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HomeMy WebLinkAbout03-0098 PETITION FOR PROBATE and GRANT OF LETTERS Estate of r'$7'~ ~l&- _0. fiz~65rq~'' No. also known as To: Register of Wills for the Deceased. County of ~d/eT,~&--/eg~a/0 in the Social Security No. / u~ gl - o / -' ~ '2_q' ! Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or.older an the execut/~ ~ & named in the last will of the above decedent, dated ,dr'/v~, / ~ and codicil(s) dated (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in L' ~/Y//~ ~ ~ L_,,q.4,'A . Coun,t~; Pennsylvania, with h last family or principal residence at .'~d~ ~ ~q£7~ ~-2 , ~:.,q..~;,"~ ,'7/Z~/ [;,q'/7~/I t//7~£/~=,~1 7"~-~. (list street, number and muncipality) Decendent, then ~'7 years of age, died ,~~i.~ at ,'-/oz ~ y'/'/g°/7- /-/~.5/o, T,4~/__ ', /:.4.42/,' Except as follows, decedent did not marry, was not dtvorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: .. Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF ~ ~; ~ ~ ~,=/e ~ ,~.~g ~.~ The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed /d~~~ ~ ~ ~ ~ before me this 3~ St day of ~ ~ ~'= ~ JANUARY 2003 ~ ~XXX~ _~5~,~/~4'/~- ~ ~~ ~ No. Z~-oa-q8 Estate 0f MARIE D FAGAN , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW JANUARY 31 .- 2003 XLgXXX , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated 4- 24-1 qq 7 described therein be admitted to probate and filed of record as the last will of MARIE D FAGAN ; and Letters TFgTAMENT~_Ry are hereby granted to ROSEMARI~ F K~FGAN Register of Wills FEES Probate, Letters, Etc .......... $ 1 1 .q. (lfl Short Certificates( ) .......... $ fi. 00 ATTORNEY (Sup. Ct. I.D. No.) ~t~ai~eiat~ .e.~t.ra. p. ages... $ 18. O0 - jcp $ 10.00 ADDRESS TOTAL __ $. 149.00 Filed ...... 3.:3.! .- 2.0.Q2 .................. PHONE mai]ed to executrix 1-31-2002 This is to certify that the in£ormation here given is correctly copied fi'om an original certificate oi' death duly filed with me as Local Registrar. The original certificate will be fm~arded to the State Vital Records OffSet :or permanent fiJing. WARNING: It is illegal to duplicate this copy by photostat or photograph. COMMONWEALTH OF PENNSYLVANIA o DEPARTMENT OF HEALTH * VITAL RECORDS CERTIFICATE OF DEATH NAME Of: DECEDENT (F~'s~ M~e. L~I} 9TAIE FILE NUMBER MARIE D Fa an T~Xfema1 Is~,~t s~cu..~.u~.~. 87 .... J ! { 9/25/15 ~hiladelphia,PA [,~,--~ ~,,~ ~ ~ .. Cumberland ~st Pennsboro ~p., ffOlu~P,,~,/ //OSP/lc,' '~."~ .... ' ~CE~'SUSU~L'~ KI~SI~S~STRY ~C~NTEVERIN I ~CEENT'SE~AT~ [I} ~TALST8US .----" lie- white I ~ ..... ~_ I ~ ~ I ~"~ I ~' I '~--~' I '"~"~' ,,.. homemaker {,,,. " ......... {,. {. ,~'~'~ I o,~s., { widowe'~-" 3609 Kohler Place Apt. 12 ,~a~E ~ . ,tCamp Hill, PA 17011 ~ Cumberland ~, · John H. McNeill UOTHER'S.~,~.I.U~.U~,~} ,~. ~osemar~e ~eegan 1~145 St ~drews Way Etters, PA 17319 ~ ~s~t . ~ 1/11/03 { Gate of Heaven Cemetery { Upper Allen ~p , PA ~ ~N~~ ~FS-012849-L -ParthemoreF H &C I,. I. o5 n .. I,,. d(:.nuo4~ q, Doo~ .. ,~ ~ e~s ~ ~ (~ ~ A C~E~E ~: F~E~D?/~ ~ ~12~'OF~L~E~H?Y~ ~P~ ~ ~CAU~ ~ ~ ~m~N~ ~ ~ ~ ~ ~lerm,~ P~ In~~ ~ I~P~CE~I~UR ~~'IM~' ~Y' 'Y~)s~I .... .......... 3~ :la~. o~e M. I~URY. ~lt~ ~' C~' sme)~K?~ I~-~ ~ I~URY ~U~O. ~e~~ DATE FILEDtM~ Day. LAST WILL AND TESTAMENT OF MARIE D. FAGAN 1-O3 q8 I, MARIE D. FAGAN, of :5609 Koehler Place, Camp Hill, Cumberland County, Pennsylvania, declare this to be my Last Will. 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. ?' Article III All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give, devise and bequeath, in equal shares, to my children, ROSEMARIE F. KEEGAN, of York County, Pennsylvania, and MARYTHERESA F. MAZZUCA, of Indianapolis, Indiana, provided she/they survive me by thirty (30) days. If any of my children predecease me or fail to survive me by thirty (30) days, I give, devise and bequeath her share to her issue who survive me, per stirpes, or if she has no issue, the share(s) are to be added equally to the other shares. Article IV If a beneficiary under this Will has not attained the age of twenty-one (21) years, the share of the beneficiary shall be placed in a separate trust, for the benefit of that beneficiary according to the terms in Article V. Article V In the event that a Trust is created by or as a result of any part of this Will, the terms and conditions of the Trust shall be as follows: A. To expend and apply so much of the net income and so much of the principal of the Trust as the Trustee shall consider advisable for the support, care and education of the child until the child attains the age of twenty-one (21) years. B. Upon attaining the age of twenty-one (21), the child's share shall be distributed outright to the child. 2 C. No beneficiary or remainderman of this Trust shall have any right to alienate, encumber, or hypothecate his or her interest in the principal or income of the Trust in any manner, nor shall any interest be subject to claims of his or her creditors or liable to attachment, execution, or other processes of law. Article VI In order to carry out the purposes of the Trust established by this Will, the Trustee, in addition to all other powers granted by this will or by law, shall have the following powers over the Trust estate, subject to any limitations specified elsewhere in this Will. (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 their services, and 3 (i) to conduct along with or with others, any business in which I am engaged in or have an interest in at the time of my death. Article VII I hereby appoint my daughter, ROSEMARIE F. KEEGAN, as Trustee of any Trust(s) created in this Will. In the event of the renunciation, death, resignation, or inability to act for any reason whatsoever of ROSEMARIE F. KEEGAN, I nominate and appoint my daughter, MARYTHERESA F. MAZZUCA, as the trustee of any Trust(s) created in this will. Article VIII I nominate, constitute, and appoint ROSEMARIE F. KEEGAN 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 MARYTHERESA F. MAZZUCA 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 sell both real and personal property, at private or public sale, to invest cash without being limited to statutory investments, 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 shall receive reasonable compensation for services rendered to my estate. Article IX In addition to the powers conferred by law, I authorize my 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 their services, and (i) to conduct along with or with others, any business in which I am engaged in, or have an interest in at the time of my death. IN WITNESS WHEREOF, I, MARIE D. FAGAN, hereby set my hand to this my Last Will, on this ~ .q( day of , 1997, at Harrisburg, Pennsylvania. MARIE D. FAGAN J In our presence, the above-named MARIE D. FAGAN signed this and declared this to be her Last Will and now at her request, in her presence, and in the presence of each other, we sign as witnesses. I, MARIE D. FAGAN, 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 MARIE D. FAGAN~4he Testatrix, this~,Y~/~'day of ~4.,z~/ , 1997. / . [I MARIE D. FAGAN NOTAR~At ~a,t JAN L BROWN, Notary Public J Lower Paxton Twp., Dauphin Co, PA J My Commission ~~ 6 We, the undersigned witnesses who signed the foregoing instrument, being duly qualified according to law, depose and say that we were present and saw 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 heating 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 subscribeA:l t° bef°r9 me / ' an~:'JjT~_g&4~ ~g.~ Witness witn'es~es,~'s _f~z ~ day c~ ~t4~(~. , 1997. W~it.n~ss~ / 7 JAN L. BROWN 845 SIR THOMAS COURT, SUITE 11A HARRISBURG, PENNSYLVANIA 17109 717-541-5550 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 002704 DALEY PETER J II ESQUIRE 242 WOOD STREET CALIFORNIA, PA 15419 ACN ASSESSMENT AMOUNT CONTROL NUMBER ........ fold .................. 101 $2,877,82 ESTATE INFORMATION: SSN: 184-01-3241 FILE NUMBER: 2103-0098 DECEDENT NAME: FAGAN MARIE D DATE OF PAYMENT: 06/19/2003 POSTMARK DATE: 06/17/2003 COUNTY: CUMBERLAND DATE OF DEATH: 01/09/2003 TOTAL AMOUNT PAID: $2,877.82 REMARKS' ROSEMARIE F KEEGAN PETER J DALEY II ESQUIRE CHECK# 5148 INITIALS: SK SEAL RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS PETER J. DALEY AND ASSOCIATES, P.C. Attorneys at Law 242 WOOD STREET PETER J. DALEY, II, ESQUIRE CALIFORNIA, PENNSYLVANIA 15419 JULIE WEBSTER, P^R^LEa^L (724) 938-8953 ° FAX (724) 938-8959 E Mail: pjdassoc@sgi.net June 16, 2003 Re ster of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 In Ke: Estate of Marie B. Fagan File No.21-03-0098 Dear Sir or Madam: Enclosed please find the original REV-1500 Inheritance Tax Remm Resident Decedent which Peter J. Daley II, Esquire, is filing on behalf of his client, the Estate of Marie B. Fagan, in the above matter. Please file of record at your earliest convenience. Additionally, I would be most appreciative if you would return thc enclosed copy of the cover marked with the filing date for our file. I have enclosed a self- addressed stamped envelope for your convenience in returning the copy to our o~:ice. Should you have any questions regarding thc enclosed documcms, plcasc do not hcsitatc to contact Attomcy Dalcy at thc above number or address. Very truly yours, Peter ]. Daley & Associates, P.C. lb Enclosures REV 1 500 . ~'~.t COMMONWEALTH OF " ~ PENNSYLVANIA .~~~. DEPARTMENT OF REVENUE DEPT. 28060 INHERITANCE TAX RETURN 21-0 3 0 09 8 ~HARRISBURG, PA17128-0601 RESIDENT DECEDENT DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Z Fagan, Marie B. 184 - 01 - 3241 ~ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE ILl 01-09-03 09-25-15 REGISTER OF WILLS LU (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER ,,, ~ 1. Original Return ]'~ 2. Supplemental Return [~ 3. Remainder Return (da~e of death prior to 12-13-82) ~ ~ ~ 4. Limited Estate ~ 4a. Future Interest Compromise (date of death after 12-12-82) ~ 5. Federal Estate Tax Return Required ~ m~ E~] 6. Decedent Died Testate (A~tactl copy of Will) E~] 7. Decedent Maintained a Living Trust (Attach copy of Trust) 8. Total Number of Safe Deposit Boxes < E~] 9. Litigation Proceeds Received E~ 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) E~] 11. Election to tax under Sec. 9113(A)(Altach Sch O) ~ THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Z "' NAME COMPLETE MAILING ADDRESS z Peter J. Daley, II Esquire o ... . Daley & Associates, P.O. 242 Wood Street ~ TELEPHONE NUMBER o California, PA 15419 u 724-938-8953 1. Real Estate (Schedule A) (1) -O- ~ ~. OF~:iCIAL USE ONLY 2. Stocks and Bonds (Schedule B) (2) $ 8 1 , 9 7 7.6 8 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) -- © -- 4. Mortgages & Notes Receivable (Schedule D) (4) -- 0 -- . z 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 8 9 8 · O 0  (Schedule E) ... 6. Jointly Owned Property (Schedule F) (6) 2,7 2 1.8 7 _ ,~ ~] Separate Billing Requested :~" ~ ' ' '-~:!- ::) 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) - O - ~" (Schedule G or L) <~ 8. Total Gross Assets (total Lines 1-7) (8) 8 5,5 9 7.5 5 LM 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 19,152.32 10. Debts of Decedent. Mortgage Liabilities. & Liens (Schedule I) (10) 2,4 9 3.6 6 11. Total Deductions (total Lines g &10) (11) 21 ,645.98 12. Net Value of Estate (Line B minus Une 11) (12) 63,951.57 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) -O- made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 6 3,9 5 1 · 5 7 SEE INSTRUCTIONS ON REVERSE SIDE FoR APPLICABLE I~LATES  15. Amount of Line 14 taxable at the spousal tax ~ rate, or transfers under Sec. 9116 (a)(!.2) x .0 __ (15) .~ 16. Amount of Line 14 taxable at lineal rate 63,95 1 . 57 x .0 45 (16) 2 · 877.82 O~ 17. Amount of Line 14 taxable at sibling rate x .12 (17) O 18. Amount of Line 14 taxable at collateral rate x .15 (18) ~. 19. Tax Due (19) "2,877.82 > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedent's Complete Address: STREET ADDRESS CITY STATE I ZIP Tax Payments and Credits: 1. Tax Due (Page l Line19) (1) 2,877.82 2. Credits/Payments A. Spousal Poverty Credit 0 B. Pdor Payments 0 C. Discount 0 Total Credits ( A + B + C ) (2) 2,8 '7'7.8 2 3. Interest/Penalty if applicable D. Interest 0 E. Penalty 0 Total Interest/Penalty ( D + E ) (3) 2 v 8 '7'7.8 2 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) -0- 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) - O- A. Enter the interest on the tax due. (SA) -O- B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) ;2 t 8 '7 ? o 8 ;2 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; .......................................................................................... [] [] b. retain the right to designate who shall use the property transferred or its income; ............................................ [] [] c. retain a reversionary interest; or .......................................................................................................................... [] [] d. receive the promise for life of either payments, benefits or care? ...................................................................... [] [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or secudty at his or her death? .............. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESP. DNSlBLE FOR FILING RETURN SIGNATURE OF PREPA~R~_4N' REPRESENTATIVE I ' DATE [72 RS. {}9116 (a) (1.1)(i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 RS. {}9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedenrs lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedenrs siblings is 12% [72 RS. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-150£EX + {1-9~ ~~ SCHEDULE A ' COMMO.W~,TH oF PE..SY,V^N,^ REAL ESTATE ESTATE OF FILE NUMBER Ha~e ~. ~aga~ 2~-03-0098 All mai prop~ o~ solely or as a tenant in common must b~ reposed at fair mark~ value. Fair manet value is defined as the pd~ at which prope~ would be exchanged be~n a willing buyer and a willing seller, nei~er being ~mpelled to buy or sell, bo~ having reasonable knowledge of the relevant fa~. Real pmpe~ ~ich is joi~fly.o~ed ~h right of su~o~hip must be disclosed on ~chedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF D~TH 1. TOTAL (Also enter on line 1, Recapitulation) $ 0 · 00 (If more space is needed, insert additional sheets of the same size) SCHEDULE B COMMONW HOFPENNS ^N,A STOCKS & BONDS iNHERITANCE TM R~URN RESIDENT DECEDENT ESTATE OF FILE NUMBER Marie B. Fagan 21-03-0098 All pmpe~ jointly~ed ~ffi dgM of su~o~hip mu~ ~ disclosed on Sch~ule F. ITEM ~LUE AT ~TE NUMBER DESCRIPTION OF D~TH 1. Alliance Cap Reserves 1,387.82 2. NPB Capital TRII 11,527.50 3. Fidelity Advisor Sert 2,045.41 4. Federal Home Loan Mtg. Co. 1,175.70 5. Gov't National MtG. Assn. II 613.79 6. Federal Home Loan Bank 20,487.50 7. Federal National Mortg. Assn. 4,144.99 8. Federal Home Loan Mtg. Corp. 3,277.45 9. Federal Home Loan Mtg. Corp. 1,996.89 10. Federal Home Loan MtG. Corp. 2,884.43 11. Federal National MtG. Assn. 13,471.03 12. Federal National Mt~. Assn. 10,234.37 13. Federal Home Loan Mtg. Gorp. Group 141291 3,687.29 14. Federal Home loan Mtg. Gorp. ~309465 1,088.34 15. Federal Home Loan Mtg. Corp. Group 55-5132 1,701.43 16. Gov't National Mtg. Assn. ~332719 2,355.38 TOTAL (Also enter on tine 2, Recapitulation) $ 8 1,9 7 7.6 8 (If more space is needed, insert additional sheets of the same size) .REV-1504 EX+ (1-97) ", SCHEDULE C CLOSELY-HELD CORPORATION, ~OMMONWEALTH OF PENNSYLVANIA PARTNERSHIP OR INHERITANCE TAX RETURN RESIDENT DECEDENT SOLE-PROPRIETORSHIP ESTATE OF FILE NUMBER Marie B. Fagan 2~-03-0098 Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partr]ership interest of the decedent, other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM NUMBER VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. TOTAL (Aisc enter on line 3, Recapitulation $ 0. O0 (If more space is needed, insert additional sheets of the same size) SCHEDULE C-1 COMMONWEALTH;~'~"~'OF PENNSYLVANIA CLOSELY'HELD CORPORATE .N.ER TANCE RETURN .ES.DENTOECEDENT STOCK INFORMATION REPORT ESTATE OF FILE NUMBER Ha~-ie ]3. ~'agal~ 21-O3-OO98 1. Name of Corporation State of Incorporation Address Date of Incorporation City State Zip Code Total Number of Shareholders 2. Federal Employer I.D. Number Business Reporting Year 3. Type of Business Product/Service 4. TYPE TOTAL NUMBER OF NUMBER OF SHARES VALUE OF THE STOCK Voting / Non-Voting SHARES OUTSTANDING* PAR VALUE OWNED BY THE DECEDENT DECEDENT'S STOCK Common $ O Preferred $ O Provide all rights and restrictions pertaining to each class of stock. 5. Was the decedent employed by the Corporation? [] Yes [] No If yes, Position Annual Salary $ Time Devoted to Business 6. Was the Corporation indebted to the decedent? [] Yes [] No If yes, provide amount of indebtedness $ 7. Was there life insurance payable to the corporation upon the death of the decedent? [] Yes [] No If yes, Cash Surrender Value $ Net proceeds payable $ Owner of the policy 8. Did the decedent sell or transfer stock of this company within one year prior to death or within two years if the date of death was prior to 12-31-827 [] Yes [] No If yes, [] Transfer [] Sale Number ofSharas Transferee or Purchaser Consideration $ Date Attach a separate sheet for additional transfers and/or sales. 9. Was there a written shareholder% agreement in effect at the time of the decedent's death? [] Yes [] No If yes, provide a copy of the agreement. 10. Was the decedent's stock sold? [] Yes [] No If yes, provide a copy of the agreement of sale, etc. 11. Was the corporation dissolved or liquidated after the decedent's death? [] Yes [] No If yes, provide a breakdown of distributions received by the estate, including dates and amounts received. 12. Did the corporation have an interest in other corporations or partnerships? [] Yes [] No If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest. A. Detailed calculations used in the valuation of the decedent's stock. B. Complete copies of financial statements or Federal Corporate Income Tax returns (Form 1120) for the year of death and 4 preceding years. C. If the corporation owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate appraisals have been secured, attach copies. D. List of principal stockholders at the date of death, number of shares held and their relationship to the decedent. E. List of officers, their salaries, bonuses and any other benefits received from the corporation. F. Statement of dividends paid each year. List those declared and unpaid. G. Any other information relating to the valuation of the decedent's stock. SCHEDULE C-2 P N.SVLVAN,^ PARTN E RS HiP INFORMATION REPORT ESTATE OF FILE NUMBER Ha~e B. Faga~ 21-O3-OO98 1. Name of Pa~nership Date Busings Commen~ Address Busin~ Re,lng Year Ci~ State ~p Code 2. F~era Employer I.D. Number 3. Ty~ ~ Business Pr~u~S~i~ 4. D~ent was a ~ General ~ Umit~ paAner. If d~ent w~ a limit~ pa~n~, provide inifi~ inves~ent $ 5. PERCENT OF PERCENT OF BA~NCE OF PARTNER NAME INCOME OWNERSHIP CAPITAL ACCOUNT A. B. C. D. 6. Value of the d~ent's interest $ 7. Was the Pa~nership indebt~ to the d~ent? ~ Yes ~ No If yes, provide amount of indebtedness $ 8. Was there life insuran~ payable to the pain,hip upon the death of the d~ent? ~ Yes ~ No If yes, Cash Suffender Value $ Net pro~s payable $ Owner of the ~licy 9. Did the d~ent sell or transfer an interest in this pa~nership within one year pdor to death or within ~o yearn if the date of death was 'pdor to 12-31~27 ~ Yes ~ No If yes, ~ Transfer ~ Sale Per~ntagetmndeff~sold Transfer~ or Purchaser Conside~ion $ Date A~ch a separate sheet for addi~onal ~nsfem ancot sales. 10. Was there a wd~en pa~nership agr~ment in eff~t at the time of the dec~enrs de,h? ~ Yes ~ No If yes, provide a copy of the agreement. 10. Was the d~ent's pa~nemhip interest sold? ~ Yes ~ No If yes, provide a copy of the agreement of sale, etc. 11. Was the pa~nership dissolv~ or liquidated after the d~ent's death? ~ Yes ~ No If yes, provide a breakdown of distributions received by the estate, including dates and amounts r~eiv~. 12 Was the dec~ent retat~ to any of the paAnem? ~ Yes ~ No If yes, explain 13. Did the pa~nemhip have an interest in other co~orations or pa~nemhips? ~ Yes ~ No If yes. repoA the necessa~ info~ation on a separate sheet, including a Sch~ule C-1 or C-2 for each interest A. Detailed calculations used in the valuation of the decedent's partnership interest. B. Complete copies of financial statements or Federal Partnership Income Tax returns (Form 1065) for the year of death and 4 preceding years. C. If the partnership owned real estate, submit a list showing the complete address/es and estimated fair market valuels. If real estate appraisals have been secured, attach copies. D. Any other information relating to the valuation of the decedent's partnership interest. REV-1507 EX + (1~97) SCHEDULE D COMMONWEALTH OF PENNSYLVANIA MORTGAGES & NOTES INHERITANCE TAX RETURN RESIDENT DECEDENT RECEIVABLE ESTATE OF FILE NUMBER Ha~'ie ]~. Fagan 21-03-0098 All property jointly-owned with the right of survivorship must be disclosed on Schedule F, ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. TOTAL (Also enter on line 4, Recapitulation) $ O o O O (If more space is needed, insert additional sheets of the same size) REV-I~8 EX * (1.97~ "~I~~-~~)~ SCHEDULE E COMMONWEALTH OFPENNSYLVANIA CASH, BANK DEPOSITS, & MISC. ~.HER,TA.C~ TAX RETURN ~S,D~,T DEC~DENT PERSONAL PROPERTY ESTATE OF FILE NUMBER Ha~:~.e ]3. Fagan 21-03-0098 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly.owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1, Tn'ce~'nal Revenue 898. O0 TOTAL (Also enter on line 5, Recapitulation) $ 898 · 00 (If more space is needed, insert additional sheets of the same size) SCHEDULE F COMMONWEALTH OrPENNSVLVAN,A JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Marie B. Fagan 21-03-0098 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SU~IVINGJOINTTENANT(S)NAME ADDRESS RE~TIONSHIPTODECEDENT A. Rosemarie F. Keegan 145 ST Andrews Ln Daughter Etters, PA 17319 JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERES' 1. A. 7/9~ Dauphin ~i~8~9~25 Checking 2,164.41 50% 1,082.20 2. A. 7/96 Dauphin Deposit Bank___ Money Mkt 1,756.49 50% 828 24 Acct.~98125230 ' 3. A. 7/96 Dauphin Deposit Bank Savings 1,642.86 50% 821.43 Acct.~87004915745961 TOTAL (Also enter on line 6, Recapitulation) $ 2,7 2 1.8 7 (If more space is needed, insert additional sheets of the same size) REV-1510 ,EX + {1-97),. SCHEDULE G INTER-VIVOS TRANSFERS & 'COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN MISC, NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Marie B. Fagan 2~-03-0098 This schedule must be completed and filed if the answer to any of questions I through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY % OF ITEM tNCLUDETHE NAME OFTHETRANSFEREE, THEIR RELATIONSHIPTO DECEDENT AND THE DATE OF TRANSFER, DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE ATTACH A COPY OF THE DEED FOR REAL ESTATE. NUMBER VALUE OF ASSET INTEREST irF APPUCABLE) 1. TOTAL (Aisc enter on line 7, Recapitulation) $ O · O O (If more space is needed, insert additional sheets of the same size) EV-1511EX + (1-97) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Marie B. Fagan 2]-03-0098 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERALEXPENSES: Parthemore, New Cumberland 8,764.42 1. Luncheon (Betty Knovich Catering) 1,500.00 2. Airline Tickets-Grandchildren 1,595.00 3. Airline Tickets-Sister 420.00 B. ADMINISTRATIVE COSTS: 1, Personal Representative's Commissions Name of Personal Representative (si Rosemarie Keeoan Sodal Security Number(s) t EIN Number of Personal Representative(s) 1 9 1 - 3 4- 3 2 1 5 145 St. Andrews Lane Street Address Ci~ Etters State PA Zip 17319 Year(s) Commission Paid'. 2 0 0 3 4% 3,4 2 3.9 0 2. A~omeyFees Peter J. D~ley, II Esquire 4% 3,300.00 3. Family Exemption: (if decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City, State Zip Relationship of Claimant to Decedent 4. Probate Fees 149. O0 5. Accountant's Fees - 0 - 6, Tax Return Preparer's Fees - O- TOTAL (Also enter on mine 9, Recapitulation) $ 1 9,1 5 2.3 2 (If more space is needed, insert additional sheets of the same size) "~"~'~'~'~'"~~ SCHEDULEI COMMONWEALTH OF PENNSYLVANIA DEBTS OFDECEDENT, INHERITANCE TAX RETURN RESIDENT DECEDENT MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Marie 9. Fagan 21-03-0098 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1. Moving g×pense 1,232.88 2. Moving g×pense 209.00 3. Cleanlng of Apartment 50.00 4. AT&T 19.25 5. Patrlot News 3.40 6. PP&L 49.9? 7. MCI 21.57 8. Rent (February) 680.00 9. Comcast Cable 36.93 10. AT&T 34.65 11. PP&L 27.40 12. MCI 23.74 13. MBNA/VISA 104.87 TOTAL (Also enter on line 10, Recapitulation) $ 2,493.66 (If more space is needed, insert additional sheets of the same size) SCHEDULE J COMMO.W LTH OF PENNSYLV^N,^BEN EFIClARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF 'FILE NUMBER Marie B. Fagan 21-03-0098 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) Rosemarie F. Keegan Daughter 50% 1, 145 St. Andrews Lane Etters, PA 17319 2, MarYtheresa F. Mazzuca Daughter 50% 5035 Moonlight Drive Indiannapolis, Indiana 46226 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ O o OO (If more space is needed, insert additional sheets of the same size) Peter J. Daley & Associates, P.C. 242 Wood Street California, PA 15419 CLAIM FORM ~ ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAN~OUNTY ESTATE OF MARIE D. FAGAN 21-03-98 BOSCOV ' S NO. Notice of claim by in the a~nount of $ 102.21 filed pursuant to section 3384, Probate, Estates and Fiduciaries Code Laws of 1972, Act No. 104 effective July 1, 1972 as amended. Date 19 9441 LBJ FREEWA'f To ~ CLSR~ OF THE OR~'_~S' COUR~ D~VISIO., Lock Box 30 Enter the claim of Boscov's Dallas, TX 75243 {Claimant and Address) in the amount of $102,21 against the above entitled Estate. The decedent who resided at 3609 KOHLER PLACE APT. 12, CAMP HILL, PA 17011 1/9/03 (Address) died on (DaUe) Written notice of said claim was given to ROSEMARIE F. KEEGAN · (Personal Representative or Counsel) at 145 ST. ANDREWS WAY, ETTERS, PA 17319 (Address) on. (Date) The basks of aforesaid claim is as follows: (Itemize fully to enable personal representative to make proper investigation). Acct.#201299810 Claimant's Counsel ( Name ) ~ 9441 hBJ FREEWAV Lock Box 30 ( Add r e.. ) Da'l~,~l~ 75243 PROBATE COURT Cumberland County, State of Pennsylvania Marie D. Fagan, Deceased Case #21-03-98 Proof of Mailing I mailed the creditors claim to the fiduciary (and attorney, if applicable) as follows: I deposited a copy/copies of the claim with the United States Postal Service in a sealed envelope with the postage fully pre-paid. I used first-class mail. I am en~ployed in the county where the mailing occurred. The envelope (s) was/were addressed and mailed as follows: Ms. Rosemarie Keegan 145 St. A_ndrews Way Etters, PA 17319 Date of Mailing: ~__ County of Mailing: Dallas, Texas I declare un~ per/lty of perjury that the foregoing is true and correct. Date: ,~/~F/~_~ ~ent fOrBoscov' s P.O. Box 741026 Dallas, TX 75374 Page: 1 Document Name: BARBARA kRiQ ) BOSCOV S CAE2mT DIVISION PAGE 01 05/18/2003 , ' ~ 15:48:35 ~ ~ INQUIRY AC~OUN~ -~ 998~0 REL T ~ 7311082 BLOCK CODES H ORGANIZATION 100 ~OG~ 110 ACCT 00000000002012 ~ SHORT NAME FAGAN ESTATE OF ~E PA HOME PHONE 7!7 EMPL 'CD STATUS Z NBR PLANS ~' 00 CARD USAGE ~'T CR LMT 0 0 CSH AUTH ' 2A CR LMT .00 TOT DISP ~' .00 BILLING CYCLE ,CASH BAL ~ e~? '~ 00 iASH AVAL .00 ~A~n DSP v · O-T-B ~***~*~0 CYCLE DB 0 .00 DATE OPENED 03/10/i99~ ~nT LEVEL / ID S PA1 CYCLE CR 0 .00 CARD FEE ~ATE CURR BAL 102.21 CYCLE PMTS .00 DTE LST BILL 05/15/200~ ESTATE CLAIMS SERVICE ,~'~'~. '**<,.~. .... ,, ~-~--'~-~":-'~'.,-.-._ -~_~ ~1L~ FREEWAY · LOCK BOX30- DAL~S, TE~S 75243 Clerk, Probate Division Cumberland County Registrar of ~Tills 1 Courthouse Sq., Rm. 102 Carlisle, PA 17013 CONNONWEALTH OF PENNSYLVANZA BUREAU OF ZNDZVZDUAL TAXES DEPARTNENT OF REVENUE ZNHERZTANCE TAX DZVZSZON DEPT. zsO6al HARRZSBURG, PA 171Z8-0601 NOTZCE OF ZNHERZTANCE TAX APPRAZSENENT, ALLONANCE OR DZSALLO#ANCE OF DEDUCTZONS AND ASSESSNENT OF TAX RE¥-lS¢?EX&FP¢01-O$) ~. .DATE 07-28-200~ ~-~ ESTATE OF FAGAN MARIE D DATE OF DEATH 01-09-2005 FZLE NUNBER 21 05-0098 '03 JUL 28 /\9 L.~.~UNTY CUHBERLAND PETER d DALEY Z! ESQ ACN 101 P d DALEY & ASSOCS Aeount 2~Z WOOD ST CALZFORNZA PA 1541~U!¥~L_; .... HAKE CHECK PAYABLE AND RENZT PAYNENT TO: REGZSTER OF WZLLS CUNBERLAND CO COURT HOUSE CARLZSLE, PA 17015 CUT ALONG THZS LZNE ~ RETAZN LOWER PORTZON FOR YOUR RECORDS REV-15~7 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSENENT, ALLOWANCE OR DZSALLOWANCE OF DEDUCTZONS AND ASSESSNENT OF TAX ESTATE OF FAGAN NARZE D FZLE NO. 21 05-0098 ACN 101 DATE 07-28-2005 TAX RETURN #AS: (X) ACCEPTED AS FZLED ( ) CHAN~ED RESERVATZON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: ORZGZNAL RETURN 1. Real Estate (Schedule A) (1) .00 NOTE: To insure proper 2. Stocks and Bonds (ScheduZe B) (2) 81~977.68 credit to your account, $. Closely Held Stock/Partnership Znterest (Schedule C) ($) .00 submit the upper portion q. Mortgages/Notes Receivable (Schedule D) (q) .00 of this fora w/th your 5. Cash/Bank Deposits/Nisc. Personal Property (Schedule E) (5). 898.00 tax payeent. 6. Jointly O~ned Property (Schedule F) (6) 2;721.87 7. Transfers (Schedule G) (7) .00 8. Tote1 Assets (8) 85,597.55 APPROVED DEDUCTZONS AND EXENPTZONS: 19,15Z.$2 9. Funoral Expenses/Adm. Costs/N/sc. Expenses (Schedule H) (9) 10. Debts/Hortgege Liabilities/Liens (Schedule Z) (10) 2,495.66 11. Tote1 Deductions (11) ~].6~;.g~ 12. Net Value of Tax Return (12) 6~,951.57 15. Charitable/governeental Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00 lq. Net Value of Estate Subject to Tax (lq) 65,95Z.57 NOTE: Z~ an assessment was issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 ~111 reflect flgures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line lq at Spousal rate (15) .00 X O0 = .00 16. Amount of Line 1¢ taxable at Lineal/Class A rata (16) 65,951.57 x Oq5 = 2,877.82 17. Amount of Line Zq at Sibling rata (17) .00 X 12 = .00 18. Amount of Line 1~ taxable et Collateral/Class B rata (18) .00 X Z5 = .00 19. Principal Tax Due (19)= 2,877.82 TAX CREDZTS: PAYHEN1 RECEIPT D/$COUNT AHOUNT PAZD DATE NUHBER ZNTEREST/PEN PAZD (-) 06-17-2005 CD002704 .00 2,877.82 TOTAL TAX CREDZT I 2,877.82 BALANCE OF TAX DUEI · 00 ZNTEREST AND PEN. I .00 TOTAL DUE I . O0 ZF PAZD AFTER DATE ZNDZCATED, SEE REVERSE ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS RE9UZRED. FOR CALCULATTON OF ADDZTZONAL ZNTEREST. ZF TOTAL DUE ZS REFLECTED AS A "CREDZT' (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SZDE OF THZS FORN FOR ZNSTRUCTZONS.) RESERVATION: Estates of decadents dying on or before December 1Z, 198Z -- if any futura interest in the est-eta is transferred in possession or enjoyment to Class S (collateral) beneficiaries of the decedent after the expiration of any estate for life or Tot years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class S (collateral) rate on any such future interest. PURPOSE OF NOTXCE: To fulfil1 the requirements of Section ZXqO of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (TI P.S. Section 9140). PAYNENT: Detach the top portion of this Notice and submit with your payment to tho Register of Hills printed on tho reverse side. --Hake check or money order payable to: REGXSTER OF #ZEES, AGENT REFUND (CR): A refund of a tax credit, ahich was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Hills, any of the Z3 Revenue District Offices, or by calling the special Z4-hour anseering service for forms ordering: 1-BOO-36Z-ZO50; services for taxpayers with special hearing and / or speaking needs: 1-800-447-30Z0 (TT only). OBJECTIONS: Any party in interest not satisfied aith the appraisement, allowance, or disallowance of deductions, or assesseent of tax (including discount or interest) as sheen 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. ZalOZ1, Harrisburg, PA 171la-lOll, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADNIN- ISTRATIVE CORRECTIONS: 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. Z80601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three (3) calendar months after the dacedsnt's death, a five percent (5Z) discount of the tax paid is allowed. PENALTY: The 15Z 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 tho end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the saea tiaa period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes ahich became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 198Z mill bear interest at a rate which mill vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 19BI through ZOO3 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 198Z ZOZ .000548 1987 9Z .000247 1999 7Z .O0019Z 1963 162 .000~38 1988-1991 I1Z .000301 ZOO0 8Z .000219 1984 llZ .000301 1992 92 .000247 2001 9Z .000Z¢7 1985 13Z .000356 1993-199~ 72 .000192 ZOOZ 6Z .00016~ 1986 IOZ .000274 1995-1998 92 .O00Z~7 2003 5Z .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent mill 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 Notice, additional interest must be calculated. October 1, 2003 Cumberland County Register of Wills Courthouse Carlisle, PA 17013 ATTN: Ms. Donna M. Auto Probate Division Dear Ms. Auto: Enclosed is a check in the amount of $85 regarding the Notice of Additional Probate fees for the Estate of Marie D. Fagan, No. 21-2003-0098. Sincerely, Rosemarie F. Keegan, Executrix 145 Saint Andrews Way Etters, PA 17319 ~In the ~ourt of ~ommon 'l~leao of ~umberlanO ~ount~, 'l~enn~?l~ania IN RE: ORPHANS' COURT DIVISION NO. 21-2003-0098 ESTATE OF FAMILY SETTLEMENT MARIE B. FAGAN, Deceased. AGREEMENT Filed on behalf of: Rosemaric F. Kecgan, Executrix of the Estate of Marie B. Fagan, Deceased. Counsel of record for this party: Peter J. Daley & Associates, P.C. Peter J. Daley II, Esquire 242 Wood Street California, PA 15419 Phone: (724) 938-8953 Facsimile: (724) 938-8959 · Atty. I.D.# 70244 IN RE: ' IN THE COURT OF COMMON PLEAS : OF ESTATE OF ' CUMBERLAND COUNTY, PENNSYLVANIA MARIE B. FAGAN, Deceased. ' ORPHANS' COURT DIVISION : No. 21-03-0098 ~mil9 ~cttlcmcnt THIS AGREEMENT is made this ~_'/ er'day of ,2003, by and among KOSEMARIE F. KEEGAN, Executrix of thc Estatc of Marie B. Fagan, Dcccascd, (hereinafter referred to as "Decedent") and Rosemarie F. Kccgan, individually, and Marythcresa F. Mazzuca, individually, heirs to thc Dcccdcnt. WHEREAS, thc deceased, Marie B. Fagan, died on January 9, 2003, while rcsiding at 3609 Kohlcr Placc Apt. 12, Camp Hill, Cumberland County, Pennsylvania 17011; and WHEREAS, the decedent died testate; WHEREAS, an Executrix has been duly appointed and the estate advertised; (thc original advertisements are attached hereto, made a part hereof and marked Exhibit "A"); WHEREAS, Roscmaric F. Kecgan, has acted as thc Executrix of said estate pursuant to thc Authority of thc Cumberland County Register of Wills; WHEREAS, thc Executrix has undertaken to file all necessary documents and have pcrfi)rmcd all of thc duties in a satisfactory manner and in order to conclude their In accordance with their desire that the administration of the Estate of Mairc B. Fagan, be terminated without thc expense and delay of a court accounting, thc parties hereto, and in consideration of thc mutual covenants herein expressed, and intending to be legally bound hereby agree that: 1. The Estate of Marie B. Fagan, who died testate on January 9, 2003, is now in the process of administration, Letters Testamentary having been duly granted to the Executrix by thc Register of Wills of Cumberland County on June 11, 2003. 2. Under the provisions of Article III of the decedent's will, she bequcathed all the rest, residue and remainder of her property to her children, Rosemarie F. Keegan and Marythcrcsa F. Mazzuca. 3. The parties acknowledge that the Executrix has received the Estate assets and made payments as set forth in the Inheritance Tax Return which has been accepted by thc Department of Revenue, as is evidenced by the Appraisement. (A copy said Appraisement is attached hereto and marked Exhibit "B' and incorporated herein). 4. The parties hereto agree that the remaining balance of the estate assets have been distributed pursuant to an Agreement between and among the beneficiaries, including distribution of all legacies and devises as set forth in decedents will, without intending to limit the rights or remedies of the Executrix, the parties further agree to release and hold harmless the Executrix, her heirs, personal representatives, successors, and assigns, from and against all liabilities arising from her administration of the estate or resulting from them making the above referenced distribution without a formal audit. Page 2 of 3 from and against all liabilities arising from her administration of the estate or resulting from them making the above referenced distribution without a formal audit. 5. Thc parties further agree to refund to thc Executrix any portion of the distribution to which said heir is latcr dctermincd to bc not properly entitled. 6. This Agreement shall be binding upon all the parties and thcir rcspectivc heirs, ncxt-of-kin, personal representatives and assigns. THEREFORE, we, thc undersigned being fully appraised of thc consequences of our actions do hereby affix our signatures below and declare that wc have not been unduly influenced by an individual, individuals or by the representatives of this estate. A ~3~OW, ~vc affix our signatures, with the intcnt of being fully bound by the prov~s~o~ / ROSEMARIE F. KEEGAN, Excc~trix ROSEMARIE F. KEEGAN, indi~dually / as beneficiary MA~I"hERESA F. MAZZ~, individually as beneficiary Page 3 of 3 PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland. Lori Saylor, Classified Advertising Manager of THE SENTINEL, of the County and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a newspaper of general circulation in the Borough of Carlisle, County and State aforesaid, was established December 13th, 1881, since which date THE SENTINEL has been regularly issued in said County, and that the printed notice or publication attached hereto is exactly the same as was printed and published in the regular editions and issues of THE SENTINEL on the following dates, viz Copy of Notice of Publication ESTATE NOTICE Estate of MARIE B. FAGAN, Camp Hill, Cum~r~ndCoun~, June 28 & July 5 & 12, 2003 Pennsylvania, Letters Testamentary upon the above estate having b..gr..~for~ Affiant further deposes that he is not interested in undersigned, notice is he~Y ,~en fo -, tho. the subject matter of the aforesaid notice or indebted thereto, to make immediate payment, andtOall advertisement, and that all allegations in the those having claims or damandsto present foregoing statement as to time, place and character them for settlement and/orCOnalderetion by' ofpublication are true. the undersigned or their attorneys. Roasemarie Keegan ~ ~ ~ 145 SL Andrews Lane [ /'~/~).,~J j/ Etters, PA 17319 Peter J: Dalay & Associates, P.C. -- - ' Petar J. Daisy II, Esquire 242 Wood Street California, PA 15419 July 16, 2003 Sworn to and subscribed before me this 16th day of July ,2003. Notary Public My commission expires: NOTARIAL SEAL t ELLEN B. RUNDLE, Notary Public i Mechanicsbur§ Cumberland Count~nn_~ EXHIBIT l~.t~' Comrn~ss on Expires. September 17~ PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929), P. L.1784 STATE OF PENNSYLVANIA : : SS. COUNTY OF CUMBERLAND : Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, viz: JULY 4, 11, 18, 2003 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. ~//~is~d 19I-arie Coyne, Edi~ Fagan, Marie B., dec'cl. SWORN TO AND SUBSCRIBED before me this Late of Camp Hill. 18 day of JULY, 2003 Executrix: Rosemarte Keegan, -- 145 St. Andrews Lane, Etters, Attorneys: Peter d. Daley & As- sociates, P.C., Peter J. Daley, II, Esquire, 242 Wood Street, Cali- fornia, PA ! 5419. I ' COHHONWEALTH OF PENNSYLVANIA BUREAU OFI~IVIDUALTAXES DEPARTHENT OF REVENUE INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOHANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE 07-28-2003 ESTATE OF FAGAN HARIE D DATE OF DEATH 01-09-2003 FILE NUHBER 21 03-0098 COUNTY CUHBERLAND PETER J DALEY 1! ESQ ACN 101 P J DALEY & ASSOCS 242 WOOD ST ':-..' I Amoun(Rmmi((ed CALIFORNIA PA 15q19 HAKE CHECK PAYABLE AND REMIT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS REV-15~7 ~X AFP [01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT~ ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF FAGAN HARIE D FILE NO. 21 03-0098 ACN 101 DATE 07-28-2003 TAX RETURN gAS: (X) ACCEPTED AS FZLED ( ) CHANGED RESERVATZON CONCERNZNG FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es*e*e (Schedule A) (1) .00 NOTE: To insure proper 2. S~ocks and Bonds (Schedule B) (2) 81;977.68 credi~ ~o your account, $. Closely Held S~ock/Par*nership In~eres~ (Schedule C) ($) .00 sub~i~ ~he upper portion ~. Hot,gages/No,es Receivable (Schedule D] (q) .00 of ~his form ~i~h your 5. Cash/Bank Deposits/Misc. Personal Proper~y (Schedule E) (5) 898.00 ~ax paymen*. 6. Jointly O~ned Proper~y (Schedule F) (6) 21721.87 7. Transfers (Schedule G} (7) .00 8. To~alAsse~s (8) 85,597.55 APPROVED DEDUCTIONS AND EXEHPTZONS: 19,152.32 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H] (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 2z~93.66 11. To*el Deductions (11) 12. Ne* Value of Tax Re*urn (12) 63,951.57 1~. Chari*abla/Governmen*al Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00 1~. Ne~ Value of Es~a~e Subjec~ ~o Tax (1~) 63,951.57 NOTE: Z~ an assessment was issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 will reflect flgures that lnclude the total of ALL returns assessed to date. ASSESSHENT OF TAX: 15. Amoun~ of Line 1~ a~ Spousal re*e (15) .00 X O0 = .00 16. Amoun~ of Line 1~ *axable a~ Lineal/Class A ra*e (16) 63,951.57 X 0~5 = 2,877.82 17. Amoun~ of Line lq a~ Sibling ra~e (17) .00 x 12 = .00 18. Amoun~ of Line 1~ ~axable a~ Collateral/Class B re~e (18) .00 X 15 = .00 19. Principal Tax Due ':'(19)= 2,877.82 TAX CREDITS: PAYMENT ' RECEIPT I DISCOUNT DATE NUMBER I INTEREST/PEN PAID (-) AMOUNT PAID 06-17-2005 CD00270q .00 2,877.82 [~EXHIBIT I TOTALTAXCREDZTll 2'877'82I BALANCE OF TAX DUEl .00 "~" INTEREST AND PEN. [ .00 TOTAL DUE I .00 ~ IF PAID AFTER DATE INDICATED~ SEE REVERSE ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIO~L INTEREST. IF TOTAL DUE IS REFLECTED AS A VCREDIT~. [CR)~ YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) Cumberland County Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 12/01/2004 KEEGAN ROSEMARIE F 145 ST. ANDREWS WAY ETTERS, PA 17319 RE: Estate of FAGAN MARIE D File Number: 2003-00098 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 1/09/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Counsel Judge r2] STATUS REPORT UNDER Rt!'LB 6..1.2 Will No.: ...... P'~sum~t to P~ule 6.12 of the Supreme Cou¢ O~s' fbllowing wifll respect to completion of ~e a~s=afion of~e ~ove-¢apfion~ estate: 1. S~he~er a&~nis~ion of the estate is complete: Yes~ No ~ 2. ~e ~sw~ is No, state whm the personal r~resmtafive re~onably believes · at ~e ~minls~afion Will b~ oomplete: 3. ~ ~e ~wer to N0.1 is Yes. state the foRow~g: m Did ~¢ personfl repro,creative ~e a ~al aocotmt ~ ~e Co~? b. ~e s~at, Oeh~' Co~ No. (ff~y) for ~c pm-~onal ~resentafive~s accomt is: __ c. Did ~e pcrson~r~enmfive state ~ accmmt Mfo~y to ~e p~es c. Copies of receipts, relies, joiuders md approv~ of focal or ~om~ aoco~ may be filed ~ ~e Clerk of~e ~hm~s' Court ~d may be aaached to o~:~ ~ .. '7/7 - f~' ~7~7 ~ ~:,: ~ ~ ~ c.:: Telephone No. ELL. '" ~;::, ?::~ ~ o~. ~ Com~sel for p~sonal representative