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HomeMy WebLinkAbout03-0987PETITION FOR PROBATE and GRANT OF LETTERS Estate of 7/~7"tr~ [c / tO ..~o?~ , ~ No. also known as f ~',-~Z~ C~ ~A ~-- ~-~l d~ To: Deceased. Social Security No. ./ ~ ~ - ;,?cf - '~i9,1 ~- The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut g-~ in the last will of the above decedent, dated 3~L'-i g and codicil(s) dated Register of ~.~,s for the County of ~ ~-7'd~-~0~n the Commonwealth of Pennsylvania named (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in ~.4~,o0 ~rL(o.q~/) County, Pennsylvania, with h ~/2_. last family or principal residence at (list street, number and muncipality) Decendent, then q~ years of age, died Afov~-o'~t~r~- 15 , .1.9-_,-~(-x~, at----r~i e Oc rl,.r..' {4.05 ~o, . 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 $ coo (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: {~ I,.5'" floR--/D~ 5> ~ WHEREFORE, petitioner(s) respectfully presented herewith and the grant of letters theron. request(s) the probate of the last will and codicil(s) (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA -I COUNTY OF (~6e"~~ Y ss The petitioner(s) abovemamed 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 aff~rmr, ql and subscribed b,e~ore me this O~l':~ day of ~ ~ .... ~~ter COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN. RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 21 COUNTY CODE 03 00987 YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Priar, Patricia Joan 168 - 24- 4212 z~ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE ,?, l 1/13/2003 10/24/1929 REGISTER OF WILLS ~ IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER [] [] [] 12-3'1-91 and 1-1-95) lAME Austin F Grogan 1. Odginal Return [] 2- Supplemental Return [] 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate [] 4a. Future Interest Compromise (date of death after [] 5. Federal Estate Tax Return Required 12-12-82) 6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach 8. Total Number of Safe Deposit Boxes of Will) copy of Trust) 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death between[] 11.Election to tax under Sec. 9113(A) (Attach Sch O) COMPLETE MAILING ADDRESS FIRM NAME (If applicable) Coyae & Coyne, P.C. 'ELEPHONE NUMBER 7 ] 7/737-0464 3901 Market Street Camp Hill, PA 17011-4227 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) [] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 140,000.00 Non~=~ None' None 15,013.00 None None 20,467.85 34,849.79 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 (8) 155,013.00 55,317.64 9.9,695.36 1,000.00 98,695.36 (11) (12) (13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) 16. Amount of Line 14 taxable at lineal rate x .045 (16) 17.Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 98,695.36 4,441.29 4,441.29 20. [] Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ~ITY ADDRESS 1715 Bridge Street STATE PA ZIP 17070 New Cumberland Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 4,441.29 4,859.79 Total Credits (A + B + C) (2) 4,859.79 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 0.00 4. If Line 2 is greater than Line I + Line 3, enter the difference. This is theOVERPAYMENT. (4) 4 1 8.5 0 Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is theBALANCE DUE. (5B) 0.0 0 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: Yesm No a. retain the use or income of the property transferred;...~ ......................................................................... H b. retain the right to designate who shall use the property transferred or its income; ................................ ~ v~ 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.security at his or her death? ......... [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficia~ 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 th s return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration preparer other than the personal representat ve s.based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Di~ Butina SIGNA'T[TR-~ OF PEF~ON RESPONSIBLE FOR FILING RETURN ADDRESS DATE 1805 Brid~e Street /r///6,/o New CumlSerland, PA 17070 ADDRESS DATE SIGNATURE OF PREPARER OTHER TN~N R~RESENTATIVE ADDRESS DATE Austin F/~ogan lJ ~/~ 3901 Market Street ' /la, lO' { ~. ~-~ ........ CamP Hill,?A .17011_4227 ..... ltl, /~ ,~ For dates of death on or after July 1, and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the survMng 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 statutedoes not exempta 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 ESTATE; OF Priar, Patricia Joan SCHEDULE A REAL ESTATE FILE NUMBER 21-03-00987 Al real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a wil]ing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with .right of survivorship must be disclOsed on schedule F. ITEM NUMBFR 1 DESCRIPTION 1715 Bridge Street New Cumberland TOTAL (Also enter on Line 1, Recapitulation) VALUE AT DATE OF DEATH 140,000.00 140,000.00 COMMONWEALTH OF PENNSYLVANIA iNHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Priar, Patricia Joan SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21 - 03 - 00987 Inc ude 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 disc osed on schedule F. ITEM NUMBER 1 Checking account Household property Cars VALUE AT DATE OF DESCRIPTION DEATH TOTAL (Also enter on Line 5, Recapitulation) 8,363.00 4,000.00 2,650.00 15,013.00 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPEN.?~S & ADMINISTRATIVE COSTS ESTATE! OF FILE NUMBER Priar, Patricia Joan 21 - 03 - 00987 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER 4,712.00 Bo 4. ,'5. (5. '7. FUNERAL EXPENSES: Musselman Funeral'Hom ADMINISTRATIVE COSTS: Personal Representative's Commissions Diane But/ma Social Security Number(s) / EIN Number of Personal Representative(s): 194-42-9305 Street Address 1805 Bridge Street City New Cumberland State PA Zip 17070 Year(s) Commission paid Attorney's Fees Coyne and Coyne, P.e. Family Exemption: {If decedent's address is not the same as claimant's, attach explanation) Claimant S[reet Address City Relationship of Claimant to Decedent Probate Fees Cumberland County State Zip Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Legal notices/Patriot News Cumberland County Law Journal TOTAL (Also enter on line 9, Recapitulation) 9,300.00 6,000.00 287.00 93.85 75.00 20,467.85 COMMONWEALTH OF PENNSYLVAN]A INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Priar, Patricia Joan 21 - 03 - 00987 Include unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 1 2 3 4 5 6 7 8 Utilities for home during probate before sale ol~ house Repair cost to home inorder to sell and home insurance during probate process Cleaning serivce to clean home Closing cost to sell home Medical bills Newspaper ads for the sate of home and personal property 2003 Tax return fees Misc repairs to estate vehicles to sell 1,173.14 1,834.00 1,150.00 3,000.00 27,428.45 109.70 4.00 150.50 TOTAL (Also enter on Line 10, Recapitulation) 34,849.79 REV-1515 EX+.(9-00) ~ SCHEDULE J co MMONW~L*, OF pEN NSYLVAN,^ B E N E Fl C IA RI E S INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE[ OF FILE NUMBER Pr/ar, Patricia Joan · 21 - 03 - 00987 RELATIONSHIP TO AMOUNT OR SHARE NUMBI=R NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE D_o Not List Trustee(s) I. TAXABLE DISTRIBUTIONS (include outright spousa[distributions) 1 Diane Butina and John Butma daughter and son in law Receive 50% of the 1805 Bridge Street residue estate. New Cumbeland 2 Darinda Dorward grandaughter Receive 17% of the 505 Third Street residue estate Lemoyne, PA 17043 3 Travis Butina grandson Receive 17% of the 619 Harding Street residue estate New Cumberland PA 17070 4 Mackenize Dorward great-grandaughter Receive 16% of the 505 Third Street residue estate i Lemoyne, PA 17043 See Continuation Schedule(s) attached Enter dollar amounts for distributions shown above or~ lines 15 through 18, as appropriate, on Rev 1500 cover she{ II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 Oour Lady of Lourdes 1,000.00 225 Salt Road Enola PA 117025 TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE" 1~000.00 ~.~ SCHEDULE J COMMONWEALTH OF PENNSYLVANIA B E N E F I C IARI E S CO nti n u e d INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATI? OF FILE NUMBER Priar, Patricia Joan 21 - 03 - 00987 - RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT Do Not List Trustee(s) OF ESTATE [include outdght spousal distributions, and transfers under I. TAXABLE DISTRIBUTIONS Sec. 9116(a)(1.2)] 5 Tracy Irwin niece My quiet moments 1.00 522 Union School Road ,tatue 6 Elizabeth Byrd sister My St. Jude Statue 1.00 176 South Second Street Steelton PA 17113 7 Carol Heisey niece '~ Guardian Angel wittl.00 117 Colebrook Road Chilcken picture Elizabethtown, PA 17022. Page 2 of Schedule J Last Will and Testament of Patricia Joan Priar I, PATRICIA JOAN PRIAR, of New Cumberland, Cumberland County, Pennsylvania, being of sound and disposing mind, memory, and understanding, do hereby make, publish, and declare this to be my Last Will and Testament and hereby revoke all other Wills and Codicils, if any, that I have made. FIRST: I direct that all my just debts and the expenses of my last illness and funeral . shall be paid from the assets of my estate as soon as practicable after my decease. I authorize my personal representative to expend funds from my estate, in such mounts, as my personal representative shall consider necessary and desirable, for the disposition of my remains in accordance with the instructions I have provided to my Executrix. SECOND: I give, devise, and bequeath the following to the following individuals: · A. My Baskets, Jewelry, Coins, and Brass Crucifix to DIANE BUTINA; B. My Bears, Sacred Heart & Blessed Mother statUes, $500.00 for first communion and $500.00 for co~n-mation to MACKENZIE DORWARD; My Longaberger Pottery and Princess House to DARINDA DORWARD $1,000.00 to OUR LADY OF LOURDES, Enola, .pennsylvania; My Mary Mother of Grace and World War II memorabilia to my grandson, TRAVIS BUTINA; F. My Quiet Moments statue to TRACY IRWIN; G. My St. Jude Statue to ELIZABETH BYRD; H. My Guardian Angel with Children and picture, No Ending to God's Love to CAROL HEISEY; TH/RD: I give, devise, and bequeath my Estate, of whatever nature and wherev~'r situate, to the following individuals in the following percentages: A: To my daughter and. son-in4aw DIANE BuTINA and JOHN BUTINA, a.k.a. DICK BUTINA, per stirpes, of 1805 Bridge Street, New Cumberland, Cumberland County, Pennsylvania. I direct that they shall receive in equal proportion fiftY percent (50%) of the residue of my estate, per stirpes. B: To my granddaughter, DARINDA DORWARD, and grandson, TRAVIS BUTINA, and my great-granddaughter, MACKENZIE DORWARD, of 3~ Street Lemoyne, Cumberland County. I direct they shall receive in equal proportion fifty percent (50%) of the, residue of my estate, per stirpes. FOURTH: Should my great-granddaughter, MACKENIZE DORWARD, not have attained the age of twenty-two years a~ the time of my death, I direct that my Estate as given to MACKENZIE DORWARD in part THIRD of this, my Last Will and Testament, be given to my Trustee, hereinafter named, in trust for the fOllOwing uses and purposes and upon the following granddaughter's care, maintenance, determine in her absolute discretion. (A) The net income of the .Trust shall be paid to and be applied for my great- education, or support at such times as my Trustee shall Should the income from this Trust be insufficient to provide adequate, maintenance, education, or support, my Trustee, in his sole discretion, may invade the principal for this purpose. (B) In the administration of the Trust, the Trustee shall have the following powers, ,:teemed to be supplementary to and not exclusive of, the general powers of trustees pursuant to law and including ali powers necessary to carry the same into effect, all of which shall be exercised in a fiduciary capacity: 1. To hold any or all of the Trust Estate in the form received. 2. To sell at public or private sale, to mortgage, pledge, or hypothecate or to exchange or lease (including lease for a period extending beyond the term of this Trust), any stocks, notes, securities, real estate, minerals, ad other trust property, upon such terms, cash or credit, or both, as she may deem advisable. 3. To invest and reinvest the Trust Estate in investments limited to real or personal property, minerals, royalties, and leaseholds. 4. To construct, add to, repair, or demolish (in whole or in part) any improvements upon any Trust property. 5. To participate in any reorganization, consolidation, merger, or dissolution of any corporation, the stocks, bonds, or other securities of which may be held at any time as part of the Trust Estate and to receive and continue to hold any property which may be allocated or distributed to it by reason of participation in any such reorganization, merger; or dissolution. 6. To make or hold investments or any part of the Trust Estate in common or undivided interests with other persons, corporations, or trusts. 7. To demand, receive, receipt for, sue for, and collect any and all rights, money, properties, or claims, to which this Trust may be entitled, and to compromise, settle, arbitrate, or abandon any claim or demand in favor of or against this Trust. 8. To borrow funds for this Trust in such amounts and for such purposes as she shall deeTM for the best interest of this Trust and the beneficiary thereof, and to purchase property on the credit of this Trust, and,. in connection with such borrowing or such purchase, to execute and deliver promissory notes or other evidences of indebtedness of this Trust and to morigage or pledge all or any part of the Trust Estate to secure payment of such indebtedness, and to repay such indebtedness out of the Trust Estate. 9. To employ agents, legal counsel, brokers, and assistants, and to pay their fees and expenses as she may deem necessary or advisable to carry out the provisions of this Trust. 10. To vote in person or by proxy any shares of stock which may form part of this Trust. 11. To lend money to any person or persons upon such terms, but with adequate interest and security, as she may deem advisable for the best interests of this Trust. 12. To elect, appoint, and remove directors of any corporation, the stock of which shall constitute Trust property, and to act as a director and officer of any such corporation. 13. Generally, and without limitation by any specific enumeration herein, to manage, control, operate, reconvert, invest, reinvest, sell, exchange, lease, mortgage, pledge, pool, or otherwise encumber and deal with the property of this Trust, for and in behalf of this Trust and the beneficiary thereof, to the same extent and with the same powers that any individual would have in respect to l~er own property and funds. 14. To act freely under all or any of the powers by this agreement given to the Trustee in all matters concerning this Trust, after forming his/her judgment based upon all the circumstances of any particular situation as to the interest of this Trust and the beneficiary hereunder, without the necessity'of obtaining the consent or permission of any person interest therein, or the consent or approval of any court, and notwithstanding that she may also be acting individUally, or as trustee of other trusts, or as agent for other persons or corporations interested in the same matters, or may be interested in connection with the same matters as stockholder, director, or otherwise, provided, however, that she shall exercise such powers at all times, in a fiduciary capacity primarily in the interest of the beneficiary hereunder. 15. To invest Trust funds in interests in any common Trust fund or funds now or hereafter established and being administered by the Trustee solely for the investment of Trust funds. (C) I specifically direct that my Trustee shall not be required to segregate the shares held in Trust in some separate accounts prior to the termination of any Trust created hereunder. Should the Trust, in the sole opinion of my Trustee, be or become too small to warrant continuing such fund in Trust, or should its administration be or become impractical for any other reason, my Trustee, in her sole discretion, may deposit the Trust monies in a savings account in a savings institution of the Trustee's choosing, payable to the beneficiary at majority. (D) This Trust shall terminate, and' the Trustee shall pay the accumulated and undistributed principal and income then remaining in her hands at termination to my great- granddaughter when my great-granddaughter has attained the age of twenty-two years. FIFTH: All interests of any beneficiary in the income or principal of this Estate, while undistributed and in the possession of my Executrix and Trustee, even though vested and distributable, shall not be subject to attachment, execution or sequestration for any debt, contract, obligation or liability of any beneficiary and, furthermore, shall not be subject to pledge, assignment, conveyance, or anticipation. sIxTH: All inheritance, estate, and succession taxes including interest and any penalties thereon 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. SEVENTH: I nominate, constitute, and appoint the following persons: (A) DIANE BUTINA, as Executrix of this, my Last Will and Testament. In the event of the renunciation, death, resignation, or inability of DIANE BUTINA, to act for whatever reason in this capacity, then I nominate, constitute, and appoint JOHN BUTINA, a.k.a. DICK BUTINA, as Executor of this, my Last Will and Testament. (B) DIANE BUTINA, as Trustee of the Trust described herein. In the event of the renunciation, death, resignation or inability of DIANE BUTINA, to act for whatever reason in this capacity, then I nominate, constitute, and appoint JOHN BUTINA, a.k.a DICK BUTINA, as Trustee. I direct that no representative named above shall be required to post security for the faithful performance of her/his duties in any jurisdiction insofar as I am able by law to relieve her/him of such obligation. Any of my representatives shall be entitled to reasonable compensation for the performance of the duties set forth herein. 'IN WITNESS WHEREOF, I have hereunto set my hand and seal this ff~ day of 3-' d'~l ,2002, on this, the sixth of six typewritten pages. I have also signed the left-hand margin of the first five of these pages for purposes of identification only. PATRICIA JO~ PRIAR SIGNED, PUBLISHED, and DECI_2tRED by the Testatrix, PATRICIA JOAN PRIAR, as her Last Will and Testament, in the presence of us, who at her request, in her presence, and in the presence of each other, have hereunto subscribed our names as witnekses. ACKNOWLEDGMENT Commonwealth of Pennsylvania County of Cumberland I, PATRICIA JOAN PRIAR, Testatrix, whose name is signed to the attached instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. PATRICIA JOAN PR[AR Sworn or affirmed Testatrix, this ~13dl day of to and subscribed, before me by PATRICIA JOAN PRIAR, the ,2002. NOTARY PUBLIC ~.~srm E O~g~, ~o~ PuNk 1 Cnmp Hill Boro,~rl~d C~nW i ag, Commisaion Expire Aug. 6, 2~5 Men'f, ~ns~an~ m~ ~ ~des AFFIDAVIT Commonwealth of Pennsylvania County of Cumberland We, Rhonda D. Rudy and Mary M. Loper, the witnesses whose names are signed to the attached instrument, being duly qualified acCording to'law, depose and say that we were Present and saw the Testatrix sign and execute the instrument as her Last Will and Testament; that PATRICIA JOAN PRIAR executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that, to the best of our knowledge, the Testatrix was at that time 18 years of age or older, of sound mind, and under no constraint or undue influence. Sworn or affLrmed to and subscribed before me by Rhonda D. Rudy and Mary M. Loper, witnesses, this ,2002. /¥ . . . :tO. ' My Commissto' ~.,.'~ ...... - ...... Merilber, Pellfls-~,/~.:~,,~/..q, r~:>..~ ': . ~ ,~,:,far es' Estate of ~/~P<-rfz~c~ ~ ~- ~g, ,4-P-- , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW ~t~,.vc&~,. ~xC0 ~L~) ~ q~.__, 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 ~"~, L~ ~ o2~o ~, described therein be admitted to probate and filed of record as the last will of /O~ Cat ~- ~.m-' and Letters are hereby granted FEES Probate, Letters, Etc .......... Sa~ ,~ Short Certificates( ) .......... $ TOTAL __ $ Filed . ~.: ~.~. 7 ~~ ................ ATTORNEY (Sup. Ct. I.D. No.)  l~,.tADDRESS PHONE his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Off]ce for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 9650560 No. Local Registrar NOV i $ ?_GO3 Date COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH I i --24 --4212 "11-13-03 ~0~.. ; o.. I .~.. M~.----I , .o~ ~, I ~,.~,,. t.os.,_. ~ . 74 v~ ~ I : I10-14-29 IEmlenton,Pa ' : I ; I.. [,. [~ I ~N~ ~ ~H I ~. ~, ~P OF DEATH [FAC~ N~E (11 ~ ,n.,M~. ~ .r~ a~ num~, Dauphin · Har-:-=-- , ..... , -- -- '~:'~".~.~.~- (~ rapped meits i,,~ I,,. 13. I 1715 Bridge st. ]~u~ ,..~,. Pa. · ,,~.~ . . . New Cumberland, Pa ~ '~ I 7070 ,m.~., O,,mh~r] an~ 1~,.~ ~'~ F~R*S NAME (F~, M~. L~) - -- - I .~ ~) ~ DI.OV 1/,2003 IRolllno green .em ~ark m, k~ 1,~248 L ~u~g ~n F.H & C.S. Inc_ 324 Hummel IIIIlllllf II IltItliI ...................... ' , P , It(I) mild [] Last Will and Testament of Patricia Joan Priar I, PATRICIA JOAN PRIAR, of New Cumberland, Cumberland County, Pennsylvania, being of sound and disposing mind, memory, and understanding, do hereby make, publish, and declare this to be my Last Will and Testament and hereby revoke all other Wills and Codicils, if any, that I have made. FIRST: I direct that all my just debts and the expenses of my last illness and funeral shall be paid from the assets of my estate as soon as practicable after my decease. I authorize my personal representative to expend funds from my estate, in such amounts, as my personal representative shall consider necessary and desirable, for the disposition of my remains in accordance with the instructions I have provided to my Executrix. SECOND: I give, devise, and bequeath the following to the following individuals: A. My Baskets, Jewelry, Coins, and Brass Crucifix to DIANE BUTINA; B. My Bears, Sacred Heart & Blessed Mother Statues, $500.00 for first communion and $500.00 for confirmation to MACKENZIE DORWARD; C. My Longaberger Pottery and Princess House to DARINDA DORWARD D. $1,000.00 to OUR LADY OF LOURDES, Enola, Pennsylvania; E. My Mary Mother of Grace and World War II memorabilia to my grandson, TRAVIS BUTINA; F. My Quiet Moments statue to TRACY IRWIN; G. My St. Jude Statue to ELIZABETH BYRD; H. My Guardian Angel with Children and picture, No Ending to God's Love to CAROL HEISEY; THIRD: I give, devise, and bequeath my Estate, of whatever mature and wherev~ situate, to the following individuals in the following percentages: A: To my daughter and son-in-law DIANE BUTINA and JOHN BUTINA, a.k.a. DICK BUTINA, per stirpes, of 1805 Bridge Street, New Ctmaberland, Cumberland County, Pennsylvania. I direct that they shall receive in equal proportion fifty percem (50%) of the residue of my estate, per stirpes. B: To my granddaughter, DARINDA DORWARD, and grandson, TRAVIS BUTINA, and my great-granddaughter, MACKENZIE DORWARD, of 3'0 Street Lemoyne, Cumberland County. I direct they shall receive in equal proportion fifty percent (50%) of the residue of my estate, per stirpes. FOURTH: Should my great-granddaughter, MACKENIZE DORWARD, not have attained the age of twenty-two years at the time of my death, I direct that my Estate as given to MACKENZIE DORWARD in part THIRD of this, my Last Will and Testament, be given to my Trustee, hereinafter named, in trust for the following uses and purposes and upon the following (A) The net income of the Trust shall be paid to and be applied for my great- granddaughter's care, maintenance, education, or support at such times as my Trustee shall determine in her absolute discretion. Should the Mcome from this Trust be insufficient to provide adequate maintenance, education, or support, my Trustee, in his sole discretion, may invade the principal for this purpose. (B) In the administration of the Trust, the Trustee shall have the following powers, deemed to be supplementary to and not exclusive of, the general powers of trustees pursuant to law and including all powers necessary to carry the same into effect, all of which shall be exercised in a fiduciary capacity: 1. To hold any or all of the Trust Estate in the form received· 2. To sell at public or private sale, to mortgage, pledge, or hypothecate or to exchange or lease (including lease for a period extending beyond the term of this Trust), any stocks, notes, securities, real estate, minerals, and other trust property, upon such terms, cash or credit, or both, as she may deem advisable. 3. To invest and reinvest the Trust Estate in investments limited to real or personal property, minerals, royalties, and leaseholds. 4. To construct, add to, repair, or demolish (in whole or in part) any improvements upon any Trust property. 5. To participate in any reorganization, consolidation, merger, or dissolution of any corporation, the stocks, bonds, or other securities of which may be held at any time as part of the Trust Estate and to receive and continue to hold any property which may be allocated or distributed to it by reason of participation in any such reorganization, merger, or dissolution. 6. To make or hold investments or any part of the Trust Estate in cormnon or undivided interests with other persons, corporations, or trusts. 7. To demand, receive, receipt for, sue for, and collect any and all rights, money, properties, or claims, to which this Trust may be entitled, and to compromise, settle, arbitrate, or abandon any claim or demand in favor of or against this Trust. 8. To borrow funds for this Trust in such amounts and for such purposes as she shall deem for the best interest of this Trust and the beneficiary thereof, and to purchase property on the credit of this Trust, and, in connection with such borrowing or such purchase, to execute and deliver promissory notes or other evidences of indebtedness of this Trust and to mortgage or pledge all or any part of the Trust Estate to secure payment of such indebtedness, and to repay such indebtedness out of the Trust Estate. 9. To employ agents, legal counsel, brokers, and assistants, and to pay their fees and expenses as she may deem necessary or advisable to carry out the provisions of this Trust. this Trust. 10. To vote in person or by proxy any shares of stock which may form part of 11. To lend money to any person or persons upon such terms, but with adequate interest and security, as she may deem advisable for the best interests of this Trust. 12. To elect, appoint, and remove directors of any corporation, the stock of which shall constitute Trust property, and to act as a director and officer of any such corporation. 13. Generally, and without limitation by any specific enumeration herein, to manage, control, operate, reconvert, invest, reinvest, sell, exchange, lease, mortgage, pledge, pool, or otherwise encumber and deal with the property of this Trust, for and in behalf of this Trust and the beneficiary thereof, to the same extent and with the same powers that any individual would have in respect to her own property and funds. 14. To act freely under all or any of the powers by this agreement given to the Trustee in all matters concerning this Trust, after forming his/her judgment based upon all the circumstances of any particular situation as to the interest of this Trust and the beneficiary hereunder, without the necessity of obtaining the consent or permission of any person interest therein, or the consent or approval of any court, and notwithstanding that she may also be acting individually, or as trustee of other trusts, or as agent for other persons or corporations interested in the same matters, or may be interested in connection with the same matters as stockholder, director, or otherwise, provided, however, that she shall exercise such powers at all times in a fiduciary capacity primarily in the interest of the beneficiary hereunder. 15. To invest Trust funds in interests in any common Trust fund or funds now or hereafter established and being administered by the Trustee solely for the investment of Trust funds. (C) I specifically direct that my Trustee shall not be required to segregate the shares held in Trust in some separate accounts prior to the termination of any Trust created hereunder. Should the Trust, in the sole opinion of my Trustee, be or become too small to warrant continuing such fund in Trust, or should its administration be or become impractical for any other reason, my Trustee, in her sole discretion, may deposit the Trust monies in a savings account in a savings institution of the Trustee's choosing, payable to the beneficiary at majority. (D) This Trust shall terminate, and the Trustee shall pay the accumulated and undistributed principal and income then remaining in her hands at termination to my great- granddaughter when my great-granddaughter has attained the age of twenty-two years. FIFTH: All interests of any beneficiary in the income or principal of this Estate, while undistributed and in the possession of my Executrix and Trustee, even though vested and distributable, shall not be subject to attachment, execution or sequestration for any debt, contract, obligation or liability of any beneficiary and, furthermore, shall not be subject to pledge, assignment, conveyance, or anticipation. SIXTH: All inheritance, estate, and succession taxes including interest and any penalties thereon payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursemem from any person. SEVENTH: I nominate, constitute, and appoint the following persons: (A) DIANE BUTINA, as Executrix of this, my Last Will and Testamem. In the evem of the renunciation, death, resignation, or inability of DIANE BUTINA, to act for whatever reason in this capacity, then I nominate, constitute, and appoint JOHN BUTINA, a.k.a. DICK BUTINA, as Executor of this, my Last Will and Testamem. (B) DIANE BUTINA, as Trustee of the Trust described herein. In the evem of the renunciation, death, resignation or inability of DIANE BUTINA, to act for whatever reason in this capacity, then I nominate, constitute, and appoint JOHN BUTINA, a.k.a DICK BUTINA, as Trustee. I direct that no representative named above shall be required to post security for the faithful performance of her/his duties in any jurisdiction insofar as I am able by law to relieve her/him of such obligation. Any of my representatives shall be emitled to reasonable compensation for the performance of the duties set forth herein. IN WITNESS WHEREOF, I have hereunto set my hand and seal this day of ..~ ~L~ ,2002, on this, the sixth of six typewritten pages. I have also signed the left-hand margin of the first five of these pages for purposes of identification only. PATRICIA JO~tq PRIAR SIGNED, PUBLISHED, and DECLARED by the Testatrix, PATRICIA JOAN PRIAR, as her Last Will and Testament, in the presence of us, who at her request, in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses. ACKNOWLEDGMENT Commonwealth of Pennsylvania County of Cumberland I, PATRICIA JOAN PRIAR, Testatrix, whose name is signed to the attached instrumem, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instmmem as my Last Will and Testamem; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. PATRICIA J~AN PRIAR Sworn or affirmed to Testatrix, this ~¢ day of (~OV/ and subscribed before me by PATRICIA JOAN PRIAR, the ,2002. i '\~' c'(:,nmission Expires Aug. 6, 2005 AFFIDAVIT Commonwealth of Pennsylvania County of Cumberland We, Rhonda D. Rudy and Mary M. Loper, the witnesses whose names are signed to the attached instrument, being duly qualified according to law, depose and say that we were present and saw the Testatrix sign and execute the instrument as her Last Will and Testament; that PATRICIA JOAN PRIAR executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as wimesses; and that, to the best of our knowledge, the Testatrix was at that time 18 years of age or older, of sound mind, and under no constraint or undue influence. Sworn or affirmed to and subscribed before me by Rhonda D. Rudy and Mary M. Loper, witnesses, this ~X[d day of~ ,2002. NOTAR~,,,PUB~/~C 14~, ~__~ -- [~AST ~[iLI, ~ '['ESTA~'.[EN~' OF PAT~iCIA JANE PP, IA]~ Law Offices of 24 N. 32nd Street Camp Hill, PA 17011 {7171 737-1956 Name of Decedent: Date of Death: Will No.: To the Register: CERTIFICATION OF NOTICE UNDER RUI,F~ 5.6(a) PATRICIA JOAN PRIAR November 13, 2003 21-03-0987 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 January 13, 2004 Diane Butina 1805 Bridge Street New Cumberland, PA 17070 Tracy Irwin 522 Union School Road Mount Joy, Pa 17552 John Butina 1805 Bridge Street New Cumberland, PA 17070 Carol Heisey 117 Colebrook Road Elizabethtown, PA 17022 Darinda Dorward 505 Third Street Lemoyne, PA 17043 Elizabeth Byrd 176 S. Second Street Steelton, PA 17113 Mackenzi Dorward 505 Third Street Lemoyne, PA 17043 Travis Butina 619 Harding Street New Cumberland, PA 17070 Our Lady of Lourdes 225 Salt Road Enola, PA 17025 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: COYNE & COYNE, P.C. BY: Austin F' Gr°g~' E~/quire\ 3901 Market Street ~x_ ) Camp Hill, PA 17011--'4~27 (717) 737-0464 Pa. Supreme Ct. No. 59020 Counsel for Personal Representative CERTIFICATION OF NOTICE UNDER RUI,E 5.6(a) Name of Decedent: Date of Death: Will No.: To the Register: PATRICIA JOAN PRIAR November 13, 2003 21-03-0987 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 January 13, 2004 Name: Address: OFFICE OF ATTORNEY GENERAL Charitable Trusts and Organizations 14th Floor, Strawberry Square, Harrisburg, PA 17120 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None COYNE & COYNE, P.C. ~ li~vlFa-r ~re ?~;;; tE s q uir e (./ ! Camp Hill, PA 17011-4227 (717) 737-0464 Pa. Supreme Ct. No. 59020 Counsel for Personal Representative ............ ' REV-1500 - INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 03 00987 COUNTY CODE YEAR NUMBER I DECEDENT'S NAME (LAST, FIRST. AND MIDDLE INiTiAL) Priar, Patricia Joan DATE OF DEATH (MM-DD YEAR) DATE OF BIRTH (MM-DD-YEAR) 10/14/1929 11/i3/2003 i iiE APPLICABLE) SURVIVING SPOUSES NAME ( LAST, FIRST AND MIDDLE INITrAL) [] 1 Original Return [] 2. Supplemental Return SOCIAL SECURITY NUMBER 168-24-4212 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ] 3 RemalnderRetum(dateofdeathpriorto12.13.82) ] 4 Limited Estate [] 4a Future Interest Compromise (date of death after 12 ~2-82} [] 5. Federal Estate Tax Return Required [~6 Decedent Died Testate (Attach copy [] 7 Decedent Maintained a Living Trust (Attach 8 Total Number of Safe Deposit Boxes of WillI copy of Trust) ~E] 9 LJt,gat,onProceedsRecewed [] 10'~S2P~J~lalaPnd0~%~Cred't(date°fdeathbetween [] 11BlectiontotaxunderSec9113(A)(AttachSchO) T~_,~ S EOT[ON MUST B E C0 MPLETED:: ALt CO RRESPONDENC~;~ND Austin F Grogan ICOMPLETE MAILING ADDRESS ~IRM NAME (If applicable) Coyne & Coyne, P.C. 3901 Market Street TELEPHONE NUMBER Camp Hill, PA 17011-4227 717/737-0464 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) [] Separate Billing Requested 7. inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 140,000.00 Non~ Nonk 15,013.00 None None 11,167.85 34,849.79 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) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, x .00 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 Bue 155,013.00 (11) 46,017.64 (12) 108,995.36 (13) 1,000.00 (14) 107,995.36 (15) 107,995.36 x .045 (16) 4,859.79 x .12 x .15 (17) (18) (19) 4,859.79 Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Defedent's Complete Address: STREET ADDRESS 1715 Bridge Street CITY Ne~v Cumberland STATE PA 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 (1) Total Credits (A + B + C) (2) 3, Interest]Penalty if applicable D. Interest E. Penalty Total Interest]Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference, This is theOVERPAYMEN~ (4) Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + SA. This is theBALANCE DUE. (SD) Make Check Payable to: REGISTER OF WILLS, AGENT 4,859.79 0.00 0.00 4,859.79 4,859.79 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, benefi s or care? ...................... [] [] 2. If death occurred after December 12, 1982, did decedent transfer property wdhin 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 nomprobate 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 pel~ury, I declare that I have examined this return, including accompanying schedules and statements and to the beet of my knowledge and belief, [t is [rue, correct and complete. Declaration preparer other than [he personal representative is based on all information of which preparer has any knowledge SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS DATE Diane Butina '~ ~ 1805 Brid~e S=eet ~ ~,~., ;~. New Cumberland, PA 17070 ~//--(~/ SI~RE OF PER~N RESPONSIBLE FOR FILING RETURN ADDRESS DATE ~ ADDRESS DATE 3901 Market Street Camp Hill, PA i7011-4227 For dates of death on or after July 1 i t 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. §91 ~L ) (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 statutedoes not exempta 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. SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Pdar, Patricia Joan 21 - 03 - 00987 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither be ng compelled to buy or se , both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F ITEM NUMBER DESCRIPTION 1715 Bridge Street Ne~v Cumberland VALUE AT DATE OF DEATH 140,000.00 TOTAL (Also enter on Line 1, Recapitulation) 140,000.00 COMM©NWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Priar, Patricia Joan FILE NUMBER 2i - 03 - 00987 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 NUMBER Checking account 2 Household property 3 Cars DESCRIPTION TOTAL (Also enter on Line §, Recapitulation) VALUE AT DATE OF DEATH 8,363.00 4,000.00 2,650.00 15,013.00 SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Priar, Patricia Joan Debts of decedent must be reported on Schedule I. FILE NUMBER 21 - 03- 00987 ITEM NUMBER A. 1 FUNERAL EXPENSES: Musselman Funeral Horn DESCRIPTION AMOUNT 4,712.00 4.. ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zfp Year(s) Commission paid Attorney's Fees Coyne and Coyne, P.c. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent Probate Fees Cumberland County State Zip 6,000.00 287.00 Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Legal notices/Patriot News Cumberland County Law Journal 93.85 75.00 TOTAL (Aisc enter on line 9, Recapitulation) 11,167.85 COMMONWEALTH OF PENNSYLVANIA INHERJTANC~ TAX RETURN SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF Priar, Patricia Joan , FILE NUMBER 2I - 03 - 00987 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT Utilities for home during probate before sale of house Repair cost to home inorder to sell and home insurance during probate process Cleaning serivce to clean home Closing cost to sell home Medical bills Ne~vspaper ads for the sate of home and personal property 2003 Tax return fees Misc repairs to estate vehicles to sell [,173.14 1,834.00 1,I50.00 3,000.00 27,428.45 109.70 4.00 t50.50 TOTAL (Also enter on Line 10, Recapitulation) 34,849.79 REV-1513 EX+ (9-00} ~ COMMONWEALTH OF PENNSYLVANIA SCHEDULE J BENEFICIARIES ESTATE OF Priar, Patricia Joan NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) Diane Butina and John Butina 1805 Bridge Street New Cumbeland FILE NUMBER 21 - 03 - 00987 RELATIONSHIP TO DECEDENT AMOUNTORSHARE OFESTATE !daughter and son mlawlReceive 50%ofthe residue estate, 2 Darinda Dorward 505 Third Street Lemoyne, PA 17043 3 Travis Butina 619 Harding Street I New Cumberland PA 17070 4 Mackenize Dorward 505 Third Street Lemoyne, PA 17043 grandaughter Receive 17% of the residue estate !grandson Receive 17%ofthe residue estate great-grandaughter Receive 16% of the Yesidue estate II. See Continuation Schedule(s) attached Enter dollar amounts for distributions shown above on ~ines 15 through 18, as appropriate, on Rev 1500 cover sheet NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE lB CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS our Lady of gourdes 225 Salt Road Enola PA 117025 1,000.00 TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEEi 11000.00 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES continued ESTATE OF NUMBER ?dar, ?a~cia Joan NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY FILE NUMBER 21 - 03 - 00987 RELATIONSHIP TO DECEDENT DO Not List Trustee(s) AMOUNT OR SHARE OF ESTATE Io TAXABLE DISTRIBUTIONS 5 Tracy Irwin 522 Union School Road 6 Elizabeth Byrd 176 South Second Street Steelton PA 17113 Carol Heisey 117 Colebrook Road Elizabethtown, PA 17022 [include outright spousal distributions, and transfers under Sec 9116(a)(1 2)] niece sister niece My quiet moments 1.00 istatue My St. Jude Statue 1.00 Guardian Angel witll.00 Children picture Page 2 of Schedule J Last Will and Testament of Patricia Joan Priar I, PATRICIA JOAN PRIAR, of New Cumberland, Cumberland County, Pennsylvania, being of sound and disposing mind, memory, and understanding, do hereby make, publish, and declare this to be my Last Will and Testament and hereby revoke all other Wills and Codicils, if any, that I have made. FIRST: I direct that alt my just debts and the expenses of my last illness and funeral shall be paid from the assets of my estate as soon as practicable after my decease. I authorize my personal representative to expend funds from my estate, in such mounts, as my personal representative shall consider necessary and desirable, for the disposition of my remains in accordance with the instructions I have provided to my Executrix. SECOND: I give, devise, and bequeath the following to the following individuals: A. My Baskets, Jewelry, Coins, and Brass Crucifix to DIANE BUTINA; B. My Bears, Sacred Heart & Blessed Mother Statues, $500.00 for first communion and $500.00 for confnmation to MACKENZIE DORWARD; C. My Longaberger Pottery and Princess House to DARINDA DORWARD D. $1,1300.00 to OUR LADY OF LOURDES, Enola, Pennsylvania; E. My Mary Mother of Grace and World War II memorabilia to my grandson, TRAVIS BUTINA; F. My Quiet Moments statue to TKACY IRWIN; G. My St. Jude Statue to ELIZa,_BETH BYRD; H. My Guardian Angel with Children and picture, No Ending to God's Love to CAROL HEISEY; THIRD: I give, devise, and bequeath my Estate, of whatever nature and wherev~'r situate, to the following individuals in the following percentages: A: To my daughter and son-in-law DIANE BUTINA and JOHN BUTINA, a.k.a. DICK BUTINA, per stirpes, of 1805 Bridge Street, New Cumberland, Cumberland County, Pennsylvania. I direct that they shall receive in equal proportion fifty percent (50%) of the residue of my estate, per stirpes. B: To my granddaughter, DARINDA DORWARD, and grandson, TRAVIS BUTINA, and my great-granddaughter, MACKENZIE DORWARD, of 3r~ Street Lemoyne, Cumberland County. I direct they shall receive in equal proportion fifty percent (50%) of the residue of my estate, per stirpes. FOURTH: Should my great-granddaughter, MACKENIZE DORWARD, not have attained the age of twenty-two years at the time of my death, I direct that my Estate as given to MACKENZIE DORWARD in part THIRD of this, my Last Will and Testament, be given to my Trustee, hereinafter named, in trust for the following uses and purposes and upon the following terms: (A) The net income of the Trust shall be paid to and be applied for my great- granddaughter's care, maintenance, education, or support at such times as my Trustee shall determine in her absolute discretion. Should the income from this Trust be insm~icient to provide adequate maintenance, education, or support, my Trustee, in his sole discretion, may invade the principal for this purpose. (B) In the administration of the Trust, the Trustee shall have the following powers, deemed to be supplementary to and not exclusive of, the general powers of trustees pursuant to law and including all powers necessary to carry the same into effect, all of which shall be exercised in a fiduciary capacity: 1. To hold any or all of the Trust Estate in the form received. 2. To sell at public or private sale, to mortgage, pledge, or hypothecate or to exchange or lease (including lease for a period extending beyond the term of this Trust), any stocks, notes, securities, real estate, minerals, and other trust property, upon such terms, cash or credit, or both, as she may deem advisable. 3. To invest and reinvest the Trust Estate in investments limited to real or personal property, minerals, royalties, and leaseholds. 4. To construct, add to, repair, or demolish (in whole or in part) any improvements upon any Trust property. 5. To participate in any reorganization, consolidation, merger, or dissolution of any corporation, the stocks, bonds, or other securities of which may be held at any time as part of the Trust Estate and to receive and continue to hold any property ~vhich may be allocated or distributed to it by reason of participation in any such reorganization, merger, or dissolution. 6. To make or hold investments or any part of the Trust Estate in common or undivided interests with other persons, corporations, or trusts. 7. To demand, receive, receipt for, sue for, and collect any and all rights, money, properties, or claims, to which this Trust may be entitled, and to compromise, settle, arbitrate, or abandon any claim or demand in favor of or against this Trust. 8. To borrow funds for this Trust in such amounts and for such purposes as she shall deem for the best interest of tiffs Trust and the beneficiary thereof, and to purchase property on the credit of tiffs Trust, and, in connection with such borrowing or such purchase, to execute and deliver promissory notes or other evidences of indebtedness of this Trust and to mortgage or pledge all or any part of the Trust Estate to secure payment of such indebtedness, and to repay such indebtedness out of the Trust Estate. 9. To employ agents, legal counsel, brokers, and assistants, and to pay their fees and expenses as she may deem necessary or advisable to carry out the provisions of this Trust. 10. To vote in person or by proxy any shares of stock which may form part of this Trust. 11. To lend money to any person or persons upon such terms, but with adequate interest and security, as she may deem advisable for the best interests of this Trust. 12. To elect, appoint, and remove directors of any corporation, the stock of which shall constitute Trust property, and to act as a director and officer of any such corporation. 13. Generally, and without limitation by any specific enumeration herein, to '5." manage, control, operate, reconvert, invest, reinvest, sell, exchange, lease, mortgage, pledge, · 'u pool, or otherwise encumber and deal with the property of this Trust, for and in behalf of this "-~ Trust and the beneficiary thereof, to the same extent and with the same powers that any individual would have hi respect to her own property and funds. 14. To act freely under all or any of the powers by this agreement given to the Trustee in all matters concerning this Trust, after forming his/her judgment based upon all the ckcumstances of any particular situation as to the interest of this Trust and the beneficiary hereunder, without the necessity of obtaining the consent or permission of any person interest therein, or the consent or approval of any court, and notwithstanding that she may also be acting individually, or as trustee of other trusts, or as agent for other persons or corporations interested in the same matters, or may be interested in connection with the same matters as stockholder, director, or otherwise, provided, however, that she shall exercise such powers at all times in a fiduciary capacity primarily in the interest of the beneficiary hereunder. 15. To invest Trust funds in interests in any common Trust fund or funds now or hereafter established and being administered by the Trustee solely for the investment of Trust funds. (C) I specifically direct that my Trustee shall not be required to segregate the shares held in Trust in some separate accounts prior to the termination of any Trust created hereunder. Should the Trust, in the sole opinion of my Trustee, be or become too small to warrant continuing such fund in Trust, or should its administration be or become impractical for any other reason, my Trustee, in her sole discretion, may deposit the Trust monies in a savings account in a savings institution of the Trustee's choosing, payable to the beneficiary at majority. (D) This Trust shall terminate, and the Trustee shall pay the accumulated and undistributed principal and income then remaining in her hands at termination to my great- granddaughter when my great-granddaughter has attained the age of twenty-two years. FIFTH: Ail interests of any beneficiary in the income or principal of this Estate, while undistributed and in the possession of my Executrix and Trustee, even though vested and distributable, shall not be subject to attachment, execution or sequestration for any debt, contract, obligation or liability of any beneficiary and, furthermore, shall not be subject to pledge, assignment, conveyance, or anticipation. SIXTH: All inheritance, estate, and succession rexes including interest and any penalties thereon 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. SEVENTH: I nominate, constitute, and appoint the following persons: (A) DIANE BUTINA, as Executrix of this, my Last Will and Testament. In the event of the renunciation, death, resignation, or inability of DIANE BUTINA, to act for whatever reason in this capacity, then I nominate, constitute, and appoint JOHN BUTINA, a.k.a. DICK BUTINA, as Executor of this, my Last Will and Testament. (B) DIANE BUTINA, as Trustee of the Trust described herein. In the event of the renunciation, death, resignation or inability of DIANE BUTINA, to act for whatever reason in this capacity, then I nominate, constitute, and appoint JOHN BUTINA, a.k.a DICK BUTINA, as Trustee. I direct that no representative named above shall be required to post security for the faithful performance of her/his duties in any jurisdiction insofar as I am able by law to relieve her/him of such obligation. Any of my representatives shall be entitled to reasonable compensation for the performance of the duties set forth herein. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~g'r'~ day of 3' ~,-~ ,2002, on this, the sixth of six typewritten pages. I have also signed the left-hand margIn of the fn:st five of these pages for purposes of identification only. PATRICIA JOA~lq PRIAR SIGNED, PUBLISHED, and DECLARED by the Testatrix, PATR/CIA JOAN PR/AR, as her Last Will and Testament, in the presence of us, who at her request, in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses. ~..3' ACKNOWLEDGMENT Commonwealth of Pennsylvania County of Cumberland I, PATRICIA JOAN PRIAR, TestatrLx, whose name is signed to the attached instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. PATRICIA JOAN PRIAR Sworn or affirmed to and subscribed before me by PATRICIA JOAN PRIAR, the Testatrix, this g:P~ day of ,2002. / \,,,, ~ Cc'~missmn ~i~ Aug. 6. AFFIDAVIT Commonwealth of Pennsylvania County of Cumberland We, Rhonda D. Rudy and Mary M. Loper, the witnesses whose names are signed to the attached instrument, being duly qualified according to law, depose and say that we were present and saw the Testatrix sign and execute the instrument as her Last Will and Testament; that PATRICIA JOAN PRIAR executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that, to the best of our knowledge, the Testatrix was at that time 18 years of age or older, of sound mind, and under no constraint or undue influence. Sworn or affkrmed to and subscribed before me by R_honda D. Rudy and Mary M. Loper, ~"' ,2002. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES ©EPT 280601 HARRISBURG, PA 17128 0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV 1162 EX(11 96) NO. CD 004257 BUTINA DIANE 1805 BRIDGE ST NEW CUMBERLAND, PA 17070 ESTATE INFORMATION: SSN: 168-24 4212 FILE NUMBER: 2103 0987 DECEDENT NAME: PRIAR PATRICIA JOAN DATE OF PAYMENT: 08/11/2004 ~OSTMARK DATE: 08/11/2004 COUNTY: CUMBERLAND DATE OF DEATH: 11/13/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 (;4,859.79 TOTAL AMOUNT PAID: $4,859.79 REMARKS: D BUTINA SEAL CHECK# 1027 INITIALS: VZ RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT, 280601 HARRISBURG, PA 1711&-0601 COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEMENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX RE¥-1~47 EX &FP (01-D$) AUSTIN F GROGAN COYNE & COYNE PC $901 MARKET CAMP HILL DATE 10-11-200q ESTATE OF PRIAR DATE OF DEATH 11-15-2005 FILE NUHBER 21 03-0987 COUNTY CUMBERLAND ACN 101 Amoun'l: Remi**ed PATRICIA J HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE I~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF PRIAR PATRICIA J FILE NO. 21 03-0987 ACN 101 DATE 10-11-200q TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~e (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (2) $. Closely Held S~ock/Par*nership In~eres~ (Schedule C) ($) ~. Mortgages/No,es Receivable (Schedule D) (~) S. Cash/Bank Deposits/Misc. Personal Proper~y (Schedule E) (5) 6. Join*ly O~ned Proper~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al Asse*s APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expensas/Adm. Costs/Misc. Expanses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 11. To,al Deductions 12. Na~ Value of Tax Re~urn 1~0/000.00 .00 .00 .00 15~013.00 .00 .00 (8) 11,167.85 3~.8~9.79 (11) (12) 13. 1~. NOTE: Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) Ne~ Value of Es~a~e Sub~ec~ ~o Tax (1~) Zf an assess;ent ~as issued previously, lines 1~, 15 and/or 16, 17, reflect figures that include the total of ALL returns assessed to date. NOTE: To insure proper credi~ ~o your account, submi~ ~he upper pot*ion of this fore wi~h your ~ax payment. 155,013.00 ASSESSHENT OF TAX: 15. Amoun~ of Line lq a~ Spousal ra~e 16. Amoun~ of L/ne 1R ~axable a~ Lineal/Class A ra~e 17. Amoun~ of Line lq a~ Sibling ra~e 18. Amoun~ of Line 1~ ~axable a~ Collateral/Class B re~e 19. Principal Tax Due TAX CREDITS: PAYflENT RECEZPT DZ$COUNT (+J DATE NUMBER INTEREST/PEN PAID (-) 08-11-200~ CDOOq257 .00 108,995.36 ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 1,000.00 107,995.36 18 and 19 Nill (15), .00 x O0 = .00 (16) 107,995.36 X Oq5 = q,859.79 (17) .00 x 12 = .00 (18) .00 x 15 = . O0 (19)= ~,859.79 AMOUNT PAID ~,859.79 q,859.79 .00 .00 .00 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ( ZF TOTAL DUE IS LESS THAN $1, NO PAYMENT ZS RE~UZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDZT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 1Z, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of tho 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 futura interest. To fulfill the requirements af Section ZlqO of the Inheritance and Estate Tax Act, Act 23 of ZOO0. (72 P.S. Section 91q0). Detach the tap portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side. --Make check or money order payable to: REGISTER OF MILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may ba requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-13iB). Applications are available at the Office of the Register of Nills, any of the 23 Revenue District Offices, ar by calling the special Z4-hour answering service for forms ordering: 1-800-362-Z050~ services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 171ZB-lOZ1, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. lBO601, Harrisburg, PA 1712B-0601 Phone (717) 787-6505. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-lEO1) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedant's death, a five percent (BX) discount of the tax paid is allowed. The 15X tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 19BI bear interest et the rate of six (SX) 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 19BZ through 2004 are: Interest Daily Interest Daily Interest Year Rate Factor Year Rate Factor Year Rate 1982 ZOZ .000548 ~J~-& - 1991 llZ .000301 ~ 97. 1963 162 .000438 1992 92 .000247 ZOOZ 67. 19B4 117. .000301 1993-1994 77. .000192 2003 57. 1985 137. .000356 1995-1998 97. .000247 2004 47. 1986 107. .000274 1999 77. .000192 1987 107. .000274 ZOO0 72 .000192 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NU~IBER OF DAYS DELIN{~UENT X DAILY INTEREST FACTOR Daily Factor .000247 .000164 .000137 .000110 --Any Notice issued after tha tax becomes delinquent will reflect an intarsst 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 ba calculated. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' C- BUREAU OF INDIVIDUAL TAXES. ... INHERITANCE TAX DIVISION PO BOX 2806Dl HARRISBURG PA 17128-0601 :NDTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX RfV-1547EKAFP(lt-041 AUSTIN F GROGAN COYNE & COYNE 3901 MARKET ST CAMP HILL DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-31-2005 PRIAR 11-13-2003 21 03-0987 CUMBERLAND 101 Aaouni: R...itted PATRICIA J PA 17011 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ... REV:U'1,".Eic".K~p..(a1"--6'!r.N5TYCE.'Oi!.rNtlERYf~NCi.i"AX.A.pIlRA'isEliE'At:..KtL'OWANCE.b;r................ DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX PATRICIA J FILE NO. 21 03-0987 ACN 101 PRIAR ESTATE OF TAX RETURN WAS: I I ACCEPTED AS FILED I X I CHANGED SEE DATE 01-31-2005 ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN NO. 01 1. Real Estate (Schedule A) (ll 2. stocks and Bonds (Schedule BJ (2) 3. Closely Held stock/Partnership Interest (Schedule C) (3) ~. Mortgages/Notes Receivable (Schedule DJ (4) 5. Cash/Bank Deposits/Misc. Personal Property {Schedule EJ (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets . 00 NOTE: To insure proper . 00 credl t to your account, . 00 sub.i *' the upper portion .00 of this forll with your . 00 tax paYlIHmi. .00 .00 (81 .00 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adft. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule Il 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/GovernMental Bequests; Non-elected 9113 Trusts (Schedule ~) 14. Net Value of Est.te Subject to Tax (91 llOI 9,300.00 .00 (111 1121 1131 1141 9.300 00 9,300.00- .00 98,695.36 I~ an assessmen~ was issued previOUSly. lines 14. 15 and/or 16. 17. 18 and 19 will re~lect ~igures ~ha~ include ~he ~o~al o~ abb returns assessed ~o date. ASSESSMENT OF TAX: IS. Allaunt of line 14 at Spousal rat. (IS) 16. Aaount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 ai Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class 8 rat. (18) 19. Principal Tax Due S: NOTE: .00 X 98,695.36 X .00 X .00 X 00 = 045 = 12 = 15 = 1191= .00 4,441.29 .00 .00 4,441.29 DATE 08-11-2004 NUMBER CD004257 INTEREST/PEN PAID (-I .00 AMOUNT PAID 4,859.79 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 4,859.79 418.50CR .00 418.50CR . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED./ IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU MAY BE DUE S/ A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I 01{ REV-1470 EX (8-88) . . INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANiA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVlOUAL TAXES PO Box 280601 HARRISBURG PA 1712a~0601 DECEDENTS NAME Patricia Priar FILE NUMBER 2103-0987 REVIEWED BY ACN Sandra J Eslinger 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES Accepted additional debts. ROW Page 1 BUREAU OF INDIVIDU~lAKES INHERITANCE TAX DIVISIoN-- PO BOX Z80601 HARRISBURG PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REV-1607 EX AFP 112-D~) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-07-2005 PRIAR 11-13-2003 21 03-0987 CUMBERLAND 101 Allount Rellitted PATRICIA J , AUSTItlF--SROGAN COYNE & COYNE 3901 MARKET ST CAMP HILL PA 17011 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLEI PA 17013 NOTE: To insure proper credit to your account I subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ... ~~:r&~~.I5r.A~~..r81~.~J'.......i;..:rA~!~~elr~l5r.~tl~~.b~.l~l:~O~...j(i..................... ESTATE OF PRIAR PATRICIA J FILE NO.21 03-0987 ACN 101 DATE 03-07-2005 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUEl APPLICATION OF ALL PAYMENTS I THE CURRENT BALANCEI ANDI IF APPLICABLE I A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 01-24-2005 PRINCIPAL TAX DUE:. 41441.29 PAYMENTS (TAX CREDITS): ~ PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 08-11-2004 CD004257 .00 41859.79 02-15-2005 REFUND .00 418.50- TOTAL TAX CREDIT 41441.29 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATEI SEE REVERSE TOTAL DUE .00 II SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $11 NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRll YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. l Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 10/11/2005 GROGAN AUSTIN F 24 NORTH 32ND STREET CAMP HILLt PA 17011 RE: Estate of PRIAR PATRICIA JOAN File Number: 2003-00987 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 RULESt NO. 103 SUPREME COURT RULES DOCKET NO. 1t for decedents dying on or after July 1, 1992t the personal representative or his counselt within two (2) years of the decedent's deatht shall file with the Register of wills a Status Report of completed or uncompleted administration. This filing is due by: 11/13/2005 Your prompt attention to this matter will be appreciated. Thank You. s;;;:;:~~ ., GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge .~ &-- Cumberland County - Register Ot WLL1s One Courthouse Square Carllsle, PA 17013 Phone: (71 7) 240 - 6345 Date: 10/11/2005 BUTINA DIANE 1805 BRIDGE ST NEW CUMBERLAND, PA 17070 RE: Estate of PRIAR PATRICIA JOAN File Number: 2003-00987 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 is due by: 11/13/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~,~Jk~ GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Counsel Judge \ c.:;- ,--- LLJ EE> c) C:) 1,J._1 C:J Cf-: C_) -- -, '--~ LU Q- Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 fA Td'lA C- u\ To (l-tJ ?CL I t4-fL Name of Decedent: No vc""""- ~ l."YL (~! ~;)c.3 Date of Death: Estate No.: <2.PO 3 - co '1~1 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration ofthe above-captioned estate: Date: 1. State ~ther administration of the estate is complete: Yes il?1 No 0 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 person~resentative file a final account with the Court? Yes 0 No ~ b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the person~presentative state an account informally to the parties in interest? Yes ~ No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. It/o~1 05' ~~ Signature / fitJS-rIN ,c 61l n4d C"') N "-1 Name 0- 3 ~()I If4lU1<'c/ 5, Address ~,P #111 /',,4 17u 1/ '1/7- 73 7-{)~iJ Telephone No. o >- C) z Lr:I = = C-....J Capacity: 0 ~ersonal Representative IM'Counsel for personal representative ~t