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Home My WebLink About04-0470 STATUS REPORT UNDER RULE 6.12 Name of Decedent: Rosa Sicheri Date of Death: 12-11-2002 Will No.: Admin. No.: 21-04-0470 Pursuant to Rule 6.12 of the Supreme Court Orphans' Com-t Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes ~-] No ['-1 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' Com't No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes [~ No [Z] 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 JAMES ~ MEYER ~,.. ~R AND WAGNER ~ :~ 115 LAFAYETTE STREET ~:< SAINT MARYS, PA 15857 Address :? 814-781-3445 :Z Telephone No. .... Capacity: [--]. Personal Representative .~ Counsel for personal representative Register of Wills of CUMBERLAND County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of Rosa Sicheri No.--, .~,--u--~J~--O~-~'~ also known as , Deceased Social Security No. 163-38-8100 Petitioner(s), who is/are 18 years of age or older, apply(les) for: (COMPLETE 'A' or 'B' BELOW:) ~ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut ~ named in the last Will of the Decedent, dated 6-19-68 and codicil(s) dated State relevant circumstances, e.g., renunciation, death of executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: [] B. Grant of Letters of Administration (c.t.a.; d.b.n.c.t.a; pendente lite; durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: J Name Relationship --- Re=~=~nce ' (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with hi~er last family or principalresidence at 208 College Hill Rd., Enola, PA 17025 (list street, number, and municipality) Decedent, then 89 years of age, died 12-11-2002 at Villa Teresa Nursing Home, Harrisburg, PA (Location) Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 43,731.00 (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Si~lnature, Typed or printed name and residence ~'x ~ ~ ~~ Zita E. Sicheri 208 College Hill Rd., ENola, PA 17025 Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form RW- 1 (1991) Oath of Personal Representative2: Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. ,,~', Sworn to or affirmed and sub3cribed ~-~2 ~--~ , 4 ~14~.~ before me this~) dayof No. Estate of Rosa Sicheri Deceased Social Security No: 163-38-8100 Date of Death: 12-11-2002 ANDNOW, ~[)~__{) ~fl ~ ,inconsideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters F-~ Testamentary [~ Of Administration (c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate) are hereby granted to Zita E. Sicheri in the above estate and that the instrument(s) dated June 19, 1968 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters ........... $ 80 , C)O ~PJL'r~ I~ ~ {-~)4-~. ,/~x~;} ~ j o~"Will~ --- IV'" ' ' Register ~ ~~ Short Certificate(s) ..... $ 6 OO Renunciation ........ $ Attorney: James A. Meyer Affidavits ( ) .... $ I.D. No: 00237 Extra Pages ( ) .... $ 3 .(:DL.~ Address: 115 Lafayette St. Codicil ........... $ St. Marys~ PA 15857 JCP Fee .......... $ 10 . <:> O Telephone: 814-781-3445 Inventory .......... $ Other ........... $ TOTAL ......... $ 99 , ~ ~ Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 {1991) IN RE: ESTATE OF · IN THE OFFICE OF THE REGISTER · OF WILLS FOR ELK COUNTY, PA. Rosa Sicheri DECEASED LATE OF AFFIDAVIT OF SUBSCRIBING WITNESS STATE OF PENNSYLVANIA COUNTY OF ELK · SS. James A. Meyer ' , a subscribing witness to the attached written document swears (or affirms) that, in the presence of the affiant, Rosa Sicheri , being of sound mind, signed, published and declared the said document to be his (or her) Will. Sworn to and subscribed before me this ]_q/~ day of ~,~ , 1,~.._~,~/ Register of~ills / / ~egister ~f ~iIl~ ~f (guml~erlan~ (g~unt~ ~enn~l~ania OATH OF NON-SUBSCRIBING WITNESS Estate of ~O~c:x ~,~e_& No. Also know as , Deceased " (~a) a subscriber hereto, (L~r,h) being duly qualified according to law, depose(s) and sa.y(s) ~t ~we are) familiar with the signature o~ ., testat O.x ~ ;~i(one of the subscribing wimesses to) the will/codicil presented herewith and that ~_ believes the s~gnature on the will/codicil is in the handwriting of ~r>~ ~;, c Xtx.~,z~ to the best of knowledge and belief. Swom to or affirmed and subscribed ~ before me this 2~~c'*'' day of X ~. ~ ~(~q'~ · ~\ ,20Cba4-- (Si~amre) ~~c~~~ ~~~ (Si~at~e) Sworn to or affirmed and subscribed before me this __ day of (Signature) ,20 (Signature) For the Register H105.905 REV.(01/04) This is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records in accordance with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953. WARNING: It is illegal to duplicate this copy by photostat or photograph. Calvin B. Johnson, M.D., M.P.H. ~ ~.~-~: Charles Hardester Secretary of Health ~ State Registrar 3 2 1 3 0 1 5 o 8 2004 No. Date "~ -' 124096 H105.14~ Re~.;2/~7 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH ~cx,~ )~-$e 3;~A*~ ~as.~e ,. 163 -- 38 -- 81~O ,.~c~ 11, 2002 ,.T~, PA ~ ~O.~.. ' ~ 5-14-1913 ~ E~,,.~ ~ ~ ,,~ H~r ,,~ H~se duties ~,,. ~ ~ ~,,.Un~ ~ ~ ......' -. N~er ~i~ ,,. ~TU~ ,~. PA - ,,~.~ ~ ~ r~r P~t~ 1051 Avila R~ ~ ~.~ ~.~' ' ,, ~k Sic~ri ~,. Jos~h~e Di~ ~ ~na Si~ri ~. 208 Collie Hill R~, ~ola, PA 17025-2111 ~.~ ~ ~ 16, 2002 St. ~niface C~t~ F~, PA 15846 la~,. iaaa. ~ ~. ~ 10541 ~-~k~ ~, St. ~, Ph 15~57 .~ .~..,t,,~ ...................... Q ~. ~l MA~ S~ ~:~w,~ I~ ~ /7/0/ LAST WILL AND TESTAMENT OF ROSA SICHERI BE IT REMEMBERED, that I, ROSA SICHERI, of Fox Township, Elk County, Pennsylvania, being of sound mind, memory and under- standing, do make, publish and declare this as and for my last wi and testament, hereby revoking and making null and void any and ali wills and testaments or writings in the nature thereof by me at time heretofore made. FIRST. I order and direct the payment of all my just debts and funeral expenses as soon as conveniently may be after my decea . SECOND. All the rest, residue and remainder of my estate, both real and personal, whatsoever and wheresoever situate, I give devise and bequeath, share and share alike, to my sisters, Zita E. Sicheri and Aldina Lena Sicheri, or the survivor of them. THIRD. I hereby nominate, constitute and appoint my sister, Zita E. Sicheri, to be the executrix of this my last will and teStament. IN WITNESS WHEREOF, I have hereunto set my hand and seal this /~ day of June, 1968. OR~COL~ eRE~O~Y & ¢OP~LO ATTORNEYS AT LAW ST. ~ARY$, PA. Signed, sealed, published and declared by the above named Rosa Sicheri, testatrix, as and for her last will and testament, in the presence of us, who, at her request, and in her presence, and in the presence of each other, have hereunto signed our names as subscribing witnesses thereto. DIIISCOLL, GREGORY & COI~OLO ATTORNEYS AT LAW ST* MARYS, PA. COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 003943 MEYER JAMES A 115 LAFAYETTE STREET ST MARYS, PA 15857 ACN ASSESSMENT AMOUNT CONTROL NUMBER ........ fold .......... - ....... 101 $19,516.14 ESTATE INFORMATION: SSN: 163-38-8100 FILE NUMBER: 21 04-0470 DECEDENT NAME: ROSA SICHERI DATE OF PAYMENT: 05/18/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 12/11/2002 TOTAL AMOUNT PAID: $19,516.14 REMARKS: CHECK# 01991557 INITIALS: JA SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS OFFICIAL USE ONLY REV- o0 EX+ (6-00) R NV-- 1 500 COMMONWEALT, OFPENNSY'VAN,A INHERITANCE TAX RETURN FILE NUMBER DEPARTMENT OF REVENUE RESIDENT DECEDENT I DEPT. Z80601 HARRISBURG, PA 17178-0601 COUNTYCODE YEAR NUMBER ED I DECEDENT'SNAME(LAST'FIRST'ANiMIDDLEINITIAL)s'icMeri m. osa SOCIALSECURITYNUMBER163_38_8100 C DATE OF DEATH (MM-DO-YEAR) DATE OF BIRTH (MM-OD-YEAR) THIS RETURN MUST BE FILED IN DUPUCATEWrI'H THE E D 12/11/2002 05/14/1913 REGISTER OF WILLS E (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER N T 1. Original Return 2. Supplemental Return 3. Remainder Return prior [o 12-13-82) C A mP 4. Limited Estate 4a. Future Interest Compromise (date of death after 1Z- 1Z-82) 5. Federal Estate Tax Return Required H P ? 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 1 8. Total Number of Safe Deposit Boxes EP~' C R ~ (Attach copy of Will) (Attach copy of Trust) KO~: ~ 9. Litigation Proceeds Received [~]10. Spousal Poverty Credit [~ 11. Election to tax under Sec. 9113(A) (date of death between 12-31-91 and 1-1-95) (Attach Sch O) NAME COMPLETE MAILING ADDRESS C O James A. Meyer R FIRM NAME(If Applicable) 115 Lafayette Street R E Meyer & Wagner St. Marys, PA 15857 S TELEPHONE NUMBER 814./781- 3445 1. Real Estate (Schedule A) (1) None ..~' eFF'ICIAL. USE ONLY 2. Stocks and Bonds (Schedule B) (2) None 3. Closely Held Corporation, Partnership or (3) None Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) (4) None R 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 43,730.69 E (Schedule E) C A 6. Jointly Owned Property (Schedule F) (6) 124,103.03 I [~, Separate Billing Requested T U 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) None L (Schedule G or L) A T 8. Total Gross Assets (total Lines 1-7) (8) 167,833,72 I o 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10,231.00 N 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) None 11. Total Deductions (total Lines 9 & 10) (11) 10,231.00 12. Net Value of Estate (Line 8 minus Line 11) (12) 157,602.72 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) .... 14. Net~ValueSubjec~t~Tax-(l_ine-12 minus Line__13). 11._4) ....... ~7,602~_2 C O SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES M T UP 15. Amount of Line 14 taxable at the spousal tax A I rate, or transfers under Sec. 9116(a)(1.2) X .0 0 (15) 0.00 X T 16. Amount of Line 14 taxable at lineal rate 0.00 X .0 45 (16) 0.00 I 17. Amount of Line 14 taxable at sibling rate 157,602.72 x ,12 (17) 18~912.33 O N 18. Amount of Line 14 taxable at collateral rate X .15 (18) 0,00 19. Tax Due (19) 18,912.33 Copyright (c) ~'000 form software only T he Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 208 College Hill Rd. CITY ] STATE ZIP Enola J PA 17025 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 18,912.33 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits(A+B+C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 0.00 4. If Line 2 is greater than' Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line Z0 to request a refund (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference, This is the TAX DUE. (5) 18,912.33 A. Enter the interest on the tax due, (SA) 603.81 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SB) 19,516.14 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 its income; ........... c. retain a reversionary interest; or .................................... d. receive the promise for life of either payments, benefits or care? ................... 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............................................. [-'] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................ ~ [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SiGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Z'~.ta F.. Sicheri DATE 208~Cc!!ege Hill Rd ~i~ ~ ~x~J~%~J gnola, PA 17025 SIGN/~URE~)--F~RE~A~_~EE'RO/THERTHANREPRESENTATIVE Meyer & Wagner DATE '~J~~ ~- 115 Laf_a~ette Street ~-~/~ ~iili ;iiii !iii ii'iii i ~ ---~i ]- ~l[-~: - i~-~ - - i-~ ~7- ......................... ... For dates of d~t"h ~n' '~';f~er July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of th; ' ' 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 exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable 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 lineal 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. Copyright (c) Z000 form software only The Lackner Group, I nc, Form REV- 1500 EX (Rev. 6-00) REV-I$08 EX + (1-97) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. ~.,ER~T^.CET~XRETUR" PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Rosa Sicheri SS~/ 163-38-8100 12/11/2002 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 First Commonwealth Bank CD No. 14250000090880 Date of death 43,730.69 balance TOTAL (Also enter on line 5, Recapitulation) $ 43,730.69 (if more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV- 1508 EX (Rev. 1-97) REV-1509 EX + (1-97) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Rosa Sicheri SS# 163-38-8100 12/11/2002 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Zita Sicheri 208 College Hill Rd sister Enola, PA 17025 JOINTLY-OWNED PROPERTY: LE~ER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH Include name of financial institution and bank DATE OF DEATH DECD'S VALUE OF ITEM FOR JOINT MADE account number or similar identifying number, NUMBER TENANT JOINT Attach deed for jointly-held realestate. VALUE OF ASSET INTEREST DECEDENT'S INTERES 1 A 04/06/00 First Commonwealth Bank CD 47,593.03 50.00% 23,796.52 No. 14300511000488 - Joint with Zita Sicheri - Date of death balance 2 A 07/07/97 First Commonwealth Bank 83,500.17 50.00% 41,750.09 Savings Account No. 1100112693 - Joint with Zita Sicheri - date of death balance 3 A 08/08/91 National City Bank CD No. 44,040.82 50.00%' 22,020.41 400028148 - Date of death balance 43,475.00 plus 565.82 accrued interest; joint account with Zita E. Sicheri 4 A 08/08/91 National City Bank Checking 28.94 50.00% 14.47 Account 401004342 - Date of death balance; joint account with Zita E. Sicheri 5 A 09/05/91 National City Bank CD No. 43,714.89 50.00% 21,857.45 400029543 Date of death balance 43,705.61 plus 9.28 accrued interest; joint account with Zita E. Sicheri Total of Continuation Schedule(s) 14,664.09 TOTAL (Also enter on line 6, Recapitulation) $ 124,103.03 (If more space is needed inse~ additional sheets of the same size) Co.right (c) 1996 form software only CPSystems, Inc. Form REV-1509 EX (Rev. 1-97) Estate of: Rosa Sicheri Soc Sec #: 163-38-8100 Date of Death: 12/11/2002 Continuation of Schedule F (Jointly Owned Property) Item Ltr for Date Description of property Total Val Dollar Val of # Jt Ten Joint of Asset Decds Interest 6 A 04/06/00 National City Bank CD No. 29,328.18 50.00% 14,664.09 9039335776 - Date of death balance 29,218.71 plus 109.47 accrued interest; joint account with Zita E. Sicheri 14,664.09 REV-1511 EX +(1-97) SCHEDULE H FUNERAL EXPENSES & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Rosa Sicheri SS# 163-38-8100 12/11/2002 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 Lynch-Radkowski Funeral Home Funeral expenses 8,231.00 lit. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State __ Zip Year(s) Commission Paid: 2. Attorney's Fees Meyer & Wagner 2,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State ~ Zip Relationship of Claimant to Decedent 4. Probate Fees ,5, Accountant's Fees Tax Return Preparer's Fees 7. Other-Administrative Costs TOTAL (Also enter on line 9, Recapitulation) $ 10,231 . 00 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97) REV-1513 EX + (9-00) SCHEDULE J · COMMONWEALTH OF PEN"S~'V^N=A BENEFIClAR lES I..ERITA.CE T~X RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Rosa S cheri SS~/ 163-38-8100 12/11/2002 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.Z)] 1 Lena Sicheri Sister One Half 208 College Hill Rd. Residue Enola, PA 17025 2 Zita Sicheri Sister One Half 208 College Hill Rd. Residue Enola, PA 17025 ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET I1. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC. 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 SHEET $ 0.00 (if more space is needed, insert additional sheets of the same size) Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00) BE IT'REMEMBERED, that I, ROSA SICHERI, of.Fox Township, Elk County, Pennsylvania, being of sound mind, memory and under- standing, do make, 'publish and declare this as and for my last wil and testament, hereby revoking and making null and void any and wills and testaments or writings in the nature thereof by me at time heretofore made. FIRST. I order and direct the payment of all my just debts and funeral expenses as soon as conveniently may b~ after my decea~ SECOND. All the rest, residue and remainder of my estate, both real and personal, whatsoever and wheresoever situate, I give devise and bequeath, share' and share alike, to my sisters, Zita E. Sicheri and Aldina Lena Sicheri, or the survivor of them. THIRD. I hereby nominate, constitute and appoint my sister, Zita E. Sicheri, to be the executrix of this my last will and testament. IN WITNESS WHEREOF, I have hereunto set my'hand and seal this /~ day of June, 1968. Signed, ~ealed, published and declared by the above named Rosa Sicheri, testatrix, as and for her last'will and testament, in the presence of us, who, at her request, and in her presence, and in the presence of each other, have hereunto signed our names as subscribing witnesses thereto. ATTORNEYS AT ~AW 81To MARY$, PA. COMMONWEALTH OF PENNSYLVANZA BUREAU OF ZNDZVZDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DZSALLOgANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547EXAFP(01-O$) DATE 07-15-200q ESTATE OF SZCHER! ROSA DATE OF DEATH 12-11-2002 FILE NUMBER 210q-O~70 COUNTY CUMBERLAND JAMES A MEYER ACN 101 MEYER & WAGNER Amount Reeitted 115 LAFAYETTE ST ST MARYS PA 15857 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS REV-15q7 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SZCHER! ROSA FILE NO. 210q-OqTO ACN 101 DATE 07-15-200q TAX RETURN gAS: (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) .00 NOTE: To insure proper 2. Stocks end Bonds (Schedule B) (2) .00 credit to your account, $. Closely Held Stock/Partnership Interest (Schedule C) ($) .00 submit the upper portion q. Mortgages/Notes Receivable (Schedule D) (q) .00 of this fore with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) q3;750.69 tax payment. 6. Jointly Owned Property (Schedule F) (6) 12q;103.03 7. Transfers (Schedule G) (7) .§0 8. Total Assets (8) 167,833.72 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ada. Costs/Misc. Expenses (Schedule H) (9) 10,231.00 10. Debts/Mortgage Liabilities/Liens (Schedule Z) (10) .00 11. Total Deductions (11) 1§.231.0§ 12, Net Value of Tax Return (12) 157,602.72 15. Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00 lq. Net Value of Estate Sub~ect to Tax (lq) 157,602.72 NOTE: I~ an assessment was issued previously, lines lq, 15 and/or 16, 17, 18 and 19 will reflect flgures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line lq at Spousal rata (15) .00 X O0 = .00 16. Amount of Line lq taxable at Lineal/Class A rate (16) ~'i'~0 X 0~5 = .00 17. Amount of Line lq at Sibling rate (17) 157,602.72 x 12'= 18,912.33 16. Amount of Line lq taxable at Collateral/Class B rata (18) .00 X 1} = .00 19. Principal Tax Due (A9)= 18,912.33 TAX CREDITS: PAYHEN1 RECEZPT DZSCOUNT (+) 'i'1 DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 05-18-200q CDOO39q3 576.77- 19,516.1q TOTAL TAX CREDIT I 18,939.37 BALANCE OF TAX DUEl 27.0qCR INTEREST AND PEN. .00 TOTAL DUE 27.0qCR ~ IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS RE~UIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE~ A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before December 1Z, 198Z -- 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 for life or for years, the Commonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class 8 (collateral) rate on any such future interest. PURPOSE OF NOTICE: To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (7Z P.S. Section 9140). PAYNENT: Oetach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side. --Make check or money order payable to: REGISTER OF NILLSj AGENT REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications are available at the Office of the Register of Rills, any of the Z3 Revenue District Offices, or by calling the special 24-hour answering service for forms ordering: 1-800-36Z-ZOSO; services for taxpayers with special hearing and / or speaking needs: 1-800-447-30Z0 (TT only). OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as sho~n on this Notice must object aithin sixty (60) days of receipt of this Notice by: --written 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. ADH/N- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in ~riting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. See page S of the booklet "Instructions for Inheritance Tax Return for e Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedant's death, a five percent (5Z) discount of the tax paid is allowed. PENALTY: The lSZ tax amnesty non-participation penalty is computed on the total of tho tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you ~ould appeal tho tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date af death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. AIl taxes Nhich became delinquent on and after January 1, 1982 ~ill bear interest at a rate ahich Nil1 vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO4 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 19aZ ZOZ .000548 ~'~-1991 11Z .OOO$Ol L~ 9Z .O00Z~7 1983 16Z .000438 199Z 9Z .000247 ZOOZ 6Z .000164 1984 llZ .000301 1993-1994 7Z .000192 2003 5Z .000137 1985 13X .000356 1995-1998 9Z .000Z47 2004 4Z .000110 1986 lOX ,000274 1999 7Z ,00019Z 1987 IOZ .000274 ZOO0 7Z .00019Z --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NURBER 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 assess;ant. If payaent is made after the interest computation date shown on the Notice, additional interest must be calculated. Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 09/01/2004 MEYER J~MES A, ESQ. 115 LJtFAYETTE ST ST MARYS, PA 15857 RE: Estate of ROSA SICHERI File Number: 2004-00470 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 09/26/2004 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, Clerk of the Orphans' Court cc: File Personal Representative (s) Judge Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 09/01/2004 SICHERI ZITA 208 COLLEGE HILL RD ENOLA, PA 17025 RE: Estate of ROSA SICHERI File Number: 2004-00470 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 09/26/2004 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, GLENDA FARNER ~ Clerk of the Orphans' Court cc: File Counsel Judge CERTIFiCATiON OF NOTICE UNDER RULE Name of Decedent: Rosa Sicheri Date of Death: December 11, 2002 WillNo. 2004-00470 Admin. bio. 21 04 0470 To the Register: ! certify that notice of Coenefic~ml tntere~) tare mdni tion 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 6-16-04 Name Address Lena Sicheri 208 College Hill Rd., Enola, PA 17025 Zita Sicheri 208 College Hill Rd., Enola, PA 17025 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except· Signature Name James A. MeTer Address 115 Lafayette St. St. Marys, PA 15857 . ~ ~ '-- Telephone (814. 781-3445 Capacity: __ Personal Representative ~, ~ ,,~ ,2 ~ ~Counsel for personal representative Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 11/10/2004 MEYER JAMES A, ESQ. 115 LAFAYETTE ST ST MARYS, PA 15857 RE: Estate of ROSA SICHERI File Number: 2004-00470 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 12/11/2004 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~, GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge THE ESTATE OF ROSA SICHERI, DECEASED ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY MEYER & WAGNER ,__n__." ATTORNEYS AT LAW; 115 Lafayette Street St. Marys, PA 15857 (814) 781-3445 t . I F AMIL Y SETTLEMENT AGREEMENT t'. c THIS AGREEMENT entered into this 2ih day of May, 2005, by Zita Sicheri, in her capacity as Executrix under the Will of Rosa Sicheri, deceased, and Zita Sicheri, as heir under the Will of Rosa Sicheri, and Zita Sicheri as Executor and sole beneficiary under the Will of Lena Sicheri, deceased beneficiary BACKGROUND 1. Rosa Sicheri died on December 11, 2002, and was a resident of Enola, Pennsylvania, leaving a Will. 2. Decedent's Will, dated June 19, 1968, was admitted to probate by the Register of Wills of Cumberland County on June 16,2004, and Letters Testamentary were issued to Zita Sicheri, Executor. 3. Zita Sicheri and Lena Sicheri were sole beneficiaries of the estate of Rosa Sicheri. 4. Lena Sicheri died August 2, 2004 and under her Last Will and Testament, she appointed Zita Sicheri as Executor and named Zita Sicheri as sole beneficiary of her estate. 5. Zita Sicheri, as Executor of the Estate of Rosa Sicheri, has filed a Pennsylvania Inheritance Tax Return and paid the appropriate taxes thereon. 6. Said Executor has paid all of the taxes, debts and expenses of the Rosa Sicheri estate known to her. She has no knowledge of any unpaid claims, absolute or contingent, which may be asserted against the said estate, nor does she have any reason to believe there are any such claims. 7. The Executor and sole beneficiary of the Estate of Rosa Sicheri and as Executor and sole beneficiary of the Estate of Lena Sicheri, desires that this Family Settlement Agreement make unnecessary the filing of an accounting in the Orphans Court Division of the Court of Common Pleas of Cumberland County. NOW THEREFORE, intending to be legally bound, the parties do hereby agree as follows: 1. I waive the filing of an account of the administration of the estate in any Court; 2. I have examined an informal accounting, find it to be true and correct in all particulars, accept and approve it with the same force and effect as if it had been prepared and filed with, audited, adjudicated and confirmed absolutely by a Court of competent jurisdiction and as if the balance had been awarded by the Court in accordance with a Schedule of Distribution; 3. I warrant that the beneficiary named in the informal account and statement is the sole remaining party of interest in the estate and is entitled to receive the entire distribution in accordance with the informal account and statement of distribution; 4. I know of no outstanding and unsatisfied claims against the estate; 5. I approve the distribution of the balance of the estate shown in the informal account; 6. I acknowledge that I have a responsibility to honor any valid claims hereafter made against the Estate and agree to pay such claims. This Agreement is binding on the heirs, executors, administrators, personal representatives and assigns of the parties. EXECUTOR AND BENEFICIARY OF THE ESTATE OF ROSA SICHERI, DECEASED I) "Jr. .!- ., .~ Zita Sicheri i ' Id.l ~\~ ! EXECUTOR AND SOLE BENEFICIARY UNDER THE WILL OF LENA SICHERI, DECEASED 'j ',..-- ""' -t.f t.L Zita Sichhi . i V i \. ,. I' .' . .......J ~ vtlL"\...J ..1x....C:_""r-,j\,-1""\ r r- BUREAU OF INDIVIDUAL ~~-,'i':Li:!:; +-[;('[1: ('{ INHERITANCE TAX DIVISION .." -' J,J '~' PO BOX ZS0601 ,~,.'" " ,- HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV-16D7 EX AFP {03-05) ZDD5MG 12 PI; I: OS DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-18-2005 SICHERI 12-11-2002 21 04-0470 CUMBERLAND 101 Mount R...i Heel ROSA ('I en:! , 0;-;" , JAMES A MEl/'ER - 115 LAFAYETTE ST ST MARYS PA 15857 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure prop.~ credit to your 8ccOuntl sub.it the upper portion of this for. with your tax paym8nt. CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS - ------------------------------------------------------------------------.-- REV-1607 EX AFP (03-05) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF SICHERI ROSA FILE NO. 21 04-0470 ACN 101 DATE 07-18-2005 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE' NAIlED ESTATE. SHOWN BELDN IS A SUMHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 07-06-2004 PRINCIPAL TAX DUE: 18,912.33 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 05-18-2004 ~ CD003943 576.77- 19,516.14 07-05-2005 REFUND .00 27.04- TOTAL TAX CREDIT 18,912.33 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 . SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR], YOU HAY BE DUE A REFUND. SEE REVERSE SIDE DF THIS FDRK FDR INSTRUCTIONS. ] ~-{. q,.., COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* ROBERT M FREY 01 5 S HANOVER ST,j CARLISLE (~..dCi:ttOl'ICE OF DETERMINATION AND .'1 I "--ASSESSMENT OF PENNSYLVANIA EStATE TAX BASED ON FEDERAL CLOSING LETTER DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN REY-73' EX AFP 10'-05) BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 "0M JI II ? I. LuUJ Ur... r...-' f\l\!1:35 07-24-2006 LINE 07-25-2004 21 04-0740 CUMBERLAND 202 APPEAL DATE: 09-22-2006 (See reverse side under Objections) Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT SADIE E PA 17013 TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, sub.it the upper portion of this for. with your tax pay.ent. CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR FILES +- R'EV=736--E;t'AFP-Toi':.-o2i-----..-Ncffic'E--oF--D'ET'E-RMIN'AfIcfti-AN-D'-AifsEss-MENY------------------------ ---- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER .. ESTATE OF LINE SADIE E FILE NO.21 04-0740 ACN 202 DATE 07-24-2006 ESTATE TAX DETERMINATION 1. Credit For State Death Taxes as Verified 31,188.00 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) 316,164.75 3. Inheritance Tax Assessed by Other States or Territories of the United States (Excluding Discount and/or Interest) .00 4. Total Inheritance Tax Assessed 316,164.75 5. Pennsylvania Estate Tax Due .00 6. Amount of Pennsylvania Estate Tax Previously Assessed Based on Federal Estate Tax Return .00 7. Additional Pennsylvania Estate Tax Due .00 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 -IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAY"ENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT"" (CR), YOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS.) Cb