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.
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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
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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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
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OFFICIAL USE ON.. Y
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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)
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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
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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 < <
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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.
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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
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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
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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)
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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
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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.
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GEORGE, E/ HOFFER, ~ P. J .\!
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STATUS REPORT UNDER RULE 6.12
Date of Death:
'7
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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. '~"
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John . roujos
4 N. Hanover St., Carlisle, P A 17013
717-243-4574
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Capacity:
Personal Representative
('II'")
V Counsel for Personal
Representative