ C'" '-' c.:-' c:' c_ ~p, C) c:::c <-' Capacity: ~ Personal Representative o Counsel for personal representative ft