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HomeMy WebLinkAbout02-0797PETITION FOR PROBATE and GRANT OF LETTERS Estate of~ ~w n4.-~I ~"_ Cvb~i sk,. also known as ecp~rsed. Socia! Security No. O ( - ~ " v Nn. a2 i- o a - 7 9 '7 To: Register of Wills or the County of C~,M w far` (~ in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older in the last will of the above decedent, dated i - I and codicil(s) dated (state relevant eirmtmstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in ~ v M be-r ~ a t1~ County, Pennsylvania, with ! S___. last family or orincioal.residence at -1 'R Id4e~Q v p f t ~.. . _ (list street, number and muncipali[y) Decendent, the _ named 19_~ ~_ 1'Q~.~ at Y+r0. f\CX ~r++'L rtl IL Ln rIIS 12 ('H 1 IVt~ Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: _ Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: WHEREFORE, petitioner(s) res presented herewith and the grant of [heron. ter.. ~u t~l ~~ A n K probate of the last will and codicil(s) (testamentary; ad~{rinistration c.[.a.; administration d.b.n.c.t.a.) a c ca (i;.rlt ~ 1741 ,~ a ` mow 7~ A m $ _ $ _ r~ ~,.,Or.,, AC.~.,~~ ~~ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cv~rrh~ 1v ncl ss The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed ~ `~-~^»-}"` ~ be re me this _~ Ur. day of ~~``~ OU0.C ° R gister f ~ ~~--~ No. zl-oz-~9~ Estate of BERNARD J. cYSULSxI ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW SEPTEMBER 4th %~ 9009, 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_ .tANIIARY 1 1 7 986 described therein be admitted to probate and filed of record as the last will of BERNARD J CYBUL4KI , and Letters TESTAMENTARY are hereby granted to MARY JEAN KOVACH FEES Probate, Letters, Etc.......... 5 25.00 Short Certificates(2) .......... S 6.00 Renunciation ................ $ 5.00 EXTRA PAGES I JCP S~ TOTAL _ S 44.00 Filed ,SEPTEMBER.4,, 2002 .............. n q /j7 //J~j~j{,, 3 /~f//tCL~//t .1/:L( LG~ / AIL/j(%/~~Ti--~/. /L/..~ G/~ G. A~:k~~~[: ~~. Registerr ofJA'ills ATTORNEY (Sup. Ct. LD. No.) 4DDRE55 PHONE MAILED TO EXECUTRIX SEPTEMBER 5, 2002 This is to certify chat the information here given is corrcaiy copied hom an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded m the tierce Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Ice For this certificate, ;52.00 P 8391 No. Hros ;a H.. vn rrvuPRIN, PEHY.LNEH! Buck 4k z d~-f'-sn.t-Qh-E-Q XAQ la Local Registrar a ~~ care COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH nME OE DE<EOEN1Nav. Mipde..w Wr_a Vw SE% SCCMLSECVPIIr NUMBER OI.IEOr LiRH.MUN. pav,.w x. Bernard J. Cy bulski Male 208 _ ,, - 16 - 5220. June 6, 2002 ncf unN eKn oE - arl ux RrvE.w uNDERIDR pnFE DFYWN eurtNPLwL~IUYam PLKE OroEaNlcna.wlr.n._..m wvdnm '^r•I ~ N N"N MgpM dY. Ibv v Mms ~in.4YXNl YwwwlcgY~lwnsl PoyPIW .... N1NEP: 76 v, rwl Aug 20, 1925 Nanticoke, w^ ERnMP.n.NG ow LJ ,sky 4NMnN~1 ;s ; G B, ["I P ' cwNFV OEDE.RN ,. CnY.BOIq.1WPLf OERN FnCknr NRNEI i earyW mmpw, NY80ECEMMOF NISMXk'.ORIGIM IULEMn v,NWan.YV.,WM•. wc. K Cumberland South Middleton Twp. Manor Care "°~ "G"'""'[^G-0in 'EM`"' ._ ,,, w.NN.PMrI[Rlun.w White ' E CECEOEM S VSUnL CCCVPRkN1 %WOCEBUSWEByIN415TgV YNSCELEpEM EVEfl IH ~CELENi'SEpICRICN %PISLL SWVB-MVr rB, IGwWrtld mvEUyypu VS.1RYEpfClleEa) i YIVIH0 a Pp1 ~ [ X ~ ~1 ~ dawrm, 4.wlmrw Bml Manufacturin [I °,• w(~ M^ E"w"'°"19iwnpiry ww ~rswdY; Inventory Control Analy ( 9 l • _ ~a R a N,NErI Widowed ' ~ )E „ ~ IE. LECEOEM SYMLING neG1ES818xg1,Cryl4rmr, SxY, La Caw1 OECEOENi'S cTUR ,,,,Yaw Pennsylvania YE „E,L7cW., M[.NNW.,n C~IvQr CDlI DTvn 7 Ridgeway Drive REYpENDE N[pN, -~-_-= w. Mechanicsburg Pennsylvania 1705 .~.; "`"• °[' , rE Cumberland '°~'^~) °•[•°•X"-^ im ' wwd iRNEP'SNMAE IFVN.MWnlanl ["NNv ' O E Max Cybulski MpTHEP SMnYE1FM.MgW.M uYr namnl N ' Sophie Golembiewski E I ORMYIi SNnELEnroNPrwl Mary Jean Kovach IrroRMR,ra YMLwDRmPESSI4M PaPwn, saw. zmwPl METIIODOE p5Po511%M! WTECf pBPpS ip 1 A aloosa Wa Carlisle Pa. 17013 I H PIACE OF45Po/Jlllpr-4nwd C•nwlwn CrNnYay LCC41pLF.Cry/rgnL SUN. Zn LOY ^ M°'••.4T Nw1 ugMr Pyu &nn GurwwO MwalnanY w ~°"U ~ Jun 10, 2002 Gale o(HeaVen Cemete ,,, ,, ry Mechanicsburg Pa 17055 • . ,, , . SIGNR ELCE EpiPE AGTIN5n55VCN LILENY HVMBEfl MWE4lDIKPF84pFfIG1LOy a , FD-014316-L Mars Funeral Home Inc 37 East Main Street MechanicsDUr Pa 1]055 •^u TY<[nN.ranwnMlp bEmdmY [[w NNrMr r mw.yUwpY[•nuN LkEM$E NUMBER pnry[wwegrwaYdaNlwdbunm p.VE 4pNED uniryuw•dsNn. P4vaL 4v. wr1 II•m•I410r^u1E•mµuNh YE OE CERX pRE PRDNWHCEDCEMIMmN, Dey llvl YNSC SE REEEPPEDWMEDKN EIGMIHERILMBNIEP) P•rmn Nm pmwM••MM. f,.MNrI EnvrM[iww.vlNraaUmnNNnm NNlrralaanlM4aln 4xv.nIN IMnMaolglrq,w[nuurW[ar rugaWryarrM.•M[YwMan MYr! IEaMNans LW [MY Vnuw•[n•MAaw. MRr O; 01r myvrpyymyaM_y NWE[u11 LOMavs ~ IaarvM M aan br'•JYiOn Y•uWN•V Penn MRrl. NwNyyyEylr ~UE4NRlG[NNR•09,l IFUW ~ ~ ~" C `jENCEIt •rarpneaYnl-w /w•©OO/ ' Mrt WlViwtnLCfLSFWENCE OFl: --~ r Y .NUY btlliyn^•MNM• Ens LMpfplylYD p11E Wl(YK.CbISEWENLE Lii'. - 1 ~ CYIBIIO navo•yvY _ ~ w sIE WIVI M%LCdLEOVENLE C31: a•rquwnrlL41 a NRS nNRPpIrSV WERE WIOPBY FINdIgB MyINER CF DERH pRE CEIM~PV iWEOFIXWRY WJVRYRNMk, pESLPIBE NpVIWUPY OLCIIRNEO. PEPFCPMEOt NILILAµEIRIpI W / IMmm paY. I CCYPLETICN OEGUSE r ~ ( L -1 t CF pEON, NuUM llo-rrub G ^ v.. ^ 4^ ^ P.nd M r M w n M w w L] w[r~,Lt W. ^ w (~ srlam. ^ cwaw MNl.Imm.N L I ~ EmuuugY-, mmr I mm• NwN r.nN dM M DLR . . . . Y. L YaImw.L.man SINN s •w ISPUiNI ]Y. ]M . ,E. W. E0., CEgIIFIER ILYSxmY U•I TiLECi CEPI I 51GNRURE.Wp 'CEPFMYINGPMYEICMXIMYxcancndynp uuydUeyN nnanandnq Pnvsvannax pugnreoueem an ~vnnaelW PNn t]i ,y1 6uwbnel mY ErmmaaM.avnnxew•a Nwn Oa[wMNaM mmmrnmlw...._,__.___. _..____. _. _.. ...__ Lrl ly , G I LILEHBE HMBER pRE 51GNEDIWnN.4Y'warl 'PROMWMLWG.WOCEBixYIYq IHYE1CI.L111Rµ~cano-el YOrwrcu U¢ ~n n n - n an mi N Y mm.E..aNmYLrmNaaB..mN:[Nwanw MM.a.Y..Mma[.,wE "'°ml°i: em:I;~~ra. N.rw... vn~i~H4 ~ t i .t %ME NIDI.OMEGSOF PEPSOH WLN)GWhEIEOLRISE OfpERN 'YEDICEL EIIYINEIVCORONER (clam t7l TYMar PrIM iN%!C ~L IiCK On LM MY I IMIInn EnN I 1 YNn,r Ina llm•.J E I , mann... tw_. ... k Y D auY a: a paces, •na el,uN mN nlrulR nNe MS xr. ,{p .. ._.... ._. _. .._ .. vN U ' ». ,cn.Dy,,,c PA /'EOY3 ' PfGS P a EXENRUgf /.HONUMBEP OREiILEDIMwm. Day, UaU 21-02-797 LAST WILL AND TESTAMENT of BERNARD J. CYBULSKI I, Bernard J. Cybulski, of 158 Alden Mountain Road, Newport Township, Luzerne County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament hereby revoking all previous Wills and Codicils hereto- fore made by me. ITEM I: I direct that all my just debts, expenses of my last illness and funeral expenses be paid as soon after my decease as is possible. ITEM II: I give my entire estate, real, personal and mixed, of every nature and wheresoever situate, to my wife, Florence M. Cybulski. ITEM III: In the event that my wife, Florence M. Cybulski, predeceases me, then in that event, I give, devise and bequeath my entire estate in two (2) equal shares to my two (2) children, namely, Joseph A. Cybulski, of Library, Pennsylvania, and my daughter, Mary Jean Kovach, of Lancaster, Pennsylvania. ITEM IV: In the event that my wife, Florence M. Cybulski, predeceases me and either one or both of my aforesaid children should predecease me, then in that event, I give, devise and bequeath the share of such deceased child or children to his or her issue, per stirpes, share and share alike. ITEM V: I hereby nominate, constitute and appoint my wife, Florence M. Cybulski, to serve as the Executrix of this, my Last Will and Testament:. 1. In the event that my wife predeceases me or is unable to serve as my said Executrix, then in that event, I nominate, constitute and appoint my two (2) children namely, Joseph A. Cybulski and Mary Jean Kovach, to serve as the joint personal representatives of this, my Last Will and Testament. I further direct that my said personal representatives shall not be required to post bond in any jurisdiction in which they might serve. IN WITNESS WHEREOF, I have hereunto set my hand and seal this _~(~day of January, 1986. u~r~'~ti'~"~Y'K`I ?"''"`e~""~-' (SEAL) Bernard J. Cybulski SIGNED, SEALED, PUBLISHED and DECLARED by the above-named Testator, as and for his Last Will and Testament, in the presence of us, who at his request, in his presence, and in the presence of each other, have hereunto subscribed our names as witnesses thereto. J residing at eL~ -- ~~~,~~~-~~~~ _residing at! / ,~ / ~ / ~ ~ 4 ~I. l 2. 21-02-797 (each) a subscribing wits law, depose(s) and say(s) REGISTER OF WILLS OF OATH OF SUBSCRIBING the testa[ ,sign the same a request of testat in h other subscribing witness(es)). Sworn to or affirmed and subscribed before codicil to the will presented her ith, (each) being duly qualified according to _ day of 19 me this Register (Address) (Address) REGISTER OF WILLS OF ~~CG~ce~~/~.~G COUNTY OATH OF NON-SUBSCRIBING WITNESS Q (each) a subscriber hereto, (each) being duly qualified accordingyto~ law, depose(s) and say(s) that -i- c, V't~ familiar with the signature of I;SG f1G Y C~ 7 . w ~o sJ~ C,~ 1 co testat ~~ of (one of the subscribing witnesses to) the wil presented herewith and 1"~`~ dicil that ~~ L, be.~ 12y-~- the signature on th wil is in the handwriting of to the best of ~ knowledge and belief Sworn [o or affirmed and subscribed before ~, me this ~ day of rl ar ABC%Y Register M ~ ~<-~t-o.~ ('nar Jefl~l Kc~1QCI'1 !Name) 1 ~1~c~.loosc>_ Wav ~r(Isle (~~1~ /Address) (Name) present and saw signed as a witness at the (in the presence of each other) (in the presence of the (Name) {7 oi3 (Address) 21-02-797 REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIBING WITNESS (each) a subscribing witness to the law, depose(s) and say(s) that the testat ,sign the same and request of testat in h pr other subscribing witness(es)). / Sworn to or affirmed and subscribed before me this _ day of 19 presented hafewith, (each) being duly qualified according to present and saw and signed as a witness at the presence of each other) (in the presence of [he (Name) (Address) / Register (Name) (Address) ;EGISTER OF WILLS OF CC/~rn-~c~~iw12-~ COUNTY OATH OF NON-SUBSCRIBING WITNESS (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that ..L Q rr familiar with the signature of~IJE~/r.~tr<i 7 ~ ~~~ ~JY`k,~_, c ~~ testate ; of (one of the subscribing witnesses to) the will presented herewith and _ dicil that ~- L "- ~ ~ ~'~re- believes the signature on th will in the handwriting of ~1 (•.r nr, r ~I :7 . C ~ b risk; to the best of / knowledge and belief. ,, / ~/~ 1 Sworn to or affi~ d and subscribed before ~tiC~~ta_ ~.% ~- g~3 ~ I ~ 7- me is ~ day of _ Dd'~~L ~lnryrc~t~Yl~[~.~/ ~~~ i7 _2~ Register ~ !Name) 303MC(jYCr~art dr. C'pnonsburG' Pf? /537 (Address) (Name) (Address) 21-02-797 RENUNCIATION In Re Estate of ~ ~ r, ~'+ t'C'~ ~ . ~v b y l S~C , deceased. To the Register of Wills of C U M. ~~d ~0. Y~C~ County, Pennsylvania. The undersigned J o ` ~ ~ h A , of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters be issued [o ~qt `i U E'q ~ I~c~vG C h ~fi WITNESS hand this- day of 1~ t . `1Q~~Q ?~' '/ r (Signature) ~~ZS G/riUSe ~vs7 ~Q~ ~~,~. P~ ~5-,a z Address) I (Signature) (Signature) (Address) CERTIFICATION OF NOTICE UNDER RULE 5.6(al Name of Decedent: /~ ~l( t'~ ~ Y CI J - \ V b U 1 S Date of Death: ~ J~ ~ ~~ ~ a O O d-- Will No. O o7-- ~9~ Admin. No. To the Register: I certify that notice of (bene£ICial interest) estate administration required by Rule 5.6(a) of th Orph ms' Court Rules was served on or mailed to [he following beneficiaries of [he above-captioned estate on ~ o`l l~ Name Address ~~Seo~n f~ . C~IbUlsk, 11 a5 Gvdyse.'k:~v~ "I~oa~l ~i. e+hei ~Q~1~~ ~~ ISIo 2- Notice has now been given to all persons entitled thereto under Rule 5.6(a) Date: ~ a--~ ~ ~ ~ ~-- Signatur Name l`~ ~w ~ ~ e rx r KOV ct C Address ` ~~Y~ f~ Q. ~ 0 0 S C.~. ~1J 0.l Carl1S~~ ~~ 1`~01~~ Telephone( ~) '~ ~1 (o a~ Capacity: V Personal Representative Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 260601 HARRISBURG, PA 1]128~O6D1 RECEIVED FROM: KOVACH MARY JEAN 1 APPALOOSA WAY CARLISLE, PA 17013 foie PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: ssN: 2os-is-5220 FILE NUMBER: 2102-0797 DECEDENT NAME: CYBULSKI BERNARD J DATE OF PAYMENT: 02/25/2003 POSTMARK DATE: 02/24/2003 COUNTY: CUMBERLAND DATE OF DEATH: 06/06/2002 REV-1162 EX~11-96~ NO. CD 002218 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 54,449.74 TOTAL AMOUNT PAID: REMARKS: MARY JEAN KOVACH CHECK#1647 SEAL INITIALS: CW RECEIVED BY 54,449.74 DONNA M. OTTO _ DEPUTY REGISTER OF WILLS REGISTER OF WILLS ~,~ i~~~i ~~ j ~~~{ ~: F ~ ~~` ~5~t3} `', ,~ n, ,yf !~ :, ~ ~' a o ~' ~~a ~~~ ~~ '7 r cJ '~ l•~ ~~ Cn ~ a M v S .{- `~ ~ ~ , ~' r. v ~ `+ v ~, ~~ ~J ~' S 7 . Q.i ~~ U O s~ =~ ,~ ~J ~n ~_ ' = V/~ O V r'i j.. {~ i ~a t? ~~.~ T v s ;t\<.lf>lKlEX,(6-OOl ... COMMONWEALlliOF . PENNSYLVANIA OEPI>.R1MENT OF REVENUE OEPT. 280601 HARRISBURG, PA 17128-0601 1'1- 'i{lD- 2- REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT /./ FILE NUMBER ::2. L - E J.. COONTY COIlE YEAR _QI~'L ........ J- Z W Q W o W Q DECEDENTS NAME (lAST, FIRST, AND MiDDlE INIThlLl C',!'oV\-o,~, OZJ. ('Ie.l.n( ~ DATE OF.. DEA.JH(MM-DD-YEAkl ~OFBIRJH(MM:DD-YEAA). ._.__..~. ._.. 0<:,..-:. 0(,.. .2\)0 J- 0'3 - .)..\:) - \ ~.. 'd.5....___ (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAl) SOCIAL SECURITY NUMBER ~ O. ~ - I <;,,-=--~ d. d.. 0__ .. THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS w ,., ,,~;! ld~g "'l!'.... Utm .. ~,.OrigirlalR&brifl D4.LlmiledEstate o 6. Decedent Died Testate (Al1ad1 c:q:Iy "'I'M) o 9. litigation Proceeds Rece~d SOCIAL SECURITY NUMBER o 2. Supplemental Return 048. Future Intel8St Compromise (dale<iOOad\af\ef'1A2.u) 07. Decedent Maintained a Living Trust (AIlad'lcql:yllTrusll o 10. Spousal Poverty Credil_ofdeB!hbetwe8l 12-31-91 am 1-1-95J o 3. Remainder Raturn(daleof-'J\priortD12-13-<12J o 5. Federa\ Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (AllarhSchD} ... z w " ~ .. '" w '" '" o U THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFWENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME Mo./ _-.\.L~Ka\jQc~.._..__~.. COMPLETEMAIUNGADDRESS FIRMNAME~ \ Arpa... lc:.<:::>:so..... C.Qdl:".Je P A TELEPHONE NUMBER "I n '\ '"t Wo...{ lio () 8-.\?, ! 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or SoIe-Proprietorshlp (3) 4. Mortgages & Notes ReceiVable (Schedue D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) l q S.9. 'i? z (Schedule E) 0 6. Jointly Owned Property (Schedule F) (6) 1'6l{()'i.('1 ~ o Separate Billing Requested ~ (7) '6'3 SId.. ~" ::;) 7. Inter-Vivos Transfers & Miscellaneous Non.probate Property t: (Schedule G or L) a.. 8. Total Gross Assets (total Lines 1-7) <I: 0 )J,^,"" "" W 9. Funeral Expenses & AdministratiVe Costs (Schedule H) [9) 4 . J<:) It: (10) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) (8) (0.[-,-/ .4-3 (11) <6 'J,'1 1.(..-;)..5 (12) q'i?'?'8~.I<6 (13) -' (14) 98'~~.-:J,.lg 13. Ch3ritable and Go"emmental8equeslslSec 9113 Trusts for which an eleCtIon to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus LIne 13) SEE INSTRUCnONS ON REVERSE SIDE FOR APPLICABLE RATES z o !;( .... ::;) a.. :E o o ~ 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a){1.2) 16. Amourn. of Lme 14 taxab\e at lineal rate 17. Amount ofl-Ine 14 taxable atslblktg (ate 18. Amount at Line 14 taxable at colateral rate 19. Tax Due 200 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT x.o_ (15) x .0 ':fS. (16) 4-44'1."14 x .12 (17) l(. .15 (18) [191 4Y-49.l4 C\~8~21.t'6 > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SWE AND RECHECK MATH < < De~edent's Complete Address: STHE', ADD~~f-"'-,loa ~ c.'"__,,^,, <:)..-'1-- CITY STATE P- A- Co.t"\\~"t~ Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CredilslPaymenls A. Spousal Poverty Credil B. Prior Paymenls C. Discount liP lfo I (1) 4 Y 4"\ .1 4 Tolal Credils(A+ B + C) (2) ~ 3. InterestlPenally d applicable D. Interest E. Penally _._.~-'---- -- TotallnierestlPenally (D + E) 4. II Line 2 is greater than Line 1 + Line 3, enler the difference. Th~ ~ the OVERPAYMENT. Check box on Page 1 Une 20 10 request a refund (3) (4) (5) 4 Lj 4"l .-' 4 5. If line 1 .. Une 3 is greater than Une 2, enter the difference. This is (he TAX DUE. A. Enter lhe interest on the lax due. (SA) (5B) 4Lf41.14 B. Enter Ihe lotal 01 line 5 + SA. This is the BAlANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN .X. IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property lransferred;.......................................................................................... 0 b. relain the right to designale who shall use the property lranslerred or ils income; ............................................ 0 c. retain a reversionary interest; Dr....................................................................................."................................... 0 d. receive the promise for life of either payments, benefits or care? ...........................,........................................., 0 2. If death occurred affer December 12, 1982, did decedenllransler property within one year 01 death wilhoul receiving adequale consideration? .............................................................................................................. 0 3. Did decedenl own an "In Imsl lor" or payable upon death bank account or secunly al his or her death? .............. 0 4. Did decedent own an Individual Retirement Account, annuity, or other noo-pmbale property which contains a beneficiary designation? ....................................................................................,................................... ~ No ~ ~ ~ [5;[ fiQ 5a Under petafties of psrjUIy, I deClare flat I have axanined this NUn, indtKing aa:o~ sd1edUfes and statements., and 10 \he best d my I\nOw\edge and belief, itis true, correct and comj:ieli!. 0ediva1Im of preparer oIher ttan !he personal representaljve is based on an infmnation of wtich PrepaIe( hllS any knoWledge. SIGNATURE OF PERSON RESPONSIBlE FOR FILING RETURN M~~ C~ 0. \~ ADDRESS 1 ~o... \00 So... \)0a...1" SIGNATURE OF PREPARER l1iAN REPRESENTP,I111E Cc......t\S It" PA ADDRESS DATE For dales of death 00 or affer July 1, 1994 and before January 1, 1995, the lax rale imposed 00 the net value 01 transfefs 10 or for the use of the surviving spouse is 3% [72 P.S. ~9116 (a) (1.l) (i)). For dales of death 00 or aIIer January 1, 1995, the lax rate imposed 00 the net value of transfers \0 or lor the use 01 the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)). The statute does not exernot a transfer to a surviving spouse frum tax, and the statutory requirements for disclosure of assets and filing a tax return are sUII applicable even if lhe surviving spouse is the ooly beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net vafue of transfers from a deceased child twenty-one years of age or younger at dealh to or for the use of a natural parent, an adoptive parent. or a stepparent 01 lhe child is 0% [72 P.s. ~9116(aXl.2)J. The lax rale imposed 00 the net value oftiansfers \0 or lor \he use of Ihe decedenl"s lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116{1.2) [72 P.S. ~9116(a){I)}. The lax rate imposed on the net value of tJansfe1s to or for Ihe use of the decedent's siblings is 12% [72 P.S. !i9116(aX1.3)]. A sibling is defined, under SecIion 9102, as an individual who has alleast one parent in common with the decedsnt, whether by blood or adoptioo. -,--""-'* COMMONWEALTH OF PENNSYLVANIA INHERlT ANCE TAX RETURN S1DEm DECEDENT EST.&,E OF - \-6iU' {\ Q. '( Cl SCHEDULE G INTER.VlVOS TRANSFERS & MISC. NON-PROBATE PROPERTY -:r C:'16vl~L FILE NUMBER '). OO~ - OOlen Th~ schedule must be completed and flied ff IIle answerlD any of ques1ion.lll1rough 4 on 1IIe rever.lO side ofllle REV-I500 COVER SHEET is yes, DESCRIPTION OF PROPERTY %OF ITEM INCl.UD€THENAMEOFTlETRAHSFEREE.nElR~"OOt4SKIPltIilEtBlENTANDlHE DATEOFTRAHSFER. DATE OF DEATH DECO'S EXCLUSION TAXABLE VALU NUMBER ATTACH A COPY' OF TlEOfEOFORREAL ESTATE. VALUE OF ASSET INTEREST 1\f.If'PI.~\ 1. N':l( 't'Y\-v '" \,~ ~ <..\ \ -\ \)'f\' lI'I\ \ 0'0010 '\? 'g <':, -I").. :>. <., 'iSgSi;).. :I: ('<... (\ cD TOTAL (Also enter on line 7, Recapilulalion) $ 8 ~s J J,.d-.G (If more space is needed, insert addilional sheels oIlhe same size) REV-1509 EX+ (6-98) . . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOlNTLy-oWNED PROPERTY ESTATE OF '7:l 0<;:./ r, Q r cl J C'J bu I-o,k; K an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. FILE NUMBER (1., 00 6-- OO'7Cil SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A \"\Cl.r "I J<u.;,,, K.<;)'\J C\ ( ~ \ f.\~{lo.. loos G-... WO-{ C'o.(\\Sk PA nCJ(~ \::Ie" uOh+tV B. ::}ClI;."<-.pYl R (>71o\J\<;'\(, VJ.'6 Gre<<.t KIH_\::.. t){\~ {~",tr\E \ PC\r\L (? A IS \ 0 :>- S<IY\ c. JOINTLY-OWNED PROPERTY: lfITER DAT. DESCRIPTION Of PROPERTY %OF DATE OF DEATH "'" FORJO"T .ADE INCLUDE NAME OF AHANCIAL "STnuTlON AND BANK ACCOUNT NUMBER DR SIMILAR DATE OF DEATH a;.CO.S VALUE OF NUMBER TENANT rom IDENTIFY"G NUMBER. ATIACH DEED FOR JOMlV-HElD RfALESl"TE. o.JAlUE. Of ASSET INTEREST OECfDENTS INTEREST 1. A (1)1'6{00 C I -t \<-R (\ " ~Q ",Ie. S5J-?-1,5~ ,>~y :> 3 ''''to''),' <\- CD 0 TOTAL (Also enter on line 6, Recapitulation) $ \"6' Lt-o(U9 q (If m<lJe space is needed. Insert additional sheets of the same size) .":"",,,,,,.,,. COMl!ONWEAlTH Of PENNSYLVANIA 'NHERITANCE TAX RETURN RESIDENT D CEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF ~~ f\(l, d .:::r C'(bulsK 1 FILE NUMBER ~on;}.,- 0 01'11 Debts of decedent must be reported on Schedule L ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. \-\ cN'I\ ~ 8145.00 r<'\'t't.XS fU(\'(A "J LAC.. Q'o .....\) 0..<" "I ~~~ - IIMe~ ~Q.<iy ~~5 IY9.d-.5 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representallve (s) Social Security Number(s) I EIN Number of Personal Representative(s) Streel Address Cilt Stale Zip Yea~s) Commission Paid: 2. Attomey Fees 3. Family Exemp1ion: (If decedenfs address is not the same as daimanfs. attach explanation) Claimant Street Address City Stale Zip Relationship of Claimanl 10 Decedent 4. Probale Fees 5. Aocoontanfs Fees 6. Tax Return Prepare(s Fees 7. TOTAl (Also enler on line 9. Recapilulation) $ g ~9 \j . d.. 5 (ff more space is needed. insert additional sheets of the same size) .REv'~"~"~. COMMONWEALTH OF PENNSYLVANIA INHERJTANCE TAX RETURN RES! NT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF ~"U'(\~<ct -..J ~'1Io\..)\s\Z\ Include \lie proceeds of liligalion anti !he date !he proceeds w,,", received by \lie esta1e. All properly jointly.owned _the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. FIlE NUMBER ;;1.00 d- .OO,C{-' c't-\c.e (\":, ~G. ,,,-t(oo Ch~ IJC\{"\.l\ '95.Qg TOTAL{Alsoenteronline5,Recapitulation) $ 1<15 .9 '6 flf mNJ:o o;:n~ ie n~ i....,....rf .....Aifi^....1 ..h......'- ...1 ~_ _...__ _l__\ 1-888-910-4100 (<Ill Citizens' Ph<:-n><E'auk ~n'jt'~'! f;::..{ ",CtOl.m\ 1nkrm<ltiotl. CUIl.er1t rates and ami'..-ef, tD YOIJf questiom. US002 BR292 BERflARO CYBULSKI 1 APPALOOSA WAY CARLISLE PA 17050 CO Statement . OF Beginning June 21, 2002 through December 31, 2002 CD SUMMARY Balance Calculation Previous Balance Withdrawals Deposits & Additions Interest Paid Current Balance ~ <ff) 56,341. 25 - .00 + 1,113,67 + .00 ~ (:,-0<.1-00-- BERNARD CYBULSKI t'lARY JEAN KOVACH JOSEPH CYBULSKI 12 month CO 6140-817536 Amoullt 55,227.58 fRAtBACTIOU DeTAILS Oat~ 07117 08/16 09/17 10(17 11/11; ii;18 11/18 192.27 230.13 231. 08 224.53 232.98 2.68 56,341.25 Interest Interest Rate Annual Percentage Yield Intef€5t Paid this Year 1.74* 1. 75'" 2.361.72 Oe'icriptlon Intere-st Intere-st Interest Interest Iflte!est Interest Withdrawal o o PH~vhl1lS Batance- Total Trimsacti<ms 55,227.58 Cllrrent Balance .00 Register of Wills of CUMBERLAND County, pennsylvani Certificate of Grant of Letters No. 2002-00797 PA No. 21-02-0797 ESTATE OF CYBULSKI BERNARD J (LA::;'l, ),'lK::;'l, JVLLUUL.e;) Late of SILVER SPRING TOWNSHIP CUMti~KLAND LUUN1Y, Deceased Social day Security No. 208-16-5220 of September 2002 an instrumen WHEREAS, on dated January was admitted to the 4th 11th 1986 probate as the last will of CYBULSKI BERNARD J (LA:;:)'l, ./:' ..L.tG::d I I"LlLJlJLh] late of SILVER SPRING TOWNSHIP CUMBERLAND County, who died on the 6th day of June 2002 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, MARY C. LEWIS , Register of Wills in and for the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to KOVACH MARY JEAN who has duly qualified as Executor (rix) and has agreed to administer the estate according to law, all of which fully appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal ot my Office the 4th day of September 2002. ~'" '-'f, I';~ /} / " ~f ( -I' i/" , ".'""< ,,',,' ':)',/>.'" J, Keg'i~'t'~r o~f vi~'tl'~' * *NOTE* * ALL NAMES ABOVE APPRAR (T.A~7' J>TR!':7' MTnnT.J>I f'j 02(') O(J)';:i -0-1..... -<Ol;i ISZ zrn", g :n o:l % ~ I'll :>:: Cl S ~ In I I I I I I I I \ \ I I \ I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 5':~ ~ m~ :0 C)-o Z :J:)> )> ~5 ~ ClO sa CJ)CJ) ~ CD)> ~ c::< c :lJ> Z; G'l-< " -0 - )> ::. '" g; '" ~ '" ~ \."" ~;; :'i! ~ 5t.;: :::2: ~'"? ,_~, ~ ~ ''8 rn ~ :2 -'s S --1 ~......\ ~ ~ C~, 01 .~ ~~p is ~ &~ G -; .5~ ? ~~~ -" '":J.m ~f,-~':D N r.::;. .,~;. ..-- '" 0' o t" l:.....l.~., I I I I I o ...,., ,,r~ r\ ~ 3:J t' 0 ~iflO:n >,~i/:l~ (lHH-I :r;tDZ- . ::.\100 tTllfl Z ><: f; nn ~[;l8~- :on H~ 1><"" r:J oC: """, o o~ ",,0 ... ,.,r:J ri ~~ ",,,, :o~ ~o -< '" '" ~ '" ,., '" o '" '" '" .... " '" ~ o o c :z -I :z c ia '" :D Yt ~"' "' <f\ '0 00 -< " "' 1) 8 c: z -< "0 &;:1: "'1'11 :\\0 z" 0_ "Z 5;" G> \')0 )> 1'11. "'to z- o -i. 1\ ~ m o '" m r o '" I I 1 'I Myers Funeral Home, Inc. 37 East Main Street Mechanicsburg, Pa, 17055 Boyd L. Myers Jr., Supervisor (717) 766-3421 STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED Charges are only for those items that you selected or that are required. [fwe are required by taw or by a cemetery or crematory to use any items, we wil explain in writing below. If you selected a funeral that may reqUire embalming, such as a funeral with viewing, you may have to pay for embalming. Yo do not have to pay for embalming you did not approve if you selected arrangements such as direct cremation or immediate burial. If we charge you for a embalming, we will explain why below. Date of Contract Carlisle. Pa. June 7, 2002 17013 - - - z;p--- I nne 6, 2002 Date Of Death 1 Appaloosa Way ----Ai1(fress --- For Services of , _-'!l!rna~dJ.C1:bul!iI<L___ Charge to Mary Jean Kovach -Name Sfiik -.---nmCI\)'-- C. SPECIAL CHARGES Forwarding Remains to other Funeral Home $ Receiving Remains form other Funeral Hom~--- $ immediate Burial $ -------, Direct Cremation $ $ A, CHARGE FOR SERVICES SELECTED: L PROFESSIONAL SERVICES Services of funeral Director and Staff Embalming Casketing, d-ressfr;g~cosmetOiog~_ Other Preparation of bod)'_ !j~irdre~s~! (Barber ~~_~t:lP~':-' Rem~_ins__ $ $ $ $ $ $ $ .---"-'------ SUB-TOTAL PROFESSIONAL SERVICES 2, USE OF FACILITIES AND SERVICES For visitation! wake service For funeral ceremon~~ For memorial service Equipment & scrvi~es"ior-g~-;~es~d-;;--ser~-ice---- 1795,00 &95,00 ---- - 295,00 95,00 SUB-TOTAL OF SPECIAL CHARGES D, CASH ADVANCED Opening Grave!CryJ~!___ Newspaper____~,oc_~______ _ ______ Newspaper Clergy! Mass OtJering __"' __ Certified Copies of Death Certificate \0 Family Flowers ~~!llet~~~{!::9~~~e~~~=__ 9!g~!Lst C$ $ $ m $_ $ $ $ $ $ $ $ 650,00 130,00 3,080,00 Al$ $ $ $ $ $ --- ---- SUB- TOTAL FACILITIES AND EQUIPMENT 3, AUTOMOTIVE EQUIPMENT Vehicle to transfer remains to Funeral Home Hearse (Casket Coach) flower Car l Floral Distribution Family Ca~___ _ ____ Lead Car! Clergy Car ___~__~ Utility Car Out of town transportatio_~_ 525,00 550,00 100.00 20,00 395,00 \25.00 75,00 A2$ 1,470,00 $ -$--- $ $ $ $ $ $ SUB-TOTAL AUTOMOTIVE EQUIPMENT TOTAL SERVICES, FACILITIES, AUTOMOBILE B. CHARGES FOR MERCHANDISE SELECTED Casket Belmont 4506850 $ Other Receptacle $ Outer Burial Container Guardian $ Acknowledgment Cards $ Register Book __ $ Memorial Folders $ ------~----------- Prayer Cards $ Temporary Grave Markers $ Burial Clothing $ Other Clothing__ $___ Cremation urn $ $ $ 350,00 295,00 lnel Incl 195,00 0$ 1,\00,00 SUB-TOTAL OF CASH ADVANCED We charge you for our scn-ices in obtaining the following: NONE SUMMARY OF CHARGES TOTAL ABOVE ITEMS (A,B,c'D) $..__9,885,00 Sales Tax (if ^i'p)@_ % $ 0,00 TOTAL OF ALL SECTIONS $ -.2,885,00 LESS: Payment Maie._ $ {.ESS: Credits Pending _ _____. ____ LESS: Credits grante..Q____.- P~ck~ge Price Discount BALANCE DUE by ______ }ul 7, 2_002 A3 $ A$ 840,00 5,390.00 $ $ 1,740,00 8,145'(1,0 2,5()0~0 850,00 loci 45,00 Incl A tate charge of \ .5% per month on the outstanding balance (annual rate of 18%} will be added to the balance. - L C> oS 0 R.~A:~O~FO~REQ[JI~ED~ERV~C:~S <>,~MERC:HAN()[SE ~0tjS- Reason for embalming family viewing Cemetery requires outer bllrial container DISCLAIMER OF WARRANTIES Our funeral home makes no representations or warranties regarding caskets or outer burial containers. The only warranties, expressed or implied, grante in connection with goods sold with the funeral service are the express writte warranties, if any, extended by the manufacturer thereof. No other warrantie including the implied warranties of merchantability or fitness for particula TOTAL MERCIiANDlsESELECl'EDn' - B $ 3,395,00 purpose are extended by the seller, 1 agree that I have examlned the items of goods and services selected above and found them to be correct and according to the arrangements I hav requested. I acknowledge receipt of a copy of th!s Statement of Funeral Goods and Services Selected. I rep~~ent that I have sufficient.n:mds available f payment of the cash price for the goods and servIces selected. I also agree to make payment of $ 8145.00 withIn SO days. , agree to be Jomtly and several liable with anyone else who signs below. A LATE CHARGE of 1.5% per month (18%J'er annum) will be apP'Ied to the unpaid balance begmning)O days afte the date of this contract. I will also pay the Funeral Director all reasonable costs pai by the Funeral Director to collect amounts I owe under thIS agreemen . Those costs may include attorney fees and court costs. Any items requested after the date of this agreement will be considered part of this agreement and w 1 be reflected on the final bill. June 7, 2002 CofltractDat-em (Seal) - - purchaser (Seal) ciirlstopfier 1\1: WiHlamsLlcense-ifFunerafDireCtor-- pm:criaser STATUS REPORT UNDER RULE 6.12 Name of Decedent :'~'%,~ ,C~ ex 'c c~ [~'~ Date of Death: [o- C-o- Q) ~ Will No.: Admin. 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: 1. State whether administration of the estate is complete: Sol2 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes _~ No ['] b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal r~resentative state an account informally to the parties in interest? Yes ,[~ No [--] Co and may be attached to this report. Date: 5 - ~ '~ - (~ ~ Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the. Orpbam' Court Name Capacity: Address Telephone No. Personal Representative Counsel for personal representative t-7o 3 ~PT. 180601 HARRISBURG, PA 17118-060! HARY JEAN KOVACH i APPALOOSA WAY CARLISLE NOTICE OF ZNHERZTANCE TAX APPRAISEMENT, ALLOWANCE OR DZSALLO#ANCE OF DEDUCTTONS AND ASSESSHEHT OF TAX '04 tiAY 17 PA 17013 DATE 0~-lq-ZO03 ESTATE OF CVBULSK! DATE OF DEATH 06-06-2002 FILE NUH~ER 2! 02-0797 ?!k~;)~ITY CUMBERLAND ACN 101 Aeoun~ Rmnit~ed REV-I$~ EX AFP BERNARD J MAKE CMECK PAYABLE AND REHZT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE II~ RETAIN LOWER PORTZON FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF ZNHERZTANCE TAX APPRA/SEMENT, ALLOWANCE OR DXSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF CYBULSKI BERNARD J FILE NO. 21 02-0797 ACN 101 DATE 0~-1~-200~ TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVAT/ON CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Reel Estate (Schedule A) (1) Z. S~ks and Bonds (Schedule B) ~. Closely Held S~ock/Partnership Interest (Schedule C) ~. Mortgages/Notes Rece~v~Ze (Sc~dule D) (~) $. Cash/Bank Deposits/Misc. Personal Property (Sch~ule E) (5) b. JointlyO~ned Prol~r~y (Schec~le F) (6) 7. Transfers (Schedule G) (7) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ad~. Costs/Nisc. Expenses (Schedule H) (9) 10. Debts/Not,gage Liabilities/Li~ns (~dule I} {10) 11. Total De~c~ions 12. Net Value of Tax Return 15. 1~. Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) Net Value of Estate Subject to Tax .00 .00 .00 .00 195.98 18~09.19 88~572.26 8,29~ .25 .00 NOTE: To insure proper credi~ to your account, submit the upper por~ion of ~his form ~ith your tax payment. NOTE 107,177.~3 02-2q-2003 TAX CREDITS: PAYMENT DA, TE · O0 x O0 = . O0 98,883.18 x 0~5: ~,~9.7~ .00 x IZ : .00 · O0 x 15 = . O0 (19)= ~,~9.7~ ASSESSMENT OF TAX: 1E. Amount of Line 1~ at Spousal rate 16. Amr~unt of Line 1~ taxable at Lineal/Class A fete (16) 17. Amount of L/ne 1~ et Sibling rate (17) 16. Amount of Line 1~ taxable at Collateral/Class B rate (18) 19. Principal Tax Due RECEIP1 NUHBER CDOOZ218 IF PAID AFTER DATE ZNDZCATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. DISCOUNT (+) INTEREST/PEH PAID (-) .0O AHOUNT PAID TOTAL TAX CREDIT BALANC~ OF TAX DUE 1NTEREST AND PEN. TOTAL DUE .0o .00 .o0 ( IF TOTAL DUE IS LESS TH~ $1, ~ PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFU~. SEE REVERSE SIDE OF THZS FORH FOR INSTRUCTIONS.) If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that lnclude the total of ALL returns assessed to date. (11} 8.29~. 25 (lZ) 98,885.18 (13) .00 (].~) 98,883.18 Register of Wills of CUMBERLAND County, Pennsylvania Certificate of Grant of Letters WHEREAS, on the 4th ~ted January !ith 1986 No. 2002-00797 ESTATE OF PA No. 21-02-0797 CYBULSKI BERNARD J (1~'1', ~*1~'1', Late of Deceased Social Security No. 208-16-5220 day of September SILVER SPRING TOWNSHIP CUM~L~ND CUUN'I'~, 2002 an instrument ~s admitted to probate as the last will of CYBULSKI BERNARD J (~a~'l-, ~'z~'i', M~uu~) Lte of SILVER SPRING TOWNSHIP , CUMBERLAND County, who died on the 6th day of June 2002 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, MARY C. LEWIS , Register of Wills in and for .e County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify .at I have this day granted Letters TESTAMENTARY KOVACH MARY JEAN o has duly qualified as Executor(rix) d has agreed to administer the estate according to law, all of which fully pears of record in my Office at CUMBERLAND COUNTY COURT HOUSE, RLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal my Office the 4th day of September 2002. **NOTE** ~.AT.T. NAMES ABOVE AJ?PEAR (LAST, FIRST, MIDDT,~.) :,~ ~*,' ~ D ~ r,~z.~¢z'oz.~ h,,llh,,ilh,,,,,Ih,lh,,hlhh,,,hh,lh,h,lhh,hh,i