HomeMy WebLinkAbout03-0168Estate of Antonio G.
also known as
, Deceased
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Mendez No.
John P. Mowery
Social Security No. 580 - 32- 3554
Petitioner(s), who is/are 18 years of age or older, apply(les) for:
(COMPLETE 'A' or 'B' BELOW:)
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut __
the Decedent, dated and codicil(s) dated
named in the last Will of
State relevant circumstances, e.g., renunciation, death of executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
B. Grant of Letters of Administration
(c.ta.; db.n.c.ta; pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and
heirs:
Name Relationship Residence
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland
County, Pennsylvania with his/her last family
or principal residence at 2395 Ritner Hishway, West Pennsboro Township, Carlisle,
(list street, number, and municipality)
Decedent, then 71 years of age, died 01/24/2003 at Carlisle, PA
Decedent 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
PA 17013
(Location)
35,000.00
situated as follows: none
Wherefore, Petitioner(s)
letters in the
of the la,~_Will and Codicil(s) presented with this Petition and the grant of
Typed or printed name and residence
P. Mowery
711 Centerville Rd., Newville, PA 17241
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, I nc.
17'
Form RW-1 (1991)
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal repre~en, t,a'tive'~s) of
the Decedent, Petitioner(s) will well and truly administer the estate according to law
Sworn to or affirmed and subscribed
' h John P. Mowery
before me thJsj ~ dayof ~ /"~
Estate of Antonio G. Mendez
Social Security No: 580 - 32 - 3554 Date of Death:
AND NOW, ~-~-~,2_ '~-~'~.k_.~ ', ~ .~
01/24/2003
Deceased
, ~(.,~t~ , in consideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters [~] Testamentary ~-~ Of Administration
(c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate)
are hereby granted to John P. Mowery
in the above estate and that the instrument(s) dated
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters ........... $ rTo. 0~) ~'"~L'~ 1 )//~
I Regi;ter~f Wil-¢
Short Certificate(s) ..... $ ~.O-
Renunciation ........ $ Attorney: Robert C.
Affidavits ( ) .... $ I.D. No: 21458
Saidis, Shuff, Flower & Lindsay
Extra Pages ( ) .... $ Address: 2109 Market Street
Codicil ........... $
Camp Hill, PA 17011
JCP Fee .......... $ I O, Of~ Telephone: 717/73 7 - 3405
Inventory .......... , '~--~L J~
Other ........... $
TOTAL ......... $ ' ~r~, O0
Prepared by the Pennsylvania Bar Association CopyricJht (c) 1996 form software only CPSystems, Inc.
Form RW-1 (1991)
ESTATE OF ANTONIO G. MENDEZ
Decedent, who died intestate, was not married at the time of his death and did not leave
any surviving children. The Cumberland County Coroner, Mike Norris, contacted the police in
Puerto Rico to attempt to locate two brothers of the decedent. It is believed that one brother is
believed to be in a mental institution in Puerto Rico (and so not competent to act as
administrator) and who was not able to be located, and another brother who could not be located
using his last known address. Decedent did not have any known creditors.
The Decedent was employed by the Petitioner as a grounds supervisor and lived on the
golf course owned by the Petitioner. Because of the relationship between the Decedent and the
Petitioner, Petitioner is requesting that letters of administratioa be issued to him in lieu of the
unavailability of intestate heirs of the estate.
REGISTER OF WILLS OF YORK COUNTY, PENNSYLVANIA
CERTIFICATION OF NOTICE UNDER RULE 5.6(A)
Name of Decedent: Antonio G. Mendez
Date of Death: January 24, 2003
Will No. Admin. No. 21-03-0168
To the Register:
I certify that notice of Estate Administration required by Rule 5.6(a) of the
Orphans' Court Rules was served on or mailed to the following beneficiary of the above-
captioned estate on June , 2003.
Name Address
Commonwealth of PA
Dept. of Revenue, Bureau of Individual Taxes,
Dept. 280603, Harrisburg, PA 17128-0603
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
none ~. Sm~~E
Ro ' ' squire
2109 Market Street
Camp Hill, PA 17011
(717) 737-3405
Capacity:
X
__ Personal Representative
Counsel for Personal
Representative
· REV;1500 EX + (6,-00)
CAPB
HpRL
EpIO
cRAC
KOTK
ES
Co"
R
E
C
A
P
I
T
U
L
A
T
I
O
N
C
O
M
xl
T
I
O
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DATE OF DEATH (MM-DD-YEAR)
07/25/1931
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
DECI:U~-NT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Mendez Antonio G.
DATE OF BIRTH (MM-DO-YEAR)
I
0I~/~03
1. Odginat Return ~ 247!
4,. Limited Estate ,
6. Decedent Died Testate
(Attach copy of Will)
[--'"] 9. Litigation Proceeds Received[--110.
OFFICIAL USE ONLY
FILE NUMBER
21-03-0168
COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
58O-32-3554
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
Supplemental Retum I I 3.
~FlIl~r~j~ Compromise (date of death after 12-12- 2)E~
5.
Beqei~hedt Maintained a Living Trust 0 8.
(~ltt~3J~eopy of Trust)
Spousal Poverty Credit ~J 11.
~)f death between 12-31-91 and 1-1-95)
(d~
Remainder Retum pn
Federal Estate Tax Return
Total Number of Safe Depo
Election to tax under Sec. 9
(Attach Sch O)
NAME
Robert C. Saidis
FIRM NAME (If Applicable)
Saidis, Shuff, Flower & Lindsay
TELEPHONE NUMBER
717/737-3405
COMPLETE MAILING ADDRESS
2109 Market St.
Camp Hill, PA 17011
1Real Estate (Schedule A) (1)
2Stocks and Bonds (Schedule B) (2)
3Closely Held Corporation, Partnership or (3)
Sole-Proprietorship
4Mortgages & Notes Receivable (Schedule D) (4)
5Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6Jointly Owned Property (Schedule F) (6)
I~eparate Billing Requested
7inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8.Total Gross Assets (total Lines 1-7)
9Funeral Expenses & Administrative Costs (Schedule H) (9)
1CDebts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11Total Deductions (total Lines 9 & 10)
l~let Value of Estate (Line 8 minus Line 11)
N.en~
None
None
None
37,534.22
None
None
13,756.93
126.83
13Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14~et Value Subject to Tax (Line 12 minus Line 13)
~,,~ ~ OFFICIAL USE ONLY
(6) 37,534.22
(11) 13,883.76
(12) 23,650.46
(13) 23,826.09
(14) (175.63)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15{~,mount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(a)(1.2)
16~mount of Line 14 taxable at lineal rate
17Amount of Line 14 taxable at sibling rate
1SO, mount of Line 14 taxable at collateral rate
0.00 X .0 0 (15) 0.00
0.00 X .0 45 (16) 0.00
0.00 X .12 (17) 0.00
0.00 X .15 (18) 0.00
19rax Due (19) 0.00
[~i'~'*~i~i~i!~i~i~,iI ....... :~i ............. l~'~.' *:~ ~' ~ ~ ~:" '~'* ':*~'~;*' ;'" ;'~' ~"::":~'" ': ~i;*:*::':' '":*'%?';':':~ ::'~:~;?":'=:~,.~ .... · ..................... ~ ........ ~ ~. ~ ................
Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV- 1500 EX (Rev. 6-00)
Decedent's Complete Address:
STRip, ADDRESS
2~95 Ritner Highway
CITY
Carlisle
Tax Payments and Credits:
1.Tax Due (Page 1 Line 19)
2Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3Jnterest/Penalty if applicable D. Interest
E. Penalty
17013
Total Credits ( A + B + C ) (2)
Total Interest/Penalty ( D + E ) (3)
(1) 0.00
4Jf 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)
5Jf Line I + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SB)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1Did 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 fe of either payments, benefits or care? ...................
2if death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ................................ ~ ~]
3Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death? .............................................. [~] ~]
4Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation? ................................ r~ [~]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS '(ES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
0.00
0,00
0,00
0.00
0.00
0.00
Under penalties of pedury, I declare th~,~ave examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is tree,
correct and com! ~te/ecl~a~ionof~13~3arerotherthanthepersonalrepresantatve s based on all information of which preparer has any knowledge.
'~RS~J(~IBLE FORFILI__i~~ ~ 3ohn P Mowerv
/~/~//~_ 711 Ce~tervil~e Rd.
~//_~d/r/~,-....-- -- -~&~%-fi l~- ;- Pi--- i}¥~ i ...........................
RESENTATIVE Saidis, Shuff, Flower & Lindsay
2109 Market St.
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. 9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets
and filing a tax retum are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2)
[72 P.S. 9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(a)(1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Copyright (c) 2000 fon~ software only The Lackner Group, Inc. Form REV- 1500 EX (Rev. 6-00)
REV-1508 EX + (1-97)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Antonio G. Mendez SS# 580-32-3554 01/24/2003 21-03-0168
Include the proceeds of litigation and the date the proceeds were received by the estate, All I~rol~e~/jointly-owned with the right of
survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
cash
Alfirst Bank, savings
accrued interest
acct.,
#87004906727565
TOTAL (Also enter on line 5, Recapitulation)
262.00
37,245.06
27.16
37,534.22
(If more space is needed, insert additional sheets of the same size)
Copyright (c)1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97)
REV-1511 EX + (1-97)
COMMO~IWEALIH OF PENNSYLVANIA
INHERITANCE[ TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Antonio G. Mendez SS#
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
580-32-3554 01/24/2003
FILENUMBER
21-03-0168
Debts of decedent must be reported on Schedule I.
iTEM
NUMBER DESCRIPTION AMOUNT
A.
Home,
5.
6.
7.
:UNERALEXPENSES:
Ewing Bros. Funeral
grave opening
funeral, marker,
deed,
~,DMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) John ~P, Mower¥
Social Security Number(s) / EIN Number of Personal Representative(s)
StreetAddress 711 Centerville Rd.
City Newvi 11 e State PA
__Zip17241
Year(s) Commission Paid:
2003
Attorney's Fees Saidis, Shuff, Flower & Lindsay
Family Exemption: (If decedent's address is not the same as claimant's, aRach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
OtherAdministrativeCos~
The Sentinel, estate notice
Cumberland Law Journal, estate notice
Register of Wills, filing fee
PNC Bank, check fee
TOTAL (Also enter on line 9, Recapitulation)
10,120.50
1,500.00
1,875.00
122.63
75.00
15.00
48.80
$ 13,756.93
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev, 1-97)
REV-1512 EX + (1-97)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Antonio G. Hendez SS~/~ 580-32-3554, 01/24/2003 21-03-0168
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
1 AT&T Wireless 126.83
TOTAL (Also enter on line 10, Recapitulation)
$ 126.83
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev, 1-97)
REV-1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Antonio G. Mendez SS~/
NUMBER
II.
SCHEDULE J
BENEFICIARIES
580-32-3554 01/24/2003
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I'AXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116(a)(1,2)]
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
FILE NUMBER
21-03-0168
AMOUNTORSHARE
OF ESTATE
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 181 AS APPROPRIATE1 ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
~,. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLEANDGOVERNMENTALDISTRIBUTIONS
Commonwealth of PA
Dept. of Revenue
Dept. 280603
Harrisburg, PA 17128-0603
Note: in accordance with PEF sec. 2103 intestate distribution
(after a proper search, administrator was unable to locate any
heirs or next of kin in USA or Puerto Rico, decedent's homeland)
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET
entire estate
$ 0.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00)
allfirst
March 11, 2003
Law Offices
Saidis, Shuff, Flower & Lindsay
A Professional Corporation
2109 Market Street
Camp Hill, PA 17011
Allfirst Financial Center N.A.
P.O. Box 900
Millsboro, DE 19966
RE: Estate of Antonio G. Mendez
Date of Death: January 24, 2003
Soc!_~_! Security Number: 580-32-3554
Dear Mr. Saidis:
In response to your request, please be advised that at the time of death, the above-
named decedent had on deposit with this bank the following accounts.
1. Account T~lpe ........................... Savings Account
Account Number. ............ ~ ......... 87004906727565
Ownersh/p (Names oj~ .............. Antonio G. Mendez
Opening Date ........................... 03/28/88 (account closed 03/10/03)
Balance on Date of Deatlz ......... $37,245.06
Accrued Interest $ 27.16
Total ....................................... $37,272.22
This letter does not include any accounts in which the deceased may have been listed as power of attorney,
custodian of uniform transfers, representative payee, sr trustee under a written trust agreement.
For any additional im%rmation on these accounts, please contact our branch at:
812 ½ West High Street
Carlisle, PA 17013
Phone: (717) 240-6717
Sincerely,
(302) 934-2722
I"]-
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DTV/SZDN
DEPT. 280601
HARRISBURG, PA 17118-0601
ROBERT C SAIDIS
SAIDIS ETAL
2109 HARKET ST ~.~
CAHP HILL PA 170~
CONNONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOT/CE OF /NHER/TANCE TAX
APPRAZSENENT, ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTXONS AND ASSESSNENT OF TAX
REV-1S~i7 EX AFP COl-OS)
DATE
ESTATE OF
DATE OF DEATH
FILE NUHBER
~COUNTY
ACN
10-15-2005
HENDEZ
01-24-2005
21 05-0168
CUHBERLAND
101
Amount RemAtted
ANTONIO G
HAKE CHECK PAYABLE AND REHTT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THZS LZNE ~ RETAIN LOWER PORTZON FOR YOUR RECORDS ~
REV-1547 EX AFP [01-03} NOTICE OF TNHERZTANCE TAX APPRAZSEHENT, ALLOWANCE OR
DTSALLOWANCE OF DEDUCTTONS AND ASSESSHENT OF TAX
ESTATE OF HENDEZ ANTONIO GFZLE NO. 21 05-0168 ACN 101 DATE 10-15-2005
TAX RETURN NAS: (X) ACCEPTED AS FXLED { ) CHANGED
RESERVATTON CONCERNING FUTURE TNTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (SchaduZs A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Stock/Partnership Intsrast (Schedule C) (3)
q. Nortgagas/Notas Receivable (Schedule D) (~)
S. Cash/Bank Daposits/NAsc. Personal Property (Schedule E) (5)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTZONS AND EXENPTZONS:
9. Funeral Expanses/Adm. Costs/Nisc. Expenses (Schedule H) (9)
10. Dabts/Nortgaga LAabAli~ias/LAens (Schedule [) (10)
11. Tote1 Deductions
12. Net Value of Tax Return
O0
57~554 22
O0
O0
15,756.95
.00 NOTE: To Ansura proper
00 credit to your account,
O0 submit the upper portion
of this form with your
tax payaent.
(8) 37,554.22
126.85
(11) 1~ .88s.76
(1~.) 25,650.46
15.
1~.
NOTE:
Charitabla/$ovarnaantal Bequests; Non-elected 911:5 Trusts (Schedule J) (13)
Net Value of Estate SubSact to Tax (lq)
Zf an assessment ~as lssued previously, lines lq, 15 and/or 16, 17,
reflect f/gures that include the total of ALL returns assessed to date.
25,826.09
175.65-
ASSESSNENT OF TAX:
15. Aaount of Line lfi et Spousal rate
16. Amount of LAne 1~ taxable et LAneal/Class A rats
17. Amount of L/ne 1~ et SAblAng rate
18. Aaount of LAne 1~+ taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDZTS:
PAYMENT RECEIPT DzSCOUNT (+)
DATE NUNBER ZNTEREST/PEN PAZD (-)
18 and 19 will
(1~) .00 X O0 = .00
(16) .00 X 045 = .00
(17) .00 X 12 = .00
(18) .00 x 15 = .00
(19)= .00
AMOUNT PATD
ZF PA/D AFTER DATE IND/CATED~ SEE REVERSE
FOR CALCULATION OF ADD/TZONAL INTEREST.
TOTAL TAX CREDIT
BALANCE OF TAX DUE
ZNTEREST AND PEN.
TOTAL DUE
.00
.00
.00
.00
( XF TOTAL DUE XS LESS THAN $1, NO PAYNENT 1S REDUIRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT' (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF TH/S FORN FOR INSTRUCT/ONS.)
RESERVATION:
Estates of decadents dying on or before December 12, 1982 -- if any futura intarast in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of tho decedent after tho expiration of any estate for
life or for years, the Coeaanaaalth hereby expressly reserves tho right to appraise and assess transfer Inheritance Taxes
at the la. ful Class B (collateral) rate on any such futura Interest.
PURPOSE OF
NDTICE:
PAYNENT:
REFUND (CR):
OBJECTIONS:
ADNIN-
ZSTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
To ~ulf111 the requirements of Section 2140 of tho Inheritance and Estate Tax Act, Act 23 of ZOO0. (71 P.S.
Section 9140).
Detach the top portion of this Notice and submit eith your payment to tho Register of Hills printed on the reverse sides
--Hake check or money order payable to: REGISTER OF HILLS, AGENT
A refund of a tax credit, ehich aaa not requested on the Tax Return, may be requested by completing an "Application
far Refund of Pennsylvania Inheritance and Estate Tax" (REV-Z313). Applications ara available at the Office
of tho Register of Hills, any of the 13 Revenue District Offices, or by calling the special Z4-hour
answering service for forms ordering: 1-800-361-2050; services for taxpayers with special hearing and / or
speaking needs: 1-800-447-3010 (TT only).
Any party in interest not satisfied with the appraisement, alloeance, or disalloaanca of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object aithin sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dapt. ZalOZ1, Harrisburg, PA 171Ia-lOll, OR
--election to have the matter determined at audit of the account of tho 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. Sea page 5 of the booklet "Instructions for Inheritance Tax Return far a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
If any tax duo is paid eithin three (3) calendar months after tho dscedent's death, a five percent (51) discount of
the tax paid is allowed.
The 151 tax amnesty non-participation penalty is computed an the total of tho tax and interest assessed, and not
paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation
penalty is appealable in the same manner and In the the same tiaa period as you mould appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning aith first day of delinquency, or nine (93 months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at tho rate of
six (6Z) percent par annum calculated at a daily rate of .000164. Al1 taxes ahich became delinquent on and after
January 1, 1982 mill bear interest at a rate which will vary from calendar year to calendar year aith that rate
announced by the PA Department of Revenue. The applicable interest rates for 1981 through 2003 are:
Interest Dally Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 ZOZ .000548 1987 91 .000147 1999 71 .000191
1983 161 .000438 1988-1991 112 .000301 2000 82 .000119
198¢ llZ .000501 1991 91 .000Z47 2001 92 .000147
1985 13Z .000356 1993-1994 7Z .000191 Z002 6Z .000164
1986 lOX .000274 1995-1998 92 .000247 2003 52 .000137
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent mill reflect an interast calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shown an the
Notice, additional interest must be calculated.
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
FIRST AND FINAL ACCOUNT OF
JOHN P. MOWERY, ADMINISTRATOR
FOR THE
ESTATE OF ANTONIO G. MENDEZ
NO. 21-03-0168
Date of Death:
Date of Administrator's Appointment:
First Complete Advertisement of
Grant of Letters
January 24, 2003
February 25, 2003
March 14, 2003
Accounting for the Period: April 8, 2003 to October 31, 2003
Purpose of Account: John P. Mowery, Administrator, offers this
account to acquaint interested parties with the transactions
that have occurred during his administration. The account also
indicates the proposed distribution of the estate.
It is important that the account be carefully examined.
Requests for additional information or questions or objections
can be discussed with:
Robert C. Saidis, Esquire
Saidis, Shuff, Flower & Lindsay
2109 Market Street
Camp Hill, PA 17011
(717) 737-3405
SUMMARY
Proposed Distribution to Beneficiary
Page
No.
PRINCIPAL:
Receipts 3
Less Disbursements 3
Balance Before Distributions
Distribution to Beneficiaries 3
PRINCIPAL BALANCE REMAINING
INCOME:
Receipts
Less Disbursements
INCOME BALANCE REMAINING
COMBINED BALANCE REMAINING
3-4
4
15,442.78
0.00
52.47
8.08
$23,207.83
38,106.22
22,663.44
22,663.44
$44.39
$22,707.83
2
PRINCIPAL RECEIPTS
Per copy of Inventory attached
$38,106.22
TOTAL PRINCIPAL RECEIPTS
$38,106.22
2003
PRINCIPAL DISBURSEMENTS
April 08
10
18
June 26
Aug. 15
18
Oct. 31
AT&T wireless bill
Ewing Bros. Funeral Home
Saidis, Shuff, Flower & Lindsay, reimbursement
for probate cost and advertising
PNC Bank, check printing fee
The Sentinel, estate notice
Register of Wills, tax filing fee
AT&T Wireless, balance due
Central Penn Medical
Stoken Opthamology
INA, cost of research of next of kin
126.83
10,120.50
161 00
48 80
122 63
15 00
1 99
248 00
48 03
175 00
ITEMS TO BE
DISBURSED:
Saidis, Shuff, Flower & Lindsay,
attorney fees
John P. Mowery, Administrator's commission
Reserve for filing fees and pending
completion of all tax matters
1,875.00
1,500.00
1,000.00
TOTAL PRINCIPAL DISBURSEMENTS
$15,442.78
DISTRIBUTIONS TO BENEFICIARIES
TOTAL DISTRIBUTIONS TO BENEFICIARIES
$0.00
INCOME RECEIPTS
Alfirst Bank, savings account, interest from date of death
until account closed April 2, 2003 17.20
3
PNC Bank,
04/29/03
05/29/03
06/26/03
07/30/03
08/28/03
09/29/03
estate checking
TOTAL INCOME RECEIPTS
INCOME
PNC Bank,
interest
04/17/03
05/29/03
06/29/03
07/30/03
estate checking
withholding:
account #5003274667:
8.37
7.72
5.61
6.05
4.06
3.46
DISTRIBUTIONS
account #5003274667,
2.51
2.31
1.57
1.69
35.27
$52.47
TOTAL INCOME DISTRIBUTIONS
$8.08
4
COMMONWEALTH OF PENNSYLVANIA)
COUNTY OF CUMBERLAND )
: SS.
John P. Mowery, Administrator of the Estate of Antonio G.
Mendez, deceased, hereby declares under oath that he has fully
and faithfully discharged the duties of his office; that the
foregoing First and Final Account is true and correct and fully
discloses all significant transactions occurring during the
accounting period; that all known claims against the estate have
been paid in full; that, to his knowledge, there are no claims
now outstanding against the estate;~d th~ all taxes presently
due from the estate havbee~~/j
/~ ~u~u~ ozTio G. Mendez
Sworn to and subscribed before me
~__[~,~ .~__~this ', .~~~~/i. - 'c , 2003.
NOTARIAL SEAL
DAWN M. SHUGHART, Notary Public
M coCr~%~!e' Cumberland COunty
y ission Expires
ESTATE OF ANTONIO G. MENDEZ
Proposed Schedule of Distribution
COMBINED BALANCE REMAINING =
$23,207.83
Note: After a diligent search, the Administrator has not been
able to locate any next-of-kin of the decedent. Therefore,
proposes that the combined balance remaining in the estate be
distributed to The Commonwealth of Pennsylvania as intestate
heir of the Estate of Antonio G. Mendez. Attached is a copy of
a report from Information Network Associates, who conducted an
investigation to locate possible living relatives of Mr. Mendez
in the United States and Puerto Rico.
6
OCT 3 0 2003
P.O. Box 60515
Harrisburg, PA 17106-0515
(717) 599-5505
(800) 443-0824
Fax (717) 599-5507
29 October 2003
Ms. Shelby L. Yingling, Estate Paralegal
Saidis, Shuff, Flower & Lindsay
2109 Market St.
Camp Hill, PA 17011
RE: The Estate of Antonio G. Mendez
Dear Ms. Yingling:
This report summarizes Information Network Associates, Inc.'s (INA) efforts on your
behalf to perform investigative services concerning the death and estate of Antonio
Mendez. Enclosed please find the following documents:
· Cumberland County Coroner's Office Report
· Cumberland County Coroner's Office handwritten notes
As Investigator Earl Bock indicated to you, the investigation conducted by the coroner's
office was very thorough, and resulted in no contact with any family member.
As per the request for the status of Mr. Mendez's United States citizenship, INS would
not release any information to us. INS advised us someone would have to appear at their
office and fill out a "Freedom of Information" document, and present a death certificate.
The information in this report and the enclosed documents is self-explanatory; however,
if you have any questions or if additional investigation is requested, please advise. Thank
you for using INA to fulfill your information and investigation requirements.
Very truly yours,
Information Network Associates, Inc.
By:j '(~[l~n F. Shinko~vsky,
D~rector of Investig~io/fis
Enclosures
/ 0~'~--10--0~ 2:~0
CORONER
PHONE:
PM M L NORRIS
OFFICE OF THE CORONER
CUMBERLAND COUNTY
P. O1
6375 BASE:WORE: RD, ~UITE: I
ME:CHAfllCSBUR(~, PA 1'70~$
FAX 717-766-6419
Fax Cover Sheet
October 10, 2003
From: Rich Middlekauff
Deputy Coroner
To: Earl Bock
Re: Antonio G. Mendez
l%lumber Pages including cover ]~_
0 ~W --ol 0 -- 0 ~
12 :~;1
PM M L NORRIS
P.02
Page 6 Case #28-447
Next of Kin search for A. Mendez
Friday, January 2~.~, 2003
[ ar;ived on the scene at 1040 and began my initial examination of the body. I
removed a wallet from his right rear pocket and examined the contents. There was
persorial identification but nothing to indicate whom to notify in case of emergency or
next o~'kin. Mr, Martin, the bus driver, and his supervisor checked with their office and
found ~o next of kin listings. I spoke with staff at the Dialysis Center and they had no
listin~ for next of kin for Mr, Mendez, They had requested the information numerous
times ~owever he refused to give it to them, I called Dr. Albright's office and was told
they l~ad no information for next of kin listed in their records. I called the Cumberland
County Office of the Aging and was advised they only referred Mr. Mcndez to the
Transportation Department and they had no information. At 1315 1 searched Mr.
Mend?z's residence for next of kin information. Under tho bed I found numerous boxes
of letters and correspondences, some of a personal nature but most dealing with health
insur~ce. I also found a bankbook. Thc personal letters were all written in Spanish and
some ~ated as far back as 1979. The most recent was from 1999. I secured the residence
and resumed to the Coroner's Office. I attempted to contact Officer Meneses from the
Mech~nicsburg Bore Police department, but he was not available. I called the Office of
Emerl~ency Preparedness and received a list of emergency contacts for Spanish
interp.~eters. Beginning at 1600 and continuing until 2200, I made numerous attempts to
conta6t an intcrpreter most of whom did not want to be bothered or were no longer at the
numb.~r supplied.
Saturday, January 25th, 2003
A(09301 went to the Cumberland County 911 Center to review the list for Spanish
interpreters. I was informed by Supervisor Hall that Officer Rife of the Shiremanstown
Polic~ Department was fluent in Spanish and he was on duty. I contacted Officer Rife and
madelarrangements to meet him at his station, I arrived at 1116 and we began to review
the letters I had found. The letters showed he had a brother named Wilfredo Guzman,
who l~ved in San Sebastian, Puerto Rico. The latest was dated in 1979, There were other
letter~ but we could not confirm if they were from family members. A group of letters
were ~'rom a girlfriend who also lived in San Sebastian. Officer Rife made contact with
the S,an Sebastian Police Department and spoke to Officer Torres. Officer Torres noted
the address we had was no longer valid as the area had been developed in the last twenty
years ~nd now had street address not PO boxes. He checked with his local database and
founc[ a listing for a Wilfredo Guzman in the San Sebastian area He sent officers to make
notlfigation, I received a call from the San Sebastian Police at 1741 advising me they met
with l~a'. C}uzman, but he was not related to Mr. M~dez, He said he had never heard of
him alnd checked with his family to see if any knew of him, The answer was no.
0~T--.10--0~ 12:~ PM M L NORRIS P.O1
Page 7 Case #28-44?
Sunday, Sanuary 26th, 2003
At liOl 8 1 returned to the residence to search again for any information I may have
missedlth¢ first time. I found two letters from his girlfriend dated in 1999 and 2000 in a
box ofkiedical bills and notices. There were no other letters or written information found
in the r~sidence. ! called Officer Rife and made an appointment to meet him at 1400,
Office~ Rife translated the two letters confinning she was a girlfriend and not a wife.
Officcl~ Rife contacted the police in Puerto Rico and attempted to find information on. the
girlfriend. The police checked their database and directory assistance but found nothxng.
At ~$10 1 called Don M. owery of the Cumberland Oolf course, Mr. Mendz's
employer, Mr. Mowery said he had no next of kin information on Mr Meridez as he had
a problem with his family in the late 1970's - early I980's. His famil~ felt hc was not
sendinl~ enough of his money back to them so they disowned him. He had not contact
with th~m for at least twenty years. Mr. Mowery thought he had an illegitimate son but
had no~co' ntact with him ever as he was th~ reason Mr. l~endez left Puerto Rico. He had
gone b/~ck home a few times .but the experience was less than pleasant. Anytime the
familybr friends came. to visxt he paid for all ~xpenses as they felt he was a wealthy
AmeriCan. lie had a g~rlfriend since the early 1980's but she had been a probl~ri for him.
She eli imed to bc his wife but Mr, Mendez said he would never marry her, as she was
prone t violence. Once on a visit in the early 1990's she attacked him with a knife and
was re~ aoved by State Police from the residence. He had no contact with her since
Februa 'y or March of 2000, Mr, Mowery gave me the phone number for another
emplo ~ee, Thelma C,-odlove, and said she was better aquainted with his personal life.
I called Thelma and spoke to her and her daughter Jenny. They confirmed the
inform ~tion supplied by Mr. Mowery and said Mr. Mendez had returned to Puerto Rico
in 199,' to try and make amends with his family, He returned early from the trip and was
despon lent, as his family would have nothing to do with him while he was there. To their
knowledge, that was the last time he had any contact with his family, His girlfriend had
interm!}tent contact with her last visit in 1999 or 2000. She had arrived an~demanded he
marry .~er and once again assaulted him. She returned to Puerto Rico and was living with
an aunt. Apparently she assaulted the aunt, seriously injuring her in the precis and was
placed in an institution by her family in March of 2000. Her father contacted Mr. Mendez
to see i~he would marry her. and take responsibility for he, but due to his failing health,
he refu~ed. Mrs./3odlove said that was the last time he had any contact with anyone from
Puerto Rico. Mr. Mcndez very seldom spoke of his family, but he did tell her he had a
sister i/} New York City and a brother who was a police officer in Puerto Rico, however
he gave. no names or addre~se~ to her. She directed me to speak to Albert Mutter, as he
had as/jsted Mr. Mendee with some social security issues.
~0C'~--1~0--03 12.'$4 PM M L NORRIS P. 02
Page 8 Case//28-447
I ca
submit
led Mr. Mutter at 1650 who told me he had helped Mr, Mendez fill out and
some forms but had no other information in reference to his n~t of kin.
· Monday, January 27th, 2003
I wils contacted by John Mowery, son of Don Mower),. He confumed the information
supplie~l by his father and said Mr. Mendez had worked for the Goli'Course since it was
first bu
workex
any coJ
spent a
Mcnde
case of
Mr. M~
rclcas~
It in 1960. He said depending on Mr. Mendez's mood, his son ~ither owned or
in a restaurant in Puerto Rico but to his knowledge, Mr. Mendez had never had
tact with his son and had never told anyone his name..rolm said he and his family
lot oftime with Mr. Mendez and fclt he was part of their family. However, Ma'.
: very scldom spokc of his own family and refused to make any arrangements in
his death. Mr. Mowery said he and his father would gladly take responsibility for
ndez's ftmeral and would keep their employees away from his residence until we
I it.
Richard C. Middlekauff
Deputy Coroner
~T~10--0~ 12:34 PM M L NORRIS P.O~
'
L NORRIS
P.04
OCTJlO-O~ 12 :~5 PM M L NORRIS
P.05
0CT--i0-05 12:55 PM M L ~ORRI$ P.06
OCT--~O--O~
PM M L NORRIS
P.~)?
12:36
PM M L NORRIS
P.08
0CT--10--05 12:37 PM M L NORRIS P. 09
OCT--io--o~ 12 :~?
FrceTranslation.,~om
PM M L NORRIS
P.10
Pal~e I of I
Translation Reililte by SDL International:
Tenemos su direcJ:16n de hermano, ~,Es, WILFREDO GUZMAN, Ruta Rural #2, Buzon 53t San Sebastian PR
Nosotros neceslta)~os la poli;ia Io~el en Puerto
RIM para notlflca~ la FAMILIA de ANTONIO? 4Ustecl es capaz de ayudamos?
~tto:ffwww.fteetrlinslation.com/rem~its.a~n ~ n,t ~,~nn.~
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
ESTATE OF:
ANTONIO G. MENDEZ
Deceased
Late of West Pennsboro Township
Date of Death - Jan. 24, 2003
: No. 21-03-0168
:
: Social Security
: No. 580-32-3554
INVENTORY
o
Cash found in decedent's residence
Alfirst Bank, savings account 87004906727565
accrued interest
Internal Revenue Service, refund on 2002 income
tax return
262.00
37,245.06
27.16
572.00
TOTAL
$38,106.22
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ss:
John P. Mowery, being duly sworn according to law, deposes
and says that he is the Administrator of the Estate of Antonio G.
Mendez, late of West Pennsboro Township, Cumberland CoUnty,
Pennsylvania, deceased and that the within is* ah Inventory made
by John P. Mowery, the said Administrator, of the entire estate
of said decedent, consisting of all the personal property and
real estate, except real estate outside the Commonwealth of
Pennsylvania, and that the figures opposite each item of the
Inventory represent it's fair value as of the dec~nt's death.
Sworn to and Subscribed before X~
me this i -~ day of ~~J/
~A~vember, 2003.~ )~hn P. Mow~y,' /-~-
~ XX ^~ [ ~ // /Administrator /
]_ J/~-~ /Y \~7~i--~;~ 711 Centerville ~o~
Ndt~ry-P~blt~~' ' ~ Newville, PA 17~
DAWN M. SHUGHART Notaly Pub'ic [
Carse Cu~b ' ' ' ":
· ', ~. errand Count~
[My Commission Expi~e~ r,,tov 08 s, Or,,'
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Date of Death:
Will No.
Antonio G. Mendez
January 24, 2003
Admin. No. 21-03-0168
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is
complete: Yes X ; No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes 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? Yes ; No X
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Clerk of the Orphans' Court and ma~ched to this report.
Date: ~ d /t
Sig
Capacity:
Name: Robert C. Saidis, Esquire
I.D. No. 21458
SAIDIS, SHUFF, FLOWER & LINDSAY
2109 Market Street
Camp Hill, PA 17011
(717) 737-3405
Personal Representative
X Counsel for Personal
Representative