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Home My WebLink About03-0308PETITION FOR PROBATE & GRANT OF LETTERS Estate of FLORENCE I. MALACHOWSKI also known as , deceased. Social Security No. 201-16-5471 No. 21-03- To: Register of Wills for the County of Cumberland Commonwealth of Pennsylvania The Petition of the undersigned respectfully represents that: Your Petitioners, who is 18 years of age or older and the Executrix named in the Last Will of the above decedent dated October 4, 2000 , and codicils dated NONE . The Executor named Derwood L. E,qe died June 26, 2002 Renunciations for NONE attached hereto. Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at 1827 W. Lisburn Road, Carlisle, Monroe Township Decedent, then 78 years of age, died March 2 ,2003, at her residence 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: Decedent at death owned property with estimated values as follows: (If domiciled in PA) Alt personal property (If not domiciled in PA) Personal property in PA (If not domiciled in PA) Personal property in County Value of real estate in Pennsylvania, situated as follows: 1827 West Lisburn Road, Carlisle, PA 17013 $65,000.00 $ $116,000.00 WHEREFORE, Petitioners respectfully requests the probate of the Last Will and Codicil(s) presented herewith and the grant of letters testamentary thereon. Signature(s) and Residence(s) of Petitioner(s): Dadene F. Kerch 140 Boyer Road Carlisle, PA 17013 717-258-3762 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA · COUNTY OF CUMBERLAND · ss 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 representative of the above decedent, petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this ~ ~ day of April ,2003. Darlene F. Ketch Re,lister ~ No. 21-03-,~08 Estate of FLORENCE I. MALACHOWSKI , deceased. DECREE OF PROBATE & GRANT OF LETTERS AND NOW, April ~ , 2003, 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 October 4, 2000 described therein be admitted to probate and filed of record as the Last Will of Florence I. Malachowski ; and Letters Testamentary are hereby granted to Darlene F. Kerch FEES Probate, Letters, Etc ........ $ 235.00 Short Certificates(-3- ) .... $ 9.00 Renunciation(s) ........... $ JCP .................... $10.00 Other Will Pages (-2-) .... $ 6.00 · -- TOTAL: .... $ 260.00 Filed . ~. F.~ : .O.. ,,~ ........... '. . .~. . . . - k. Register'of V~II~ ~/ IR,~IN McKNIGHT.& HUGHES Ro.qer,B. I~,in, Esquire (06282) ATTO~N~J( (Sup. Ct. I.D. No.) 60 West Pomfret St., Carlisle, PA 17013 ADDRESS 717-249-2353 PHONE his is to certify that the information here given is correctly copied from an original certificate Local Registrar. The original certificate will be forwarded to the State Vital Records ()ff]ce for t)crm:mem WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 i'"~,/ .~1[;~.~ "~=z~./ Local Rcg,strar No. ~~ Date Florence Cumberland Monroe o~~,~. Restaurant · ~. Sine. Z~ Code) ID~CEOENT'S 1827 L~sburn .~..~ Carlisle Pennsylvania 17013 ~.~ S.A~,..~, ~ Ear Bricker ¢,~'~ Darlene F. Kerch COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH * VITAL RECORDS CERTIFICATE OF DEATH (Coroner) Malachowskt . . . ~9z4 t-~o .~u ! 71. stale Carlisle, PA. ~ [] ~,~ ~) [] 1827 West Ltsburn Road ,~.~c~. ~ite ~,~, Cumberland ~.,.o..~p,..o..~..~,.,. March 2, 2003 ,~,win~m)~ . ClUSlve ~oronary Artery Disease I I ~E ~ (~ ~ A C~QUENCE ~: ' I I - mm~ ~. ~ I i 3,.. ' .................................................................... ~ a. Mechantcsburg. Pa. 17050 &~OTHER'SNAME{Fkal, Mi~e,M~ide~name) Verna Zeigler ;~'~'d~~;~ 70~ 3 (~h, Day ~a,) 2003 '"-- Trindle Spring I Mechanicsburg. Pennsylvania ~ ~. Mar 6. I~.. I~¢. 17055 LICENSENUUBER FD-014318-L ~yers~ner~ome. Inc. 37 East Main Street Mechan~sb~g. Pa 17055 22b. ~. LAST WILL AND TESTAMENT RI - 03 - $08 I, FLORENCE I. MALACHOWSKI, of Monroe Township, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly revoking all Wills and Codicils heretofore made by me. 1. I direct my executors to pay all of my debts, funeral and administrative expenses as soon as may be done conveniently after my decease. 2. I authorize and empower my executors to sell any realty owned by me at my death, and not specifically devised herein, at either public or private sale, and to give good and sufficient deeds therefor, in fee simple, as I could do if living. My executors are authorized and empowered to continue to engage in any business in which I may be engaged at my death, for such period of time as seems expedient to them. 3. I give, devise and bequeath all of the my estate of every nature and wherever situate to my two children, share and share alike, the child or children of any deceased child taking the share their parent would have taken if living. 4. I nominate and appoint my son, Derwood L. Ege and my daughter, Darlene F. Kerch, to be the executors of this my Last Will and Testament, they are to serve as such without bond. Should they die before my death, renounce or refuse to serve for any reason, or die leaving any of my estate unadministered, I nominate and appoint Roger B. Irwin, Marcus A. McKnight, III and James D. Hughes, as substitute executors with the same powers as are given herein to my executors and also without the filing of any bond. 5. I hereby suggest that my personal representatives retain the services of Irwin, McKnight & Hughes as attorneys in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this October, 2000. __ day of FLORENCE I. MALACHOWSKI .(SEAL) Signed, sealed, published and declared by FLORENCE I. MALACHOWSKI, the Testatrix above named, as and for 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 subscribed our names as witnesses hereto. 2 ACKNOWLEDGMENT AND AFFIDAVIT WE, FLORENCE I. MALACHOWSKI, CHERYL L. CLELAND and MARTHA L. NOEL, the testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her Last Will, and that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the wimesses, in the presence and hearing of the testatrix, signed the Will as a witness and that to the best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. FLORENCE I: MA/15ACH/~O~SKI (~HER~ L. CLkL~ND - / M~YfiA L~OEL COMMONWEALTH OF PENNSYLVANIA : : SS: COUNTY OF CUMBERLAND : Subscribed, swom to and acknowledged before me by, FLORENCE I. MALACHOWSKI, the testatrix herein and subscribed and sworn to before me by CHERYL L. CLELAND and MARTHA L. NOEL, witnesses, this v'~ day of October, 2000. Notary Public(/~ i "' N6tadal Seal I Roger B. InNin, Notaq/Public I Carlisle Bom, Cumberland County J, IV~ Commission Expires Oct. 3, 2004 FLORENCE I. MAI..~CHOWSKI LAW OFFICES IRWIN, MCKNIGHT & HUGHES WEST POMFRET PROFESSIONAL BUILDING 60 WEST POMFRET STREET CARLISLE, PENNSYLVANIA 17013-:3222 (717) 249-23513 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Estate No.: FLORENCE I. MALACHOWSKI MARCH 2, 2003 21-03-0308 To the Register: I certify that notice of the beneficial interest required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on May 13, 2003 . Name Address Darlene F. Kerch Heather Bridwell 140 Boyer Road, Carlisle, PA 17013 116 Creekview Drive, Jacksonville, NC 28540 William G. Ege Holly E. Ege Crystal L. Ege 890 Market Street, Mt. Wolf, PA 17347 1929 William Penn Way, Lancaster, PA 17601 1681 Trindle Road, Carlisle, PA 17013 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none . Date: 05/13/03 IRWIN, McK4;& HUGHES Name Roger B. Irwin, Esquire Address 60 West Pomfret Street Carlisle, PA 17013 Capacity: Telephone (717) 249-2353 X __ Personal Representative __ 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 002633 IRWIN ROGER B ESQ 60 W POMFRET ST CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 201-16-5471 FILE NUMBER: 21 03-0308 DECEDENT NAME: MALACHOWSKI FLORENCE I DATE OF PAYMENT: 06/02/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 03/02/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $6,000.00 TOTAL AMOUNT PAID' $6,000.00 REMARKS: ROGER B IRWIN ESQUIRE SEAL CHECK# 019868 INITIALS: JA RECEIVED BY: DONNA M. OTTO DEPUTY 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) 0O2795 IRWIN ROGER B ESQ 60 W POMFRET ST CARLISLE, PA 17013 ESTATE INFORMATION: SSN: 201-16-5471 FILE NUMBER: 21 03-0308 DECEDENT NAME: MALACHOWSKI FLORENCE I DATE OF PAYMENT: 07/11/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 03/02/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $204.03 REMARKS: TOTAL AMOUNT PAID: ROGER B IRWIN ESQUIRE $204.03 SEAL CHECK# 019985 INITIALS: JA RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS REV- 1500 EX + (6-00) D E C E D E N T cAPB upRL ~plO cRAC KoTK ES C O R R E S R E C A P I T U L A T I O N C O M A x[ T I O N COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. Z80601 HARRISBURG, PA 171Z8-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Malachowski Florence I. DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-OD-YEAR) 03/02/2003 08/28/1924 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) 1. Original Return ~ ?. Supplemental Return 4. Limited Estate 4a. Future Interest Compromise (date of death after 1Z- 12-8Z) 6. Decedent Died Testate 7. Decedent Maintained a Living Trust (Attach copy of Will) (Attach copy of Trust) [~ 9. Litigation Proceeds Received [----] 10. Spousal Poverty Credit (date of death between 17-31-91 and 1-1-95) OFFICIAL USE ONLY FILE NUMBER 21-03-0308 COUNTYCODE YEAR NUMBER SOCIAL SECURITY NUMBER 201-16-5471 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER (date of death 3. Remainder Return prior to 12-13-87) `5. Federal EstateTax Return Required 8. Total Number of Safe Deposit Boxes Election to tax under Sec. 9113(A) (Attach Sch O) NAME Roger B. Irwin Esq. FIRM NAME (If Applicable) IRWIN McKNICHT & HUGHES TELEPHONE NUMBER 1717/249-2353 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or (3) Sole-Proprietorship 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) COMPLETE MAILING ADDRESS 60 West Pomfret Street West Pomfret Professional Bldg. Carlisle, PA 17013 lO8,OOO.O5' None None None 37,149.44 21,288.16 None OFFICIAL USE ONLY C.__ I-'- 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 20,834.65 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 718 o 14 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) (8) 166,437.60 (11) 21,552.79 (12) 144,884.81 (13) (14) 144,884.81 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 1,5. 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 O. O0 x .0 0 144,884.81 x .0 45 0.00 x .12 0.00 x .15 (15) O. O0 (16) 6,519.82 (17) O. O0 (la) 0.00 (19) 6,519.82 Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV- 1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 1827 West Lisburn Road CITY STATE ZIP Carl i s le PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 6,000.00 315.79 Total Credits ( A + B + C ) 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 the OVERPAYMENT. Check box on Page 1 Line 20 to re~luest a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB) 6,519.82 6,315.79 0.00 0.00 204.03 0.00 204.03 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 ;[ retain the use or income of the property transferred; ......................... ~ ~ retain the right to designate who shall use the property transferred or its income; ........... c, retain a reversionary interest; or .................................... d, receive the promise for life of either payments, benefits or ca~e? ................... 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. Darlene F. Kerch DATE SIGNATURE OF PIERSON RESPONSIBLE FOR FILING RETURN ~ SIGNATURE OF PREPARER OTHER THAN REP IRWIN McKNIG[-Tr & [-TUGHES DATE ~iili i!ii~ilili~ ~ 60 Wes1::_ ~o_ _m~e_ _1::_ _S_~_~_e_e.~ ....................... Of transfers ~to or'for the 7~//°;the surviving spouse ~o [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)l. 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. Copyright (c) ZOO0 form software only The Lackner Group, Inc. Form ~E~-'[~(~ ~-~ ~Re'~. 6-00/ REV-I$02 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT E$¥ATE OF Florence I. Malachowski SCHEDULE A REAL ESTATE FILE NUMBER SS~/ 201-16-5471 03/02/2003 21-03-0308 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 being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with ri~lht of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 1827 W. Lisburn Road, Monroe Township, Carlisle, Cumb. Co TOTAL (Also enter on line 1, Recapitulation) 108,000.00 108,000.00 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1502 EX (Rev. 1-97) REV- 1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Florence I. Malachowski SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER SS~ 201-16-5471 03/02/2003 21-03-0308 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 1 2 3 DESCRIPTION M&T Bank - checking account M&T Bank - certificate of deposit Personal property sold TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 14,088.05 7,313.39 15,748.00 37,149.44 Copyright (c) 1996 form software only CPSystems, Inc. Form REV- 1508 EX (Rev. 1-97) REV- 1509 EX + (1-97) SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Florence I. Malachowski SS# 201-16-5471 03/02/2003 21-03-0308 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A.Darlene F. Kerch Dau§hter 140 Boyer Road Carlisle, PA 17013 JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION Of PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank DATE OF DEATH DECD'S VALUE OF account number or similar identifying number. NUMBER TENANT JOINT Attachdeed for jointly-held realestate. VALUE OF ASSET INTEREST DECEDENT'S INTERES 1 A 09/01/00 M&T Bank - certificate of 42,576.32 50.00% 21,288.16 deposit TOTAL (Also enter on line 6, Recapitulation) $ 21,288.16 (If more space is needed insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1509 EX (Rev. 1-97) REV- 1511 EX +/1-97/ SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Florence I. Malachowski SSi/ 201-16-5471 03/02/2003 21-03-0308 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION 2 3 4 5 6 FUNERAL EXPENSES: Myers Funeral Home ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Attorney's Fees IRWIN McKNIGHT & HUGHES 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 Register of Wills Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Brickers Auction - commission Canopy rental fee for public sale Cumberland Law Journal - DEW & Sons public sale Gary Smith, lawn care Register of Wills State Zip estate notice publication filing fee Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) AMOUNT 8,355.00 7,100.00 200.00 2,920.00 137.80 75.00 55.00 460.00 25.00 1,506.85 $ 20,834.65 Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97) Estate of: Florence I. Malachowski Soc Sec #: 201-16-5471 Date of Death: 03/02/2003 Continuation of Schedule H-B7 (Other Administrative Costs) Item Description Amount 9 10 Robert Herring, trash removal Settlement charges (1% transfer tax) on real estate Steven W. Barrett Real Estate - appraisal fee The Sentinel Legal - estate notice publication 60.00 1,080.00 275.00 91.85 1,506.85 REV - 151 g EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Florence I. Malachowski SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS SS# 201-16-5471 03/02/2003 FILENUMBER 21-03-0308 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1 2 3 4 5 6 7 Agway, fuel oil Agway Oil, check written 03/01/03; cleared 03/07/03 CPO2 Billing Center Geisswein Plastic Surgery Met-Ed Pulmo Dose Pharmacy Sprint Telephone TOTAL (Also enter on line 10, Recapitulation) AMOUNT 194.98 186.15 52.95 9.61 75.14 104.42 94.89 718.14 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97) REV-1513 EX + (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Florence I. Malachowski SS~/ 201-16-5471 03/02/2003 21-03-0308 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 2 II, TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1 Heather Bridwell 116 Creekview Drive 3acksonville, NC 28540 Crystal L. Ege 1681 Trindle Road Carlisle, PA 17013 Holly E. Ege 1929 William Penn Way Lancaster, PA 17601 William G. Ege 890 Market Street Mount Wolf, PA 17347 Darlene F. Kerch 140 Boyer Road Carlisle, PA 17013 Granddaughter Granddaughter Granddaughter Grandson Daughter 12.5% of remainder 12.5% of remainder 12.5% of remainder 12.5% of remainder 50% of remainder ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A, SPOUSAL DISTRIBUTIONS UNDER SEC. 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 $ 0.00 (If more space is needed, insert additional sheets of the same size) Copyright (c) Z000 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00) LAST WILL AND TESTAMENT I, FLORENCE I. MALACHOWSKI, of Monroe Township, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly revoking all Wills and Codicils heretofore made by me. 1. I direct my executors to pay all of my debts, funeral and administrative expenses as soon as may be done conveniently after my decease. 2. I authorize and empower my executors to sell any realty owned by me at my death, and not specifically devised herein, at either public or private sale, and to give good and sufficient deeds therefor, in fee simple, as I could do if living. My executors are authorized and empowered to continue to engage in any :business in which I may be engaged at my death, for such period of time as seems expedient to them. 3. I give, devise and bequeath all of the my estate of every nature and wherever situate to my two children, share and share alike, the child or children of any deceased child taking the share their parent would have taken if living. 4. I nominate and appoint my son, Derwood L. Ege and my daughter, Darlene F. Kerch, to be the executors of this my Last Will and Testament, they are to serve as such without bond. Should they die before my death, renounce or refuse to serve for any reason, or die leaving any of my estate unadministered, I nominate and appoint Roger B. Irwin, Marcus A. McKnight, III and James D. Hughes, as substitute executors with the same powers as are given herein to my executors and also without the filing of any bond. 5. I hereby suggest that my personal representatives retain the services of Irwin, McKnight & Hughes as attorneys in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this October, 2000. __ day of FLORENCE I. MALACHOWSKI (SEAL) Signed, sealed, published and declared by FLORENCE I. MALACHOWSKI, the Testatrix above named, as and for 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 subscribed our names as witnesses hereto. 2 ACKNOWLEDGMENT AND AFFIDAVIT WE, FLORENCE I. MALACHOWSKI, CHERYL L. CLELAND and MARTHA L. NOEL, the testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her Last Will, and that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the Will as a witness and that to the best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. FLORENCE I: MA~)ACH~O'~KI CHER~ L. CL~L~ND M~fiA L~OEL COMMONWEALTH OF PENNSYLVANIA : : SS: COUNTY OF CUMBERLAND : Subscribed, sworn to and acknowledged before me by, FLORENCE I. MALACHOWSKI, the testatrix herein and subscribed and sworn to before me by CHERYL L. CLELAND and MARTHA L. NOEL, witnesses, this v'e day of October, 2000. Notary Public~ ~ "N~tarial Seal | Roger B. Irwin, Notary Public | Carlisle Bom, Cumberland County l My Commission Expires Oct. 3, 2004 C. Note: LAW OFR CES IRWIN, McKNIGHT & HUGHFS D. NAME OF BORROWER: ADDRESS: E. NAME OF SELLER: ADDRESS: F. NAME OF LENDER: ADDRESS: G. PROPERTY ADDRESS: ti. SETFLEMENI' AGENT: PLACE OF SETTLEMENT: I. SETTLEMENT DATE: IAEST POMFRET PROFESSIONAL BUILDING 60 t4EST POMFRET STREET CARLISLE. PENNSYLVANIA 17013-3222 A.. Settlement Statement U.S. Department of Housing and Urban Development OMB No. 2502-0265 B. TYPE OF LOAN 1. [']FHA 2. i-]FmHA 3. l-]Cony. Un(ns. 4. I-]VA 5. 7lConv. Ins. 6. FILE NUMBER J 7. I. OAN NUMBER HASCOA06/03 I 1805084082 8. MORTGAGE INSURANCE CASE NUMBER This form is furnished to give you a st&l, eff.~,,i of actual settlement costs. Amounts paid to and b the settlement agent are shown. Items marked "(p.o.c.)" were paid outside the closing; they are shown here fo~ information purposes and are not included in the totals. WARNING: It is a crime to knowingly make false statements to the United States on this or any other similar form. Penalties upon conviction can include a fine and imor sonment, For details see: Title 18 U. S. c_r,,~, Section 1001 and Section 1010 ANDREW W. HASCO and CAROL J. HASCO 876 HAWMORN AVE., MECHAN1CSBURG, PA 17055 THE ESTATE OF FLORENCE I. MALACHOWSKI 1827 LISBURN ROAD, CARLISLE, PA 17013 NORTHWEST SAVINGS BANK P.O. BOX 1793, WARREN, PA 16365 1827 L1SBURN ROAD, CARLISLE, PA 17013 Monroe Township IMH REAL ESTATE SERVICES, LLC, Telephone: 717-249-2353 Fax: 717-249-6354 West Porn(ret Professional Bldg, 60 West Porn(ret Street, Carlisle, PA 17013 06/26/2003 100. 101. 102. 103. 104. 105. J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: GROSS AMOUNT DUE FROM BORROWER Contract sales Personal ProDertv Settlement charges to borrower (line 1400i 107. County taxe~ 108. School Tax 109. 110, 111. 112. 120. 200. 201. 202. 203, 204. 205. 206. 207. 208. 209. 213. ;~14, 215. 216, 217. 218. 219. 220. 300. 301. 302. 303. 108,000.00 5t565.40 Ad!ustments ~r items paid by seller 06/26/03t~12/31/03 06/26/03te06/30/03 GROSS AMOUNT DUE FROM BORROVVER AMOUNTS PAID BY OR ON BEHALF OF BORF Deooslt or earnest money Princioal amount of new loans Exist(n(3 loan(s1 taken sub_leer to advance 131.34 13.15 113t709.89 OWER 5,000.00 73,000.00 Adjustments for items unpaid bv seller TOTAL PAID BY/FOR BORROWER 78 t 000.00 CASH AT SE1 [LEMENT FROM OR TO BORROWER Gross amount due from borrower (line 120} [ 113 t 7 0 9.8 9 Less amounts ;)aid bvlfor borrower (line 220) I 78 r 000.00 CASH FROM BORROVVER I 35,709.89 400, 40t. 402, 40;L 404, 4011, 407. 408. 405, 410, 411, 41Z, 420. 500. 501. 502. 503. 504. 505. 506. 507. 508. 509. 513. 514, 51~. 516/ 517. 518. 519. 520. 600. 601. 602. 603. GROSS AMOUNT DUE TO SELLER: Contract sales or(ce Personal Prooerty Adjustments for items paid by seller County taxes 06/26/03t~12/31/03 School Tax 06/26/03t~06/30/03 GROSS AMOUNT DUE TO SELLER: REDUCTIONS IN AMOUNT DUE TO SELLER Excess Deoosit/see instructions) Settlement charges to seller fl(ne 1400) Existing Ioan(s! taken sub_iect to PaYoff of First Mortaage Loan 108,000. advance 131. * 13.* 108,144.~ 5,000.! 1,080.( Adiustments for items unoaid by seller 6,080.C 108,144.4 6,080.0 102,064.4 TOTAL REDUCTION AMOUNT DUE SELLER CASH AT SE3-1'LEMENT TO OR FROM SELLER Gross amount due to seller (llne 420) Less reduction amount due seller (line 520} CASH TO SELLER '['illeExpress Settlement System Printed 06/26/2003 at 13:04 REV. HUI)- I (3/86 U.S. DEPARTMENT OF ttOUSING AND URBAN DEVELOPMENT File Number: HASCOA06/03 SETTLEMENT STATEMENT PAGE 2 FIN,AL L, SETTLEMENT CHARGES 700. TOTAL SALES/BROKER'S COMMISSION based on price $1.08,000.00. = Division of commission Iline 700) as follows: 701, $ to 702. $ to 703. Commission paid at Settlement Paid FROM BORROWER'S FUNDS At SE3-1'LEMENT PAID FROM SELLER'S FUNDS AT SETTLEMENT 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. 802. 803. 804. 805. 806. 807. 808 810 811 Loan OriginaUorl Fee Loan Discount 3 Appraisal Fee tO NORTtFw'~ST APDRAISA_% S~~. ) 275.00 CreditReoo~ to THE C~DIT B~AUt INC. (P.O.C.) 50.00 FLOOD DETERM. FEE to FIDELITY NATION~ ~OOD ~~ 9.00 LOAN PROCESSING FEE to NORT~ST SAVINGS B~ AssumDtion F~ LR Buyer LR Buyer LR Buyer LR LR 2,190.00 250.00 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest Fro~)6/26/2003 to 07/01/2003 @$ 9. 8900 902. Mortgaoe Insurance Premium for to 903. Hazard Insurance Premium for i tO STATE AUTO INS. 904. /day ([:,.o.c.) 5 Days LR ] 316.00 Buyer 49.43 905. 1000. 1001. 1002. 1003. 1004. t005. 1009. 1100. 1101. 1102. 1103. 1t04. 1t05, 1106. tt07. 1108. RESERVES DEPOSITED WITH LENDER FOR Hazard Insurarl~;e 3 mo, ~ $ 2 6.33 /mo Mortgaoe Insurance mo. @ $ /mo City Property Taxes mo. @ $ /mo County Prooertv Taxes 5 mo. @ $ 21.14 /mo School Tax 13 mo. ~_ S 8 0. O0 /mo Aagregate Analysis Ad_iustment to NORTHWEST SAVINGS BANK TITLE CHARGES Settlement or closing f{~{~ Abstract or title search Title examlnatioR LR 78.99 LR 105.70 LR 1,040.00 Title insurance binder Document Preparation Nota~ Fees Attorney's fees (includes above items Ne; Title Insurall(;e to NOTARY PUBLIC LR 137.22- flncludes above itoh16 NO; 1109. Lender's Coverage $ 73 t 000. O0 - 1110. Owner's Coverage $ 108r 000.00 - 1111. 1112. ATTORNEY CERTIFICATE tO IRWINt MCKNIGHT & HUGHES 1113. 10.00 775.00 0.00 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees Deed $ 38.50 : Mortgage $ 64.50 ; Release $ 1202. Ci~lCounty taxlstamos Deed S 1,0 8 0.0 0: Mortgage $ 1203. State Taxlstam0s Deed $1,080.00: Mortgage $ 1204. 1,080 1,080.00_ 1205. 1300. 1301. t302. 1304. 1305. 1306 1307. 13011, ADDITIONAL SETTLEMENT CHARGES OVERNIGHT MAIL to IMH REAL ESTATE SERVICES t LLC 20.50 ANDREW W. HASCO TIIE E!~ATE OF y),ORENCE I. MALACHOWSKI WARNING: IT I$ A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE TITLE 18: U.S. CODE SECTION 1001 AND SECTION 1010. TitleExpress Settlement System Printed 06/26/2003 at 13:04 The HUD-1 Settlemont Statement which I have prepared Is a true and accurate account of this transacfi I have caused Or will cause the funds to be disbursed in accordance with this statement. By: ~ 9. ~DATE REV. I IUD-I 1400. TOTAL SETTLEMENT CHARGES lenter on lines 103. Section J and 502. Section K) 5t565.40i lt080.00' HUD CERTIFICATION OF BUYER AND SELLER I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it is a tree and accurate statement of all receipts and disbursements made on my account or in this transaction. I further certify that I have received a copy of the HUD-1 Settlement Statement. BRICKERS AUCTION Buy & Sell on Commission - Complete Sale Service 93 Texaco Rd., Mechanicsburg, PA 17055 766-5785 Personal Property of Address Sold At Public Sale _~ . //~__ 20 ~ ~ Outstanding Total Sale C ecks~01./. / - Total Total Cash cash After Payout Expenses Auctioneer & Clerks Adv. Cost 3.~'~! a ~' Property Fee // d (..)/~. ~ ~ Sale Setup or Help Total Expenses Thank You For Selecting Chuck Bricker, Auctioneer & Staff M&TBank March 26, 2003 Manufacturers and Traders Trust Company, 1100 Wehrle Drive, PO Box 767. Buffalo, NY 14240-0767 APR -2 200, Estate Search The Estate of: Date of Death (D.O.D.) FLORENCE I MALACHOWSKI 3/02/2003 To Whom It May Concern: IRWIN, McKNIGHT & HUGHES Identified below is the account information requested. 1. M&T Bank accounts in which the decedent's name appears: Account Account Number Account Title Opening Branch D.O.D. Type Balances (Includes Acm:. Int.) cHK 741906 FLORENCE I 4303 $14,088.05 $.00 OPENED 9/67 MALACHOWSKI CD 31003908144064 FLORENCE I 4303 $7310.41 $2.98 OPENED 12/02 MALACHOWSKI CD 31003911003710 FLORENCE I 4303 $42,453.44 $113.88 OPENED 9/00 MALACHOWSKI DARLENE F KERCH DERWOOD EGE Accrued Interest 2. Loans, Mortgages, or other obligations titled in the decedent's name Account Number Amount Owed Account Description NO Safe Deposit Box titled in the Decedent's name existed at our office. If you have any questions about the information provided, please contact our Records Department at (716) 635-4010 or 1-800-724- 2440 outside of the Buffalo, NY calling area. Thank you. Sincerely, M&T BANK CORPORATION AuthoX't~zed Signature DATE: 3" "~.-C~'- O -,~ COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND Darlene F. Kerch being duly sworn according fo law, deposes and says that she is the Executrix of the Estate of Florence I. Malachowski late of Monroe Township._ ..... , Cumberland County, Pa., deceased and that the within is an inventory made by Darlene F. Kerch , the said E×ecutr±x of the entire estate of said decedent, consisting of all the personal property and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. Sworn and subscribed before me, Date of Death Member,~Aesocl~mot;~o~ades 140 Boyer Road Carlisle, PA 17013 Address 03 2003 2. 3. 4. Day Month Year INSTRUCTIONS An inventory must be filed within three months after appointment of personal repr~enfative~= A supplement inventory must be filed within thirty days of discovery of additional assets, r- Additional sheets may be attached as to personalty or realty See Article IV, Fiduciaries Act of 1949. , -~o o z >. 7 Z o,-, ~ ~ ~ Z 0 0 Inventory of the real and personal estate of FLORENCE I. MALACHOWSKI deceased 1. 1827 West Lisburn Road, Monroe Township, Carlisle, Cumberland County, PA. 2. M&T Bank - Checking Account ......................... 3. M&T Bank - Certificate of Deposit ...................... 4. Personal Property Sold ............................ TOTAL ................... 108,000 00 14,088 05 7,313 39 15,748 00 145,149 44 BUREAU OF ZNDZVZDUAL TAXES ZNHER/TANCE TAX DTVISZnN DEPT. Z8060! HARRXSBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF ZNHERZTANCE TAX APPRAZSEMENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTZONS AND ASSESSMENT OF TAX REV-16dI? EX AFP C01-05) ROGER B IRWIN ESQ IRWIN ETAL 60 W PONFRET ST CARLISLE i~A'17015 DATE 08-25-2005 ESTATE OF HALACHOWSK! DATE OF DEATH 03-OZ-ZO0$ FILE NUMBER 21 05-0508 COUNTY CUHBERLAND ACN 101 Amount Remitted FLORENCE HAKE CHECK PAYABLE AND REN'rT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LOWER PORTZON FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRATSENENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTZONS AND ASSESSHENT OF TAX ESTATE OF HALACHOWSKI FLORENCE I FTLE NO. 21 05-0308 ACN 101 DATE 08-25-2003 TAX RETURN NAS: (X) ACCEPTED AS FZLED ( ) CHANGED RESERVATZON CONCERNTNG FUTURE TNTEREST - SEE REVERSE APPRAZSED 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) ($) q. Mortgages/Notes Receivable (Schedule D) (q) 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 EXENPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule T) (10) 11. Total Deductions 12. Nat Value of Tax Return 108~000.00 O0 O0 00 37/1qg.qq Zl~Z88.16 O0 (8) ZO,83q.65 718.1q NOTE: To insure proper credit to your account, submit the upper portion of this fore with your tax payeent. 13. 1~. NOTE: 166,q37.60 (11) 21.552.7g (12) 1qq,88q.81 Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) Net VaXue of Estate Subject to Tax (lq) ]:f an assess, ant was lssued prev/ously, llnes 14, 15 and/or 16, 17, reflect figures that include the total of ALL returns assessed to date. ASSESSHENT OF TAX: 15. Amount of Line lq at Spousal rata 16. Amount of Line 1~ taxable at Lineal/Class A rata 17. Amount of Line lq at Sibling rata 18. Amount of Line lq taxable at Collatara1/CXmss B rate 19. PrincipeX Tax Due TAX CREDITS: PAYMENT RECEIPI DISCOUNT DATE NUMBER TNTEREST/PEN PAID (-) 06-02-2003 CD002633 315.79 07-11-2003 CDOOZ795 .00 .00 1qq,88q.81 TF PATD AFTER DATE XNDXCATED, SEE REVERSE FOR CALCULATTON OF ADDITTONAL TNTEREST. 18 and 19 will (15), .00 X O0 : .00 (16). Xqq,88q.81 x Oq5 = 6,519.82 (17). .00 x 12 = .00 (la), .00 x 15 = .00 (19)= 6,519.82 AMOUNT PA/D 6,000.00 20q.03 TOTAL TAX CREDZT BALANCE OF TAX DUEI INTEREST AND PEN. TOTAL DUE 6,519.82 .00 .00 .0O ( TF TOTAL DUE XS LESS THAN $1, NO PAYMENT TS REIIUTRED. TF TOTAL DUE TS REFLECTED AS A "CREDTT" (CR)~ YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF THTS FORM FOR TNSTRUCTTONS.) RESERVATION: Estates of decedents dying on or before December 1Z, 198Z -- if any futura interest in the estate is transferred in possession ar enjoyment to Class B (collateral) beneficiaries of the decedent after tho expiration of any estate for life ar For years, the Ccaaoneealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the laeFul Class 8 (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYHENT: REFUND (CR): OBJECTIONS: ADHIN- ISTRATIYE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To ~uXfiX1 the requirements of Section 21q0 of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (7Z P.S. Section 9lqO). Detach the tap portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: REGISTER OF HILLS, AGENT A refund of a tax credit, ehich was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-IS13). Applications ara available at the Office of the Register of Hills, any of the Z3 Revenue District Offices, or by calling the special Z~-hour answering service for forms ordering: 1-800-S62-2030; services for taxpayers with special hearing and / or speaking needs: 1-800-4~7-30Z0 (TT only). Any party in interest not satisfied eith 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. ZSiOZ1, Harrisburg, PA 17IlS-lOll, 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 eriting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Reviee Unit, Dept. Z80601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Sea page 5 of the booklet "Instructions For Inheritance Tax Return for a Resident Decadent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decadant's death, a five percent (Si) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed an 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 mould appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning eith first day of delinquency, or nine (9) months and one (1) day free the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent par annum calculated at a daily rate of .00016~. Al1 taxes ehich became delinquent on and after January 1, 198Z 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 198Z through ZOO3 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rata Factor 198Z ZOZ .0005~8 1987 9Z .O00Z~7 1999 7Z .O0019Z 1983 16Z .000~38 1988-1991 llZ .000301 ZOO0 8Z .000Z19 198~ llZ .O003Ol 1992 9Z .O00Z~7 ZOO1 9Z .0002~7 1985 1Si .000356 1993-199~ 7Z .00019Z ZOOZ 6Z .00016~ 1986 lOX .OOOZ7~ 1995-1998 9Z .0002q7 2003 SZ .000137 --Interest is calculated as folloas: INTEREST = BALANCE OF TAX UNPAID X NUNBER 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 Notice, additional interest must be calculated. STATUS REPORT UNDER RULE 6.12 Name of Decedent: FLORENCE I. MALACHOWSKI Date of Death: MARCH 2, 2003 No. 21-03-0308 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: X Yes __ No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes X No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? X Yes No Date: 12/19/03 d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphan's Court and may be attached to this report. Roger B. Irwin, Esquire Name (please type or print) 60 West Pomfret Street Address Carlisle, PA 17013 City, State, Zip (717) 249-2353 Telephone Number Capacity: X Personal Representative Counsel for Personal Representative