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HomeMy WebLinkAbout04-0413Estate of' also known as Deceased. Social Security No. /~/' ~.ff-- / ¢, 'a ! The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or old,~,qr an the exefut in the last will of the above decedent, dated and codicil(s) dated PETITION FOR PROBATE and GRANT OF LETTERS To: Register of Wills for ~he County of ~L_/.444.~/. ff,.'...~R', in the Commonwealth of ~-~n~ylv~nia n d , 19 ~n~g (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in C~'~ ~ ~ ~ ~ ~ ~ family ~ princioal residence at ~ ? (~st street, number and muncipality) DecenCy? ,eh _ q 3..y~rs of age, died Except as follows, fiecedent did no'marry, was not divorced and did not have a child born or adopted ~fter execution of th~i~ered for probate; was not the victim of a killing and was never adjudicated ~ncompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioner(s) respectfully request.Os) tl3e probate i~f the last will and codicil(s) presented herewith and the grant of letters theron. (testamentary; administration~.t.a.; administration d.b.n.c t..a.) bSW~orn to .o.r aff~m~ed~ and subscribed e~9~e me tills ,,,4~2:~. dav ~egiste~ 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 represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. NO,, _ Estate Of "~OY~/2~/~_. , Deceased DECREE OF PROBATE AND GRANT OF LETTERS the reverse side hereoL sa~facto~ proof having been presented before ~e, IT IS DEC~ED that the inst~ment(s) dated ~1~~ ~ ~~ described therein be admitted to probate and file~f re~r~s the l~st will of ~e hereby granted to ~ ~...__~, in consideration of the petition on FEES Probate, Letters, Etc .......... $ Shgrt_Certificates( ~ .......... $ Ren~n~ ................ $ Filed Register of WilLs ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 No. Local Registrar ~' Dine Hr05 143 Rev. 2/87 d Zl-Oq- q NAME OF DECEDENT (First, Middle, Last) COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH AGE (Last Margaret G. Coghlan COUNTY OF DEATH Cumberland DECEDENT'S USUAL OCCUPATION ,.. LPN ,b. Cornwall Manor DECEDEN/'S 312 Glenn Road ACTUAL RESIDENCE ~,. Camp Hill, Pa 17011 ~n other .ida) SEX J SOCIAL SECURITY NUMBER J DATJ[ OF DEATH (Month, Day, Year remalel,. 191 - 24 - 100.. ~TE OF BIRTH BIRTHP~CE (~ a~ (Mon~, Day, Y~) State ~ F~gn C~) Cl~. BORO. ~ OF ~TH FACILITY ~ME (If n~ thallium, give J~J i~d ng~) : ORIGIN? J RACE - Am~n I~ian, ~a~. ~ite, I~0. ~ite KIND OF BUSINESS I INDUSTRY DECE~NT'S E~CATION MARITAL STATUS. Ma~,I SURVI~NG S~USE U,S, ARMED FO~S? N~r Maffi~ ~, vasE ~ ,~, ,z WidowedJ ~7,. sim de~,,~ ,7c. ~yas. ~t,~ ~. ~s t Penns~ro witNn ~ I~s ~ FATHER'S NAME IF/st Middle Last) cityFooro -- ' ' MOTHER'S NAME (First, Middle, Maiden Surname) ~,. William McClintock I,, Alice Yost INFORMANT'S NAME ~rype/Pdnt) J IN~ORMANT'~MA AOOR SS (S et /Town S t Code ,o, Marianne McManus ' 312 ~ ~ w ,.gt~ ,. ,q ~ ~ ~ ME~'HOO OF DISPO$1T !~. ~,J. enn tqoaa camp Hlii ~ Pa 17011 Tr~ ~ ~ J ~A~TE OF DISPOSITION I PLACE OF DISPOSITION. Name o~ Cemetory, Crematory LOCATION - City/Town State Zip Code Donation' ~r-I BurlalOther[~rCremation LJ%moval from Stale. L.I J( oath Day '(,~'). , ~ I or Other P~ace J . , ~,,. _ ,(s~, DI,,,.Apr~J- ;'6,2004 J:lcHOly Cross Cemetery J,,, Harrisburg,Pa SI~NATURE~OF FUN~'* w'CFa'Ig'CENSEE OR PER .................... ' , - -' -~*- ;7-__v_~~ ~ 122b. ,-,J.J-u.Jq-b h,c.myers-Harner uuneral Home Inc '11 brreet --~'~.~ .... 4a?or~ywne~c~,gty,,g TO . , · h5 Pa 17011 ceafy cease o~ death. I3al :~- ' .............. ~ ! I(Month, Day. Yeer) I T'MEO~ D.~L~.~ J DATE ~iONO" ~NC/EO D.~EA~D (Mon~th, Day, ~;ar, I 2Vv~Ab~ CASE REFERRED TO A MEDICAL EXAM!N2E~/CORONER, IMMEDIATE CAUSE (Final · sease Or co~JriJon resulting in death).---4, a. Sequentially #al conditions b. Approximate interval delweon onset and death PART IhOther significant con.atone contributing to death, but nol resulting in the undedyff~g cause given in PART 'MEDICAL EXAMINER/CORONER On the basis M examination and/~r InveeBgatlon, In my opinion, death occurred at the time, data, and place and riue to the caase~(e and ~?,nn.,..tat,, ............................................................................................... : ............................................................ [] REGISTRAR'S SIGNATUR ~ -- I NAME AND ADDRESS OF PERSON WHO COMPLETED CAUSE Of: DEATH. (Item 27) Type or Pdm./~'.~. ~' ~ .~-~,1 w~'. ~ DATE FILED (Month, ~y, Year) :au~e.f any, lee(llngEnter UNDERLYING to immediate [f] DUE TO {OR AS ^ CONSEQUENCE OF): CAUSE (Disease or mju~ ,,, that inriiated events D,JE TO (OR A~ A CONSEQUENCE OF): rosuriing on death ) LAST ; WAS AN AUTOPSY ~ WERE AUTOPSY FINDiNGS MANNER OF DEATH ~ DATE OF INJURY T ME OF INJURY {N)URY AT WORK? DESCRIBE HOW INJURY OCCURRED PERFORMED? I AVAILABLE PR OR TO __ I (M~S% Day, YaM} ICOMPLET'O"OFCAUSE INane' I~' .om,ode [] , / I I Accident ~ Pending ,nvealigalion []l I Yas [] No [] I I aso NoD [] cou,d ,.dete .. · ~ ~ PLACE OF INJURY -At home far~ street factor/ office I LOCATION (Street, CityFr~ *(~ER11FYING PHYSICIAN (Physician cert~..i~ cause of death,-~ .......... SIGNATURE AND TITLE OF CERTj~[~r -o the bHt Of my anowio~dg~[, dseth oc~l~:r'~c'i due t o th e ca ~'~'~ .=i~lonl ~nS~raansn~tPed..rd.o..~...~... ~..(. ,te.,..a!.h..a..n.d... complatecl itom 23 ) ~ . 'PRONOUNCING AND CERTIFYING PHYSICIAN (Physician bo~ pe(mouncing death and cellifying to cause of death LICENSE NUMBER. DATE SIGNED (Month. Day, Year Tofftebeetofmyknowle · delthocCUlTe~el ) dg , the time, date, i.d place, and due to the caulel(I) and manner aa Iteted ...................... [] 31c. /gj~.l~/~ ~ 2. WILL OF MARGARET G. COGHLAN I, Margaret G. Coghlan, of 20 Hunter Lane, East Pennsboro Township, Cumberland County, Pennsylvania, make this Will, hereby revoking all my former wills and codicils. 1. All legal debts, funeral expenses, costs of administration of my Estate, estate taxes, inheritance taxes, transfer taxes and other taxes of a similar nature payable by reason of my death to any government or subdivision thereof upon or with respect to any property subject to any such tax, and any penalties thereon, shall be paid by the Executor out of my residuary estate, and all interest with respect to any such taxes partly out of the income and partly out of the principal or portion of my Estate, in the absolute discretion of the Executor; provided, however, that the Executor shall not pay any such taxes, penalties or interest attributable to any property included in my Estate solely because of a power of appointment thereover which I possess, and such property shall bear its proportionate share of such taxes, penalties or interest. 2. I direct that if my sister, Alice McClintock, is residing with me at 20 Hunter Lane at the time of my death, then she shall have the right to occupy the same premises until either her death or she elects to sell the house. Should my sister Alice elect to sell the house during her lifetime, then my Estate's share of the proceeds shall be placed in the Trust established under my Will for the uses hereinafter described. 3. During my sister Alice's lifetime, and for so long as she resides at 20 Hunter Lane, the furniture, furnishings, appliances and the other household items shall remain on the premises for her use. 4. I give, devise and bequeath all the rest, residue and remainder of my property, real, personal or mixed, tangible or intangible, of whatsoever kind and wheresoever situated, together with any property to which I may have any power of disposition or appointment and whether acquired during or after my lifetime, IN TRUST, for the following uses and purposes: a. during the lifetime of my sister, Alice McClintock, the Trustee shall make distribution of income, or principal if necessary, for her health, maintenance, support and education, or during illness or emergency, after taking into consideration her other readily available assets and sources of income. 5. My Trustee and Executor hereunder shall have following powers, in addition to those given by law: the a. To invest in, accept and retain any real or personal property, including stock of a corporate fiduciary or its holding company, without restriction to legal investments. b. To sell, exchange, partition or lease for any period of time any real or personal property and to give options therefor for cash or credit, with or without security; c. To borrow money from any person including any fiduciary acting hereunder, and to mortgage or pledge any real or personal property; d. To hold shares of stock or other securities in nominee registration form, including that of a clearing corporation or depository, or in book entry form or unregistered or in such other form as will pass by delivery; 2 e. To engage in litigation and compromise, arbitrate or abandon claims; f. To make distributions in cash, or in kind at current values or partly in each, allocating specific assets to particular distributees on a no-pro rata basis, and for such purposes to make reasonable determinations of current values; g. To make elections, decisions, concessions and settlements in connection with all income, estate, inheritance, gift or other tax returns and the payment of such taxes without obligation to adjust the dis- tributive share of income or principal of any person affected thereby; h. To retain uninvested cash, in such amounts and for such periods of time as the fiduciary shall deem advisable for the proper administration of the property. 6. Ail shares of principal and income shall be free from anticipation, assignment, pledge or obligation of the beneficiar- ies and shall not be sub3ect to any execution or attachment. 7. The Trustee shall have the power to terminate the Trust under this instrument, should the share of a beneficiary, in the sole opinion of my Trustee, be or become too small to warrant continuing such fund in trust, or should its administration be or become impracticable for any other reason, my Trustee, in his sole discretion, may pay such share, absolutely, to the beneficiary. Notwithstanding anything in the Will to the contrary, if the beneficiary is a minor, my Trustee shall pay the amount to the person maintaining said minor or may deposit such share in the minor's name in a savings account in a savings institution of its choosing, payable to the minor at majority. 3 8. Upon the death of my sister, Alice McClintock, the Trust shall be terminated and the principal and income accrued to such date, as well as any other undistributed assets which are not a part of the Trust, shall be distributed equally to my children, Margaret A. Houseworth, Marianne F. McManus and John D. Graham, to share and share alike, provided they are living at the time of distribution. 9. If after the lapse of six (6) weeks from the date of my death or my sister Alice's death, whichever is later, my children have been unable to determine the in-kind distribution of any of my assets among themselves, then those items which have not been distributed at the end of six weeks shall be sold and the entire proceeds shall be given to the Sacred Heart Catholic Church in Cornwall, Pennsylvania. 10. Should any of my beneficiaries predecease me or die prior to the date of distribution, then I direct that his or her share shall be evenly divided among the surviving beneficiaries. 11. I appoint my son, John D. Graham, as Executor and Trustee of my Estate. If my son is unable or unwilling to act or continue as Executor and/or Trustee, for any reason whatever and whether before or after my death, I appoint my daughter, Marianne F. McManus, as successor Executrix and Trustee. 12. I direct that if my son, John, or my daughter, Marianne, elect to take an Executor's fee, then he or she shall forfeit his/her share as a beneficiary of my Estate under my Will. 4 13. No fiduciary under this Will shall be required to give bond or other security for the faithful performance of the fiduciary's duties. IN WITNESS whereof, I have hereunto set my hand this ~i' ? TESTATRIX: Signed, sealed, published and declared by the above-named Margaret G. Coghlan, the TESTATRIX as and for her Last Will, in the presence of us and each of us, who, at her request and in her presence and in the presence of each other, have hereunto subscribed our names as witnesses thereto the day and year last written above. WITNESS: WITNESS: Address Address 5 COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF DAUPHIN : I, Margaret G. Coghlan, the TESTATRIX, 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, and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by Margaret G. Coghlan, the TESTATRIX, this 5~ day of ~3~,.(L~- , 198~. (SEAL) COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN TESTATRIX: the witnesses who~ n~Wes a~e signed to ~he 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 the TESTATRIX, signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the TESTATRIX signed the Will as a witness; and that to the best of our knowledge the TESTATRIX was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. , Sworn to or , affirmed and subscribed to .~before me WITNESS: WITNESS: by (SEAL) DllC // HArriSbURG, O.~.UPHIN MY CO~MtSStON [XPIRES OCT. t9, Member, Pemtsylvania Association of PETITION FOR PROBATE and GRANT OF LETTERS rstate o r' / No.. also known as To: , Deceased. Social Security No. /9/' ~pe_ / c' ~ ! The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or old.~qr an the exe~ut in the last will of the above decedent, dated r and codicil(s) dated ! Register of Wills for Ihe County of OL~.q~4?~..~ff~/~¥~, in the Commonwealth of Pennsylvania (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in ~-~/~, ~ ~',~//~-,~ C-4 family ~ princioal residence at ~ ] & ~ ~ ~ County, Pe~sylvania, with (list street number ] ~ 6' ~'/ , and muncipality) DecenO~t, then ~' 3 y~rs of a~e, died ExcePt as folldws, fiecedent did no'marry, was not divorced and did not have a child born or adoptefi ~fter execution of th~i~ered for probate; was not the victim of a killing and was never adjudicated ~ncompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioner(s) respectfully requestS) tl~e probate 9f the last will and codicil(s) presented herewith and the grant of letters theron. (testamentary; administration~.t.a.; administration d.b.n.c t a ) OATH OF' PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ COUNTY OF /(r/~/_~/~/~ f ss Sworn to or affirmed and subscribed 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. BEFORE THE OFFICE OF THE REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA IN RE: ESTATE OF MARGARET G. COGHLAN, · DECEASED · NO. 2004-00413 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Will Number: Margaret G. Coghlan, Deceased April22,2004 2004-00413 TO THE REGISTER: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on May 27, 2004. John D. Graham, 16 Sugar Knoll Drive, Devon, PA 19333 Marianne McManus, 312 Glenn Road, Camp Hill, PA 17011 Margaret Houseworth, 6216 Elaine Avenue, Harrisburg, PA 17112-1766 Notice has now been given to all persons entitled thereto under Rule 5.6(a). Date: 214 N. Jackson Street, Media, PA 19063 (610) 565-3800 Capacity: Counsel for Personal Representative REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 2] COUNTY CODE 04 04]3 HARRISBURG' PA 17128'0~°1 YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURIT'f NUMBER Coghlan, Margaret G. 191-24-1001 z DA3~E OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-OD-YEAR} O THIS RETURN MUST BE FILED IN DUPLICATE WITH THE ,9, 04/22/2004 08/22/] 9 ] 0 REGISTER OF WILLS F APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL1 SOCIAL SECURI~ NUMBER ] 3. Remainder Return (date of death prior to 12-13~2) Copyright 2000 form software only The Lackner Group, Inc. Form REV-I$00 EX (Rev. 6-00) 99,785.83 4,490.36 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfem under Sec. 9116(a)(1,2) 16. Amount of Line 14 taxable at lineal rate x .04~ (16) 17. Amount of Line 14 taxable at sibling rate x .1 ? (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) None OFFICIAL USE ONLY NoG ~ C~ Nor~ '"':~ ~' ,~.~; ~ ~?'~ 113,572.8~; None ~> ~ ~ ~ No~ A~ ........... ~ .................... ~.. (8) 119,540.78 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) ] 7,9 7 4.5 3 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 1,780.42 11, Total Deductions (total Lines 9 & 10) (11) 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Properb/ (7) (Schedule G or L) 19,754.95 99,785.83 99,785.83 4,490.36 214 N. Jackson St. Media, PA 19063 ~ELEPHONE NUMBER 6 ] 0/565-3800 PIRM NAME (If applicable) Kassab Archbold & O'Brian, LLP [] 1. OriginaIRetum [] 2. SupplementaIReturn [] 4. LimiledEstate [] 4a. FuturelnterestCompmmise(dateofdeath aEer 12-12-82) [] 6, Decedent Died Testate (A~ach copy [] 7. Decedent Maintained a Living Trust (Attach of Will) copy of Trust) [] 9. LifigationProceedsReceiveq [] 10. SpousalPovedyCredit(dateofdeathbetween 12-31-91 and 1-1-95 lAME John Yanoshak [] 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes [] 11.Eleclion to tax under Sec, 9113(A) (Attach Sch O) Decedent's Complete Address: STREET ADDRESS 312 Glenn Rd. CITY Camp Hill [ STATE [zip 17011 PA Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Pdor Payments C. Discount 224.52 Total Credits (A + B + C) (t) 4,490.36 (2) 224.52 3. Interest/Penalty if applicable D. Interest E. Penalty Total InterestJPenalty (D * E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 4,265.84 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SR) 4,2 6 5.8 4 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; .....................................................................................[] ~ b. retain the right to designate who shall use the property transferred or ita income; ......................................... c. retain a reversionary interest; or ..................................................................................................................... [] d. receive the promise for life of either payments, benefits or care? .................................................................. y 2. if death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ..................... . ................................ [] y [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ............... [] y 4. Did decedent own an individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ [] y [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. v~,,~.,,~_ -- [I Media, PA 19063 '71 ~ lC~I es of d~it~l on or after July I, 1994 and before January 1, 1995, the tax rate imposed on the net value of trensfere to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicebre even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's fineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116 (a) (1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. SCHEDULE B STOCKS& BONDS ESTATE OF FILE NUMBER Coghlan, Margaret G. 21 - 04 - 0413 All proper~y jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 NEF New England Sec. Brokerage A/C 4NE-922279 5,967.93 Short Term Income Money Market Fund - 3,454.06 211.253 Harris Assocs. Focus Value Fund - 2,513.87 TOTAL (Also enter on line 2, Recapitulation) 5,967.93 SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Coghlan, Margaret G. 21 - 04 - 0413 Include the proceeds of litigation and the date the.[3roceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule ~-. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 2 3 4 M& TBank - Checking A/C 230011 M & T Bank - Savings A/C 15004205314749 Personalty, old and used Bethany Village - nursing home refund 1,779.26 I10,493.59 300.00 1,000.00 TOTAL (Also enter on Line 5, Recapitulation) 113~572.85 SCHEEXJLEH FUNERAL EXPENSES & ADMeaSTRA~ ~ ESTATE OF FILE NUMBER Coghlan, Margaret G. 21 - 04 - 0413 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. 1 2 3 4 5 6 B. 1. FUNERAL EXPENSES: Myers-Hamer Funeral Home Holy Cross Cemetery - grave opening Radisson Hotel/Nino's Bistro - funeral meal C-ingfich's Monuments - headstone Acknowledgments, postage, misc. out of pocket expenses Blooms by Vickery - funeral flowers ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State -- Zip Year(s) Commission paid Attorney's Fees Kassab Archbold & O'Brien, LLP Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Marianne F. McManus Street Address 312 Glenn Rd. City Camp Hill State PA Relationship of Claimant to Decedent daughter Probate Fees Cumberland County Register of Wills Zip 17011 Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Cumberland County Bar Assoc. - Estate Advertisement The Sentinel - Estate Advertisement Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) 8,832.00 700.00 1,412.58 600.00 100.00 212.00 2,000.00 3,500.00 234.00 75.00 108.95 200.00 17~74.53 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Schedde H ESTATE OF FILE NUMBER Cog]dan, Margaret G. 21 - 04 - 0413 3 4 John D. Graham - travel expenses to Cumberland County for probate and estate adminis~-ation services Kassab Archbold & O'Brien - reimbursement for xerox, postage, notary, fax and misc. 100.00 100.00 Page 2 of Schedule H SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Coghlan, Margaret G. 21 - 04 - 0413 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 VISA Bridges At Bent Creek Nursing Home - Final bill 669.14 1,111.28 TOTAL (Also enter on Line 10, Recapitulation) 1,780.42 ~ SCHEDULE J COMMONW~,L~ OF PENNSYLVANIA BEN EFICIARIES ESTATE OF FILE NUMBER Coghlan, Margaret G. 21 - 04 - 0413 RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE Io TAXABLE DISTRIBUTIONS (include outright spousal distributions) I John D. Graham Son One-third tangible 16 Sugar Knoll Dr. personalty and residue Devon, PA 19333 2 Marianne F. McManus Daughter One-third tangible 312 Glenn Rd. personalty and residue Camp Hill, PA 17011-1135 3 Margaret G. Houseworth Daughter One third tangible 6216 Elaine Ave. personalty and residue Harrisburg, PA 17112-1766 Enter dollar amounts for distributions shown above on lines 15 through 18, 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LiNE 13 OF REV-1500 COVER SHEE'I MaTBank June 7, 2004 Kassab, Archbold & O~rien, L.L.C. 214 North Jackson Street P.O. Box 626 Media, PA 19063 499 Mitchell Street, Millsboro, DE 19966 RE: Estate of Margaret (~. Coghlan Date of Death: April 22, 2004 Social Security Number: 191-24-1001 Dear Ms. Willis: In response to your request, please be advised that at the time of death, the above- named decedent had on deposit with this bank the following accounts. 1. Account iPtjpe ........................... Checking Account Account Number ....................... 230011 Ownership (Names of] ..............Margaret G. Coghlan Opening Date ........................... 08/68/64 (account closed 06/03/04) Year to Date Interest. ................ $2.96 Balance on Date of Death. .........$1,777.56 Accrued Interest $ 1.70 Total. ...................................... $1,779.26 Account T!tpe ........................... Savings Account AccountNumber. ...................... 15004205314749 Owners/dp (Names of] ..............Margaret G. Coghlan Opening Date ........................... 12/12/03 (account closed 04/28/04) Year to Date Interest. ................ $576.47 Balance on Date of Deatlt .........$110,448.49 Accrued Interest $ 45.10 Total ....................................... $110,493.59 Z roker"d e A¢ooun! Stalem eot Period: ~- Transactions by. Type of Activity 04102/o., 0~,/~0/~4 SOLD - ' mJ~mm¢ 04m/~4 SOLD ~SAO03O2~ ' '-~t,~89 '- ~I~100 G~ YOU ~i Cfl~K ~b~qS~ 0161 J" -93~38 ~A~ DOLL~ and qu~ ~d m~ h~,e ~en ro~d. 3,72~32 U~ " Income Summary D[vl~ea~ and Inlet1 ~,.~J~l ~ncl Dividends - Curr~nl Year A.'LOn~ F~nd Income i'otal Divi~ends attd Inte~'t 0.00 0.82 0.00 0,00 0o0 $11,47 SO. O0 ,account Number..'~E-92227g MoneyMarket Fund Detail /~weepManeyMarkelFund ~ " ' - /amnt -- MoNEY FUND puRGiAsE NfO NEY FUND RED~,",PTION IN £OME-P,E~hflfF=q' 828-99. 5;B 11.99 3,66324 ~l R~ir~eslitmnt - Tbs ~lh~ ~n6~..6~ o)'.M~tu~J ~nd.d~ 'b ' " thase ~sacli~'~v~h would ~:~'a~ on c~sfi~ bc~g I~ ~a ol axe~:i~fl ~ Ac¢c~nt Number. 4NE.-9'~2~79 ~(ARGARET G CO GHLAN : ~,,~m~ ~ ~k.m ~t u ...... WILL OF MARGARET G. COGHLAN reason of my death to any government or subdivision thereof upon or with respect to any property subject to any such tax, and any penalties thereon, shall be paid by the Executor out of my residuary estate, and all interest with respect to any such taxes partly out of the income and partly out of the principal or portion of my Estate, in the absolute discretion of the Executor; provided, however, that the Executor shall not pay any such taxes, penalties or interest attributable to any property included in my Estate Solely because of a power of appointment thereover which I possess, and such property shall bear its proportionate share of such taxes, penalties or interest. ~.- 2. I direct that if my sister, Alice McClintock, is residing with me at 20 Hunter Lane at the time of my death, then she shall have the right to occupy the same premises until either her death or she elects to Sell the house. Should my sister Alice elect to sell the house during her lifetime, then my Estate's share of the proceeds shall be placed in the Trust established under my Will for Margaret G. Coghlan, of 20 Hunter Lane, East Pennsboro Township, Cumberland County, Pennsylvania, make this Will, hereby revoking all my former wills and codicils. 1. Ail legal debts, funeral expenses, costs of administration of my Estate, estate taxes, inheritance taxes, transfer taxes and other taxes of a similar nature payable by the uses hereinafter described. she 3. During my sister Alice's lifetime, and for so long as resides at 20 Hunter Lane, the furniture, furnishings, appliances and the other household items shall remain on the premises for her use. 4. I give, devise and bequeath all the rest, residue and remainder of my property, real, personal or mixed, tangible or intangible, of whatsoever kind and wheresoever situated, together with any property to which I may have any power of disposition or appointment and whether acquired during or after my lifetime, IN TRUST, for the following uses and purposes: ~ .... a. during the lifetime of my sister, Alice McClintock, the Trustee shall make distribution of income, or principal if necessary, for her health, maintenance, support and education, or during illness or emergency, after taking into consideration her other readily available assets and Sources of income. 5. My Trustee and Executor hereunder shall have the following powers, in addition to those given by law: a. To invest in, accept and retain any real or personal property, including stock of a corporate fiduciary or its holding company, without restriction to investments, legal b. To Sell, exchange, partition or lease for any period of time any real or personal property and to give options therefor for cash or credit, with or without security; c. To borrow money from any person including any fiduciary acting hereunder, and to mortgage or pledge any real or personal property; d. To hold shares of stock or other securities in nominee registration form, including that of a clearing corporation or depository, or in book entry form or unregistered or in such other form as will pass by delivery; 2 e. To engage in litigation and compromise, arbitrate or abandon claims; f. To make distributions in cash, or in kind at current values or partly in each, allocating specific assets to particular distributees on a no-pro rata basis, and for such purposes to make reasonable determinations of Current values; g. To make elections, decisions, concessions and settlements in connection with. all income, estate, inheritance, gift or other tax returns and the payment of such taxes without obligation to adjust the dis- tributive share of income or principal of any person affected thereby; h. To retain uninvested cash, in such amounts and for such periods of time as the fiduciary shall deem advisable for the proper administration property, of the 6. Ail shares of principal and income shall be free from anticipation, assignment, pledge or obligation of the beneficiar- ies and shall not be subject to any execution or attachment. 7. The Trustee shall have the power to terminate the Trust under this instrument, should the share of a beneficiary, in the sole opinion of my Trustee, be or become too small to warrant continuing such fund in trust, or should its administration be or become impracticable for any other reason, my Trustee, in his sole discretion, may pay such share, absolutely, to the beneficiary. Notwithstanding anything in the Will to the contrary, if the beneficiary is a minor, my Trustee shall pay the amount to the person maintaining said minor or may deposit such share in the minor's name in a savings account in a savings institution of its choosing, payable to the minor at majority. 3 8. Upon the death of my sister, Alice McClintock, the Trust shall be terminated and the principal and income accrued to such date, as well as any other Undistributed assets which are not a part of the Trust, shall Margaret A. Houseworth, share and share alike, distribution. be distributed equally to my children, Marianne F. McManus and John D. Graham, to provided they are living at the time of 9. If after the lapse of six (6) weeks from the date of my death or my sister Alice's death, whichever is later, my children have been unable to determine the in-kind distribution of any of my assets among themselves, then those items which have not been distributed at the end of six weeks shall be sold and the entire proceeds shall be given to the Sacred Heart Catholic Church in Cornwall, Pennsylvania. 10. Should any of my beneficiaries predecease me or die prior to the date of distribution, then I direct that his or her share shall be evenly divided among the surviving beneficiaries. 11. I appoint my son, John D. Graham, as Executor and Trustee of my Estate. If my son is unable or unwilling to act or continue as Executor and/or Trustee, for any reason whatever and whether before or after my death, I appoint my daughter, Marianne F. McManus, as.successor Executrix and Trustee. 12. elect to I direct that if my son, John, or my daughter, Marianne, take an Executor's fee, then he or she shall forfeit his/her share as a beneficiary of my Estate under my Will. 4 13. No fiduciary under this Will shall bond or other security for fiduciary's duties. be required to give the faithful performance of the IN WITNESS whereof, I have hereunto day of 0 , 198 set my hand this TESTATRIX: Signed, sealed, published Margaret G. Coghlan, the presence of us and each of us, 't G. Coghian and declared by the above-named the TESTATRIX as and for her Last Will, in who, at her request and in her presence and subscribed our written above. in the presence Of each other, have hereunto names as witnesses thereto the day and year last WITNESS Address WITNESS: Address COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF DAUPHIN : I, Margaret G. Coghlan, the TESTATRIX, whose name is signed to ~he 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, and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and ackno~edged before me by Margaret G. Coghlan, the TESTATRIX, this 5 day of TESTATRIX: MARG · T G. COGHLAN Notary Pu61~ ' C0~ONWEALTH OF PENNSYLVANIA : ~sses whose n~es are ~'~gned to e 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 the TESTATRIX, signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearin~ and sight of the TESTATRIX signed the Will as a witness; and that to the best of our knowledge the TESTATRIX was at the time 18 or more years of age, of sound mind and under no cons%taint or undue influence. ,, Sworn to or . affirmed and subscribed to ~before me ~ifn~-~ses, this ~f And WITNESS: WITNESS: by (SEAL) KAO KASSAB ARCHBOLD & EDWARD KASSAB WILLIAM CORNELL ARCHBOLD, JR.* JOSEPH PATRICK O'BRIEN*' RICHARD A. STANKO TIMOTHY B. ANDERSON PATRICK S. MINTZER July 15, 2004 O'BRIEN, L.L.C. OFCOUNSEL JOHN YANOSHAK FORMER PA HOUSE SPEAKER MATTHEW J. RYAN 1932-2003 *ALSO MEMBER DC BAR **LLM TAXATION Cumberland County Courthouse Register of Wills Office One Courthouse Square Hanover and High Streets Carlisle, PA 17013-3387 Re: Estate of Margaret G. Coghlan, Deceased Date of Death: April 22, 2004 File No.: 2104-0413 Dear Sir or Madam: On behalf of John D. Graham, Executor of the above-referenced Estate, I enclose herewith the following documents for filing of record: Inheritance Tax Return of Resident Decedent, in duplicate with copies of valuation data and Will attached; 2. Inventory, in duplicate; 3. Check in the sum of $4,265.84, representing tax calculated to be due at discount. Please forward receipt for payment as promptly as possible. Very truly yours, ~ . /(,~...7...~__ DONNA LEE WILLIS, Paralegal DLW/dd Enclosures cc: John D. Graham, w/encls. 214 North Jackson Street · P. O. Box 626 · Media, Pennsylvania 19063 (610) 565-3800 · (800) 648-8597 · Fax (610) 892-6888 · http://www, kassablaw, com· e-rnail: mail@kassablaw, com COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA l 7128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 004176 GRAHAM JOHN D 16 SUGAR KNOLL DRIVE DEVON, PA 19333 fold ESTATE INFORMATION: SSN: 191-24-1001 FILE NUMBER: 2104-041 3 DECEDENT NAME: COGHLAN MARGARET G DATE OF PAYMENT: 07/19/2004 POSTMARK DATE: 07/1 9/2004 COUNTY: CUMBERLAND DATE OF DEATH: 04/22/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $4,265.84 TOTAL AMOUNT PAID: 94,265.84 REMARKS: SEAL CHECK# 1 O4 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ,¢, $~.75o ° KASSAB ARCHBOLD & O'BRIEN, L.L.C. 214 N. Jackson Street, P. O. Box 626, Media, PA 19063 Cumberland County Courthouse Register of Wills Office One Courthouse Square Hanover and High Streets Carlisle, PA 17013-3387 Register of Wills of Cumberland County, INVENTORY Estate of Coghlan, Margaret G. also known as , Deceased John D. Graham Pennsylvania No. 21 -04-0413 Date of Death 4/22/2004 Social Security No. 191-24-1001 The Personal Representative(s) of the above Estate, deceased, vedfy that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Personal Representative I.D. NO.: 23032 S,g~ Signature: Address: 214 N. Jackson St. Address: 16 Sugar Knoll Dr. Media, PA 19063 Devon, PA 19333 Telephone: 610/565-3800 Telephone: r-~ Dated: oc Personal Property NEF New England Sec. Brokerage A/C 4NE-922279 Short Term Income Money Market Fund - 3,454.06 211.253 Harris Assocs. Focus Value Fund - 2,513.87 5,967.93 M & T Bank - Checking A/C 230011 M & T Bank - Savings A/C 15004205314749 Personalty, old and used Bridges At Bent Creek - Nursing home refund Total Personal Property 1~1,779.26 493.59 300.00 000.00 $119,540.78 (Attach additional sheets if necessary) Total Personal Property and Real Estate $119,540.78 KASSAB KAO ARCHBOLD & O'BRIEN, L.L.C. EDWARD KASSAB WILLIAM CORNELL ARCHBOLD, JR.* JOSEPH PATRICK O'BRIEN** RICHARD A. STANKO PATRICK S. MINTZER September 24, 2004 OF COUNSEL JOHN YANOSHAK FORMER PA HOUSE SPEAKER MATTHEW J. RYAN 1932-2003 *ALSO MEMBER DC BAR **LLM TAXATION Register of Wills County of Cumberland One Court House Square Carlisle, PA 17013 Attn: Jackie Aust Re' Dear Ms. Aust: Estate of Margaret G. Coghlan, Deceased No. 21-04-0413 I am enclosing the original and one copy of the Inventory in the above estate for filing. I am also enclosing our firm check in the sum of $10.00. I attempted to file this form in July, but inadvertently neglected to send the filing fee. I apologize for any inconvenience this may have caused. ! am also enclosing a extra copy of the Inventory for you to time-stamp and return to me in the enclosed enVelope. Thank you for you attention to this matter. Very truly yours, / / DONNA LEE WILLIS, Paralegal DLW/cm Enclosures 214 North Jackson Street · P. O. Box 626 · Media, Pennsylvania 19063 (610) 565-3800 · (800) 648-8597 ° Fax (610) 892-6888 · http://www.kassablaw, com· e-mail: mail@kassablaw, com BUREAU OF INDIVIDUAL TAXES TNHERTTAHCE TAX DZYTSTOH DEPT. 180601 HARRISBURg, PA 17118-0601 COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-15~i? EX AFP JOHN YANOSHAK '04 SEP 15 /18:25 KASSA]} ETAL 21q N JACKSON ST ',, HEDZA ~A '19063 DATE 09-1q-200R ESTATE OF COGHLAN DATE OF DEATH Oq-ZZ-200~ FILE NUHBER 21 0~-0q15 COUNTY CUHBERLAND ACN 101 Amoun~ Remi~ed HARGARET G HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAZN LOWER PORTION FOR YOUR RECORDS ~ DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF COGHLAN HARGARET GFZLE NO. 21 0~-0~15 ACN 101 DATE 09-1~-200q TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Par~nership Interest (Schedule C) (3) q. Mortgages/Notes Receivable (Schedule D) $. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (ScheduZe G) (7) 8. Total Assets APPROVED BEDUCTZONS AND EXENPTZONS: 9. Funeral Expenses/Ada. Costs/Misc. Expanses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule Z) (10) 11. Total Deductions 12. Nat VaZua of Tax Return 51967.95 O0 1151572.85 00 O0 NOTE: To insure proper credit to your account, subeit the upper portion O0 of this fore with your tax payment. 00 (8) 17,97q.53 1:5. lq. NOTE: ASSESSMENT OF TAX: 15. Aeoun~ of Line lq at Spousal rata 16. Aeount of Line 1~ taxable a* Lineal/Class A rate 17. Aeount of Line lq at Sibling rata 18. Amount of L/ne lq ~axable a~ Collateral/Class B ra~e 19. Principal Tax Due TAX CREDITS: PAYMENT DATE 07-19-200q 119,5~0.78 1,780.fi2 (11) 1q.7~4.95 (12) 99,785.83 Charitable/Governmental Bequests; Non-elected 911:5 Trusts (Schedule J) (1:5) . O0 Nat Value of Estate Subject to Tax (lq] 99,785.83 Z~ an assessment ~as issued previously, lines 14, 15 and/or 16, 17, 18 and 19 ~111 re~lect ~igures that include the total of ALL returns assessed to date. RECEZPT NUMBER CDOOq176 DZSCOUNT (+) ZNTEREST/PEN PAID (-) ZZq.52 (15) .00 x O0 = .00 (16) 99,785.83 x Oq5= q,q90.36 (17) . O0 X 12 = . O0 (lB) .00 x 15 = .00 (1~)= q,~90.36 AMOUNT PAID q,265.8q q,q90.36 .00 .00 .00 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THZS FORM FOR INSTRUCTIONS.) ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. RESERVATION: PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS: ADNIN- ISTRATZVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate far lifo or for years, tho Commonaaalth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the laaful Class B (collateral) rate on any such future interest. To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (7Z P.S. Section 91¢0). Detach the top portion of this Notice and submit aith your payment to the Register of Rills printed on the reverse side. --Make check or money order payable to: REGISTER OF HILLS, AGENT A refund of a tax credit, which ams not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications ara available at the Office of the Register of Rills, any of the 25 Revenue District Offices, or by calling the special Z¢-hour answering service for fores ordering: 1-800-$6Z-Z050; services for taxpayers with special hearing and / or speaking needs: 1-800-¢¢7-$020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount ar interest) as shown on this Notice must object aithin sixty (60) days of receipt of this Notice by: --arittan protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, 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 Reviee Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) far an explanation of administratively correctable errors. If any tax due is paid within three (5) calendar months after the decadent's death, a five percent (52) discount of the tax paid is allowed. The lex 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 appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning aith first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes ahlch became delinquent before January 1, 1962 bear interest at the rate of six (6X) percent per annum calculated at a daily rate of .00016q. All taxes which became delinquent on and after January 1, 198Z ail1 bear interest at a rate ahich ail! vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZOOq are: Intarest Daily Intarest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 ZOZ .0005¢8 ~'~)'~& - 1991 112 .OOO3Ol ~ 9X .0002¢7 1983 162 .000¢38 1992 91 .0002¢7 ZOOZ 6Z .00016¢ 198¢ llZ .000301 1993-199¢ 7X .000192 2003 SZ .000137 1985 132 . 000356 1995-1998 92 . 0002¢7 ZO0¢ CZ . 000110 1986 XOZ .00027¢ 1999 72 .000192 1987 107. . 00027¢ ZOO0 72 . 000192 --[ntarast is calculated as follows: INTEREST = BALANCB OF TAX UNPAID X NUI{BER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. Xf payment is made after the interest computation date shown on the Notice, additional interest must be calculated. Register of Wi lIs of Cumberland County Name of Decedent: STATUS REPORT UNDER RULE 6.12 tv1/'1-R CrA (e.t. T G C () (7 H L 1'1, /-.1 L/_ 22- Z OOL{ L I (; q - 0 LI L 3 Date of Death: Estate No.: 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: I. State whether administration of the estate is complete: Y es ~ No 0 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. I is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 0 No IE1 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 l8J. No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: c:/t)r/ ~ :::) }) G 1Cr1 KI\ VY\ ., J I L? S iJC~(\tC kNOLL D~ Address }) f \i('\~j fA- , cr 333 G I 0 - _~ 2 S - G ( C0 ~:'AT. (.,3 07 Telephone No. Capacity: l8l Personal Representative o Counsel for personal representative cd IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: ESTATE OF MARGARET G. COGHLAN DECEASED NO . 21 - 04 - 0413 RECEIPT AND RELEASE KNOW ALL MEN BY THESE PRESENTS, that I, MARGARET HOUSEWORTH, am one of the heirs of Margaret G. Coghlan, Deceased and I hereby acknowledge having received from John D. Graham, Executor of the Estate of Margaret G. Coghlan, Deceased, the sum of Forty Thousand Two Hundred Nineteen Dollars and Eighty-two Cents ($40,219.82) In full satisfaction of all sum or sums of money, share or shares, purports and dividends which were due, owing and payable and belonging to me, by any means whatsoever for or on account of my full share, part of the dividend of the real and personal Estate of Margaret G. Coghlan, Deceased. AND, I do by these presents remise, release, quit-claim and forever discharge the said Executor, his heirs, executors and administrators of and from the said legacy or legacies and of and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever, for or by reason thereof or of any other act, matter, cause or thing whatsoever from the beginning of the world to the day and date of these presents. this IN WITNESS WHEREOF, I have 'I fit day of (/' ~ ~ I i / , 2005. ~~ Mar. a t Houseworth hereunto set my hand and seal - IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: ESTATE OF MARGARET G. COGHLAN DECEASED NO. 21- 04 - 0413 RECEIPT AND RELEASE KNOW ALL MEN BY THESE PRESENTS, that I, MARIANNE McMANuS, am one of the heirs of Margaret G. Coghlan, Deceased and I hereby acknowledge having received from John D. Graham, Executor of the Estate of Margaret G. Coghlan, Deceased, the sum of Forty Thousand Two Hundred Nineteen Dollars and Eighty-two Cents ($40,219.82) in full satisfaction of all sum or sums of money, share or shares, purports and dividends which were due, owing and payable and belonging to me, by any means whatsoever for or on account of my full share, part of the dividend of the real and personal Estate of Margaret G. Coghlan, Deceased. AND, I do by these presents remise, release, quit-claim and forever discharge the said Executor, his heirs, executors and administrators of and from the said legacy or legacies and of and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever, for or by reason thereof or of any other act, matter, cause or thing whatsoever from the beginning of the world to the day and date of these presents. IN WITNESS WHEREOF, I have hereunto set my hand and seal this e-h\ , 2005. day of ~<JIfV~ - IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: ESTATE OF MARGARET G. COGHLAN DECEASED NO . 21 - 04 - 0413 RECEIPT AND RELEASE KNOW ALL MEN BY THESE PRESENTS, that I, JOHN D. GRAHAM, am one Two Hundred Nineteen Dollars and Eighty-two Cents ($40,219.82) in Estate of Margaret G. Coghlan, Deceased, the sum of Forty Thousand acknowledge having received from John D. Graham, Executor of the of the heirs of Margaret G. Coghlan, Deceased and I hereby full satisfaction of all sum or sums of money, share or shares, purports and dividends which were due, owing and payable and Margaret G. Coghlan, Deceased. full share, part of the dividend of the real and personal Estate of belonging to me, by any means whatsoever for or on account of my AND, I do by these presents remise, release, quit-claim and from all actions, suits, payments, accounts, reckonings, claims and administrators of and from the said legacy or legacies and of and forever discharge the said Executor, his heirs, executors and demands whatsoever, for or by reason thereof or of any other act, to the day and date of these presents. matter, cause or thing whatsoever from the beginning of the world IN WITNESS WHEREOF, I have hereunto set my hand and seal 6, day o()r..-..-< , 2005. this