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HomeMy WebLinkAbout03-0677Estate of Ronald E. Rollason also known as Register of Wills of CUMBERLAND County, Pennsylvania PETITION FOR GRANT OF LETTERS .o. oql- 3- , Deceased Social Security No. 172-36-0303 Petitioner(s), who is/are 18 years of age or older, aplaly(ies) for: (COMPLETE 'A' or 'B' BELOW:) 1-~ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut, rix named in the last ~ of the Oecedent, dated ~ 1 I~ and codioii(s) dated .. State relevant circumstances, e.g., renunciation, death of executor, etc. Except as follows, Oecedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: B. Grant of Letters of Administration (c.t.a.; d.b.n.c.t.a; pendente lite; durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained that Oecedent left no Will and was survived by the following spouse (if any) and heirs: [ Name ..... Relationship Residence (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Carlisle, Cumberland County, Pennsylvania with his/her last family or principal residence at 1.46 East North Street, Carlisle, Cumberland County, Pennsylvania (list street, number, and municipality) Decedent, then 57 ,yeats of age, died July 24, 2003 at 146 East North Street, Carlisle, Cumberland County, Pennsylvania (Location) Decedent at death owned properb/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 request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriat, e form to the undersigned: Marjorie H. Romano Typed or printed n,ame and residence 10 Hoover Road Carlisle, PA 17013 Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form RW- 1 (1991) Oath of Personal Representative Commonwealth of Pennsylvania County of 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 representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate(~of:~_.).according to law. ~/~ ~ Sworn to or affirmed and subscribed Marjorie~. Romano . before me this ] Ztday of L_.~L~ ~ ~L~ or the RegisJer U -, 4} .... 10 Hoover Road Carlisle, PA 17013 Estate of Ronald E. Rollason Deceased Social Security No: 172-36-0303 Date of Death: July 24, 2003 AND NOW, ~~~ /'~8 ,2003 ,inconsideration f\ i~ h presented of the Petition on the reverse sfde hereon, satisfactory proof aving been before me, IT IS DECREED that Letters ~] Testamentary [--'-] Of Administration (c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante m[noritate) are hereby granted to Ma~,'ofie H. Romano in the above estate and that the instrument(s) dated Februar/8, 1991 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters ........... $ Short CoAt,ate(s) ..... $ Renunciat~n ........ $ Rlegiste~'.~f {J/ills Attorney: Thomas E. Flower, Esquire Affidavits ( ) .... $ Extra Pages ( ) .... I.D. No: 83993 Address: S. AIDIS~ SHUF,F: FLOWER & LINDSAY Codicil ........... $ 2109 Market Street:, C,amp Hill: PA 17011 JCP Fee .......... Inventory .......... Other ........... TOTAL ......... Prepared by the Pennsylvania Bar A~soclatlon $ $ Copyright (c) 1~96 form software only CPSystems. tnc. Telephone: 717/737-3405 Form RW-1 (1~1) REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIBING WITNESS codicil (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(~nd say(s) that ?~'Ly. ~ present and saw the testat c~- , sign the same and that ~*~,~ signed as a witness at the other subscribing witness(es)). m~'xthisSW°rn to or affirmed and subscribed before_,..~ day of (Address) ~D ~::~REG!STER OF W COUNTY (each) a subscriber hereto, (each) being du~ified according t~nd say(s) that ___ ~ familiar with th~,~natur~ e of codicil ~ ' ~-~a~a~_ of (one of the subscribing witnesses to)~t,l~ will presented herewit~nd ~lleve 1' slg the handwriting°f that "~~ be ~'~orn to or affirmed and subscribed before me this~ day of ~ (Name) '"'"'~~ ~ess) (Name) (Address) REGISTER OF WILLS OF ~x:~c~\~c\~ COUNTY OATH OF SUBSCRIBING WITNESS codicil (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depos~_.e.e~ and say(s) that 'Q~ ~.x_.~& present and saw the testat ~,~ , sign the same and that ~ signed as a witness at the request of testat ~ in h '~ ~ presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before this ~ day of ( ~ ~ ~ CN~me) (Address) REGISTER OF WILLS OATH OF NON.~SUBS (each criber hereto, (each)/$eing duly qualifi // I~ ?/familiar with the COUNTY CRIBING WITNESS tes~at~ ~f (one of the /~ubscribing witnesse / ,,,. / / ti;tat ~ / believes ti signat~e ! / ,/ //to the best of ~ ~nowledge and belief. I / Sworn to or affiX{ned an+cribed before I / me this \ / day of I / Register ~d according to ~a~v, depose(: ignature of c~"dicil to) the / will presen codicil on the will is in (Name) (Address) and say(s) that (Name) (Address) ;d herewith and he handwriting of Rollason; 2/8/91; DSO OF RONALD E. ROLLASON I, RONALD E. ROLLASON, of 145 South West Street, Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all former Wills, Codicils, or writings in the nature thereof, by me at any time heretofore made. FIRST: I hereby order and direct my Executrix or Executor, hereinafter named, to pay all my just debts, funeral expenses, testamentary expenses and all Inheritance, Estate, Transfer and Succession Taxes, as soon as may be conveniently done after my death, out of my residuary estate. SECOND: All the rest, residue and remainder of my estate, be it real, personal or mixed, of whatsoever kind and wheresoever situate, I hereby give, devise and bequeath to my daughter, Marjorie Hope Romano, and my son, Joseph Edward Rollason, in equal shares, per stirpes. - 1 - Rollaso.~; 2/8/91; D50 LASTLY: I hereby nominate, constitute and appoint my daughter, Marjorie Hope Romano, to be the Executrix of this, my Last Will and Testament. In the event that my said daughter shall be unable to serve as Executrix for any reason, I appoint my son, Joseph Edward Rollason, as Executor. In the event that my said son shall be unable to serve as Executor for any reason, I hereby nominate, cOnstitute and appoint Donna Garretson, of Harrisburg, Pennsylvania, as Executrix. No personal representative shall be required to file bond in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~/~ day of February, 1991. SE^L) Ronald E. Rollason SIGNED, SEALED, PUBLISHED and DECLARED in the presence of: - 2 - Rollasca; 2/8/91; D50 COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND ) I, Ronald E. Rollason, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me, by Ronald E. Rollason, Testator, this 1 991 · Testator day of February, N0'T'ARtAL SEAL MERLENE MARHEVKA, Notary Public Carlisle. Cumberland County. Pa.' My Commission Expire~ 6/7/9a~ -3- Rollaso ; 2/s/91; 05o COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND ) We, James D. Flower, Jr. and Carol J. Lindsay , the witnesses whos~ names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator, Ronald E. Rollason, sign and execute the instrument as his Last Will; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me by James D. Flower, Jr. and Carol J. Lindsay day of February, 1991. this NOTARIAL SEAL MERLENE ~ARHEVKA. Notacy Csrlisle. Cumberlan~ Count),. P~. My Commission Expires 6!7/9~ -4- RONALD E. ROLLASON LAW OFFICES MORGENTHAL & FLOWER THREE IRVINE ROW CARLISLE, PENN~V~M 17013 JOHN E. SLIKE ROBERT C. SAIDIS GEOFFREY S. SHUFF JAMES D. FLOWER, JR. CAROL J. LINDSAY KIRK SOHONAGE THOMAS E. FLOWER LINDSAY G. MACLAY JACLYN M. SMITH LAW OFFICES SAIDIS, SHUFF, FLOW-ER & LINDSAY A PROFESSIONAL CORPORATION 2109 MARKET STREET CAMP HILL, PENNSYLVANIA 17011 TELEPHONE: (717) 737-3405 - FACSIMILE: (717) 737-3407 EMAIL: attorney@ssfl-law.com CARLISLE OFFICE: 26 W. HIGH STREET CARLISLE, PA 17013 TELEPHONE: (717)243-6222 FACSIMILE: (717)243-6486 REPLY TO CAMP HILL August 28, 2003 TO THE REGISTER OF WILLS OF CUMBERLAND COUNTY: Re: The Estate of Ronald E. Rollason, deceased On behalf Marjorie H. Romano, Executrix of the Estate of Ronald E. Rollason, we concur with your determination to date the Will of February 9, 1991, according to the date stated in the body of the Will, rather than the date of the notary's acknowledgement. Very truly yours, Thomas E. Flower MBNA America P,O. Box ~5~37 Wilmington, DE 877-767-9383 19850-5137 REGISTER OF WILLS CUMBERLAND COUNTY COURTHOUSE 1 COURTHOUSE SQUARE, #102 CARLISLE, PA 17013 09/26/03 Re: In the Estate of Probate Case No. Social Security No: Last known residence: Our Client: Account Number: Amount of Debt: RONALD E ROLLASON 172360303 146 E NORTH ST CARLISLE, PA 17013 MBNA AMERICA 4264290452742422 6853.18 Dear Sir or Madam Enclosed please find a Creator's claim to be filed in the record with fl~e above-referenced Estate. Please remm a file stamped copy of the claim in the enclosed self-addressed, stamped envelope. Thank you for your assistance. If you have any questions or concems, please call our firm toll free at 1-877-767-9383. Cordially, MBNA America Enclosures A check for $5.00 for the filing fee. CC: Attomey for Estate Personal Representative This letter is an attempt to collect a debt and any information obtained will be used for that propose. This letter is from a debt collector. 3463 9/24/2003 1006589 COMMONWEALTH OF PENNSYLVANZA Zn Re: The Estate of: NO TICE OF CI_ I COURT OF COMMON PLEAS CUMBERLAND ,COUNTY ORPHANS' COURT DZVZS]~ON Court File No: 2103677 RONALD E ROLLASON Deceased TO: THE CLERK OF THE ORPHANS' COURT DZVZSZON: Notice of claim by creditor, Pursuant to Section 353:2(b)(7) of the Probate, Estates, and Fiduciaries Code, :20 PA.C.S.A. §353:2(b)(:2). MBNA AMERICA 1) 2) 3) Claimant's name: Claimant's address: P.O. BOX 15137 WILMINGTON, DE 19850--5137 8777679383 Creditor listed below is the owner and holder of a claim in the amount of $ 6853.18 4) The facts upon which this claim is based: This claim is based on an account for credit evidenced by the attached Affidavit of Account Stated. 5) Decedent's address: 146 E NORTH ST CARLISLE, PA 17013 6) Date of Death: 07/24/03 7) That the claim arose prior to the death of the decedent on or about 8) That the claim is secured by On behalf of the claimant, ! do solemnly declare and affirm under the penalties of perjury that they !nformation and representations made herein are true and correct to the best of my knowledge, information and belief. Dated: ~~ ~ ~-~~ Kyle Frenzel/Lucille Roberts/Jes~erbs - Authoriz~l~epresentative For MBNA America Written notice of claim was given to Personal ~,epresentative and/or his/her counsel as stated below: MARJORIE ROMANO Name 10 HOOVER RD Address CARLISLE, PA 17013 City/State/:~ip _ _ . uate notice m~iled IN RE ESTATE OF:RONALD E ROLLASON AFFIDAVIT OF ACCOUNT The undersigned, being first duly swom deposes and states the follows: Your Affiant is authorized by the Claimant as its Authorized Representative- In-Fact to make this Affidavit. Your Affiant has reviewed the account records of the Claimant with respect to the decedent. Your Affiant is familiar with these records and accounts and reviews them as a regular part of her duties. The Decedent purchased merchandise in the amount of $ 6853.18 evidenced by account number 4264290452742422 The unpaid balance does not include any post-death late payment charges, accrued interest, collection costs or attorney's fees. Further your affiant sayeth not MBNA America. On,elf its Authpff-ized Representatives: Kyle Frenzel Lucille Roberts Jessica Lerbs ~ MBNA America P. O. Box 15137 Wilmington, DE 19850-5137 Subscribed and sworn before me This V~dayof 5~.~/d. ¢,2003. Public y 'j ~ MBNA America P.O. Box :1.5:1.37 Wilmington, DE 'tcJ850-5~.37 877-767-9383 09/26/03 REGISTER OF WILLS CUMBERLAND COUNTY COURTHOUSE 1 COURTHOUSE SQUARE, #102 CARLISLE, PA 17013 Re: In the Estate of RONALD E ROLLASON Probate Case No. Social Security No: Last known residence: Our Client: Account Number: Amount of Debt: 2103677 172360303 146 E NORTH ST CARLISLE, PA 17013 MBNA AMERICA 5401260552002010 $ 12640.10 Dear Sir or Madam Enciosed please find a Creditor's claim to be filed in ate record with the above4eleacnccd E~,ra~e. Please remm a file stamped copy of the claim in the enclosed self-addressed, stamped envelope. Thank you for your assistance. If you have any questions or concerns, please call our firm toll flee at 1-877-767-9383. Cordially, MBNA America Enclosures A check for $5.00 for the filing fee. cc; Attorney for Estate Personal Representative This letter is an attempt to collect a debt and any information obtained will be used for that purpose. This letter is from a debt collector. 3463 9/24/2003 1006589 COMMONWEALTH OF PENNSYLVANIA NO TICE OF CLAIM COURT OF COMMON PLEAS OF CUMBERLAND COUNTY ORPHANS' COURT DIVISION In Re: The Estate of: RONALD E ROLLASON Deceased Court File No: 2103677 TO: THE CLERK OF THE ORPHANS' COURT DIVISION: Notice of claim by creditor, Pursuant to Section 3532(b)(2) of the Probate, Estates, and Fiduciaries Code, 20 PA.C.S.A. §3532(b)(2). MBNA AMERICA 1) 2) 3) Claimant's name: Claimant's address: P.O. BOX 15137 WILMINGTON, DE 19850--5137 8777679383 Creditor listed below is the owner and holder of a claim in the amount of $. 12640.10 4) S) The facts upon which this claim is based: This claim is based on an account for credit evidenced by the attached Affidavit of Account Stated. Decedent's address: 146 E NORTH ST CARLISLE, PA 17013 6) Date of Death: 07/24/03 7) That the claim arose prior to the death of the decedent on or about 8) That the claim is secured by. On behalf of the claimant, ! do solemnly declare and affirm under the penalties of perjury that they Information and representations made herein are true and correct to the best of my knowledge, information and belief. Dated: ~..~ ~ Kyle Frenzel/Lucille Roberts/d~1~a Lerbs -Author~/~d 'r~epre$~..r~ta~ive For M_I3NA America Written notice of claim was given to Personal Representative and/or his/her;:~Ounsel as stated below: MARJORIE ROMANO Name 10 HOOVER RD Address CARLISLE, PA 17013 City/State/Zip ~ "' uate notice mailed IN RE ESTATE OF:RONALD E ROLLASON AFFIDAVIT OF ACCOUNT The undersigned, being first duly swom deposes and states the follows: Your Affiant is authorized by the Claimant as its Authorized Representative- In-Fact to make this Affidavit. Your Affiant has reviewed the account records of the Claimant with respect to the decedent. Your Affiant is familiar with these records and accounts and reviews them as a regular part of her duties. o The Decedent purchased merchandise in the amount of $ 12640.10 evidenced by account number 5401260552002010 The unpaid balance does not include any post-death late payment charges, accrued interest, collection costs or attorney's fees. Further your affiant sayeth not Subscribed and swom before me This _~ day of ~~La~, 2003. N MBNA America. By: O~/of its Auth,/zed Representatives: Kyle Frenzel __ Lucille Roberts Jessica Lerbs MBNA America P. O. Box 15137 Wilmington, DE 19850-5137 COldMONWEN3H OF PENNSYLVANIA DEPARIMENT OF RE'VENUE DEFT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ,,,.__~ ~_,,,.._ __03__ 0677 ~UNt'Y ~OE ~ NLM~ IM W e~ J IJJ r~ DECEDENTS NAME (LAST, RRST, AND MIDDLE INr1'~) Rollason, Ronald E. DATE OF DEATH (MM-DD-YEAR} DATE OF BIRTH (MM-DD-YEAR) 07/24/2003 02/22/1946 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 172-36-0303 THIS RETURN MUST BE FILED IN DUPLICATE WII'H THE REGISTER OF WILLS SOCIAL SECURITY NUMBER r~l. Original Return [~4. Lim~ed Estate [~]6. Decedent Died Testate (Attain copy a'wa) ~"~ 9. Litigation Proceeds Received NAME Marjorie H. Romano FIRM NAME TELEPHONE NUMBER (717) 241-6364 r---~ 2. L._J 3, Remainder Ratum (~ of~ ~ = ~2.13.82) Supplemental Return r~ 4a. Futura Interast Compmmine (dm ofdeah a~t= 12-~2~) [~] 5. Federal Estate Tax Return Required "-]7. a Living (~ capy dT~u~t} 8. Total Number of Safe Deposit Boxes Maintained Trust ~ 10. SpousalPovortTCredit(£1=ofdmthbe{wem~2-3%~land~.~4~) ~] 11. Slectbn to tax under sec, 9113(A) ¢~a~hSc~O) COMPLETE MAILING ADDRESS 10 Hoover Rd. Carlisle, PA 17013 1. Real Estate (Schedule A) (1) :~=- 2. Stocks and Bonds (Schedula B) (2) '- 3. Closely Held Corporation, Pa~ership or Bole-Propritorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 3,576.64 (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 9,845.92 (Schedule G or L) 8. Tetal Gross Assets (total Lines 1-7) (8) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 6,919.79 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 21,573.92 11. To,al Deductions (total Lines 9 & 10) (11) 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. 13,422.56 28,493.71 0.00 Charitable end Govemmental Baqueats/sec 9113 Trusts for which an elec~on to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 0.00 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfms under Sec. 9116 (a)(1.2) x .0 (15) 16. Amount of Line 14 taxable at lineal rate x .0 (16) 17. Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) ' Decedent's Complete Address: !~i~a~ET ADDRESS 146 E. North St. crn'cadisle I STATEpA 7013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Pdor Payments C. Discount (1) 0.00 0.00 Total Credits ( A + B + C ) (2) 3. Interesl/Penalty if applicable D. Intareet E. Penalty Total Interest/Penally ( D + E ) (3) 4. If Line 2 is greater than Une 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page I Line 20 to request a refund (4) 5. If Line 1 + Une 3 is greater than Une 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. (5) (5A) (5B) B. Enter the to{al of Line 5 + 5A. This is the BALANCE DUE. 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 ~nsfer and: Yes No a. retain the use or income of the prope~ transferred; .......................................................................................... [] [] b. retain the right to designate who shall use the property transferred or its income; ............................................ r"] [] c. retain a revemionary interest; or .......................................................................................................................... [] [] d. receive the promise for life of either paymeate, benefits or cam? ...................................................................... [] [] 2. If death occurred after December 12, 1982, did decedent lmnsfer 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 secudty at his or her death? .............. [] [] 4. Did decedent own an Individual Rel~rement Account, annuity, or other nen-pmbate property which contains a beneficiary designation? ........................................................................................................................ [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST qOMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under peaaillas of pa~jmy, I declm~ that I haee examined ~s miata, Induc~g accompany~g schedu~ md ~, a~ b ~ ~ d my ~ ~ ~, ~ b ~, m~ ~ ~. Dedamtloa d pmpam~ o,~a~ ~an ~e pemmal m~e is basad on al ida-malloa o~ ~ict~ pm~mr has any knov4edge. ADDRESS Marjorie H. Romano, 10 Hoover Rd. Carlisle, PA 17013 10/07/2003 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 lmnsfers Io or for the use of the surviving spouse is 3% F2 P.S. ~116 (a) (1.1) (0]. For dates of death on or after January 1, 1995, the tax role 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 staluts does not exempt a transfer to a surviving spouse from tax, and the statulory requirements for disclosure of assets and filing a lax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or alter July 1, 2000: The tax rote imposed on the net value of transfers from a deceased child twenty-one years of age or younger al death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. ~9116(a)(1.2)]. The lax rote imposed on the net value of transfers to or for the use of the dscedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 FS. §9116(a)(1)]. The tax rate imposed on the net value d transfers to or for the use of the dscedent's siblings is 12% [72 RS. §9116(a)(1.3)]. A sibling is defined, under Seclion 9102, as an individual who has al least one parent in common with the decedent, whether by blood or adoplJon. REV-'1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rollason, Ronald E. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-03-0677 Include the proceeds of litigation and the date the proceeds were received by the estata. All property Jointly.owned with right of sundvorahlp mu~t be d~clom~d on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1976.97 Household goods and personal effects, sale proceeds -Kennys Auction Rec'd9-11-03. 85 Chrysler, 88 and 89 Ford Rangem, none running, sold to salvage yard for removal plus $100, Rec'd 9-18.03. Refund of State Farm Auto Insurance Policy 675 3320-E23-38H Rec'd8-8.03. Refund of rental United States Post Office Box Rec'd 8-28.03. Citizens Checking Account # 610072-709 Rec'd 9-8-03 100.00 257.97 30.50 1211.20 TOTAL (Also enter on line 5, Recapitulation) $ 3,576.64 (if mom space is needed, insert additional sheets a~ the same size) BUYER ITEM iBUYER TEM - Kenny's Auction Carl E. Ocker, Owner 4401 Philadelphia Avenue Chambersburg, PA 17201 ITEM _ [ LOT ~'~ 2 @ DEPOSIT TO RCCT# 2000012547326 RHOUNT $i,97G.97 09/12/03 R ~ ' ;5~,1o 0033 ~ :30 RUNNING TOTAL $ BUYER (LOT 1BUYE R 33~-- · I,,,llh,,llh,,,,,ll State Farm Mutual Automobile Insurance Company One $~e F~rm Dr Concordviffe PA 19339 552C- 2627 ROLLASON, RONAL]) E ].~6 E NORTH ST CARLTSLE PA 17015-2~$0 I,.,111,,,111,,,.,,11,,11,,,I,1,1,,I,,11,11,.,,I,,I,I1.1,1,,I ACKNOWLEDGEMENT OF CANCELLATION REQ~~.~ DATE AUG 06 2003 POLICY NUMBER 675 3320-E23~38H AUTO MULTI-CAR POLICY EFFECTIVE DATE OF CANCELLATION JUL 26 2003 ~z:o~ A.M. STANDARD TIME AGENT JOHN ZAMPELLI JR 21604-5-C PREMIUM REFUND $257.97 Non PI 38 2627 AS requested, this policy has been canceled as of the effective date shown. We thank you for having given us an opportunity to provide this insurance. * If there is a premium refund and a check is not enclosed, it will be sent to you soon. 137-5325.9 (olaO171d) Rev. 06-06-2002 6F30301 ~' UNITED STATES POSTAL SERVICE® Application and Voucher for Refund of Postage, Fees, and~Services (Use uue orUackir~andp.r~ ~t~~ Customer/Company Name ~F,,,,q~",..~qr-'--'r'~ir--'~r~..-,z, , , !~,!,~!~Z'-!.,-" ~.~..~r~!r--~r--']~---,,--',r--~r, ,, , -',, r--'~ r'-~ ?! ~l ,---- ,---- ,. .~ ., ,, ,, ,,,------.,----'- ~, -,, ,, , L._~"_J I...' ...!'!. ! .I!!~'..-~_.:' ! ....... l i.Z._.~.~ ~_---f.j L__..~'-L__j ~,LL~ ~.,~,..~_j L~_J [ ,/j L.._..: L.._j i i, i~ ii , ~i i i ..... i ii ii Mailing Addre?_ Aui ~, ou,~ ,,~u. ~ J~ L_J LJLJ L.! LJ [] [_-] !.._. i! ........ ![-] 71F'-i !. !i ...... i City State j~__j~~t'" -""-n'--"*ij .... ii' "i'---il/~! ira'"" ~J , ~--' ' L~I.__~ ~"-"~-'--"-- 'i--iF-'I,i JJ--iF-'J'" ~r-iF-"ii--"iF""-'ii-' i i' ti" j ' t L~ L__-.'"J-L_J L__J L_J L_J L_..J L_J L......J! ....... J f ....... I il i ii ii ii iL_j L....J ZIP+4 Telephone No. (Include ,Area Ondel i-')'jj.'~ij'/'"~li/-'-iF'"P.~,i ....... !F'""'iF"-'!F'""'i i ....... i ....... ji ....... ii ....... Ii ....... 1i ....... l i ....... i! ...... ii '~ c..,~ , . "~' ' L Ji il l-l~l II i- i! till i (_.J !.~J ~_.., L!=~._-_'"J' L_J L_.., L._.J-- . , ,.--.., ,-.J, ,. ...... .. r,-lr--!r-m rnmr-1 :-- --.. L__J,! ....... J! ....... jL..._j,L__...I"~.JL_.C_~_.,.[~ ....... i_~J L_.J ............ L_J! I The collection of this information is authorized by 39 USC 401,404, a~II206; Pub. L. 104-1.34 Thle in~,~w~a~l .... ,m ~. ........ when postage and fees are paid in excess of the lawful rate. As a routin law enforcement purposes; where pertinent, in a legal proceeding to wh vant to a USPS decision concerning employment, security clearances,, expert, consultant, or other pamon under contract with the USPS to fuifi: get for review of private relief legislation; to an independent certified ac(; plaints examiner appointed by the Equal Employment Opportunity Com~ Protection Board or Office of Special Counsel for proceedings or investil. as required by ~,e National Labor Relations Act; [o lhe Department of ;h address of the owner of leased property, or of the payee when different refund will not be considered. Refund Requested For: Refund Stamps and Fees (GI.A/AIC 553) Post Office PVI Error (Attach spoiled/misprinted PVl label to this form.) ~-~ Delivery Confirmation (After 30 days) r-'] Refund of Special Service Fees (Service not rendered) Precanceled Stamps (GLA/AIC 525) (Damaged or overpayment of precanceled stamps) Spoiled/Unused Printed Customer Meter Postage (GLA/AIi.. (Legible postage meter stamps must be submitted to USPS.) Permit Postage and Fees (GLA/AIC 528) (Damaged printed mailing, refund of annual fee.) Refund of Fees and Retail Services (GLA/AIC 535) (PO Box keys and service fees) Value Added Services (GLA/AIC 541) (Refunds to mailer for performing these services) ~u~uun[ ,~alance Alter Refund: (Customers Request Leffer must be on file.) [~] Sure Money Refund Principal & Fee (GLA/AlCs 545 & 646) ~'OtherRefunds:R~ ---' ~n C I /' .. . "1-.r · I'~ e ~1, k,.,,.,..., ~- ~ . ~..=1~i_. Pl~.~.~ ~o. '-'- - "~ ', '", -, -,'--o -' t Office FT]~ ~ F-/-, Post Office ZIP + 4 r F~. ...... ~, r---~ r ..... i r"--I . '.,"- Certifying Employee Signature Date ,-,,= ,=,.,-,., ~_~_~ ,:o,., ...... .,,-,,-,-,, ,,:,,,,,o., ,.,, Approved Amount to Be Refunded .... J L._.J L_.J ! --J"~--.J .__u. Finance Number and Unit ID L -L ~ L__Jg.._J .... .~L_J L__I Witness Signature Date ~,. CITIZENS B.A.~ CLOSING DEBIT - CHECKING~ ,is amou~ ~s ~n ~ to your a~nt. P~a~ adjust ~ur re~s. ACCT, (:, I 0 0'7 2 7 o't APPR. BY ~: 5 ~i~iO,,, & ],O 5~: & l, OO ? ;~ ?DC] ii"' ,,'DADO ;~ ii ], & pa,,, Total Withdrawals 13.95 REV'-1510 EX* (6-98) COMMONWEALTH OF PENNSYLVANIA INHERJTANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rollason, Ronald E. SCHEDULE G INTER-VIVOS 'TRANSFERS & MISC. NON-PROBATE PROK~ FILE NUMBER 21-03-0677 This schedule must be compleled and fled if the answm to any of queslions I through 4 on lhe reverse side of the REV.1500 COVER SHEET is, ~s. DESCRIPTION OF PROPERTY ITEM U~CLU~mE~EOFTHETe~eG~d~EE.~~TOOECa)Em~O DATE OF DEATH %OFDECD'S EXCLUSION TAXABLE NUMBER 'mE OATE OF 'm~Ee- ~,'re~ A CeP~ OF 'n.4E oE~o FOe eEA~ EStATe. VALUE OF ASSET INTEREST (FF ~LtC~a~) VALUE 1. Accumilated Pension - Death Benefit 50% Lump Sum payments paid on 9-17-2003 Beneficiaries Marjode Romano-Daughter 4922.96 9845.92 9845.9 Joseph Rollason-Son 4922.96 TOTAL (Also enter on line 7 Recapitulation) $ 9,845.9 (If mere space is needed, insert addil~onal sheets of lhe same size) Office of Gary J. Meyers Fund Administrator 202.783· 4884 ~=.x 202.393· 6475 ONEVOICE Representing Protective and Decorative Coatings Applicators · Wallcoverers · Drywall Finishers · Painters · Decorators · Scenic A~tlsts · Designers · CIvil Service Workers · Shipyard Workers · Maintenance Workers · Building Cleaners · Metal Polishers · Metallzers · Public Employees · Clerical Workers · Professional Employees · Security Guards · Safety Engineers · Bridge Painters · Riggers · Tank Painters, Marine Painters · Containment Workers · Waterblestars · Vacuum Cleaners · Sign Painters · Sign and Display Workers · Bill Posters · Convention and Show Decorators and Builders · Paint Makers · Glaziers · Architectural Metal and Glass Workers · Sandblasters · Lead Abatement Workers · Floorlaying and Decorative Coverings Workers · Journeyman and Apprentice Commercial, Industrial, Highway, Residential ConstnJction Workers ONE A6ENDA United Unions Building 1750 New York Avenue, N.W., Suite 501 Washington, DC 20006-5301 Organizing Since 1887 INTERNATIONAL PAINTERS AND ALLIED TRADES INDUSTRY PENSION FUND August 22, 2003 Marjorie H. Romano 10 Hoover Road Carlisle, PA 17013 Re: Pre-Retirement Death Benefit Participant: Ronald E. Rollason (deceased) Our File No.: Rollason-0303 Date of Death: July 24, 2003 Beneficiaries: Marjorie H. Romano and Joseph E. Rollason Dear Mrs. Romano: On behalf of the Board of Trustees and the Fund Office staff, please accept our condolences on the loss of your father. Your application for death benefits has been reviewed and approved. You are eligible for benefits from this Fund as follows: Article 3~ Section 3.18 Death Benefit states: Except as provided in section 3.20(b), in the event the Participant died before pension benefits became effective and after he or she has accrued 9,000 benefit hours during the Contribution Period, but before he or she was eligible for a pension either through vesting or by reduced eligibility rules. A Death Benefit equal to 50% of the contributions made on the Participant's behalf shall be paid to his or her designated Beneficiary. Your father accrued 34,350 benefit hours; therefore, you and your brother are entitled to 50% of the total contributions. The total contributions paid on behalfofRonald E. Rollason were $19,691.83; thus, you are entitled to a direct payment in the amount of $4~922.96 ($19,691.83 x 50% = $9,845.92 divided by 2 beneficiaries). Please complete and return the following form(s) in order for you to receive this death benefit: Claimant Statement o This statement must be completed, notarized and returned to the Fund Office in order to commence payments. N:~Pension Death BenefitsX2003LRollason 082203.doc RE~-'1511 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rollason, Ronald E. SCHEDULE H FUNERN. EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-03-0677 Oeb~ of decedeM must be mpoded on SchmJule [ ITEM NUMBER DESCRIPTION AMOUNT 1. 5. 6. 7. FUNERAL EXPENSES: Professional Services 3695.00 Casket 1995.00 Outer Burial Container 700.00 Newspaper Nolice 62.90 Clergy 75.00 Cert~ Death Certificates 40.00 Flowers 84.80 Total (6652.70) ADMINISTRATNE COSTS: Personal RepresentaOve's Commissions Name of Pemonal Repmsentatlve(s) Social Security Number(s)/EIN Number of Personal Repmsentalive(s) Street Address Year(s) Commission Paid: Attmney Fees Family Exemption: (If decedenrs address is na I~e same as claimant's, atlach explanation) Claimant c~y Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Pmparer's Fees Advertised Estate- Cumberland Law Joumal Patriot Newspaper Stae __ Zip 75.00 70.~ TOTAL (Also enter on line 9, Recapitulation) 6652.70 70.00 52.00 145.09 6,919.79 (If more space is needed, insert additional sheets of the same size) EX+ (6,.98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ronald E. Rollason SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABIUTIES, & LIENS FILE NUMBER 21-4)3-0677 Include unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 2 3 4 5 6 7 8 9 10 11 12 13 MBNA America Credit Card MBNA America Credit Card Robert Kantor MD Holy Spidt Hospital Kunkel Surgical Group Cumberland Valley Endo Cntr Quest Diagnostics Apria Healthcare Borough of Carlisle-Water PP&L-electric UGI-gas Sprint-phone Carlisle Regional Medical Center 6853.18 12640.10 95.50 90.06 161.00 88.10 102.40 1075.17 45.24 92.92 126.49 3.62 200.14 TOTAL (Also enter on line 10, ReCapitulation) $ 21,573.92 (If more space is needed, insert additional shee~ of the same size) 0F RONALD E. ROLLASON I, RONALD E. RODLASON, of 145 South West Street, Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revOking and making void any and all former Wills, Codicils, or writings in the nature thereof, by me at any time heretofore made. FIRST: I hereby order and direct my Executrix or Executor, hereinafter named, to pay all my just debts, funeral expenses, testamentary expenses and all Inheritance, Estate, Transfer and Succession Taxes, as soon as may be conveniently done after my death, out of my residuary estate. SECOND: All the' rest, residue and remainder of my estate, be it real, personal or mixed, of whatsoever kind and wheresoever situate, I hereby give, deviSe and bequeath to my daughter, Marjorie Hope ROmano, and my son, Joseph Edward Rollason, in equal shares, per stirpes. LASTLY: I hereby nominate, constitute and appoint my daughter, Marjorie Hope Romano, to be the Executrix of this, my Last Will and Testament. In the event that my said daughter shall be unable to serve as Executrix for any reason, I appoint my son, JoSeph Edward Rollason, as ExecUtor. In the event that my said son shall be unable to serve as Executor for any reason, I hereby nominate, constitute and appoint Donna Garretson, of Harrisburg, Pennsylvania, as Executrix. No personal representative shall be required to file bond in this or any other jurisdiction. IN WITNESS WHERE01~, I have hereunto set my hand and seal this ~ day of l~ebruary, 1 991 · Ronald E. Rollason SIGNED, SEALED, PUBLISHED and DECLARED in the presence of: - 2 - COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND ) I, Ronald E. Rollason, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do. hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and ack~aFledged before me, by Ronald E. Rollason, Testator, this ~/~/% day of February, 1 991 · Testator N0t~ry ~ ~ NOTARIAL SEAL MERLENE MARHEVKA. Not~ry Public Carlisle. Cumberland County. Pa.' My Commission Expires 617/94 -3- Name of Decedent: Date of Death: Will No. d/- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) 'Lq Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) o.f the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on ~ ~ Z-I-0 ~ : Name Address lT~ol Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: Name Address Car (~ sl~ ?/4 i"701% Telephone( ).,~17- ~1'~/o36q Capacity: ~/~ Personal Representative ~.Counsel for personal representative BUREAU OF ZNDZVZDUAL TAXES /NHERZTANCE TAX DIVISION DEPT. Z80601 HARRISBURG) PA 171Z8-0601 CONHONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSNENT OF TAX HARJORIE H ROHANO 10 HOOVER RD CARLISLE : PA 17013 DATE 11-2q-2003 ESTATE OF ROLLASON DATE OF DEATH 07-2q-2003 FZLE NUHBER 21 03-0677 COUNTY CUHBERLAND ACN 101 I Amoun~ Reei~ad REV-1S~i7 EX AFP (01-05) RONALD E HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF HILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-15~7 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF ROLLASON RONALD E FILE NO. 21 03-0677 ACN 101 DATE 11-Zq-Z003 TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNZNG FUTURE TNTEREST - SEE REVERSF APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate [Schedule A) (1) 2. Stocks and Bonds (Schedule B) 3. Closely Hald Stock/Partnership Zntarast (Schadula C) ($) q. Hortgages/Notas Receivable (Schedule D) 5. Cash/Bank Daposlts/MLsc. Parsonal Property (Schedule E) ($) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expenses/Ada. Costs~H/sc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule l) (10) 11. Total Deductions 12. Net Value of Tax Return 3~576.6~ .00 .00 NOTE: To /nsura proper .00 credit to your account, .00 suba/t the upper port/on .00 of this fora w/th your tax payment. 9a8q5.92 (8) 13,qZ2.56 6,919.79 211573.92 (11} 28.q93.7] (12) 15,071.15- 13. lq. NOTE: ASSESSHENT OF TAX: 15. Amount of L/ne lq at Spousal rate (15} .00 X O0 = 16. Amount of Line lq taxable at L/neal/Class A rata (16) .00 X OR5 = 17. Amount of L/ne lq et Sibl/ng rate (17) .00 X 1Z = 18. Amount of Line lq taxable at Collateral/Class B rate (18). .00 X 15 = )al Tax Due (19)= 19. Pr/nc] TAX CREDITS: PAYMENT DATE Char/table/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (1:5) . O0 Nat Value of Estate Sub~act to Tax (lq) 15,071.15- :Zf an assessment ~as issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 ~ill reflect figures that include the total of ALL returns assessed to date. DISCOUNT (+J INTEREST/PEN PAID (-) ANOUNT PAID RECEIPT NUMBER .O0 .00 .00 .00 .00 1F PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULAT/ON OF ADDITIONAL INTEREST. TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 .00 .00 .00 ( 1F TOTAL DUE ZS LESS THAN $1, NO PAYMENT 1S REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.) RESERVATION= Estates of decedents dying on or bafora December 1Z, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class 8 (collateral) benaficiaries of the decedent after the expiration of any estate for life er for years, the Couoneaalth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at tho lawful Class B (collateral) rate an any such futura interest. PURPOSE OF NOT[CE= PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST= To fulfill the requirements of Section ZIqO of the Inheritance and Estate Tax Act, Act Z~ of ZOO0. (72 P.S. Section 91qO). Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side. --Make check or money order payable to: REGXSTER OF RILLSj AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-iS13). Applications ara available at the Office of the Register of Nills, any of the Z5 Revenue District Offices, or by calling the special Z4-hour answering service for fores ordering: I-BOO-56Z-Z050; services for taxpayers with spacial hearing and / or speaking needs: 1-800-447-$DZ0 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 171ZS-10ZI, 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 Review Unit, Dept. Z8060I, Harrisburg, PA 171ZB-0601 Phone (717) 787-6505. See page 5 of the bookZat "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctabZa errors. If any tax due Js paid eithin three (3) caZandar months after the decedant's death, a five percent (Si) discount of the tax paid is alloead. 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 and of the tax amnesty period. This non-participation penalty is appaaIable in the same manner and in the the same time period as you mould appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning aith first day of delinquency, or nine (9) months and one (1) day from the date of death, to the data of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent par annum calculated et a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 mill bear interest at a rate which ell1 vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 ara: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 198Z ZOZ .000548 1987 9Z .000Z47 1999 7Z .000192 1985 16Z .000458 1988-1991 11Z .000301 ZOO0 8Z .OOOZ19 1984 11Z .O00SOZ 199Z 9Z .000247 ZOO1 9Z .000Z47 1985 13Z .000356 1995-1994 7Z .OO019Z ZOO2 6Z .O0016q 1986 lOX .00027~ 1995-1998 9Z .OOOZq7 ZOOS 52 .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the data of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. MBNA America P.O. Box 3.5't 37 Wilmington, DE 't9850-5't37 877-767-9383 REGISTER OF WILLS CUMBERLAND COUNTY COURTHOUSE 1 COURTHOUSE SQUARE, #102 CARLISLE, PA 17013 12/04/03 Re: In the Estate of RONALD E ROLLASON Probate Case No. Social Security No: Last known residence: Our Client: Account Number: Amount of Debt: 2103677 172360303 146 E NORTH ST CARLISLE, PA 17013 MBNA AMERICA 4264290452742422 $ 7369.70 Dear Sir or Madam Enclosed please find a Creditor's ciaim to ~ flied in the recor0 with ~e above-referenced Estate. Please remm a file stamped copy of the claim in the enclosed self-addressed, stamped envelope. Thank you for your assistance. If you have any questions or concerns, please call our firm toll free at 1-877-767-9383. Cordially, MBNA America Enclosures A check for $5.00 for the filing fee. cc: Attorney for Estate Personal Representative This letter is an attempt to collect a debt and any information obtained will be used for that purpose. This letter is from a debt collector. 3463 9,'24/2003 1006589 COMMONWEALTH OF PENNSYLVANZA NOTICE OF CLAIM COURT OF COMMON PLEAS OF CUMBERLAND ,COUNTY ORPHANS' COURT DZV]:SZON Zn Re: The Eatate of: RONALD E ROLLASON Deceased Court: File No: 2103677 TO: THE CLERK OF THE ORPHANS' COURT DZVZSZON: Notice of claim by creditor, Pursuant to Section 3532(b)(2) of the Probate, Estates, and Fiduciaries Code, 20 PA.C.S.A. §3532(b)(2). MBNA AMERICA l) 2) 3) Claimant's name: Claimant's address: P.O. BOX 15137 WILMINGTON, DE 19850--5137 8777679383 Creditor listed below is the owner and holder of a claim in the amount of $ 7369.70 4) S) The facts upon which this claim is based: This claim is based on an account for credit evidenced by the attached Affidavit of Account Stated. Decedent's address: 146 E NORTH ST CARLISLE, PA 17013 6) Date of Death: 07/24/03 7) That the claim arose prior to the death of the decedent on or about 8) That the claim is secured by. On behalf of the claimant, ! do solemnly declare and affirm under the penalties of perjury that they !nformation and representations made herein are true and correct to the best of my knowledge, information and belierS.- ~, ,~,'Ky ' enzel/Lucille Roberis/Jessica Lerb ed Representative For MBNA America Written notice of claim was given to Personal Representative and/or his/her counsel as stated below: MARJORIE ROMANO Name 10 HOOVER RD Address CARLISLE, PA 17013 City/State/Zip ~ f~l~ Date notic~e r~ailed IN RE ESTATE OF: RONALD E ROLLASON AFFIDAVIT OF ACCOUNT The undersigned, being first duly sworn deposes and states the follows: Your Affiant is authorized by the Claimant as its Authorized Representative- In-Fact to make this Affidavit. Your Affiant has reviewed the account records of the Claimant with respect to the decedent. Your Affiant is familiar with these records and accounts and reviews them as a regular part of her duties. o The Decedent purchased merchandise in the amount of $ 7369.70 evidenced by account number 4264290452742422 The unpaid balance does not include any post-death late payment charges, accrued interest, collection costs or attorney's fees. Further your affiant sayeth not MBNA America. One of its Authorized R[~sentative~: Kyle Frenzel ~ Lucille Roberts Jessica Lerbs MBNA America P. O. Box 15137 Wilmington, DE 19850-5137 Subscribed and sworn before me This ~' day of'~~ , 2003. Nota ~c ~ FIRST AND FINAL ACCOUNT OF MARJORIE H. ROMANO FOR THE ESTATE OF RONALD E. ROLLASON NO. 21-03-0677 Date of Death: Date of Executor's Appointment: First Complete Advertisement of Grant of Letters Accounting for the Period: 07/24/03 08/28/03 10/0303 08/28/03 -- 02/29/04 Purpose of Account: Marjorie H. Romano, Executrix, offers this account to acquaint interested parties with the transactions that have occurred during her administration. The account also indicates the proposed distribution of the estate. It is important that the account be carefully examined. Requests for additional information or questions or objections can be discussed with: Thomas E. Flower, Esquire Saidis, Shuff, Flower & Linsday 2109 Market Street Camp Hill, PA 17001-0737 [717] 737-3405 SUMMARY Proposed Distribution to Beneficiaries: [none] PRINC~AL: Receipts Page No___~. 3 $ 3,576.19 Less Disbursements: Funeral Expenses Burial Expenses Administrative Expenses Net Principal ln,qolvency: Unsecured Debts of Decedent to Be Discharged Without Payment: Life Insurance and Pension Death Benefit .Not Subject to Creditors' Claims: 4 4 3 3 3 3 ($ 7,481.83) $ 22,154.44 $ 39,996.23 2 pRINCIPAL RECEIPTS 08/08/03 Refund, State Farm auto insurance policy $ 257.97 08/28/03 Refund, post office box rental 30.05 09/08/03 Citizens Bank Checking Account #610072-709 1,211.20 09/11/03 Kenny's Auction, proceeds sale of personal property 1,976.97 09/18/03 Proceeds of sale, non-running vehicles & parts 100.00 Total principal receipts DISBURSEMENTS OF PRINCIPAL Funeral Director, Professional Services Casket Outer Burial Container Clergy Honorarium Flowers Memorial Dinner Total Funeral Expenses Headstone, Carlisle Memorials Cemetery Plot, Mt. Zion Cemetery Grave Opening Total Burial Expenses Death Certificates Obituary Notice Probate Fees Cumberland Law Jrnl., estate adv't. Patriot News, estate adv't. Landfill fees, refuse disposal Attorney Fees Tax Return Filing Fee, insolvent return Total Miscellaneous Administration Expenses Total Principal Disbursements: NET PRINCIPAL DEFICIT (INSOLVENCY) $ 3,695.00 1,995.00 700.00 75.00 84.80 143.51 ($ 6,693.31) $1,392.00 6OO.O0 975.00 ($ 2,967.00) $ 40.00 62.90 52.00 75.00 70.09 87.72 1,000.00 10.00 ($1,397.71) $ 3,576.19 ($ 7,481.83) UNSECURED DEBTS OF DECEDENT TO BE DISCHARGED WITHOUT PAYMENT MBNA Credit Card Account #4264290452742422 $ 7,369.70 MBNA Credit Card Account #5401260552002010 Robert Kantor, MD Holy Spirit Hospital Kunkel Surgical Group Cumb. Valley Endo. Cntr. Quest Diagnostics Apria Healthcare Borough of Carlisle, water/sewer bill PPL Electric, c/o Powell, Rogers & Speaks, Inc., collectors UGI Sprint Carlisle Regional Medical Center Darlene L. Moyer, Tax Collector, Per capita tax Total of debts to be discharged without payment 12,640.10 155.50 90.06 161.00 81.10 102.40 1,075.17 45.24 92.92 126.49 3.62 200.14 11.00 $ 22,154.44 FOR INFORMATION: LIFE INSURANCE & PENSION DEATH BENEFIT NOT SUBJECT TO CREDITORS' CLAIMS* Amalgamated Life Insurance Co. Death Benefit plus interest International Painters and Allied Trades Union Pre-retirement Pension Fund Death Benefit Local Union Hall 411, death benefit fund $ 30,150.31 9,845.92 2,5OO.OO Total transfers of property not subject to creditors' claims $ 42,496.23 * Decedent's children, Marjorie Romano and Joseph Rollason were designated beneficiaries of the life insurance and Trade Union pension death benefits. 4 COMMONWEALTH OF PENNSYLVANIA) · SS. COUNTY OF CUMBERLAND) Marjorie H. Romano, Executrix under the Last Will and Testament of Ronald E. Rollason, deceased, hereby declares under oath that she has fully and faithfully discharged the duties of her office; that the foregoing First and Final Account is true and correct and fully discloses all significant transactions occurring during the accounting period; that all known claims against the estate have been accounted for herein; and that all taxes presently due from the estate have been paid. Sworn to and subscribed before me this / 'S~ day of~, 2004. FIRST ASD FINAL ACO3U~E OF MAJORIE H. B0~[AbD FOP. THE ESTATE OF BONALD E. BOT.T~kqON No. 21-03-0677 By: Thomas E. Flower, Esquire I.D. # 83993 LAW OFFICES SAIDIS, SHUFF, FLOWER & LINDSAY 26 WEST HIGH STREET 2109 MARKET STREET CARLISLE, PA 17013 CAMP HILL, PA 17011 TEL: (717) 243-6222 TEL: (717) 737-3405 FAX: (717) 243-6486 FAX: (717) 737-3407 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA STATUS REPORT UNDER RULE 6.12 Name of Decedent: Date of Death: Will No. 2003-00677 RONALD E. ROLLASON 07-24-03 Admin. No. 21-03-0677 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 whether administration of the estate is complete: Yes X; No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: No a. Did the personal representative file a final account with the Court? Yes X; (Account confirmed 04/27/2004). is: b. The separate Orphans' Court No. (if any) for the personal representative's account N/A c. Did the personal representative state an account informally to the parties in interest? YES ;No X. d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: Signature Name: Thomas E. Flower, Esquire I.D. No. 83993 SAIDIS, SHUFF, FLOWER & LINDSAY 2109 Market Street Camp Hill, PA 17011 (717) 737-3405 Capacity: __ Personal Representative X Counsel for Personal Representative