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HomeMy WebLinkAbout03-0984PETITION FOR PROBATE and GRANT OF LETTERS~ Estate of Samm~ R~-~.-Scandrol No. also known ascxN~_. %~mo~,.\ ~.?~:c\ To: Dece~ed. Social Securit~a. 180-22-7059' The petition of the undersigned r~pectfu~y represents that: Yo~ petitioner(s), who is/~e 18 ye~s of age or older ~ the executor in the l~t w~ of the above decedent, dated February 3. 1998 ~d c0~cil(s) dated n~,~ Register of Wills for the " County of Cumberland in the Co _ .mmonwealth Of Pennsylvania named ,19__ (state relevant circmnstances, e.g. renunciation, d~ath Of executor, 'etc.) Decendent was domiciled at death in. Cumberland Countyi Pennsylvania, with h ~ ~ last family or principal residence at 1519 Kathryn Street. New Cumberland, PA 17070 (list street, number and muneipality) Decendent, then. 76 years of age, died November 11 ~ 2003 ,Xlg~ at 1510 ff~thryn Street. New Cumberland. PA 17070 ' Except as follows, decedent did not marry, was not divorced and did not have a child bom or adopt~n~ 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-'t~ Pa.) Personal property in Pennsylvania (If not domiciled iri'Pa.) ' PerSonal property in County Value of real estate in pennsylvania situated as follows: $.''70,000.00 $ $, 110,000.00 WHEREFORE, petitioner(s) respectfully request(s) the probate of the last .will and: codicil(s) presented herewith and the grant of letters theron. Patr±c±a A. R±cker 175 Copper Road gh,mmal ~'n~-n .. PA I 70't6 ~o (testamentary; administration~ c.t.a.; administration d.b.n.¢.t.a.) OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF c,,,.h,=.-~ ~-d 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 represen2 tative(s) of the above decedent petitioner(s) will)atel~ and truly administer the estate according to law. a ~. 'Otto st D~pur~ z ' -- ·-- ,xTF, x~/,z; 1~0. 21-2D~Y~-qR,~ - · Sam R. Scandi-ol a/k/a_ Deceased Estate of sa,.- :.- - ~aro~ . , DECREE OF PROBATE AND GRANT OF LETTERS Nove~nber 26th, ~ in consideration of the petition on AND NOW the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated ~,~hr,_,~--y 3. 1998 described therein be admitted to probate and ~ed of record as the last will of gan u. g~-ar, a*'eZ, a/k /a Samuel R. ~ ; and Letters~~ga~~~l-s°--n' n/k/a are hereby grant ' Nailed FEES Probate, Letters, Etc .......... $ 235.00 Short Certificates( 11~ .......... ~~.xx.' .x. =.p.a._qe.~.. ,(.3)$ .9.00 JCP Fee $ 10.00 TOTAL Fried ... NOvember' 26'th; 21303 .......... Let~tera to Executrix o n 11/26,/,2003. Donna M.Otto,lst Deputy Michael Cherewka ID #35073 ATTORNEY (Sup. Ct. I.D. No.) 624 North Front street ADDRESS Wormleysburg, PA 17043 717-232-4701 PHONE his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 9650705 No. Local Registrar NOV ! 9 2002 Date 143 Rev. 2/87 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH N/OSE OF DECEDENT (First. Middle. Last) [SEX [ SOCIAL SEC URiT~' ;4~iLFB~7 ..... [ DATE OF DEATH (Month. Day. ye~., s. S~uel Robot Se~ol l~ M~e J~ 180 - 22 - 7059 14 Novemb~ 17,' 2003 AGE (Last B~ay) I UNDER1Y~ I UNDERI~AY DATE OF BIRTH I BRTHP~CE(~.~ IP~CEOFOEATHICh~o~.~st~s~olhm~ I' I M~s I Days I ~u~ I M~ules I (~, D~y,y.~) I ~ ~ F~ ~) ~.ose~: ~ ~OFD~TH ~ GI~, BORO,~P OF D~TH FAGILI~ME Iln~insUtu~ givesl~landnu~r) IW~DE~E~NT~HI~P~IGORIOlN7 ,. I ' ' I ~, ' ' ' I ~o. DECEDENTS ~U~ ~UPATI~ KINOOF BUSiNESS/iNDUSTRY ~AS DECEDENT ~RiN, DECEDENTS E~CATi. i I (~e ~ ~ ~ ~ ~ ~ I ~IT~ STA~S - Ma~. SURVIVING DECEDENTS ~IMNG ADDRESS (S~t. City~n. S~, Zip C~e) [ DECEDENTS ~O~ live in a ~al~ New Cumb~land ~. ~- r~rera ~rc~ I~o~. 125 6oop~ Ro~, ff~me~own, PA 17036 ~.. -- om.(s~) D 2,~Novemb~ 19, 2003 12~~ Pen~,,lv~la Crg~or~ "1 u...;.~ .... p~ ~-~U"E~FU~ER~E~RPE~ON~GA~,~OH ILIOENSENUMBE" IN~E~D~ORESSOFF~ILI~~O" ~O~Z~ O~ ~A ~09 ~y~n~'~' m ~ av,~' .~W ~ ~:~,t me o, ~a~ ~] To m ~yof m~dge~s~na~r~ ~1 . deem ~,ed aUhe time. dale and Hace stated . ] MCENSE NUMBERDAT~SlGNED ~opr~n~s~ea~. I ....... t~ -- ~ I / )~ ( . ay, ear) IWASOASEREFERREDTOAMEDiCALE~MiNER~ER? IMMEDIATE CAUSE (Final disease or condition ~'esul~ng in Sequentle#y list cofldi~<ms if any, leading lo immediate cause. Enter UNDERLYING CAUSE (Disease or injury PART I1: Othe~ sign~ticant co~diUo~.~ conb~uUng to death, bul not resulting in the undedying cause given in PART I. WAS AN AUTOPSY I WERE AUTOPSY FINDINGS I MANNER OF DEATH J DATE OF INJURY TIME OF INJURY I N JURY AT WORK? I DESCRIBE PERFO.ED,"AVAI LEPR/ORTOcoM TIO"OFOAUBEI .omi a nit ............ I OF D~TH? Natural I ~ent ~ Pending Investigation I I I I *~E~T~I~G ~HY~IC~ (~y~n ~g cause ~ dea~ ~en ~er ~ys~an has onou~ed death a~ ~mCeted il~ 23 31b. '%~o~9B~ A~O C~.pFY~G rHYS~C~ <Phy~i,. ~ ~o~.~.~ ~,~ ~ ~,i~.. ~o ~.se o~ 'MEDICAL EXAMINER/CORONER On the belle of examination and/or InvenUgaUon, In my opinion, death occurred et the time, date, and place, and due to the causes(s) and 3ia.manner as itated ............................................................................................................................................................ [] REGISTRAR'S $~.-~TURE AND N"M_n=R..,..~,.~ ,,. NAME AND A~DRESS OR P~[I~ON WHO COMPLETED CAUSE OF DEATH (Item 27) Type or Pdnt DATE FILED (M~B, Day, Year) 34. ~/~. 21-2003-984 LAST W~J. AND TF_~qTAMENT OF SAMUE, n R. SCANDROL I, SAMUEL R. SCANDROL, of 1519 Katheryn Street, New Cumberland, Cumberland County, Commonwealth of Penn~lvania 17070, being of sound mind and memory, hereby revoke and declare null and void any and all Wills and Codicils heretofore m-de by me, and do m-be, publish, and declare this to be my Last Will and Testament. I direct my Executrix to pay my just debts, th%expenses of my last illness, and my funeral expenses from the property passing under this Will as an expense and cost of administering my estate, as soon after my death as may be found convenient. SECOND I hereby direct my Executrix to transfer all of my weapons, fishing gear, camping gear, and the like to my son, ERIC S.B. SCANDROL. I give, devise, and bequeath the rest, residue, and remslnder of my estate of every nature and wherever situate, of all that I own in equal shares to ERIC S.B. SCANDROL, VALERIE C.H. SCANDROL, and PATRICIA A. WILSON. However, should any of my children predecease me or fail to survive me by thirty (30) days, then that child's share shall pass to their descendants per stirpes by representation. It is further my desire that my Executrix, after consultation with any heir or heirs of mine who survive me, and in his, her or its discretion, choose such articles from my tangible personal property (exclusive of cash, stock certificates, bonds, and all other tangible evidences of intangible personal property) as he, she, or it believes will be useful to such heir, family member, friend, or personal acquaintance, or desirable for such person to have, either from a sentimental point of view or otherwise; and to deliver such Page 1 of 4 articles to such person, or among such heirs in equal or unequal shares as determined by the further exerdse of his, her, or its discretion, provided no heir objects to the distribution after being given suitable opportunity to do so. Any such distribution shall be taken into account at its current fair m-~ket value in regards to the final disposition of the assets of my estate. Any devise or distribution under this, my Last Will and Testament, which is payable to any beneficiary who m,y be under twenty-one (21) years of age, shall be held in a separate trust by that beneficiary's parent or guardian as trustee until such beneficiary reaches twenty-one (21) years of age. During the term of any trust created pursuant to this paragraph, the trustee is authorized to expand and apply so much of the net income and principal of each such trust as the trustee shall consider it advisable for the health, maintenance, support, education (including college education, graduate school), purchase of a residence, or payment of debts preexisting my death for each such beneficiary until he or she attahm twenty-one (21) years of age, or until all such amounts are paid out of trust. I direct that no trustee shall be required to give or post bond for the faithful perform-uce of the trustee's duties in this or any other jurisdiction. SIXTH I nominate my Daughter, PATRICIA A. WILSON, as Executrix of my estate. If she is unable or unwilling to perform her duties as Executrix, then I hereby rmme ERIC S.B. SCANDROL as First Alternate Executor. If he is unable or unwilling to perform his duties as First Alternate Executor, then I hereby name VALERIE C.H. SCANDROL as Second Alternate Executrix. I direct that no executor/trix shall be required to give or post bond for the faithful perform~uce of the executor's duties in this or any other jurisdiction. / 1998. Samuel R. Scandrol Page 2 of 4 SIGNED, SEALED, PUBLISHED, and DECLARED by the above-named Testator, Samuel R. Scandrol, 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. · aTNES~'· ~ - y ~J)DF~SS ~ ADDRESS AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) ) COUNTY OF CUMBERLAND ) SS: I, SAMUEL R. SCANDROL, Testator, whose name is signed to the attached or foregoing instrument, having been duly q--!!~ed according to law, do hereby acknowledge that I signed and executed the instrument as my last Will, that I signed it willingly, and that I signed it as my free and voluntary act for purposes therein expressed. IN WITNESS WHEREOF, I, SAMUEL R. SCANDROL, have hereunto set my hand and seal this 3rd day of February 1998. SWORN or affirmed to and acknowledged before me, and Samuel R. Scandrol, the Testat,o~, th~,/3rdc_daT-gf February 1998. Samuel R. Scandrol No!aual Seal Matthew J Eshe!ma~:,, No'.ary Cct'x.~ f-i:1i Boro, ' ,h~ ' Page 3 of 4 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND I SS: the witnesses whose names are signed to the attached or foregoing instrument, being duly q, mll/ied according to law, do depose and say that we were present and saw the Testator sign and execute the instrument as his Last Will, that he signed willingly, and that he executed it as his free and voluntary act for the purpose therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge, the Testator was at that time eighteen (18) or more years of age, of sound mind, and under no constraint or undue influence. Sworn or affn-med to and subscribed to before me by /](rlOt~ ~. ,~-ffli,}~['-and (.l~t~-// . , the witnesses, this 3rd day of February 1998. NOT,~/y~~C' . Notadaf Seal Matthew J. Eshelman, Notary Public Camp Hill Boro, Cumberland County ~4~,,' Commission Expires Nov. 15, 1999 Page 4 of 4 PATRICK E LAUER, JR. Attorney at Law 2108 Market Street Aztec Building Camp Hill, PA 17011 (717) 763-1800 ~ ...................... H!!II I IIII IIII III IIIIIII I ri III CERTIFICATION OF NOTICE UNDER RULE 5. 6(a) Name of Decedent: SAMUEL R. SCANDROL Date of Death: No. November 17, 2003 2003-00984 To the Register: I certify that the Notice of Estate Administration required by Rule 5.6(a) of the Orphans' Court Rules was served or mailed to the following beneficiaries of the above-captioned estate on January 8, 2003. NAMES ADDRESS Patricia A. Ricker 125 Cooper Road Hummelstown, PA 17036 Eric Scandrol Valerie Scandrol Phillippe Scandrol 239 Iroquois Trail York Haven, PA 17370 139 Brownstone Park Hummelstown, PA 17036 67 Rue Victor Hugo St. Medard en Jolles France 33160 Date: March 2, 2003 The Law Offices of Michael Cherewka Michael Cherewka, Esquire 624 North Front Street Wormleysburg, PA 17043 (717) 232-4701 Capacity: Personal Representative X Counsel for personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND Patricia A. Ricker being duly ..wnrn according fo law, deposes and says that she is the Executor of the Estate of .. Samuel R. Scandrol ~ate of New_C~e~:~a.o~ ....... , Cumberland County, Pa., deceased ~nd wifhin is an inventory made by Patricia A. Ricker .., the said Execptor of ~he entire estate of said decedent, consisting of all ~he personal property and real estate, except real es+ate outside asfheofC°mm°nweal~hfhe date of decedenf°f Penn, sylvanle,s death, end that the figures opposite each item of fha Inventory r~esenf it's fair value June 7. 2004 19 Executor~ Ad~ln,strator Notarial Seal Michael Cherewka, Notary Pub c Wormleysburg Bom, Cumberland County My Commission Expires Feb. 5, 2005 Member, Pennsylvar~la Association ot Notaries Date of Death __ November 17, 2003 Day Patricia A. Ricker 125 Copper Road, Hummelstown, PA 17036 Month 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. , INSTRUCTIONS An inventory must be filed within three months after-appointment of personal representative. 0 0 -~ O O Inventory of the real and personal estate of Samuel R. Scandrol deceased Residence, 1519 Kathryn Street, New Cumberland, PA 17070 Prudential, Common Stock, 11 Shares Manulife, Common Stock, 113 Shares Car, 2002 Chevrolet Malibu Pentagon FCU, .Account ~o. 347867-01-2 Prudential Discovery Plus, Account No. 95143392 PNC Bank, Account No. 51400158961 117,612 402 3,921 8,500 1,665. 18,351. 2,810. $153,262 Law Offices of Michael Cherewka 624 North Front Street Wormleysburg, Pennsylvania 17043 (717) 232-4701 (717) 901-3770 Fax (717) 232-4774 June 7, 2004 Honorable Mary C. Lewis Register of Wills Cumberland County Courthouse Carlisle, PA 17013 Re.' Estate of Samuel R. Scandrol Estate No. 21-03-00984 Our File No. 2267.00 r_ Honorable Mary C. Lewis: Enclosed please find Original and one copy of REV 1500, Inheritance Tax Return for Resident Decedent, Inventory and Estate check No. 134 in the amount of $5,359.01 representing the final payment of the Pennsylvania Inheritance Tax in the above referenced Estate. Also enclosed is an estate check in the amount of $25.00 to cover the cost of filing the Inventory and the Return. We have enclosed a copy of the front page of the return and a copy of the Inventory. We ask that you time-stamp the copies and return them to us in the enclosed stamped envelope. If you have any questions, please call the undersigned. Thank you for your consideration in this matter. Very truly yours, Michael Cherewka MC/Il Enclosures COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-O601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD O041 O9 CHEREWKA MICHAEL 624 NORTH FRONT STREET HARRISBURG, PA 17043 ........ fold ESTATE INFORMATION: SSN: 180-22-7059 FILE NUMBER: 2103-0984 DECEDENT NAME: SCANDROL SAM R DATE OF PAYMENT: 07/01/2004 POSTMARK DATE: 06/29/2004 COUNTY: CUMBERLAND DATE OF DEATH: 11/17/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $5,359.01 REMARKS: CHECK# 134 SEAL TOTAL AMOUNT PAID: $5,359.01 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS t w Office of ' :herewka ~,rth Front Street ,eysburg, PA 17043 '0,: M.. -i Honorable Mary C. Lewis Register of Wills Cumberland County Courthouse I Courthouse Square Carlisle, PA 17013 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFiCiAL USE ONLY FILE NUMBER COUNTY CODE YEAR _0__O 9 8 4 NUMBER DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Z Scandrol, Samuel R. 180 - 22 - 7059 LM DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) ~ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE U.I 11/17/03 08/05/27 REGISTER OF WILLS iii (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER I.LI UJ J--~'J 1. Original Return [] 2. Supplemental Return J---J 4. Limited Estate J---J 4a. Future Interest Compromise (date of death after 12-12-82) [] 6. Decedent Died Testate (A~ch copy of Will) [] 7. Decedent Maintained a Living Trust (A~ch copy of Trust) J---J 9. Litigation Proceeds Received ["-'"J 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) NAME Michael Cherewka, Esquire FIRM NAME (If Applicable) The Law Offices of Michael Cherewka TELEPHONE NUMBER 717-232-4701 r~3. Remainder Return (date of death pdor to 12-13-82) --]5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes E11.Election to tax under Sec. 9113(A) (A~ch Sch O) COMPLETEMAILINGADDRESS 624 North Front Street Wormleysburg, PA 17043 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Modgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) ]Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7} 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. 117,612.57 4,323.70 ~.- 0.OO 0o00 32,049,0.000.0060 t!ii~ (8) (11) (12) (13) 4,066.27 30~830.49 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) (14) OFFICIAL USE ONLY 153,985.87 34,896.76 119,089.11 0.00 119,089.11 BEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) None x .0 __ (15) 16. Amount of Line14 taxable at linea~ rate ].19 ;, O89 .1]. x .0 45 (16) 17. Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) . 0.00 5~359.01 0.00 0.00 5,359.01 Decedent's Complete Address: ScTREET ADDRESS 1519 Kathryn Street ITY New Cumberland Tax PaYments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/P~yments ' .' : ' A. Spousal P6~erty Credit . B~ Prior Payments C. Discount 3. Interest/Penalty if applicable D. Interest . (1) .5,359..01 E. Penalty : ' Total lnteresl/Penalty ( D + E.) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Une 20 to request a refund If Une 1 + Line 3 is greater than Erie 2, enter the difference. This is the TAX DUE. .. A. Enter the interest on the tax due. ~ ~ Total Credits (A+ B + C ) . (2) ADDRESS. 125 Copper ' Road, Hummelstown, PA 17036 624 N. Front street, Wormleysburg, PA 17043 0.00 (3) (4) o, oo (5).'.:' ' .5,359.01 (5A) O. OO 0.00 For dates of death on or alter July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of lhe surviving·spouse is 3% [72 P.S. §9116 (a) (1.1) (0]. · · . · For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers Io 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 sbll applicable even if the surviving spouse is lhe 0nly beneficiary. · For dates of death on or after July 1, 2000: · · · · The tax rata 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 fiatural parent; an adoptive parent, or a stepparenl of the child is 0% [72 P.S. §9116(a)(1.2)]. . The lax rate imPOsed on the net value of lransfers 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 lhe 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 wi~h the decedent, whether by blood or adoption. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 5,35'9;01 . 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: a. retain the use or income of the property Iransferred; ........................................... ~.~ .................... *.....; ................. .~ ~ No b. retain the right to designate who shall Use the Property transferred or its income;...'~ ........ ;;..i.'....i...{.:...:;.L...~:.... [] ' [] · c. retain a mvereionay interest; or ............ ' r-] ' [] d.. receive the promise for life of either payments, benefits or care? ................. ~ ......... [] [] 2. If death occurred after December 12, 1982, did decedent Iransfer property within one year of death ·: ; without'receiving adequate consideration? ;...i ....... ' . · ~ · [] · . [] · 3, Did decedent ~vn' an "in trust for" or payable Upon death bank account or security' at his or hei' death?'.':.i.i..:..., r-]' '. [] .' · 4,. Did.d.eced~.nt o~n. ,an I .ndMdual Re~tirernent Account, annuity, Or other non-probata Property whic['f ' · · contains a ~nenaary aesignation-t: ..................................... ..: ..... . ,. ;.... [] ... [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE ITAS PART.OF THE RETURN. ................ · ~, ......... ~-~, and to ttie best of my knea,~,~ a~ baler, II 8 line, correct and complele." r-'~'-"~ of P,-,~,-~,~ ether limn the pe~ mpm~tlv~ is baaed on al ideenaa)n of whl~ ~r ~s any ~ REV-1502 EX+ (6-98) REAL ESTATE ~STAT~ OF S~UEL R. SC~DROL FILE NUMBER 2[-03-00984 All real pmpe~y owned solely or as a tenant In common must be reposed at fair market value, Fair market value is defined as the pdce at which pmpe~y would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of lhe relevant facts. Real property which Is jointly-owned with right of survivorship muat be disclosed on Schedule F. ITEM NUMBER DESC._.__.~RIPTION 1. ReSidence, 1519 Kathryn Street, New um er an , Cumberland County, PA See Attached Settlement Sheet: Contract Sales Price $118,000.0~ less: Settlement Costs (387.43 _._.~OF DEATH $117,612.57 TOTAL IAIso enter on line 1, Recapi[ulation) more space is needed, insert additional sheets of lhe same size) $117,612.57 FAX R&RPLASTER&DRYWALL CO l O. N~ME O~ B~'~R Sh~ ~Jliin~ur r.. ?,~xMli OF $12LL£~C ~,~mE~ of ~nm R. Scandrol , A F~DRE~.4 N~w Cum~rland Borough Tm'n¢~' & O'Com~ll, A~orneys m Law, ~le~hone: 717-Z3~551 F~x: 717-23~.21 '~ 5 4415 No~g~a~i~r~. PA 171 lO, 21B ..... . 12~i I 122,345.25 ,~;r.,h~t T .,~ 02/16/0¢m06130!04 -~07 ~2/26/~4 05:26 FAX R&RPLASTER&DRY~ALL CO ~J3. Ha~,ar~ mc;,rmn,',e ~m~l~ Y~r , ICl ~ mn ~t_ 1 lOn_Tf11_E CH~JJ~g_ S Itoh 0.00t c_oc 12~3. ebde T~¢ae-d~ ~eoda L ~'lllO. ~0 94e :[' ~'119 T 99 I (3,.s~.[ -~ .31 9?7.7~ ~8*'T. 43 ESTATE OF SAMUEL R. SCANDROL FILENUMBER 21-03-00984 All property jointly-owned with right of survivorship must be disclosed on Schedule F, ITEM NUMBER 1. DESCRIPTION EQUISERVE - PRUDENTIAL Common Stock · Account# 6281-1683, 11 shares @$36.60 MANULIFE - 113 shares @ $34.70 Closing Price on CUSIP: 41014S 10 6 November 17, 2003 VALUE AT DATE OF DEATH $402.60 $3,921.10 TOTAL (Also enter on line 2, Recapitulation) (If n'z)re space is needed, insert additional sheets of the same size) $ 4,323.70 EO._LIISERVE February 26, 2004 LAW OFFICES OF MICHAEL CHEREWKA 624 NORTH FRONT ST WORMLEYSBURG PA 17043 PRUDENTIAL SAMUEL R SCANDROL Account Number: 6281-1683 Dear Mr. Cherewka: Thank you for your inquiry regarding the share balance of the above referenced account. We appreciate the opportunity to be of service to you. On November 17, 2003, account number 6281-1683 held 11 shares. On that date, the closing price was $36.60 per share. If you have questions related to your compensation or general demutualization questions, please call the Demutualization Information Center toll free at 1-800-305-9404 between 8:30 a.m. to 6 p.m., Eastern Time, Monday through Friday. If you are using a telecommunications device for the hearing impaired (TTY/TDD), please call 1-800-619-2837. A customer service representative will be glad to help you. Reference Number: 01339598 IBERN OLDER SERVICES SCHEDULE C .-~- I CLosELY HELD COR S~EL R. SC~DROL FILENUMBER 21-03-0098.4 S~edule C-] or C-2 (including all ~up~n~ inM~nlion} mus[ b~ ~ffa~.d for each olos~ly~eM ~orn~on/pn~nembip in~resl of ~ ~d~n[, olher [han a ITEM NUMBER NUMBER 1. sole-proprietorship. See instructions for the supporting information to be submilted for sole-proprietorships. NONE DES.___~CRIPTION VALUE AT DATE OF DEATH -O- TOTAL (Also enter oh line 3, Recapitulation) (If more space is needed, insert additional sheets of the same size) REV-1507 EX+ (6-98) COUMO~E^.T. OF.~..S~V~.,~ I MORTGAGES & NOTES INHERITANOE T~ RETURN I RECEIVABLE S~[[ ~. SC~DRO~ FILE NU~BE~[_03_00984 All property Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER NONE DE__.SCRIPTION TOTAL (Also enter on line 4, Recapitulation) (If more space is needed, inserl additional sheets of the same size) VALUE AT DATE OF DEATH -0- REV-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SAMUEL R. SCANDROL SCHEDULE E CASH, BANK DEposITS, & MISC. PERSONAL PROPERTY 21-03-00984 FILE NUMBER ITE~I NUMBER !. 2. 3. 4. 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. DESCRIPTION Car, 2002 ChevroletMalibu Refund, real estate taxes (school) Refund, real estate taxes (Local) Pentagon Federal Credit Union, Share Savings Account #347867-01-2 Plus accrued interest Prudential Discovery Plus- Death Benefit. Value as of act,.#95143392 _ November 17, PNC Bank, Checking.Account No. 5140158961 Plus Accrued Interest Refund - Susquehanno Oil Company (See Statement-Sched~+iA) (See Statement-Schedule~A~ 200'~ TOTAL (Also enter on line 5, Recapitulation) $ ~LUE ~ D~E OF D~TH $8,500.00 443.37 17.55 1,663.05 1.52 18,351.89 2,810.57 .17 .259.48 $32,049.60 (If more space is needed, insert additional sheets of the same size) -- Prudential Prudential Financial 6116104 11:06 PAGE 2/3 RightFax June 15, 2004 Values Statement SAMUEL R. SCANDROL 1519 KA'I'HRYN ST NEW CUMBERLND PA 17070-1140 Owner: SAMUEl. R. SCANDROL Aanuitant: SAMUEL R, SCANDROL Contract Number: 95143392 Contract Date: 03/13/1998 Type of Contract-: Flexible Discovery Plus Market: Non-Qualified The values provided on this statement are calculated as of 11/17/2003, Any activity aRe~ this date is not reflected in this statement. If you surrender this con:rac; yea will lose the right to future annuity benefits unde~ the c~a~ract. In addition, all or part. of the distribution may be subject to federal and/or state income tax. You may also be subject to a 10 percent penalty tax for early with&awal. You may want to consult with your tax adviser if you have any questions concerning the applicable tax treamaent, as Prudential cannot offer tax advice. Although great care has been taken in preparing this statenaent, we reserve the right to amend thc statement as needed. Fa' additional information about the benefits available to you, please refer to yot~ original conu'act. Account Summary as of 11/17/2003 Prudential Money Maflcet Prudential Diversified Bend Prudential Conservative Balanced 1,795,25400 2,440880 $4,382,00 2,326,12861 4,266000 $9,923,26 937,56498 4,316110 $4,046,63 Surrender Value as of 11/17/03 Contract Value $18,351.89 Misc. Fees $0.00 Surrender Charge $526.59 Recaptm'od Bonus $1 Flerdble Discovery Plu~ k i~suedby 2~e Prudential lm~rance Csmqpm~y ofAn~ric~ ~JnJt values ortho vaxiab]c investment op6om arc determined at the end of&e business day on thetrade date or,he ~amac~Jon. Prudential 6116/04 11:06 PAOE 313 RightF&x *Note: The death benefit will equal the highest of the Contract Fund Value or the Minimum Proceeds, defined as the surn of all purchase payments to date and any additional amounts oredited to the contract reduced proportionally by withdrawals. On the sixth contract anniversary, we will corr, p are the conu'act fund and the minimum proceeds. Whichever amoum is greater then becomes the minimmn proceeds on which we make the comparison. Withdrawals taken after 11/17/63 will potentially reduce the death benefit amount. Please consult your contract and/er prospectus for additional details on death benefit payments. Beneficiary Information Primary Beneficiaries ERIC SCANDROL PATRICIA RICKEl{ VALERIE SCANDROL Please see the beneficiary designation information in your contract for mere details. 'Kelley Blue Book THE TRUSTED RESOURCE Free Dealer ~rice Quote BLUE BOOK PRIVATE PARTY REPORT Pennsylvania · ,June 2, 2004 2002 Chevrolet Malibu Sedan 4D Engine: V6 3.1 Liter Trans: Automatic Drive: Front Wheel Drive Mileage: 15,000 Search Listings for This Car List Your Car For Sale Online Buy a New Car F r e .e_, _L.~_m_9 _n_ C_h__e q.k AutQ Lo a. r) s .. f .r__o_m__ _3 ..._ 8_5._°/_o_ A ~ _R I n~s u__r..~ n c~e~ Q.u_.qJ;e Pri_n_t.....'..'..E~o[ Sa!e, Sig.n Baym_~pt Calculator Equipment Air Conditioning Power Steering Power Windows Power Door Locks Tilt Wheel Cruise Control AM/FM Stereo Dual Front Air Bags ABS (4-Wheel) Power Seat Consumer Rated Condition: Excellent "Excellent" condition means that the vehicle looks great, is in excellent mechanical condition and needs no reconditioning. It should pass a smog inspection. The engine compartment should be clean, with no fluid leaks. The paint is glossy and the body and interior are free of any wear or visible defects. There is no rust. The tires are the proper size and match and are new or nearly new. A clean ti~;!..~ history is assumed. This is an exceptional vehicle. Private Party Value 5~arcb.ggcal L!~tings for Thl~ ~r $9,305 Private Party value represents what you might expect to pay for a used car when purchasing from a private party. It may also represent the value you might expect to receive when selling your own used car to another private pa rty. © Sear~ Usect Car Us~ing~ 0 Lis: Your Car i~ ~e Ge_t a _Used C_ac T_[a_.d~-In _~...~ Get !nvoice &MSRP ooNew car~ G~t a_ Per_s_o.n t_o Pers0n Auto.Loe. o Copyright © 2004 by Kelley Blue Book Co., All Rights Reserved. May-.lun 2004 Edition. The specific information required to determine the value for this particular vehicle was supplied by the person generating this report. Vehicle valuations are opinions and may vary from vehicle to vehicle. Actual valuations will vary based upon market conditions, specifications, vehicle condition or other htt~://www~kbb~c~m/kb/ki~d~~/kw~kc~ur?kbb.PA;573~8~;PA~4~&;sed+p&9~3;Chevr~~et;2~~2 Malibu&3;CH;... 6/2/2004 Kelley Blue Book THE TRUSTED RESOURCE © Fn~e Dealer Seas U~d Car Li-dJngs Your Car fo~ ~+ BLUE BOOK TRADE-IH VALUE Pennsylvania · June 2, 2004 2002 Chevrolet Malibu Sedan 4D Engine: V6 3.1 Liter Trans: Automatic Drive: Front Wheel Drive Mileage: 15,000 See g...O_.G~l gist.~ur Buy a New Car Free Lemon Check Auto Loans from 3.85% APR I n~s U._.r~ n~ce.....Qu 0 t e P~ay .m._e_nnt (~.~ !Cu I arq r Equipment Air Conditioning Power Steering Power Windows Power Door Locks Tilt Wheel Cruise Control AM/FM Stereo Dual Front Air Bags ABS (4-Wheel) Power Seat Consumer Rated Condition: Excellent "Excellent" condition means that the vehicle looks great, is in excellent mechanical condition and needs no reconditioning. It should pass a smog inspection. The engine compartment should be clean, with no fluid leaks. The paint is glossy and the body and interior are free of any wear or visible defects. There is no rust. The tires are the proper size and match and are new or nearly new. A clean t.i~!~ history is assumed. This is an exceptional vehicle. Trade-In Value List Your Car For Sale Online $7,200 Trade-in value represents what you might expect to receive from a dealer for this consumer owned vehicle. Keep in mind that the dealer must then absorb the cost of making the vehicle ready for sale, advertising, sales commissions, arranging financing and insurance and standing behind the vehicle for any mechanical or safety problems. Fouled theft new you Get a Private Party Value Get Invoice & MSRP on New Cars http ://www.kbb.com/kb/ki.dll/kw.kc.ur?kbb. PA;244758 ;PA041 & 17043 ;+t&278;Chevrolet;2002%20Malibu... 6/2/2004 APR-OS-2004 20~? PNCBA~< dj2 768 3458 P.01/~1 PNCBAN< ~a, pnl 6, 200~ Michael Ch~ewka 624 North Front Street Worraleysburg, PA t7043 Estate of Samuel R. Scaxtdrcl.~ deceased SSN: ] 80-22-7059 . Dear Mr. Cherewka: la ~.sponie to your request for Da. re of Death'l~a!ances for the customer notod abOve, our "~, ..." ' ' :. ' ' ~ Established:O8/O1/'1976. records show the following: Checking Accoullt A¢¢0um #$140 ~896 ! '. SAM R SCANDROL DOD balance: $2,810.57 ~' $.17 accrued interest ..... For Loan information, pl~ call 1-888-762..2265. (Account) RCA ~0030~9000012373 Pleas~ note that this offic~ only provide~ date of deat~ balan'ces fo~ d~°sit' accourtts' (IRAs, CDs, Ch~kiag and Savings accounts), we do not pro~ uny financial transactions or pr6vlde statements. If you n¢~ a.s$~sta~oe .Wi~5 any of please ca~! 1.$$$-PNC-BANK (!.ggSz762-2265) or s~6p by your local PNC Bank broach office. Sincerely, . Rach¢ll, W¢115 1-800-762-17'/5' PT-PFSC.04-F $00 Hrat Ave. Pi~t~burgh PA 15219 M~ab~ FDIC TOTAL. P. 01 MARY A, SMITH ?^Y TO '['H ~ - ' ~ ' - ................ : - ' ~~ · 0 ~' ~ ..... ~ .... Pent_agon Federal Credit Union Box 247009, Omaha, Nebraska 68124- 7009 (402) 951-2500 1-800-24 7-5626 www. PenFed. org February 21,2004 Michael Cherewka 624 North Front Street Wormleysburg, PA 17043 Re: Sam R. Scandrol File #: 347867 Dear Mr. Cherewka, We are writing in response to your request concerning the above referenced account. Our records indicate that Mr. Scandrol had the following account as of November 17, 2003: · Share Savings Account 347867-01-2 with Louise Scandrol listed as the joint owner with right of survivorship. The account had a principal balance of $1,665.05 with $1.52 in accrued yet not posted dividends for a total date of death balance of $1,666.57. This account was established on April 2, 1976. Please find enclosed the most recent signature card that could be located on this account. If you have any questions please do not hesitate to contact us at 1-800-247-5626. Sincerely, William H. Lockwood Estate Accounts Specialist Omaha Service Center MONTHLY STATEMENT c o. SO. BOX 70O DILLSBURG, PA 17019 Phone 766-1511 TO aChND~i, ~ST~T~, ~2~ COOpeR AMOUNT PAl D FINANCE CHARGE is computed at a rate c~f ~' $ 1 ~ applied to the previous balance after deducting current payments andlor credits appearing on this statement. per month, which is an ANNUAL PERCENTAGE SATE of To aVOid finance charges, pay the new balance before next billin~ date. ~- · BALANCE FORWARD ~1 ?- 97- PR::, . FO-GAS BO-BURNER CONTRACT : FO-FUEL OIL OM-CREDIT ~ ~T, · FO-KEROSENE DISC. * BS-BURNER SERVICE MB-MISCELLANEOUS ~1 /15/04 ] ~ 6 8 4 {4 ~., ALL PURCHASES AND PAYMENTS 5 ~ 6 . ~.. RECEIVED AFTER BILLING DATE WILL APPEAR ON THE FOLLOWING MONTH'S STATEMENT. REV-1509 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SAMUEL R. SCANDROL SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER 21-03-00984 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 NONE JOINTLY-OWNED PROPERTY: ITEM DATE MADE DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDEN'I1FYING NUMBER. ATTACH DEED FOR JOINTlY-HELD REAL ESTATE, NONE DATE OF DEATH DATE OF DEATH VALUE OF INTEREST --0~ TOTAL (Also enter on line 6, Recapitulation) $ (If more space is needed, insert additional sheels of the same size) REV-1510 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SAMUEL R. SCANDROL SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21-03-00984 This schedule must be completed and fi[ed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET' DESCRIPTION OF PEOPEETY ITEM I.~UOETHG NAMEOFTHETRANSFEREE, THEIRRELATIONSHtPTODGCEDENTAND DATE OF DEATH % OF DECD'S EXCLUS ON TAXABLE NUMBER THE DATE OF TRN~ER. ATTACHACOPYOFTHEDEEDFORREN. ESTATE. VALUE OFASSET INTEREST {IFAPPMCABLE~ VALUE ~' NONE -0- -0- -- TOTAL (Also enter on line 7 Recapitulation) [, insert additional sheets of the same size) REV-1511 EX+ (12-99) ..~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SAMUEL R. SCANDROL SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-03-00984 ITEM NUMBER 8. 9. 10. Debts of decedent must be reported on Schedule ]. DESCRIPTION AMOUNT FUNERAL EXPENSES: Cremation Society of Penna Memorial ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Sodal Security Number(s)lEIN Number of Personal Representative(~) Street Address City State Year(s) Commission Paid: Attorney Fees Family Exemption: If decedent's address is not the same as claimant's, attach explanation Claimant __ Zip Street Address City Relationship of Claimant to Decedent State Zip Probate Fees Accountant's Fees ~xRe~mPre~rer'sFees Legal Notices The Sentinel Cumberland Law Journal MiJcellaneous Postage, certified mail, express mail Photo copies Vital statistics - Death Certificate of Louise. Scandrol $ 210.00 327.56 3,000.00 --0-- 290.00 -0- -0- 90.71 75.00 50.00 4;00 19.00 $ 4,066.27 TOTAL (Also enter on line g, Recapitulation)I (If more space is needed, insert additional sheets of the same size) .Image' J Page 1 of 1 PATI~IA A, RICKER [ [ [ £ httos://www.mldatlnntieer~vn aro/Phr~n{¥/[ ]~I/h oor~,,nt;n~r/lm~aoe/lm~aa ~envg~g~='9'l I 'lll fl1 . Image, Page 1 of 1 . Image, Page 1 of 1 :!.5:3 5 O0000?SI, I~S~, I,.S 3S i REV-1512 EX+ (6.-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SAI~EL R, SCANDRO], SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILEzI~UI~E_Ro0984 ITEM NUMBER l, e 7. 8. 9. 10. 11. 12. 13. 14. 15. Include unrelmbursed medical expenses. DESCRIPTION Mortgage- Bank of America Loan No. 4901478372 (See Settlement Statement attached to Schedule A) Car - Chase Auto Financing (#7546) Real estate taxes, County (See Settlement Statement Schedule A) Sewer (See Settlement Statement - Schedule A) PNC Bank Line of Credit Account No. 4003049000012373 (See Settlement Statement attached to Schedule A) PP&L Electric (17010-85 002) Comcast cable (09547 175875-01-8) Pennsylvania American Water Co. (24-0621116-5) Verizon (717-774-5542-762-24-4) Sears/Citi Credit Card (Account No. 05-52781-02799-0) Gingrich Plumbing Allstate Insurance (09807771612/14) Home Depot Waste Management (611-0118798-0061~0) New Cumberland - Boro - Sewer TOTAL (Also enter on line 10, Recapitulation $ (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 9,459.24 11,748.83 79.46 11.00 7,743.10 63.74 72.77 36.48 63.60 309.38 1'90.50 96.52 566.89 328.68 60.30 $30,830.49 , ,' , . .4MQUI~T , i; , ' INTPF~S.? ? ·, PRlldC4p, q.' .,'i, '.'"' ' :',",., NKW, · / . .,.,,:, 754~ A o2e2e4 1,2334.Z7 ~tfr ~.1748 ~l~ ic~ 585 · 34 ClIK#, 064-:L39 .RR~P,t -~322.58 8EARR. WZ;"L~IDRAk~AL ~ 63!4 PA~Blig, cHASB. ,AU'%O.,~%I~M~..%.NG TIgLLBR, FEDERAL CREDIT UNION 5050 Derty Street Herrisburg, PA 17111 Telephone (717) 564.308 FAX (717) $64-1480 I PPL Electric Utilities For: SAM R $CANDROL 1519 KATHRYN ST NEWCUMBERLD PA 17070 Questions about t]iis bill? Please contact us by Dec 22 at 1-800-342-5775 or 484-634-4900 or write to: Customer Service 827 Hausman Rd. Allentown, PA 18104-9392 www.ppiweb.com Page 1 Summary Page Balance as of Dec 1, 2003 $ 0.00 Char~es: TotaFPPL ELECTRIC UTILITIES Charges $ 40.63 Total Charges $ 40.63 ~i '-'~: ::*~*ii¢i" - "~ ~ ~;J i g!~ i~gii:::i'~i'~;~:: ~:'57 ~*;~:!~i" ~i f~?Z~?~*: ~ ::'YZ-'."~':~;~:;i '~i~2i!~'.~' :? ~:: ~:*:i~?:.:~ '~ ~ ;~ :, ~ ~i~':~-~ ~I~?~ :: :-~'~.~:.~'~ ~: :.:: .: ':~.'~ Account Balance $ 40.63 i , Electric Use This graph shows your electric use over the last 13 mouths. l~ges of er Readings: Actual 1 Estimated ~ Customer ~] 36 30 Dec 1 Oct 30 24 32 Days Average - Dec 18 Temperature KWH Per Day 12 Yearly Use: , 6 Jan 2002 - Dec 2002 0 Jan 2003 - Dec 2003 DJ FMAMJ JASOND 2002 Months 2003 KWH - Average Per Day Meter Reading Information Meter//84576773 Actual 4620 Actual 4209 KWH Billed 411 2002 2003 41F 48F 15 13 Total Average Use Mont61~[ 8306 6860 572 Other important information on back t~on0 {C.omDany LLL- ano WlllCll tl-lttt croH~pany u~c~ to ~v.~ u~.ut to recover hpo'rtion of PPL Electric Utilihes' stranded costs. The gross receivts tax, which is collected for the Commonwealth of Pennsylvania, is equal to 4.4% of the ITC. For your convenience, you can nowpayyour bill using your Visa, M~terCard, Discover, or ATM Card. Uall BillMatrix at 1-800-672-2413. BiliMatrix will charge your credit and ATM card a service fee for making' this payment. Now you can receive and pay your PPL Electric Utilities' bill online. Chec~our web site for more information m~d to sign up -- www.pplweb.com No charge Co~wement Secure SAVE MONEY Save postage and late charges - signup for Automated Bill Paytnent. Questions aboUt this bill? piease contact us bY Jan22 at 1'800'34~'5775 or 484~634'4900 or write to: Customer ServiCe 827 Hausman Rd: Allentown, PA 18104,9392 vcww.pplweb.com Page 1 Summary Page Balance as of Dec 31, 2003 $ 0.00 Charges: TotarTPL ELECTRIC UTILITIES Charges $ 23.11 Total Charges $ 23.11 ~!"'~:'""~:~ <: ~,,,~.. :-~?~.~.~.~,:.~.;?~:.~.~:::,~ .......... ~ Ae~unt Balance $ 23.11 Electric Use This graph shows your electric use over the last 13 months. ePeS of ter Readings: Actual / Estimated ~ Customer ['--"] KWH - Average Per Day Meter Reading Information 36 IMeter//84576773 I 30 ] Dec 31 Actual 4808 ] I Dec 1 Actual 4620 I 24 130 Days ~ l'-'ig'g I Average - Dec 2002 2003 18 Temperature 31F 35F KWH Per Day 15 12 Yearly Use: Total Average 6 Use Mont6h91 ly Jan 2002 - Dec 2002, 8291 0 Jan 2003 - Dec 2003 6612 551 J FMAMJ JASONDJ 2002 Months 2003 Other important information on back -'~ For your convenience, you can now navvour bill using your Visa. MasterCard, Discover, or ATM Car~ l[2~tll BillMatrix at 1-800-672-2413. BillMatrix will charge your credit and ATM card a service fee for making this payment. Now you can receive and nay your PPL Electric Utilities' bill online. Chec[k our web site for mdre ififormation and to sign up -- www.pplweb.com No charge Convement Secure SAVE MONEY Save postage and late charges - sign up for Automated Bill Payment. ( omcast Visit us on the web at www.comcast,com ACCOUNT DATE NUMBER DUE TOTAL AMOUNT DUE 09547 175875-01-8 11/30/03 $70.41 13800 Tr nd e Rd Su te B camp Hill; PA 17011 lance News from Comcast Thank you for your more q[ card pay Account I ( omcast, COMCAST CABLEVISION 4008 N DUPONT HWY NEW CASTLE DE 19720-6328 ADDRESS SERVICE REQUESTED Please detach and enclose this coupon with your payment. Do not send cash. Make checks payable to: COMCAST CABLEVISION Date Due Total Amount Due AMOUNT ENCLOSED 11/30/03 $70.41 $ 000-11-03-C-C Account Number 09547 175875-01-8 AV 01 035484 76668B 98 A**5DGT SAM R. SCANDROL 1519 KATHRYN ST NEW CUMBERLAND PA 17070-1140 I,,,111,,,111,,,I,,,111,,,,,,11,,,11,1,,111,,,,,,111,1,,I,1,,I I,,,111,1,,,,11,1,1,,I,,I,,,11,11,,,11,,,,I,1,,,I,II COMCAST CABLE P 0 BOX 3005 SOUTHEASTERN PA 19398-3OO5 09547 175875 01 8 7 007041 ( omcast, Visit us on the web at www.comcast.com ACCOUNT DATE NUMBER DUE TOTAL AMOUNT DUE 09547 175875-01-8 ON RECPT $2.36 How to reach us... How to reach us: 3800 Trindle Rd, Suite B Camp Hill, PA 17011 (717)540-8900 Telephone Customer Service 24 hOurs a day, seven days a week ance & Fees Total Due News from Comcast We regret losing you as one of ou final balance shown above is now outstanding equipment must be any time should you wish to reconnect your service. Customer Account Information For ServiceTo: Samuel R Scandrol 1519 Kath ryn St Account Number: 24-0621116-5 Premise Number: 24-0367304 Billing Period & Meter Information Billing Date: Dec 03, 2003 Billing Period: Oct 30 to Dec 01 (32 days) Next reading on/about: Jan 02, 2004 Rate Type: Residential Meter readings in current billing period: Meter Number N000012725 is a 5/8-inch meter. Present-actual 6445 0 0 Last-actual 6435 0 0 Gallons used ~0~ Water Usage Corn parison Monthly usage in hundred gallons. 12 2 D J F M A M J J A S O N D 2 0 e a e a ~ a u u u e c o e 0 0 c n b r y n t g p t v c 0 2 3 Billing Summary .......... Prior Balance ........................ Balance from last bill Payments prior to Dec 03, 2003. Thanks! Total prior balance, Dec 03, 2003 .......... Current Water Charges .......... Service Charge Water Volume ($.005277 x 1,000) STAS PAWC Water 0.07% DSI - PA WC Charge 1.76% Total water charges, Dec 03, 2003 .......... Other Current Charges ........ Mthly Water Line Protec#on ~. ~i~:.~i~ e:: h a r:~ s~ ~0. i. .... $22.21 -22.21 .00 10.50 5.28 .01 .28 16.07 4.00 4.00 $20.07 Messages to ,you from Pennsylvania American Any po~on of this water bill which rs not paid as of 12/29/03 will be subject to a 1.50% penalty., * Customers may use their credit card, debit card or pay by electronic check only by c~lling t~ll free: 1-866-271-552, Customers may also pay on-line at www. water, paymybill, com. A service fee will apply. * Approximately 4. 72 percent or $. 75, of State taxes are included in your current bill. * At Pennsylvania American, our customers are our top priority. Please let us know how we can serve you better. * Sign up forAmerican Water's automaticpaymentplan. Through Electronic Transfer, you can take advantage of this convenient way to pay your bill automatically on the day it's due. No more checks, stamps, or late bills! Call the 24-hour Customer Service Center to request an application. You will need your Account Number when you call. Just press I for the option to hear about Account and Billing Information, then choose the option to r,e~ffecuest an application for automatic payment. Fill out the form and mail it back to us It's that easyl rive October 1, 2003, the Distribution System Improvement Charge (DSIC) ha's increased ~r'om 1.34% to 1.76%. This charge funds the replacement of water distribution facilities. Customer Service & Emergencies 1-800-565-7292 (24 Hours) For Hearing Impaired Customers TDD 1-800-300-6202 (24 Hours) Visit us on the INTERNET: www. pawc.com ~ ~ A1M 12195 For Service To:, Samuel R Scandrol 1519 Kathryn St Account Number: 24-0621116-5 Premise NUmber: 24-0367304 Billing Period & Meter Information Billing Date: Jan 06, 2004 Billing Period: Dec 01 to Jan 02 (32 days) Next reading on/about: Jan 30, 2004 Rate Type: Residential Meter readings in current billing period: Meter Number N000012725 is a 5/8-inch meter. Present-actual 644800 Last-actual 64450 0 Gallons used ......... Prior Balance ........................ Balance from last bill Payments prior to Jan 06, 2004. Thanks(. Total prior balance, Jan 06, 2004 ........ Current Water Charges ......... Service Charge Water Volume ($.005277x 300) STAS PAWC Water 0.07% DSI - PAWC Charge 2.62% Total water charges, Jan 06, 2004 ......... -Other Current Charges ......... Mthty Water Line Protection Total other charges, Jan 06, 2004 ....... AMOUNT DUE ................. $20.07 -20.07 .00 10.50 1.58 .01 .32 12.41 4.00 4.00 {;16.41 Messages to ,you from Pennsylvania American Any portion of this water bill which is not paid as of 2/02/04 will be subject to a 1.50% penalty. * Customers may use their credit card, debit card or pay by electronic check only by calling toll,free: 1-866-271-552 Customers may also pay on-line at www. water, paymybill, com. A service fee will apply. * Approximately 4.72 percent or $.58, of State taxes are included in your current bill * At Pennsylvania American, our customers are our top priority. Please let us know how we can serve you better. * Sign up forAmerican Water's automaticpaymentplan. Through Electronic Transfer, you can take advantage of this convenient way to pay your bill automatically on the day it's due. No more checks, stamps, or late bills! Call the 24-hour Customer Service Center to request an application. You will need your Account Number when you call. Just press I for the option to hear about Account and Billing Information, then choose the option to request an application for automatic payment. Fill out the form and mail it back to us. It's that easy! * Effective October 1, 2003, the Distribution System Improvement Charge (DSIC) has increased from 1.34% to 1.76%. This charge funds the replacement of water distribution facilities. 10290 ver z n Make progress every day Billing Date 09/25/03 Page 1 of 5 Telephone Number: 717 774 5542 Account 717 774 5542 762 24 Y How to Reach Us: See page 2 SAM R SCANDROL Account Summary Previous Charges Payments Received thru Sep 26 -30.4~ Past Due Charges $.00 New Charges Verizon (page 3) $30.58 Total New Charges due Oct 21 $30.58 Total Due [Past Due + Newl Manage Your Verizon Account Online! View & pay bills, request repairs, place orders. It's quick and easy: Go to verizon.com Click "Sign in" under "Manage My Account". First time user? Get started with ... User ID: 71777455425 Password: 6X34V4 ... and customize your ID as you register. Tt~en follow the step-by-step instructions. To enroll in the Verizon Direct Payment Option please read and sign the agreement on the reverse side of the payment form below, ver 7. n Make progress every day SAM R SCANDROL Account Summary Previous Charges Payments Received thru Nov 26 -30,61 Past Due Charges $.00 New Charges Verizon (page 3) $33.02 Total New Charges due Dec 22 $33,02 Total Due (Past Due + New) $33.02 Billing Date 11/25/03 Page 1 of 5 Telephone Number: 717 774 5542 Account 717 774 5542 762 24 Y How to Reach Us: See page 2 Congratulations/Your Line Pre-Qualifies for High-Speed Internet Access Verizon Online DSL withMSN(~8 is now at our lowest price ever. Order today by calling 1-877-668-5375. Or, if you order online at verizon.com/orderdsl you'll get your first month FREE/ Service not available on all lines and subject to circuit availability and final verification by Verizon. Other terms and restricUons apply. Manage Your Verizon Account Online/ View & pay bills, request repairs, place orders. It's quick and easy: Go to verizon.com Click "Sign in" under "Manage My Account". First time user? Get started with ... User ID: 71777455425 Sears Premier Card M,k, Oheeka Payable to 8earn Oredit O~rdt ACCOUNT 8TATEMENT AOOOURt Number 05 52781 02799 0 Customer 8ervloe: 1-800-917-7700 1 OF1 Tote1 Aa~ount Total Ore<iff Total Credit Balance Limit Available Closing Date Due Date $309.38 $3~500.00 $3~190.62 11/24/03 12/22/03 Previoue Balance Payments & Credits Purchases & Debits Other Charge. Total FINANCE CHARGES Total A__,~_ unt I Trans I Post Date I Date I ./o3 I ./o3 $502.83 $200.00 $o.oo $o.oo Ss.ss $309.38 PLEASE SEE THE ENCLOSED NOTICES FOR '1 IMPORTANT INFORMATION REGARDING CHANGES / TQ yOUR CREDIT CARD ACCO~T. PAYMENT - THANK YOU OhargeeJ Oredit~ - $200.00 Finance Charges Amount Da~ In Billing Petiod: 31 ANNUAL Petiodlo Rate Average Dally PERCENTAGE D-Day Periodic Be-La-n- -es RATE M-Month FINANCE CHARGE Beam Regular $309.38 $364.42 21.15 %* 0.0580 % (D)* $6.5S External So.oo Regular $0.00 $0.00 21.15 %* 0.0580 % (D)* Cash $0.00 Regular $0.00 $0.00 22.15 %* O.060Y % (D)* *Tho Rate Varies. NOTICE: 8es reveres aide for important information and billing tights summary. Call 1-800-917-7700 tor customer service or to report your card lost or stolen, Mon-8at 9AM-gP M, 8UN 10AM-6PM. Mail Billing Error Notices to PO BOX 8t 8017 CLEVELAND OH 44t 81-8017 PLU '~ OHEATING ~,AIR CONDITIONING ELECTRICAL i~n~oic,e 231 MARKET STREET ' NEW CUMBERLANI Detach '12/14/03 To 6114/04 Policy Issued To SAMUEL R SCANDROL 1519 KATHRYN ST NEW CUMBERLAND PA 17070-1140 (12:01 A.M. Standard Time) Due .Policy Number Description Agent And Telephone Number 0 98 077716 12/14 02 MALIBU MARK R PEIPER (717) 795-9808 Payment Options Choose the payment option below that best meets your needs. Option 1 If you want to pay in full: · Pay $ 268.60. · You~ will receive no more bills until your. policy renews or you ma~(~ a change in coverage result, lng in a[Iditional premiums. Option 2 If you want to make the minimum payment: · Pay $ 48.25. · Then your payment schedule will be as follows: DUE DATE MINIMUM AMOUNT DUE 12/14/03 $48.25 1/14/04 $48.27 2/14/04 $48.27 3/14/04 $48.27 4/14/04 $48.27 5/14/04 $48.27 Each payment includes a $ 3.50 installment fee. Option 3 If you want to pay less than the full amount but more than the minimum: · Pay any amount between $ 48,25 and $ 268,60. · A new payment schedule for your remaining payments will appear on your next bill. · You will be charged a $ 3.50 installment fee each time you choose this payment option. This statement as of November 24, 2003. 031125015876A 18 (OVER) Policy Number: 0 98 077716 12114 Premium Period: 12/14103 To 6114104 (12:01 A,M Standard Time) Policy Issued To ESTATE OF SAMUEL SCANDROL C/O PATRICIA RICKER 125 COOPER RD HUMMELSTOWN PA 17036-7801 Policy Number Description 0 98 077716 12/14 02 MALIBU Agent And Telephone Number MARK R PEIPER (717) 795-9808 Payment Options Choose the payment option below that best meets your needs. Option 1 If you want to pay in full: · Pay $ 223.85. · You will receive no more bills u,~tjl your, policy rencws cr you maK.e a change in coyerage result, lng in additional premiums. Option 2 If you want to make the minimum payment: · Pay $ 48.27. · Then your payment schedule will be as follows: DUE DATE MINIMUM AMOUNT DUE 1/14/00 $48.27 2/14/04 $48.27 3/14/00 $48.27 4/14/04 $48.27 5/14/04 $48.27 · Each payment includes a $ 3.50 installment fee. Option 3 If you want to pay less than the full amount but more than the minimum: · Pay any ..a~Lo[~r~t between $ 48.27 and $ 223.85. · A new payment schedule for your remaining payments will appear on your next bill. · You will be charged a $ 3.50 installment fee each time you choose this payment option. This statement as of December 23, 2003, 031224064308A 18 (OVER) R&I~PLASTER&PP, YW%LL PO ~OX i029 TOTAL 156. ,&, t~ !, Iq;.; ',t i : Payment Oae Da~:01~04 UNIT XXLZ~IG&L L.O~GO ~ 5,97 j s'--/, J q TOTAL ,Lg, OD ~o ,E DEPOT #4113 · * '.~tT) 558-8~65 ali3 1:)0008 2260l 12/17/0'3 Il MJLS(~ (~9..31 022~ 454319 CEILINOkqff 044600012049 CLOROX 320Z · 3 ~ 2.37 7.11 0!98000~215 WINDEX 2 ~ 2.98 035241205635 L¥~Q. TO]LET 2.39 007~0415428 HR. C OR~ 2,q7 071~01l~ [L&GRTBR~H 1.97 07t7~0~ ~C~ ~ Ot2~77U~ ~3 G~ 6L~ 9.7/ 071~B0075~ AN~ ~M ~UBTOTAL TOTAL X)(XX~XX~XX~SBB t~15 E~,T AUT~ C~E OIT~/~B~ lA VOl, JR OPINION CDUNTSI C4)HPLET£ AT ~d'~ , F IOIdEDEPOTOPII4ZON, COld TO YIN A $~JO ~ME DEPOT GIFT CAI~! 02/26/0~ 05:25 FA,'{ 7175615754 WASTE MANAGEMENT OF CENTRAL PA 4300 INDUSTRIAl. PARK RD CAMP HILL PA 17011 R&RPLASTER&DRYWALL CO Customer; Account Number; Invoice Date: tnvolee Number: Terms: ~004 P~ge 2 of 2 PLAS~T~ & I~YWALL 1-01: 8798-0061'-0 1271~/2005 2278578-0061-8 Due Upon Receipt Date Tlckel Descflptlon Que~lily. U/M Rate Amount 12/03/03 257126 'Disposal per ton 3.24 158.79 12/03/03 257126 30 Yd miloff 1.00 16500 Fuel surcharge 4.8g Total Current Charges REV-1513 EX+ (9-00) COMMONVVEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SAMUEL R. SCANDROL NUMBER I ¸2. SCHEDULE J BENEFICIARIES NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and Iransfers under Sec. 9116 (a)(1.2)] Patricia A. Ricker 125 Copper Road Humme ls town, PA 17036 Valerie Scandrol 139 Brownstone Park Hummels town, PA 17036 Eric Scandrol 239 Iroquis Trail RELATIONSHIP TO DECEDENT 0o Not List Trustee(s) Daughter Daughter FILENUMBER 21-03-00984 AMOUNTORSHARE OF ESTATE 1/3 1/3 York Haven, PA 17370 Son 1/3 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: · A, SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE NONE ' B. CHARITABLEAND GOVERNMENTAL DISTRIBUTIONS NONE TOTAL OF PART Il - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space is needed, insert additional shee{s of the same size) -0- -0- BUREAU OF TNDIVTDUAL TAXES TNHERITANCE TAX DTVTSTON DEPT. 180601 HARRISBURG, PA 17118-0601 COHHONgEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOT/CE OF /NHERITANCE TAX APPRAISEHENT, ALLONANCE OR DISALLONANCE OF DEDUCT/ONS AND ASSESSHENT OF TAX RE¥-1647 EX AFP (01-D5) DATE ESTATE OF DATE OF DEATH FILE NUHBER COUNTY ACN 08-23-200~ SCANDROL 11-17-2005 11 03-098~ CUNBERLAND 101 Aeoun~ Reei'l:'l:ad SANUEL R HAKE CHECK PAYABLE AND REHIT PAYHENT TO: REGTSTER OF NILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG TH'rS LINE ~ RETAIN LO#ER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSENENT, ALLOHANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSNENT OF TAX ESTATE OF SCANDROL SAHUEL R FILE NO. 21 03-098~ ACN 101 DATE 08-23-200~ TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~e (Schedule A) (1} 2. S~ocks and Bonds (Schedule B) (2) 3. Closely Held S~ocK/Par~nershAp Zn~eras~ (Schedule C) (3) ~. Hor~gagas/No~es RacaAvable (Schedule D) (~) 5. Cash/Bank Depos~s/Hisc. Personal Proper~y (Schedule E) ($) 6. Joln~ly O~ned Proper~y (Schedule F} (6) 7. Transfers (Schedule G) (7) 8. To,al Assa~s APPROVED DEDUCTIONS AND EXEHPTIONS: 9. Funeral Expanses/Adm. Cos~s/Nisc. Expenses (Schedule H) (9) 10. Deb~s/Hor*gaga Liabi11~1es/Lians (Schedule Z) (10) 11. To,al Daduc~/ons Ne~ Value of Tax Ra~urn 117~612.57 ~323.70 .00 .00 15. NOTE: ASSESSHENT OF TAX: 15. Amoun~ of Line 1~ a~ Spousal ra~o 16. Amoun~ of L/ne 1~ ~axabla a~ Lineal/Class A ra~a 17. Amoun~ of Line lq a~ S/bling ra~e 18. Amoun~ of Line 1~ ~axable a~ Collateral/Class B ra~a 19. Princi=al Tax Due TAX CREDITS PAYHENT RECEIPT DZSCOUNT (+) DATE NUNBER INTEREST/PEN PA/D (-) 06-29-200~ CD00~109 .00 32~0~9.60 .00 .00 ~,066.27 (8) 30~830.rt9 (11) (12) Chari/¢able/Govarneen~al Bequas*s; Non-elected 9115 Trusts (Schedule J) (15) Nat Value of Es/~a~e Sub3ec~ ~o Tax Z~ an assessment Nas issued previously, lines 14, 15 and/or 16, 17, reflect flgures that include the total of ALL returns assessed to date. NOTE: To Snsura proper credi~ *o your account, subei~ *he upper por*ion of ~his fore ,i*h your ~ax payment. 153,985.87 IF PAID AFTER DATE /ND/CATED, SEE REVERSE FOR CALCULATION OF ADD/TIONAL INTEREST. 1~9,089.11 .00 119,089.11 18 and 19 will (15) .00 x O0 = .00 (16). 119,089.11 x 0~5= 5,359.01 (/7) .00 x 12 = .00 (18), .00 x 15 = . O0 (19)= 5,359.01 AHOUNT PAID 5,359.01 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 5,359.01 .00 .00 .00 ( ZF TOTAL DUE IS LESS THAN $1, NO PAYNENT IS REI~U/RED. IF TOTAL DUE /S REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCT/ONS.) RESERVATION: PURPOSE OF NOTICE= PAYHENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCDUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 1Z, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonweatth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Ciasa B (collateral) rate on any such future interest. To fulfill the requirements of Section 210,0 of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (72 P.S. Section 910,0). Detach the top portion of this Notice and submit with your payment to the Raglster of Hills printed on the reverse side. --Hake check or money order payable to: REGISTER OF #ILLS, AGENT A refund of a tax credit, which mas not requested on the Tax Return~ may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications are available at the Office of the Register of Hills, any af the 25 Ravenu~ District Offices, or by calling the special Z0,-hour answering service for forms ordering: 1-800-562-Z050~ services for taxpayers with special hearing and / or speaking needs: 1-B00-0,0`7-5020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBIOZ1, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Sam page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within thres (5) calendar months after the dacedent's death, a five percent (52) discount of the tax paid is alloeed. The 1SI tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the 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 would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes mhich became delinquent before January 1, 1982 bear interest at the rate of six (62) percent per annum calculated et a daily rate of .000160,. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2000, are: Interest Daily Interest Daily Year Rate Factor Year Rate Factor ~ lOX .00050,8 1988-1991 Ill .000501 1983 162 .0000,58 1992 92 .00020,7 1980` 117. .000501 1993-1990, 72 .000192 1985 157. .000356 1995-1998 92 .00020,7 1986 107. .000270, 1999 72 .000192 1987 107. .000270, 2000 7Z .000192 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID Interest Dally Year Rata Factor ~ 9X .O00Z0,7 ZOOZ 62 .000160, Z003 52 .000157 2000, 0,Z .000110 X NUNBER OF DAYS DELZNI~UENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notlce, additional interest oust be calculated. STATUS REPORT UNDER RULE 6.12 Name of Decedent: SAMUEL R. SCANDROL Date of Death: November 17,2003 No. 2003-00984 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 the administration of the estate is complete: ---X- Yes No 2. If the answer is "No", state when the personal representative reasonably believes that the administration will be complete: If the Answer is "Yes" to No.1, state the following: a. Did the personal representative file a final account with the Court? Yes ----X- No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? ---X- Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: ~May 16, 2005 i I ~ ( LJ ' , I THE LAW OFFICES OF MICHAEL CHEREWKA ~~.~ Michael Cherewka, Esquire By: Capacity: _ Personal Representative ---L Counsel for Personal Representati ve J. STATUS REPORT UNDER RULE 6.12 Name of Decedent: SAMUEL R. SCANDROL Date of Death: November 17, 2003 No. 2003-00984 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 the administration of the estate is complete: Yes _x No 2. If the answer is "No", state when the personal representative reasonably believes that the administration will be complete: If the Answer is "Yes" to No.1, state the following: a. Did the personal representative file a final account with the Court? Yes ---X- No ('-.., C) = b. The separate Orphans' Court No. (if any) for the personal r~entati~ . ~~ ~ account IS: . :=g c c:: , :I~ r-i CO) zCD Ii c. Did the personal representative state an account informally t~)~l:>art~ in ' . ? ,,-(; mterest. (:J ~- I I ~ --X- Yes No -AJ .u-i -+.:::=-~ ; i' W N &"' d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: May 16, 2005 THE LAW OFFICES OF MICHAEL CHEREWKA ~~ Michael Cherewka, Esquire By: Capacity: _ Personal Representative -X- Counsel for Personal Representative \ ~