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HomeMy WebLinkAbout06-15-10 (2)1505607121 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number POBOx28o601 INHERITANCE TAX RETURN 2 1 1 0 0 2 9 5 Harrisburg PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 8 4 1 2 3 3 4 1 0 3 1 4 2 0 1 0 0 5 1 8 1 9 2 3 Decedent's Last Name Suffix Decedent's First Name MI M I C E L I J U L I E T A (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) 0 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number J A C Q U E L I N E A K E L L Y 7 1 7 5 4 1 5 5~5 0 <:.~ r~ ~ Firm Name (If Applicable) _ =~ ~ ' REGISTER 8F~1A~LS USE 01J1,Y J A N L G R O W N & A S S O C ~~ -~ c` I ~ First line of address ~ r-ri --' ' I I 8 4 5 S I R T H O M A S C T S T E 1 2 ~ ~ ;1 4 ~ / ! I~ ~_~1.~~7 ±Ja _t ~ Second line of address !.:~--- T :=~,; City or Post Office State ZIP Code DATE FILED 'Tt ~---- _-- _ ~ H A R R I S B U R G P A 1 7 1 0 9 Correspondent's a-mail address: BRENDAJLBnp,VERIZON.NET 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. ratio reparer other than the personal representative is based on all information of which preparer has any knowledge. SIGN F PERSON ESPO BL R ING RETf~IRN ~---- DATE . _ i. /.~ , ,. ~ ,~' ~"~,-Ea 6/3/2010 25 CLOUSER RD MECHANICSBURG PA 17055 SIGN URE OF PREP RE OTH THA~N RESENTATIVE DATE ~~ fin. , .. ~. __ ~ Ifn r~lF~, . 6/3/2010 84~~VS~ THOMAS CT STEM 12 HARRISBURG PA 17109 PLEASE USE ORIGINAL FORM ONLY 1505607121 Side 1 1505607121 J ~ J 1505607221 REV-1500 EX Decedent's Social Security Number Decedent's Name: JULIET A- M I C E L I 1 8 4 1 2 3 3 4 1 RECAPITULATION 1. Real estate (Schedule A) ................................... ..... 1 1 7 4 1 3 6. 5 3 2. Stocks and Bonds (Schedule B) ............................. ..... 2• 7 9 3 4. 8 4 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages & Notes Receivable (Schedule D) ................... ..... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .. ..... 5. 1 9 3 3 2 . 9 5 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .. ..... 6. 2 0 1 5 . 8 4 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property hedule G) ^ Separate Billing Requested S 7 2 4 1 2 0 0. 2 6 .. ( c ..... . 8. Total Gross Assets (total Lines 1-7) ........................... 8. 4 4 4 6 2 0. 4 2 9. p ( ) ........... Funeral Ex enses & Administrative Costs Schedule H 9. ..... 2 3 4 6 6 . 5 8 10. Debts of Decedent, Mort a e Liabilities, & Liens Schedule I 9 9 ( ) ....... 10. ..... 8 3 8 5. 0 0 11. Total Deductions (total Lines 9 & 10) ..................... ...... 11. 3 1 8 5 1 . 5 8 12 Net Value of Estate (Line 8 minus Line 11) .... 12. 4 1 2 7 6 8 . 8 4 13. Charitable and Governmental Bequests/Sec 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) .................. .................. 13. 14. 4 1 2 7 6 8 . 8 4 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x.o _ 0 0 0 15. 0. 0 0 16. Amount of Line 14 taxable 4 1 2 7 6 8 8 4 1 8 5 7 4 6 0 at lineal rate X .045 16. . 17. Amount of Line 14 taxable 0 0 0 17 0. 0 0 at sibling rate X .12 . 18. Amount of Line 14 taxable 0 0 0 0 0 0 at collateral rate X .15 1 g• . 19 1 8 5 7 4. 6 0 19. Tax Due ........................... ........... ... ....... . 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 L 1505607221 1505607221 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 10 0295 DECEDENT'S NAME JULIET A. MICELI STREET ADDRESS 325 Wesley Drive _ _ _ ___ Lower Allen Township __ _ _ __ -- __ -- CITY STATE II ZIP Mechanicsburg PA ~ 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit (1) 18, 574.60 B. Prior Payments 17,644.00 C. Discount 928.73 Total Credits (A + B + C) (2) 18, 572.73 3. InteresUPenatty if applicable D. Interest E. Penalty Total InteresUPenatty (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 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) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable fo: REGISTER OF WILLS, AGENT 1.87 1.87 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 ................................................................................................ ^ ^X 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? ....................................................................................... ^ 0 3. Did decedent own an "intrust for" or payable upon death bank account or security at his or her death? ......... X^ ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................................................................................. 0 ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1,1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [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 zero (0) percent [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 zero (0) percent [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 four and one-half (4.5) percent, 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 twelve (12) percent (72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX + (6-98) SCHEDULE A COMMONWEALTH OF PENNSYLVP,NIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER JULIET A. MICELI 21 10 0295 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real orooertv which is iointlvowned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 5180 East Trindle Road, Hampden Township, Cumberland County 174,136.53 Property ID 10-22-0523-053 Value based upon market value assessment per William Aiello, Colliers International TOTAL (Also enter on line 1 (If more space is needed, insert additional sheets of the same size) REV-1503 EX + (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER JULIET A. MICELI 21 10 0295 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. United States Savings Bonds; Series E, Quantity 19 7,884.44 The Phoenix Companies Inc (PNX) 18 shares @ $2.80/sh 50.40 TOTAL (Also enter on line 2, Recapitulation) ~ $ 7,934.84 (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER JULIET A. MICELI 21 10 0295 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Wachovia Bank Checking 1000323094886 17,094.32 2 Wachovia Bank Money Market 1010092968385 2,030.54 3 Blue Cross; cancellation refund 206.09 4 United States Treasury; 2009 1040 refund 2.00 TOTAL (Also enter on line 5, Recapitulation) I $ 19,332.95 (If more space is needed, insert additional sheets of the same size) REV-1509 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER JULIET A. MICELI 21 10 0295 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 A. Thomas E Miceli B Theresa M Miceli c rnruTl V_nWNFn PRAPFRTY~ ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. 1969 United States Savings Bonds, Series E, Quantity 3 1,881.68 50. 940.84 2 B 1969 United States Savings Bonds, Series E, Quantity 4 2,150.00 50. 1,075.00 ADDRESS 196 Lost Hollow Road (son Dillsburg PA 17019 TIONSHIP TO DECEDENT 25 Clouser Road (daughter Mechanicsburg PA 17055 TOTAL (Also enter on line 6, Recapitulation) I $ 2,015.84 (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER JULIET A. MICELI 21 10 0295 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCIUDETHENAMEOfTHETRANSFEREE,THEIRRELATIONSHIPTODECEDENTAND THE DATE OF TRANSFER. ATTACHACOPYOFTHEDEEDFORREALESTATE DATE OF DEATH VALUE OFASSET %OFDECD'S INTEREST EXCLUSION (IFAPPLICASLE) TAXABLE VALUE 1. United States Savings Bonds, Series E, Quantity 4 1,441.30 100. 1,441.30 Payable on Death to Thomas E Miceli, son 2 United States Savings Bonds, Series E, Quantity 4 1,441.30 100. 1,441.30 Payable on Death to Theresa M Miceli, daughter 3 John Hancock Non-Qualified Fixed Annuity SD7002588 36,302.80 100. 36,302.80 Thomas E Miceli and Theresa M Miceli, children, benef 4 John Hancock Non-Qualified Fixed Annuity SD7002591 77,880.46 100. 77,880.46 Thomas E Miceli and Theresa M Miceli, children, benef 5 Midland National Non-Qualified Annuity 16S0368510 39,450.11 100. 39,450.11 Theresa M Miceli, daughter, benef 6 Midland National Non-Qualified Annuity 1600012159 46,965.90 100. 46,965.90 Theresa M Miceli, daughter, benef 7 Phoenix Annuity Contract Q0006007070 37,718.39 100. 37,718.39 Decedent was receiving a regular monthly payment of $435.81 under the contract. Monthly payments commenced May 2009 and continue until Nov 2018. Decedent designated Theresa M Miceli, daughter, as beneficiary of the contract. Value represents date of death value furnished by Phoenix. TOTAL (Also enter on line 7 Recapitulation) ~ S 241,200.26 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RFSII'1FNT r1FCFnFNT SCHEDULE H FUNERAL EXPENSES 8~ ADMINISTRATIVE COSTS ESTATE OF riot numestrc JULIET A. MICELI 21 10 0295 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Malpezzi Funeral Home 6,574.27 2 Funeral repast 1,052.60 B. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Street Address City Year(s) Commission Paid: 2 Attorney Fees Jan L Brown & Associates 3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) (:laimant Street Address City State Zip Relationship of Claimant to Decedent 4. ~ Probate Fees Register of Wills, Cumberland County 5. I Acx:ountant's Fees Parks & Company 6. ~ Tax Return Preparers Fees 7, Cumberland Law Journal; legal advertising 8 The Patriot-News; legal advertising 9 Death certificates 10 Recorder of Deeds, Cumberland County; deed filing fee Adm expenses incurred in order to preserve/transfer real estate: 11 Dillsburg Excavating & Septic 12 Hampden Township; sewer/trash 13 Michael Langan Treasurer; 2010 Cumb Co & Hampden Twp Real Estate Tax 14 Pennsylvania American Water 15 PPL Electric Utilities 16 UGI 13,339.00 395.50 700.00 75.00 300.41 28.00 63.00 221.00 44.25 585.88 39.53 27.96 20.18 TOTAL (Also enter on line 9, Recapitulation) ~ E State Zip (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (12-03) SCHEDULE 1 COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS RESIDENT DECEDENT ESTATE OF ri~~ numo~R JULIET A. MICELI 21 10 0295 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1, Bethany Assisted Living 4,948.68 2 Bethany Skilled Nursing 100.00 3 Bonnie K Miller Treasurer; 2010 Per Capita Tax Cumb Co & Lower Allen Twp 9.80 4 Continuing Care Rx 230.00 5 Hampden Physician Associates 86.78 6 Jan L Brown & Associates; check dated 3/11/10 and cashed postdeath 262.00 7 PA American Water 13.06 8 PPL Electric Utilities 56.32 g Turo Law Offices 2,636.70 10 UGI 41.66 TOTAL (Also enter on line 10, Recapitulation) I $ (If more space is needed, insert additional sheets of the same size) REV-1513 EX + (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER JULIET A. MICELI 21 10 0295 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) (1.2)] 1. Thomas E Miceli, son Lineal 196 Lost Hollow Road, Dillsburg, PA 17019 Sch F & G 2 Theresa M Miceli, daughter Lineal 25 Clouser Road, Mechanicsburg, PA 17055 Sch F & G 100% residue 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ (If more space is needed, insert additional sheets of the same size) LAST WILL AND TESTAMENT OF JULIET MICELI I, JULIET MICELI, now domiciled in Cumberland County, Pennsylvania, declare this to be my Last Will and Testament. I revoke all other wills and codicils that I may have previously made. Article I My just debts and expenses of my last illness, funeral, and administration of my estate shall be paid by my Executor from the principal of my residuary estate as soon as practicable after my death. Article II All inheritance, estate, and succession taxes (including interest and penalties thereon, but not including any generation skipping tax) payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement from any person. This provision is not a waiver of any right which my Executor has to claim reimbursement for any such taxes which become payable as the result of any property over which I have the power of appointment. -;: -, ~ .:__, - lJ ,_~ J:7 .:. :a r= :_I7 - Article III I give, devise and bequeath in accordance with any memorandum which I have either handwritten or signed, located with my will or with my valuable papers and found within 30 days of the probate of my will. Gifts may only be to persons who survive me or to organizations which exist at my death, and if there is a conflict, the memorandum having the latest date shall govern. Article IV All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give, devise and bequeath to my daughter, THERESA M. MICELI, of Cumberland County, Pennsylvania. In the event that THERESA M. MICELI predeceases me or fails to survive me by thirty (30) days, I give, devise and bequeath the remainder of my estate, of whatsoever nature and wheresoever situate according to the following schedule: A. FORTY PERCENT (40%) to my grandson, JOSHUA MICELI. If JOSHUA MICELI predeceases me or fails to survive me by thirty (30) days, then I give, devise and bequeath his share to ST. JOSEPH CATHOLIC CHURCH, or its successors, of Mechanicsburg, Pennsylvania, to be used at its discretion. -2- B. FORTY PERCENT (40%) to my niece, MARY FRANCES BUCHINSKY. If MARY FRANCES BUCHINSKY predeceases me or fails to survive me by thirty (30) days, then I give, devise and bequeath her share to ST. JOSEPH CATHOLIC CHURCH, or its successors, of Mechanicsburg, Pennsylvania, to be used at its discretion. C. TEN PERCENT (10%) to CYSTIC FIBROSIS FOUNDATION OF CENTRAL PENNSYLVANIA, or its successors, of Harrisburg, Pennsylvania, to be used at its discretion in memory of my sons, Joseph Miceli and Edward Miceli. D. TEN PERCENT (10%) to ST. JOSEPH CATHOLIC CHURCH, or its successors, of Mechanicsburg, Pennsylvania, to be used at its discretion. Article V Except as otherwise provided in this Will, I have intentionally failed to provide for any other persons or relatives, whether claiming to be an heir and/or relative of mine or not. Insofar as I have failed to provide in this Will for any of my relatives, and/or issue now living or later born or adopted, such failure is intentional and not occasioned by accident or mistake. Specifically, my son, THOMAS E. -3- MICELI, of Dillsburg, Pennsylvania is not to inherit any monies or property, personal or real, under the terms of this Will. Article VI If any person or entity other than me singularly or in conjunction with any other person or entity directly or indirectly contests in any court the validity of this Will, including any amendments or codicils thereto, then the right of that person or entity to take any interest in my estate shall cease, and that person or entity shall be deemed to have predeceased me. Article VII I nominate, constitute, and appoint my daughter, THERESA M. MICELI, of Cumberland County, Pennsylvania as Executrix of my Last Will and Testament. In the event of the renunciation, death, or inability to act, for any reason whatsoever of my Executrix, I nominate, constitute and appoint my niece, MARY FRANCES BUCHINSKY as successor Executrix of my Last Will and Testament. I direct that my Executrix or successor Executrix be permitted to serve without bond and in addition to those powers granted by law, I grant them power to distribute in cash or in kind in like or in unlike shares and to file any qualified disclaimer I could have filed if living. My Executrix or successor Executrix shall receive reasonable compensation for services -4- rendered to my estate. Article VI In addition to the powers conferred by law, I authorize my Executrix and successor Executrix, in her absolute discretion: (a) to retain in the form received and to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estate, (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, (f) to file any federal income tax return for any year for which I have not filed such return prior to my death, (g) to make distributions in cash or in kind, or in both, and to determine the value of any such property, (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Executor; and to pay from my estate reasonable compensation for all -5- their services, (i) to conduct alone or with others, any Uusiness in which I am engaged in, or have an interest in at time of my death, and (j) to receive reasonable compensation in accordance with their standard schedule of fees in effect while their services are performed. IN WITNESS WHEREOF, I, JULIET MICELI, hereby set my hand to this my Last Will and Testament, on f ~ V ~ ~~ 2005. ULIET MICELI In our presence, the above-named JULIET MICELI signed this and declared this to be her Last Will and Testament and now at her request, in her presence, and in the presence of each other, we sign as witnesses. Name ~~ ~~ / Aclclre~t 845 Sir Thomas Court, Suite 12, Hamsburg, PA 17109 845 Sir Thomas Court, Suite 12, Harrisburg, PA 17109 -6- I, JULIET MICELI, Testatrix, who signed the foregoing instrument, having been duly qualified according to law, acknowledge that I signed and executed this instrument as my Will, and that I signed it willingly as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by JULIET MICELI, the Testatrix on f ~ - ~~ ~ 2005. _ ~c; ~f' otary ~ublic ,~~ CDMMONWEAtYTi OF pEpHSfI.YAtOA NOTARIAL SEAL u1CpUELiNE A. KELL`~ NOTAR'f PUBLIC LDWER PAXTON 1WP., DAUPHIN COUNTY M'( CpMMiS$ION EXPIRES DEC. L7, 2007 LIET MICELI We, the undersigned witnesses who signed the foregoing instrument, being duly qualified according to law, depose and say that we were present and sa~v the Testatrix sign and execute this instrument as her Will; that she signed and executed it willingly as her free and voluntary act for the purposes therein expressed; that each of us in her sight and hearing signed the Will as witnesses, and that to the best of our knowledge, that she was at that time eighteen (18) years or more of age, of sound mind, and under no constraint or undue influence. Sworn to or affirmed and subsci~bed to before me by t Ctu-~1~ ~,L~l~ and :, . ~ . l ~ ~ - .i ~ , witnesses, on j (- o ~~ , 2005 ~ ~ - r~ ~ `'//r ~----- -`' ~ -fit, ~/Ct iota ~'ublic c~,2,~ Witness ~ ' ~ V~~ ness COMMONWEALTH Of PEHHSYLYANIA NOTARIAL SEAL JACQUELINE A. KELLX NOTARY PUBLIC LOWER PAllTOH TWP., DAUPHIN COUNTY MY COMMISSION EXPIRES DEC.17, 2007 7- Brokers Opinion of value I ~;i} L~.. ~I~ri«cll~ [Zu~~cl, il~Ic~~l1~l~~ic~hur~~, [?~1 I7O~O G r ~''' ~i,~illiat~l ,~i~'l(~~. ~~tti~~t~ E'i~l' ~f~l'~IllCtit (~~~(?ic~~ Intcrtutiirrt?al fZr?ail C)i~ isi~,tl f'i~~'j~cr~.t~ ~ ~ ,,. I ~'ri \i;c~;; _'~ ('luu~rr !Zt~~i;l \ltt~ _~i;.~1 ~~~ ~ )tit !\il~~l!~i'i(~i' iti \tliii (~lUt1CCt~ ~1~~:~, c:,ilt~~r~~.r~.~n; ,Ili~uf~'1131ti~t Market Value Assessment (MVAj ~._____, 1. Inspection Contact a. Name: b. Phone: d. Inspection Date: 2. Property Location a. Address: b. City: d. Zip: Property Description 3. Site Description a. Topography: b. Visibility: c. Access: William Aiello 717-730-3752 c. Email: william.aiello,^a,colliers.com Saturday, May 01, 2010 180 E. Trindle Road c. ST: I FA 17050 lat :xcellent 'rindle Road d. Please Attach at Least 1 Photograph: r 4. Improvements Description a. Property Type: b. Year Built: d. Bldg/Occupancy Size: f. Building Class: g. Exterior Fagade: h. Roof Cover Type: i. # of Baths: j. Amenities: k. Exterior Condition: F. Interior Buildout Condition: m. Floor Configuration: n. Drive-Up Window: p. Comments: Picture 1 Caption See attached photos Residential/ Commercial 1920 c. Number of Elevators: e. Number of Stories 2 Residential Stone, Wood Siding Shingle 2 in house/ 1 in shop Fireplace Fair 2 Floors o. Parking Spaces: 5+ Two story 2200 sf Cape Cod style house with eat-in kitchen, living room, dining room, 2 bedrooms and full bath on first floor; Second floor: separately metered efficiency apartment with full bath, kitchen and 3 rooms. 792 sf shop on corner with 1 full bath and 2 rooms. The garage building (60x35) has 4 bays and 5 garage doors. Municipal Research 5. Real Estate Tax Assessment Parcel 1 a. Parcel ID: 10-22-0523-053 b. Land Acreage 0.77 Acres c. Assessor's FMV N/A d. Assessed Value Parcel 1 Parcel 1 Year: % of f=MV: Land: Land: $ as,ooo Building: Building: $ t7t,e9o Other: $ Other. $ Total: $ Total: g 2te,~9o e. 2009 Tax Rate: 0.0127230 f. 2009 Taxes: $ 2 757 6. Zoning a. Designation: b. Permitted Uses: Commercial Limited .esidential use (for existing dwellings); child day care center, private nursery or kindergarten; ublic utilities and facilities; telecommunication towers; municipal buildings and/or uses; theaters,,. ssembly hall, places of amusement, commercial recreation establishments including skating nks, swimming pools, golf driving ranges and outdoor movies and clubs, including health clubs nd lodges; public and semipublic uses such as churches, libraries, schools and recreational icilities; office buildings and professional offices; medical and dental clinics; Banks, investment rokers and finance agencies; personal services (in which not manufacturing plants); commercial ses serving the community; undertaking parlors and funeral homes; studios for instruction in iusic, arts, science, radio and television; dry cleaning shops, pressing shops or tailoring shops; ~staurants, tea rooms, cafes or other similar places serving food or beverages without "in-car", hive-in" or service outside the building; bakery, candy, pastry confectionery or ice cream retail ales; hotels, motels and residential hotels; private schools conducted for profit; Florists and urseries; convenience stores without fuel dispensing services; and self-service storage facility. c. Does property use conform to zoning? Y0s (Yes/No) Is there surplus land area or development potential? Yes (Yes/No) I(Yes, please explain: This property is free standing and could exist by itself. Its highest and best use would be to assemble it with the adjacent properties to provide a larger development parcel for commercial development. If this would occur there would be considerable taking of the subject parcel western perimeter for traffic infrastructure improvements. 7. Wetland/Conservation Issues? No (Yes/No) 8. at om raoaes - o ases ite Distance to Sub. res Price per Acro dJustment djusted Price 5236 E Ttindle 21 milts 0.92 $492,446.00 -50.00% $246,223.00 t Road 5238 ETrindle 22 miles 0.89 $311,124.00 -35.00% $202,230.60 2 Road 5155 E Trindle 17 miles 0.30 $383,334.00 -40.00% $230,000.40 3 Roed $226,151.33 9. Broken' Opinion X174,136.63 ~. property at 5180 Triode Road is zoned for commerolat use on a lighted T Intersecdon. Thi rsection is currently failing in rogards to Pen Dd studies. tl the properly would be rodevelope a would be considerable taking d the western pedmeter d the subject property. The ddon d the property is in poor conddon with dated Duildngs. The comparable sale #1 was best comparable in type to Ne property. This comparable was dscounted due to the 3rence in acreage and the updated t:anmerdal use on the property. This comparable is also ed on the assessed value of the properly due to lads of sale prke. The comparable #2 is ed for a commercial use but does not have a current commercal use on the property and is htly bigger in acn~ge. The final comparable sale #3 has considerably less acreage is not ed for commercial use but has a similar residendal home. Therefore the Brokers opinion of ue is bt 74, t 36.53 dollars. Prepared by W Illiam Aiello Cdliers Intemadonal 20 S 3&h Street Suite 201 Camp Hiil, PA 17011 717-730-3752 Create PDF with G02PDF for free, if you wish to remove this line, click here to buy Virtual PDF Printer ~~~~ Phoenix Life Insurance Company PHL Variable Insurance Company Phoenix Life and Annuity Company Members of the Phoenix Complmy Inc. June 10, 2010 Jan L Brown & Associates Attorneys at Law 845 Sir Thomas Court Ste 12 Harrisburgh PA 17109 1ZE: Contract i Yolicy: QOOOti007070 Deceased: JULIET A MICELI Claim No: 100322HS 1057 Fax (717) 541-9223 Dear Ms. Brown: The date of death value (as of 3/14/2010) for the above annuity is $37,718.39. We are ready to assist you with these important fmancial matters. Our Claims Examiners are available at 1-800-814-3692 to answer your questions Monday through Friday from 8:30 a.m. to 5:00 p.m. Eastern time. As always, we appreciate the opportunity to serve your insurance needs. Sincerely, ~~iG~ Life Claim Examiner Benefits PO Box 8027 Phone 800.628.1936 Boston MA 02266-8027 Internet www.PhoenixWM.com