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HomeMy WebLinkAbout02-0422 PETITION FOR PROBATE and GRANT OF LETTERS Estate of ~~ $...\ '-' 7,* \ also known as No. To: 21-02-422 Register of Wills for the , Deceased. County of L'tm ~R.,..Itt.1'\ J. in the Social Security No. 'Z-O 9 01 () q q , 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 execu~~SC:: in the last will of the above decedent, dated ~ '-.. -...Jl.. ~ 'Z- and codieilts)---dated named ,19~ (state relevant circllmstances, e.g. renunciation, death of execUtor, etc.) County, Pennsylvania, with , \I'Q... (list street, number and muncipality) Oe\~~nt, then _,~5( at ~ Except as follows, decedent did not marry, was not divorced a d did not have a chil born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: "ClN2.--' Oecendent 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: -z" OC(; ,CO $ $ $ $ WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters '1' e 5> """<1....., e '1+(.\ (' '/ (testamentary; adminIstration C.La.; administration d.b.n.c.t.a.) theron. '" v u C " ~3 " .... 0::" c -00 Co;:: cu',=, 3~ " '- 30 cu c OJ) Vi ~ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ') sn COUNTY OF CUM B E~L,qN1) j ~ 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. .S. worn to ~r affirmed and. subscribed { r4}~ -f' J r; j -:AL before me thiS 25 th _ day of 'M t I P1J.. () J/f' \ APRIL .!!t.2002 / ~. I:l 7ry"q~-;M~L/<)5~ - ! IJ-k>- L~7 No. 21-02-422 Estate of MARY S JUSICK , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW APRIL 29 Xf9 2002, 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 JUNE 22, 1992 described therein be admitted to probate and filed of record as the last will of MARY S JUSICK TESTAMENTARY KATHLEEN COPENHAVER and Letters are hereby granted to Probate, Letters, Etc. ......... Short Certificates(ltl? . . . . . . . . . . ~-pages Kerrun'Clation ................ T'-- ~ ~ $ $ $ $ S-:O'c TOTAL _ $ 66.00 ... .~~~.~ .??... .~~~?............. 25.00 30.00 6.00 FEES 4 N.Hanover St, Carlisle,PA 17013 ADDRESS Filed 717-243-4574 PHONE M ,....~ c. In \'J ["'-,I P ..1 ~ . ..... _.~C~ W ILL I, MARY S. JUSICK, of 101 Strayer Drive, Carlisle, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM ONE: I direct that all my debts and funeral expenses, including my gravemarker shall be paid from my savings accounts and residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM TWO: I give, devise, and bequeath my home at 101 Strayer Drive, Carlisle, Cumberland County and all of the contents therein, including all household effects, furniture, jewelry, and personal effects, or, in the event of sale of the home and contents i" the proceeds therecf: 'to my daughter KathleEm Gail Copenhaver, per stirpes. ITEM THREE: I give and bequeath: A. Any automobile owned by me at my death to my grandchildren Kristen Copenhaver and Todd Copenhaver, equally, or to the survivor. B. My stocks, bonds, and other investments in securities to my daughter Kathleen Gail Copenhaver, per stirpes. It is my wish that my daughter Kathleen Gail Copenhaver distribute a portion of the value of said stocks, bonds, and other securities to my son Stephen Jusick as she deems appropriate, in her absolute discretion, as a bequest. ITEM FOUR: I give and bequeath my savings accounts in banks or savings institutions and the rest, residue, and remainder of my estate to my grandchildren Stephen Kent Jusick, Jill Ellen Jusick, Todd Copenhaver, and Kristen Copenhaver equally, share and share alike, per stirpes. ITEM FIVE: I appoint my daughter Kathleen Gail Copenhaver Executrix of this my last will. Should my daughter Kathleen Gail Copenhaver fail to qualify or cease to act as Executrix, I appoint my daughter's husband Ronald C. Copenhaver to act as Executor with the same rights, powers, and duties. ITEM SIX: All estate, inheritance, succession, and other taxes, imposed or payable by reason of my death, and interest and penalties thereon, with respect to all property comprising my gross estate for tax purposes, whether or not such property passes under this will, shall be paid out of my savings accounts in banks or lending institutions and out of the residue of my estate, without apportionment or right of reimbcriement. ~t:JJUS!fl:'r~~ L./ Page One of Three ITEM SEVEN: I direct that my personal representative or guardian shall not be required to give bond for the faithful performance of their duties in any jurisdiction. ITEM EIGHT: In addition to the rights and powers given to the fiduciaries by law or elsewhere in this will, I give to my Executor during the full time necessary and for the administration of my estate the following rights and powers to be exercised in his sole discretion. A. To retain any real or personal property which may at any time form a part of my estate so long as he or she deems it advisable. B. To invest in any real or personal property without restrictions as to legal investments. c. To repair, alter, improve or lease for any period of time any real or personal property and to give options for leases. D. To sell at public or private sale, for cash or credit, with or without security, to exchange or to partition real or personal property, and to give options for leases. E. To make distribution in kind. F. To compromise claims. IN WITNESS WHEREOF, I have hereunto set my hand this June, 1992. 2zJday of '-2 SIGNEo'1-t: MARY ,. /~-c < The preceding instrument, consisting of this and two other typewritten pages each identified by the signature of the Testatrix was on the day and date thereof signed, published and declared by the Testatrix therein named as and for her last will, in the presence of us, who at her request, in her presence and in the presence of each other have subscribed our names. Page Two of Three COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND We John H. Broujos and "5~{~C\ L .4-,--\~S witnesses whose 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 the Testatrix sign and execute the instrument as her last will; that she signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the will as witnesses; and that to the best of our knowledge, the Testatrix was at the time 18 or more years of age, of sound mind and un no cons ral or undue influence. \ Sworn and subscribed to cI before me this ~ f) day of June, 1992. ~~~ ~4L~ Notary Publ~ NOTARIAL SEAL KAR!N F. BYERS, NOTARY PUiLlC BaRO OF CARliSLE, CUMBERlAND COUNTY MY COMMISSION EXPiRES MARCH 18, 1995 COMMONWEALTH OF PENNSYLVANIA : SS COUNTY OF CUMBERLAND . . I, MARY S. JUSICK, whose name is signed to the attached instrument, having been duly qualified according to law, do hereby acknowledge that I signed and execu~ed 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. '- //'(/ 1/ , Sworn and affirmed of June, 1992. ~~/ -'7A ~~ ~;::T fjl--=- Notary Publi CK / / to and acknowledged before (e/~his "q~ .{ day NOTARIAL SEAL KAI*:N F. BYERS, NOTARY PUliLlC BaRO OF CARliSLE. CUMBERLAND COUNTY MY COMMISSION EXPiRES MARCH 18. 1995 Page Three of Three (~ )), CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: Mary S. Jusick Date of Death: April 16, 2002 Will No.: Admin. No.: 21-02-0422 To the Register: I certify that Notice of Estate Administration required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on July 16,2002: Name Address Kathleen Gail Copenhaver Stephen Frederick Jusick Todd Copenhaver Kristen Copenhaver O'Neill Jill Ellen Jusick Bentley Stephen Kent Jusick 71 Channel Drive, Carlisle, P A 17013 16 VanKirk Road, Princeton, NJ 08540 1557 Runnymeade Road, NE, Atlanta, GA 30319 16 Hereford Street, #4, Boston, MA 02115 2 Tanager Drive, Ringoes, NJ 07762 23 East 10th Street, Apt. PHG, New York, NY 10003 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: none Date: 7/16/02 k/ltJul ~j 9uJCWU( Signature Name: Kathleen Gail Copenhaver Address: 71 Channel Drive Carlisle, P A 17013 Telephone: (717) 243-7120 Capacity: X Personal Representative Counsel for Personal Representative REV-1470 EX (6-88). '* INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENTS NAME FILE NUMBER Jusick, Mary S. 2102-0422 REVIEWED BY ACN Daniel Heck 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES G 1 Increased to 100% taxable per phone conversation with John H. Broujos, Esq. Office on 02/24/2003. ROW Page 1 / '? -6o-e:v '\, BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV-1607 EX AFP lOl-OS) JOHN H BRoUJoS ESQ BROUJOS & GILROY 4 N HANOVER ST CARLISLE PA 17013 ReGomf!o.'~JEot Reg!ster EmME OF DATE OF DEATH FILE NUMBER .03 APR 28 cqtI~~t} 0 ACN 04-14-2003 JUSICK 04-16-2002 21 02-0422 CUMBERLAND 101 MARY S Clerk. ..~. Cumberland Co.. PA I Allount Relli Hed MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REv=i6'ifj-Ex-AFP--foY=o3Y------...--fNifiiITANCE-fA3f-sTAfEME-tif-oF'-AC-COLiiff--...--------------------- ESTATE OF JUSICK MARY S FILE NO.21 02-0422 ACN 101 DATE 04-14-2003 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT DR RECORD ADJUSTMENT: 03-10-2003 P R I NC I PAL TAX DUE: ..mm............................................................m..mmm.mmmm..mm.mmmm........................................................................................... ........m. 3,706.99 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 07-16-2002 CDOO1413 184.21 3,500.00 03-21-2003 CD002323 .20- 22.99 TOTAL TAX CREDIT 3,707.00 BALANCE OF TAX DUE .01CR INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .01CR SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) , BURE\U OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX JOHN H BROUJOS ESQ BROUJOS 8 GILROY 4 N HANOVER ST CARLISLE PA 17013 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-10-2003 JUSICK 04-16-2002 21 02-0422 CUMBERLAND 101 *' REV-15~7 EX aFP lDl-D5l MARY S Allount Rellitted c.2:),11 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV =istrj-Ex-AFP--foY=oiY-NoYicE--oF-YNHEifiTANcE-YA'x-it-pPRitYSEi'-ENT~--ALrOWAifCE-(fR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF JUSICK MARY S FILE NO. 21 02-0422 ACN 101 DATE 03-10-2003 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 2,909.54 .00 86,635.42 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 2,663.00 4,504.46 NOTE: I~ an assessment was issued previously, lines reflect figures that include the total of ALL ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: (1lJ (12) (13) (14) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 89,544.96 7.167 46 82,377.50 .00 82,377.50 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. .00 X 00 = 82,377.50 X 045= .00 X 12 = .00 X 15 = (19)= .00 3,706.99 .00 .00 3,706.99 "~~~6' . (+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 07-16-2002 CDOO1413 184.21 3,500.00 INTEREST IS CHARGED THROUGH 03-25-2003 TOTAL TAX CREDIT 3,684.21 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 22.78 REVERSE SIDE OF THIS FORM INTEREST AND PEN. .21 TOTAL DUE 22.99 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) 1')-6C) -.;:v , BUREAU,OF INDIVIDUAL TAXES 'v INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN , I JOHN H BROUJOS ESQ BROUJOS & GILROY 4 N HANOVER ST CARLISLE . PA 17013 03-10-2003 JUSICK 04-16-2002 21 02-0422 CUMBERLAND 101 '* REV-1547 EX AFP 101-051 MARY S Allount Rellitted NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. (8) 89,544.96 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=is'4-j-i3f-AFP-foY:03Y-NOYici--OF-YtiHiifiTAi.fCE-i"-A'X-'jrpPRAYsiMENT~--Ai:.l-owAi.fcE-c'-R------------ ----- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF JUSICK MARY S FILE NO. 21 02-0422 ACN 101 DATE 03-10-2003 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (1) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 2.909.54 .00 86.635.42 (11) (12) (13) (14) 7.167 46 82,377.50 .00 82,377.50 (9) (10) 2,663.00 NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: .00 X 00 = .00 82,377.50 X 045 = 3,706.99 .00 X 12 = .00 .00 X 15 = .00 (19)= 3,706.99 4.504.46 n~_~.. l+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 07-16-2002 CDOO1413 184.21 3,500.00 INTEREST IS CHARGED THROUGH 03-25-2003 TOTAL TAX CREDIT 3,684.21 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 22.78 REVERSE SIDE OF THIS FORM INTEREST AND PEN. .21 TOTAL DUE 22.99 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT BROUJOS JOHN ESQ 4 N HANOVER ST CARLISLE, PA 17013 -------. fold ESTATE INFORMATION: SSN: 209-07-0991 FILE NUMBER: 2102-0422 DECEDENT NAME: JUSICK MARY S DATE OF PAYMENT: 07/16/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 04/16/2002 NO. CD 001413 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $3,500.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: JOHN BROJOUS ESQUIRE CHECK# 101 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS $3,500.00 MARY C. LEWIS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT BROUJOS JOHN ESQ 4 N HANOVER ST CARLISLE, PA 17013 _u_u__ fold ESTATE INFORMATION: SSN: 209-07-0991 FILE NUMBER: 2102-0422 DECEDENT NAME: JUSICK MARY S DATE OF PAYMENT: 03/21/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 04/16/2002 NO. CD 002323 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $22.99 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: JOHN H BROUJOS ESQUIRE CHECK#103 SEAL INITIALS: AC RECEIVED BY: REGISTER OF WILLS $22.99 DONNA M. OTTO DEPUTY REGISTER OF WILLS ,/(, -' <;;r STATUS REPORT UNDER RULE 6.12 Name of Decedent: Mary S. Jusick Date of Death: April 16, 2002 Will No. Admin. No. 2002-00422 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 No X 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3 - 6 months 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account/statement with the Court? Yes No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of OrPh ' Court and may be attached to this report. Date: L{-I-O i 'Qum8 :;':') 6Z: 6 Ii s- tld~ l7O~apacity: John . Broujos, Esquire 4 N. Hanover St., Carlisle, PA 17013 717-243-4574 Personal Representative X Counsel for Personal Representative Cumberland County - Register of Wills One Courthouse Square Carlisle, PAl 7013 Phone (717) 240-6345 Date: March 15, 2005 John Broujos, Esquire 4 North Hanover Street Carlisle, P A 17013 RE: Estate of JUSICK MARY S File Number: 21-02-0422 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years ofthe decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 04/1612005 Your prompt attention to this matter will be appreciated. Thank you. Sincerely, ~_~~~~h_jJ GLENDA FARNER sTmBA1j'(}H REGISTER OF WILLS cc: File Judge r) REV-115OO EX + (&00) "' , ~ ... .~ ;~/;"~U ;'. '-'-.' i~' ~~J'-"'!'r.- \ 'If;co. ~c ;.~i COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT ... z W Q W Co) W Q w ... "Sill 00:" wl!;g %0:.. U8;:m c DECEDENTS NAME (LAST, FIRST. AND MllJOlE INITIAL) JUSICK MARY S. DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-llD-Year) l&J 1. Original Return o 4. Limited Estate 00 6. DecedentDiedTestate -"..,d""l o 9. Litigation Proceeds Received o 2. Supplementel Return o 4a.FuturelnterestCompromise(daleofcleathal'lllr12-12-82) o 7. Decedent Maintained a Living Trusl 1_' _,tTM1I o 10.SpousalPovertyCIed~I""of__".31."""".1"'J '" OFFICIAL USE ON.. Y \ I ~O :J- FILE NUMBER 21-0200422 '""OOiJ'Ni-.tOO6E -YEAR- - -iMiiiER-- v 04/1612002 05/11/1913 (IF APPUCABlE) SURVIVING SPOUSE'S NAME (LAST, FIRST. AND MIIlDlE INITIAL) SOCIAl SECUR1TY NUMBER 2 0 9 - 0 7 - 0 9 9 1 THIS RETURN IIUST BE FilED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAl SECURITY NUMBER o 3. Remainder Return (daleofdealhpnorm12-13-82) o 5. Federal Estate Tax Return Requiled 00 6. Tolal Number 01 Safe Depos~ Boxes o 11. Election 10 lax under Sec. 9113(A) 1-''''' OJ THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS JOHN H. BROUJOS ESQUIRE 4 NORTH HANOVER STREET FiRM NAME (If Applicable) BROUJOS & GILROY P.C. TELEPHONE NUMBER 717-243-4574 CARLISLE PA 17013 X _(15) 39,059.79 X .045 (16) X .12 (17) X .15 (16) (19) !Z w Q Z Q .. III W 0: 0: Q o z o i= S ;:) ... ii: c( Co) w a:: 1. Real Estate (Schedule A) (1) 2. Stod<s and Bonds (Schedule B) (2) 3. CIose~ He~ Corporation, PartnBlShip or Sole-Proprielolllhip (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Depos~ & Mis<:eIlaneous PelllOOal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) o Separale Billing Requested 7. Inter-Vivos Transfelll & Mis<:ellaneous Non.f>robate Property (7) (Schedule G or L) 6. Total Gross As_ (Iotal Lines 1-7) 9. Funeral Expenses & Administrative Cosls (Schedule H) (9) 10. DebIs ofDeoedenL Mortgage L..bilffies, & Liens (Schedule I) (10) 11. Total Deductions (Iotal Lines 9 & 10) 12. Net Value of Estate (Line 6 minus Line 11) 13. Charitable and Govemmenlal BequeslslSec 9113 Trusls lor whdl an election 10 tax has not been made (Schedule J) 14. NelVelue SUbject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o i= c( ... :J ll. :Ii o Co) >< ~ 15. Amounlof Line 14 taxable al the spousai tax rate. ortransfelll under Sec. 9116 (a)(1.2) 16. Amounl of Line 14 taxable at lineal rate 17. Amounl 01 Line 14taxablealsibling rate 16. AmounlofLine 14 taxable alcollateral rate 19. Tax Due 20 [8] CHECK HERE IF YOU ARE REOUESTING A REFUND OF AN OVERPAYMENT OFFiciAL USE ONLY 0.00. 2,909.54 , 43,317.71 L__ (6) 46,227.25 2,663.00 4,504.46 (11) (12) (13) 7,167.46 39,059.79 (14) 39,059.79 1,757.69 1,757.69 > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < o d . C I t Add ece ent s ample e ress: . STREET ADDRESS , '. 71 CHANNEL DRIVE CITY I STATE I ZIP CARLISLE PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditS/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 1,757.69 3.5DO.00 175 00 Total Credits (A + 8 + C) (2) 3,675.00 3. InlerestJPenalty n applicable 0, Interest E. Penalty T otallnterestlPenalty ( D + E ) (3) 4. 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 reques1a re1und (4) 5, If Line 1 + Line 3 Is greater than Une 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) 8, Enter the lotal of Line 5 + SA, This Is the BAlANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT 1,917.31 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; ........................................................................... 0 00 b. retain lhe rightto designate who shall use the property transferred or its income; ........................................ 0 00 c. retain a re'<ersionary interest; or ...................................................................................................... 0 00 d, receive the promise for life of either payments, benefits or care? ............................................................. 0 00 2, If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration?............................................................................................... 00 0 3, Old decedenl own an 'in trustfo~ or payable upon death bank account or security at his or her death? ................. 0 00 4. Did decedent own an Individual Retirement Aooount, annuity, or other nonl'robate property which contains a beneficiary designation? ....................................................................................................... 0 00 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. PA 17013 DATE 1-1')-03 North Hanover Street arlisle PA 17013 For dates of death on or after July 1, 1994 and before January 1, 1995, Ihe tax rale imposed on Ihe 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 statule does not exemot a transfer to a surviving spouse from lax, and the statutory requirements for disciosure of assets and filing a tax retum are still applicable even if the surviving spouse Is the only beneficiary. For dates of death on or after July 1 , 2000: The lax rate imposed on lhe 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 parenl, an adoptive parent, or a stepparent of the child is 0% [72 P.S. ~9116(a)(1.2)j, The tax rate imposed on the nel vaiue of transfers to orlor the use of Ihe decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) (12 P.S, ~9116(a)(1)1. The tax rale imposed on the net value of transfers to or for the use of the decedenfs 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 adopIion. !"'....EX.11~. '- .. COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIOENT DECEOENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF JUSICK MARY S FILE NUMBER 21 02 00422 Include lt1e proceeds 01 litigation and lt1e date lt1e proceeds were received by lt1e estate. All property joInl1y-owned with the right of survivorship must be dlscloled on Schedule F. ITEM NUMBER 1. OESCRIPTION PNC Bank checking aect # 51-4042-9549 VALUE AT DATE OF DEATH 2,909.54 TOTAL (Also enteron line 5. Recapitulatioo) $ (If more space is needed, insert addttional sheets of the same size) 2909.54 ~""~":" '* COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER.VIVOS TRANSFERS & MISC. NON.PROBATE PROPERTY ESTATE OF JUSICK MARY S FILE NUMBER 21 02 00422 Thisscl1edule must be comp~ted and fi~ ~1he answer 10 any of questions 1 through 4 on 1he reverse side of the REV-l500 COVER SHEET is yes. DESCRIPTION OF PROPERTY %OF ITEM IPfJ..UoeTHE~EOFTHETRANSFEREE,TttEIRRELATIONSHIPTODECEDEIfTANDTHEDATEOFTRANSfER DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NUMBER ATTA1JHA COP'tOf THE DEEDFORRfAL ESTJtTfi. VALUE OF ASSET INTEREST (lFAPFUCABl.EI 1. Stocks/Investment Ace!. transferred 11/01 to daughter, 86,635.42 50. 43,317.71 Kathleen J. Copenhaver, 71 Channel Dr, Carlisle, PA 17013 000 RBC statement attached. TOTAL (Also enter on line 7, Recapitulation) $ 43317.71 .. (If more space IS needed, Insert additional sheets of the same size) "U'It"" h.._ .l5~o !l "1- c:~ ~ ~~&: g~ .,- I- Z LU ~ LU l- e:( l- V) I- Z ::> o u u e:( d i ~ ~ tf\ J ~' O\t ~_ll -. . , . .. ~ 0- > ~v-.9 d ci '" ci --: <I! "- ~ :; i ~ ')-~ ~ cf~ 'i M ~ ~ - II '" -,- LLI CJ Z CC ::J: U . .. . . 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COMMONWEALTH OF PENNSYLVANIA I~ERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF JUSICK MARY S FILE NUMBER 21 02 00422 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A, FUNERAL EXPENSES: 1. prepaid B. ADMINISTRATIVE COSTS: 1. PelSonal Representative's Commissions Name of Personal Representative (s) Sodal Security Numbe~s) I EIN Number of Personal Representative(s) Street Address City State Zip Yea~s) Commission Paid: 2. AtIomeyFees Broujos & Gilroy, P.C.; EIN 23-2267691 2,500.00 3. Fami~ Exemption: (If decedents eddress is not lite same as claimants, attach explanation) Claimant SlIoet Address City Slate Zip Relationship of Claimant to Decedent 4. Probate Fees - Register of Wills 121.00 5. Accountants Fees 6. Tax Retum Prepare!s Fees 7. 8. Register of Wills - inventory 10.00 9. Register of Wills - Inheritance Tax Return 15.00 10. Register of Wills - Family Settlement Agreement 17.00 TOTAL (Also enter on line 9, Recapitulation) $ 2663.00 (If more space is needed, insert additional sheets of the same size) '~"'lD"~<n *' COMMONWEAlTH OF PENNSYLVANIA INHERJTANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF JUSICK MARY S FILE NUMBER 21 02 00422 Include unrelmbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 4,504.46 1. Homeland Center - nursing care 1901 North 5th Street, Harrisburg, PA 1712 TOTAL (Also enteron line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same sizel 4 504.46 REVOI513EJC+ll.97JW !. - . ~ , , COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER II ''''f'''' itlARYS 71 07 00477 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distribotions) 1. Kathleen Gail Copenhaver daughter stocks, bonds, and other 71 Channel Drive, Carlisle, PA 17013 investments in securities; jewelry, personal effects 2. Stephen Frederick Jusick son 16 Van Kirk Road, Princeton, NJ 08540 a portion of securities as deemed appropriate and in absolute discretion of KathleenGailCopenhaver 3. Todd Copenhaver grandson 1557 Runnymeade Road, NE. Atlanta, GA 30319 1/4 of savings accounts and residue 4. Kristen Copenhaver O'Neill granddaughter 1/4 of savings accounts 16 Hereford Street, #4, Boston, MA 02115 and residue 5. Jill Ellen Jusick Bentley granddaughter 1/4 of savings accounts 2 Tanager Drive, Ringoes, NJ 07762 and residue 6. Stephen Kent Jusick grandson 1/4 of savings accounts 23 East 10th Street, Apt. PHG, New York, NY 10003 and residue ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1 B CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET S (If more space is needed, insert additional sheets of the same size) Estate of JUSICK MARY S Late of NORTH MIDDLETON TOWNSHIP RECEIVED MAY 11 2005 ~ ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA Estate No.: 21-02-00422 Date: 5/10/2005 NO.: 21-02-00422 BROUJOS JOHN ESQ 4 N HANOVER ST CARLISLE PA 17013 NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS I COURT RULE Personal Representative: COPENHAVER KATHLEEN Personal Representative Counsel: BROUJOS JOHN ESQ Date of Decedent's Death: 4/16/2002 Date of Delinquency Notice: 4/16/2005 The undersigned, Glenda Farner Strasbaugh, Clerk of Orhans' Court, in accordance with rule 6.12, 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 their counsel, have filed with the Register of Wills or Clerk of Orphans' Court, his/her Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule, and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orhans' Court Rules, was given by the Clerk of Orphans' Court on 3/03/2005 and that the ten (10) day notice to file the status report has expired. Accordingly, in accordance with Rule 6.12 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 their counsel. cc: File Personal Representative Counsel ~~~ Glenda Farner Strasbaugh Clerk of Orhans' Court A hearing is scheduled for June 17, 2005 at 9:30 AM in Courtroom No. 03. If the Status Report is filed prior to the hearing date, the hearing will automatically be cancelled. //'...~.1...i;1.!;.A /ll.t~.;r\ ,".f .~ ~F '. If to' GEORGE, E/ HOFFER, ~ P. J .\! '. I l 0" '" tb ~.. '] ~- uA STATUS REPORT UNDER RULE 6.12 Date of Death: '7 \tiAtc :\ cS \ () , Cy,,,- __ ~ U S, c: \..J Name of Decedent: Will No. -- Admin. No. 7 \ 6 L ~""Z..- 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: Date: 1. State wheth~r ,.administration of the estate is complete: Yes V No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. Ifthe answer to No. I is Yes, state the following: a. Did the personal representative file a final account/statement with the Court? Yes No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representa~.e state an account informally to the parties in interest? Yes L,.. No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphans' Court and ma be -..- attached to this report. '~" > f~ /(/;- N c:> John . roujos 4 N. Hanover St., Carlisle, P A 17013 717-243-4574 Cl- uX Capacity: Personal Representative ('II'") V Counsel for Personal Representative