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HomeMy WebLinkAbout03-0713PETITION FOR PROBATE and GRANT OF LETTERS Estate of' /bf/g~ /~/ ~ ~ /5-C //~7 No. also known as To: Deceased. Social Security No. Z 0 '7- o q - I 2 '~ ~ Register of Wills for the County of C o'~,'/8£~ ~/~,' D 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 executod~ in the last will of the above decedent, dated / ?' - '7 and codicil(s) dated in the named (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in (' O~4/flb--/q/-,6t ZP/) County, Pennsylvania, with h [5 last family or principal residence at _5-0' / 7-6'/t',/q-t~ ¢ ~ D,4J/~'~' (list street, number and muncipality) Decenden%~hen ~-3/y. ea.._rsofage,~die~d 09 - ,q - , 1~ Ca ~ , at //'d~./ lC,, /./~.3/~' i~ z- Except as follows, decedent did not marry, was not divorced 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 ~,~,~f the last will and codicil(s) presented herewith and the grant of letters 7'-Z--ZTC/7'/b'f~-///Z- ZSz .~" (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. / OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA q>- ss 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 represen- tative(s) of the above decedent petitioner(s) will well and~tfuly administer the~ estate according to law. Sworn to or affirmed and subscribed ,~ ~v~/// /~4~f~ ~ before me this 27th day of [ ~/ ~' IkSffna M. Ot'tb; l§t Deputy Regt~ter ~.f~ta,~) ~ / $0. 21-2003-713 Estate Of mm~o MXSZCA , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW Auqust 29'ch 1~ 200~ 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 December 7th, 1983 described therein be admitted to probate and filed of record as the last will of Mario Misica ; and Letters Testem]entary_ are hereby granted to Henry Miscia FEES Probate, Letters, Etc .......... $ 115.00 Short Certificates(2 ) .......... $ 6.00 ~n .x~Pagos. (2.).. $. 6.00 JCP $. 10.00 TOTAL __ $ 137.00 Filed August.29.th,.20~3 .............. Mailed Letters to Executor on 8/29/2003. Donna M. Otto, 1st Deputy ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE his is to certifi/that the iriformation here given is correctly copied from an original certificate of death duly filed with me as I,ocal Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 9571767 No. [)ate Hr05 t43 PEJPRINT RNANENT Rev 2/87 COMMONWEALTH OF PENNSYLVANIA ° DEPARTMENT OF HEALTH * VITAL RECORDS CERTIFICATE OF DEATH s. R~ ' I I I I I~ua 15, 1913 ~. Cumberland I~. E. Pennsboro Twp. .~ Self Employ~ t"~- ' h~- I'" '12 [ '' J,,. Never Married I,s. 501 Terrace Dr. ,~. New Cumberland PA 17070 i~.) 17b. ~,. Ralph M. Mi~ia ~. Clementina Bellini zh. Hen~ Mi~ia =~. 300 Fishburn St. Harrisburg, PA 17109 =~.. ~-(~) .D ~. Au~ 13, 2003 ~ z~.. Resurrection Cemete~ ~. Harrisburg, PA 17112 SIG~TURE OF FUNE~ SERVICEI~ LI~NSEILI NSEE OR PERSON ACTING ~ SUCH ~ LICENSE NUMBER ~ N~E ~O ADDRESS OF FACILI~ =z~ '~ ~. ~ 12~. 13845-L ~2zc. Gi~ L. Dai~ Fu~ H~. I~. 6~ S. 2~ St. H~., PA 17103 ~ ~ M ~ea~. ~ 2~. ~ 23b. ~ 23c. OF O~TH? ~t ~ P~d~ In~s~a~ D 3Ob, M D · CERTIFIER (Check only · 31b.SIGNATURE~~'/~AN TITLE RTl IER ~--'~) LICENS.E,~IU~ISER ~ DATE SIGNED (~4on~ Day. Year) i~ ~. ~- ~_ -- DATE FILED (M~ih, Cay, Year) ,,. 7'1/-oJ 21-2003-713 LAST WILL AND TESTAMENT OF MARIO MISCIA ?/3 I, MARIO MISCIA, of the Borough of New Cumberland, County of Cumberland and Commonwealth of Pennsylvania, do make, publish and declare this as and for my Last Will and Testament, hereby expressly revoking all wills and codicils made by me heretofore, and dispose of my estate as follows: ITEM 1: I direct the payment of my just debts and funeral expenses, including a suitable and proper grave marker, as soon as conveniently can be done following my decease. ITEM 2: I direct that all State and Federal Transfer Inheritance Tax, Estate Tax, Succession Tax or any other tax, including any interest, assessments or penalties thereon, that may become due and payable by virtue of my death, or by virtue of the passing of any property either under my Last Will and Testament, or in any other manner, shall be paid by my estate, just as if such taxes were my debts, and no beneficiary shall be required to pay or refund any part thereof. ITEM 3: Ail of the rest, residue and remainder of my estate of whatsoever nature and wheresoever situate, I give, devise and bequeath unto my brother, HENRY MISCIA, if he survives me by thirty (30) days. ITEM 4: Should my brother, HENRY MISCIA, fail to survive me, I give, devise and bequeath all of the rest, residue and remainder of my estate unto my sister-in-law, DORIS MISCIA. ITEM 5: Should my brother, HENRY MISCIA, and my sister-in-law, DORIS MISCIA, both fail to survive me, I give, devise and bequeath all of the rest, residue and remainder of my estate unto ROBERT J. HOWER of New Cumberland, Pennsylvania. ITEM 6: I nominate, constitute and appoint my brother, HENRY MISCIA, to be the sole Executor of this, my Last Will and Testament. Should my brother, HENRY MISCIA, be unable or unwilling to so act or to continue serving, then I nominate, constitute and appoint my sister-in-law, DORIS MISCIA, to be the sole Executrix of this, my Last Will and Testament. ITEM 7: I direct that no fiduciary appointed in my Will shall be required to give or enter into any bond or security in any jurisdiction, regardless of the State of their residency. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament consisting of two (2) typewritten pages, this ~7 ~ day of ~.~..~.~. , 1983. MARIO MISCIA (Seal) residing at . .~-~~3~, ~ residing at ,-~~.~(~. ~ JRL009/C COMMONWEALTH OF PENNSYLVANIA : : SS.: COUNTY OF DAUPHIN : f We,~the Testator, MARIO MISCIA, and~~3~ and ~J~'~.'~.~z~ , the witnesses, respectively, whose nam~s are sig~ed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and that he had signed willingly, and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witness and that to the best of his/her knowledge the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Testator Wi'~ ness ~. ~~- Subscribed, sworn to and acknowledged before me by the Testator, MARIO M~.S~A, and subscribed and sworn to before me by ~Ct~< ~C~.~/ and ~/~L~ /-~,. ~.~ , witnesses, this /~'~ day of "~>(d~/~]o~k. ", ~983. Notary Public (SEAL) My Commission Expires: ttill OF MARLO MISCIA LAW OFFICES GOLDBERG, EVANS ~C I~ATZI~L~N, R C. HARRISBURG, PENNSYLVANIA 17108 CERTIFICATE OF NOTICE UNDER RULE NAME OF DECEDENT: MARLO MISCIA DATE OF DEATH: August 9, 2003 WILL NO.: __ ADMIN NO.' 2003-00713 TO THE REGISTER: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on August 9, 2003: NAME ADDRESS Henry and Doris Miscia 300 Fishburn Street, Harrisburg, PA 17111 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: NONE DATE: 11/05/2003 NAME ADDRESS TELEPHONE Personal Representative CAPACITY: SIGNATURE CHARLES E. PETRIE 3528 Brisban Street Harrisburg, PA 17111 (717) 561-1939 X Counsel for Personal Representative PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE 6.12 FORM YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 NAME OF DECEDENT: MARLO MISCIA DATE OF DEATH: August 9, 2003 WILL NO: ESTATE NO: 2003-00713 Pursuant to Rule 6.12 of the Supreme Court Orphan's 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 No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: (Not Applicable in Dauphin County) c. Did the personal representative state an account informally to the parties in interest? Yes __ No __ DATE: d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. SIGNATURE CHARLES E. PETRIE NAME (PLEASE TYPE OR PRINT) 3528 Brisban Street Harrisburg, PA 17111 ADDRESS (717) 561-1939 TELEPHONE NO. CAPACITY: _ Personal Representative X Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003207 PETRIE CHARLES E ESQUIRE 300 FISHBURN STREET HARRISBURG, PA 17109 ........ fold ESTATE INFORMATION: SSN: 207-09-1256 FILE NUMBER: 2103-071 3 DECEDENT NAME: MISCIA MARLO DATE OF PAYMENT: 1 1/06/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 08/09/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 ,~1,791.21 TOTAL AMOUNT PAID: $1,791.21 REMARKS: HENRYMISCIA C/O CHARLES E PETRIE ESQUIRE SEAL CHECK# 4123 INITIALS: JA RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS R~v'-1500 EX + (t~-O0) I,- Z uJ Z 0 Q. U.I 0 Z Z COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY ~ILE NUMBE~ wt$ COUNTY (;ODE YEAR NUMBER SOCIAL SECURITY NUMBER MISCIA MARLO _ _ DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 08/09/2003 08/15/1913 REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER r~l, Original Return [~4. Limited Estate r~6, Decedent Died Testate (Attach copy of Will) ---[9. Litigation Proceeds Received ~[2. Supplemental Return -"-[ 4a. Future Interest Compromise (date ofdeath after 12-12-82) --]7. De(~dent Maintained a Living Trust (Attach copy of Trust) ] 10. Spousal Poverty Credit (dateofdeath between 12-31-91 and 1-1-95) E~3. Remainder Return (dateofdeath pdorto 12-13-82) El5. Federal Estate Tax Return Required 0__ 8. Total Number of Safe Deposit Boxes [~11. Election to tax under Sec. 9113(A) (Attach Sch O) NAME CHARLES E. PETRIE FIRM NAME (If Applicable) TELEPHONE NUMBER (717) 561-1939 COMPLETE MAILING ADDRESS 3528 BRISBAN STREET HARRISBURG PA 17111 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) E~ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Modgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) OFFICIAL USE ONLY 64,982.86 j. (8) 9,796.00 (11) (12) (13) (14) 64,982.86 9,796.00 55,186.86 55,186.86 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due X .0 (15) X .0 (16) 55,186.86 X .12 (17) X .15 (18) (19) 6,622.42 6,622.42 Decede~t's Complete Address: SI ~bbl ADDRESS 501 TERRACE DRIVE CITY NEW CUMBERLAND J STATE PA J ZIP 17070 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 331.21 Interest/Penalty if applicable D. Interest E. Penalty (1) Total Credits ( A + B + C ) (2) Total Interest/Penalty ( D + E ) 6,622.42 331.21 (3) 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) If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 6,291.21 A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB) 6,291.21 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 properly transferred; ........................................................................... [] [] b. retain the right to designate who shall use the property transferred or its income; ........................................ [] [] cI retain a reversionary interest; or ...................................................................................................... [] [] d. receive the promise for life of either payments, benefits or care? ............................................................. [] [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................................................................................... [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNA~N~ RE~NG. RETURN DATE ADDRESS 30¢'FISI:-tBURN STREET 11/5/03 HARRISBURG SIGNATURE O~.,EP ..,~.R OT.~,~ THA~RESENTATIVE PA 17109 DATE ADDRESS 3528BRISBANSTREET HARRISBURG 1 1/5/0 3 PA 17111 For dates of death on or after July I, 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 return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. {}9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF MISCIA MARIQ FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION 2. 3. 4. 5. 6. 7. FUNERAL EXPENSES: GRAVE OPENING AT RESURRECTION CEMETERY FOOD AFTER FUNERAL DAILEY FUNERAL HOME HEADSTONE & ENGRAVING ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) WAIVED Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Year(s) Commission Paid: Attorney Fees CHARLES E. PETRIE Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Zip Street Address City State Zip Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) AMOUNT 675.00 250.00 6,974.00 1,395.00 350.00 152.00 9,796.00 R~V'1513 EX + (1'9'"7) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER MISCIA MARLO RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER Do Not List Trustee(s) OF ESTATE II. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) HENRY MISCIA 300 FISHBURN STREET HARRISBURG, PA 17109 BROTHER ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE 100% OF ESTATE , ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA INVENTORY Estate of MISCIA MARLO No. 2003 00713 also known as Date of Death 08/09/2003 , Deceased Social Security No. 207091256 Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. INVe verify that the statements made in this inventory are true and correct. INVe understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: CHARLES E. PETRIE ~.D. No.: 29029 Address: 3528 BRISBAN STREET Dated 11/05/2003 HARRISBURG PA 17111 Personal Representative: HENRY MISCIA Telephone: (717) 561-1939 Description CERTIFICATE OF DEPOSIT AT PNC BANK CERTIFICATE OF DEPOSIT AT PNC BANK CHACKING ACCOUNT AT PNC BANK 1986 PONTIAC MISCELLANEOUS PERSONAL PROPERTY Real Estate (Attach Additional Sheets if necessary) Total Value 30,179.38 20,000.00 14,253.48 50.00 500.00 64,982.86 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. RW-4 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INBIVlDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD REV-1162 EX(11-96) 004242 MISCIA HENRY 300 FISHBURN STREET HARRISBURG, PA 17109-3807 ........ fold ESTATE INFORMATION: SSN: 207-09-1256 FILE NUMBER: 2103-071 3 DECEDENT NAME: MISCIA MARLO DATE OF PAYMENT: 08/06/2004 POSTMARK DATE: 11/06/2003 COUNTY: CUMBERLAND DATE OF DEATH: 08/09/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $4,500.00 R~EMARKS: CHECK# 7 SEAL TOTAL AMOUNT PAID: $4,500.00 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF iNDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD REV-1162 EX(11-96) O04242 300 FISHBURN STREET HARRISBURG, PA 17109-3807 ........ fold ESTATE INFORMATION: SSN: 207-09-1256 FILE NUMBER: 2103-071 3 DECEDENT NAME: MISCIA MARLO DATE OF PAYMENT: 08/06/2004 POSTMARK DATE: 11/06/2003 COUNTY: CUMBERLAND DATE OF DEATH: 08/09/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $4,500.00 REMARKS: TOTAL AMOUNT PAID: $4,500.00 ~SEAL CHECK# 7 INITIALS: JA RECEIVED BY' GLENDA FARNER STRASBAUGH REGISTER OF WILLS TAXPAYER BUREAU OF TNDTVTDUAL TAXES ZNHERZTANCE TAX DZVTSTON DEPT. 280601 HARRTSBURG, PA 17128-060! CHARLES E PETRIE 5528 BRISBAN ST HBG PA 17111 COHMONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE ZNHERZTANCE TAX STATEHENT OF ACCOUNT DATE 08-16-200~ ESTATE OF HISCIA DATE OF DEATH 08-09-2005 FILE NUHDER 21 03-0715 COUNTY CUMBERLAND ACN 101 Amoun~ Ree'i 'l:'l:ed REV-160? EX AFP COl-OS) MARIO HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGTSTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credLt: ~:o your account:, submit: ~:he upper por~cion of ~his fore wi~h your ~ax payment:. CUT ALONG TH'rS LZNE ~ RETAIN LOgER PORTION FOR YOUR RECORDS ~ REV-1607 EX AFP (01-03) ### 'rNHERZTANCE TAX STATEMENT OF ACCOUNT ~ ESTATE OF HISCIA HARIO FILE NO. 21 05-0713 ACN 101 DATE 08-16-200~ THIS STATEHENT ZS PROVTDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAMED ESTATE. SHOWN BELOW ZSA SUHNARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, ZF APPLICABLE, A PROJECTED TNTEREST FIGURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTMENT: 01-Z7-ZOOq PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS CTAX CREDITS): 6,622.~2 PAYMENT RECEIPT DISCOUNT C+) DATE NUHBER INTEREST/PEN PAID (-) AHOUNT PAID 11-06-2005 11-06-2005 CDO05Z07 CD00~2~2 1,791.21 ~,500.00 9~.27 256.8~ TOTAL TAX CREDIT ZF PAID AFTER THZS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) 6,622.52 BALANCE OF TAX DUE .10 ZNTEREST AND PEN. .00 TOTAL DUE .10 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 2806O1 HARRISBURG, PA 17128-0601 CHARLES E PETRIE 3528 BRISBAN ST HARRISBURG PA 17111 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF 10-04-2004 MlSClA REV-t~47 EX (12-97) PC MARLO '04 [ICl' 15 F"2:47 DATE OF DEATH 08-09-2003 FILE NO. 21 03-O713 COUNTY Cumberland ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: Register of Wills Cumberland County Courthouse Carlisle, PA 17013 CUT ALONG THIS LINE c~ RETAIN LOWER PORTION FOR YOUR RECORDS ~:= ' -liliig:i 8;1¥- i=-~ -Ibii-.-iWl'C'tl ............. 'Ii i::i'fib-li -b-~ -Iii i..I-li iil-'f,i,-li b-li-'igii(- XI~-¢ k'Ai~-Iiiil~ 'i']-A'[ILi:i~,-lil~ i=' i~ ii ................................ DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MlSClA MARLO FILE NO. 21 03-0713 ACN 101 DATE 10-04-2004 TAX R,' I URN WAS: ( [] ) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE ([])CHANGED APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Mortgages/Notes Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 11. Total Deductions 0.00 NOTE: To insure proper 0.00 credit to your account, 0.00 , submit the upper portion 0.00 of this form with your tax payment. 64,982.86 0.00 0.00 (8) 64,982.86 9,796.00 0.00 (11) 9,796.00 12. 13. 14. NOTE: that include the total of ALL returns assessed to date. Net Value of Tax Return (12) 55,186.86 Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) 0.00 Net Value of Estate Subject to Tax (14) 55,186.86 If an assessment was issued previously, lines 14, 15 and/or 16, 17 and 18 will reflect figures ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 0.00 X .00 0.00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 0.00 X .045 0.00 17. Amount of Line 14 taxable at Sibling rate (17) 55,186.86 X .12 6,622.42 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 0.00 X .15 0.00 19. Principal Tax Due TAX CREDITS: (19) 6,622.42 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 11-06-2003 C D003207 94.27 1,791.21 11-06-2003 C D004242 236.84 4,500.00 TOTAL TAX CREDIT 6,622.33 BALANCE OF TAX DUE 0.10 INTEREST 0.00 TOTAL DUE 0.00 * IF PAID AFTEI~ DATE INDICATED. SEE l[EV~l ~?~ ,,,~? .............. FOR CALCULATION OF ADDITIONAL INTEREST. DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS I~EFLECTED AS A CREDIT (CR) , YOU MAY SE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMINISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decadents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 21 of 1995. (72 P.S. Section 9140). Detach the top portion of this Notica and submit with your payment to the Register of Wills pdnted on the reverse side. Make check or money order payable to: REGISTER OF WILLS, AGENT. A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax (REV-1313). Applications are available at the Office of the Register of Wills or any of the 23 Revenue Distdct Offices, or by calling the special 24-hour answering service numbers for forms ordering: In Pennsylvania 1-800-362-2050, outside Pennsylvania and within local Harrisburg area (717) 787-8094, TDD# (717) 772-2252 (Headng impaired Only). Any party in interest not satisfied with the appraisement, allowanca or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue Board of Appeals, PO Box 281021, Harrisburg, PA 17128-1021, OR -election to have the matter determined at audit of the account of the personal representative OR --appeal to the Orphans' Court. ' 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, PO Box 280601 Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 3 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months alter the decedent's death a five percent (5%) discount of the tax paid is allowed. The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18,1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the same time period as you would appeal the tax and interest that has been assessed as indicated on this notica. Interest is charged beginning with first day of delinquency, or nine (g) 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 the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2001 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 20% .000548 1988-1991 11% .000301 2001 9% .000247 1983 16% .000438 1992 9% .000247 2002 6% .000164 1984 11% .000301 1993-1994 7% .000192 2003 5% .000137 1985 13% .000356 1995-1998 9% .000247 2004 4% .000110 1986 10% .000274 1999 7% .000192 1987 9% .000247 2000 8% .000219 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notica, additional interest must be calculated.