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HomeMy WebLinkAbout03-1024 Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of Beatrice P. Gallia also known as , Deceased late of Hampden Township, Cumberland County, PA Petitioner(s), who is/are 18 years of age or older apply(ies) for: Social Security No. 171-36-6238 COMPLETE "A" OR "B" BELOW:) · A. Probate and Grant of Letters and aver that Petitioner(s) is/are the executor named in the Last Will of the Decedent, dated February 24, 1995 and codicil(s) dated NONE State relevant circumstances, e.g., renunciation, death of executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: [] B. Grant of Letters of Administration (c.t.a.. d.b.n.c.ta.: pendente lite; durante absentia; durante minodtate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at 181 East Lauer Lane, Hampden Township, Cumberland County, PA 17011 (list street, number and municipality) Decedent, then 62 years of age, died December 3, 2003, at 181 East Lauer Lane, Hampden Township, Cumberland County, PA 17011 (Location) Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property ................................................................................ $50,000.00 (If not domiciled in PA) Personal property in Pennsylvania ............................................ $ (If not domiciled in PA) Personal property in County ...................................................... $ Value of real estate in Pennsylvania ................................................................................................... $375,000.00 Total ......... Real Estate situated as ~'(~ii;~'~; i~'i"l~i'l"~'~¥¥;~;;i'~'~'r~'~'~'~¥;~l~il~',"~;~;~'~';~'~'~i"~ ...... $~'J~'~ Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: /'") ,~ ..~-_'S~nature Typed or printed name and residence ..~ ._~/c-~:..~....~. ,]/.~;./,~_~'~... FrankJ. Gallia 181 East Lauer Lane, Camp Hill, PA 17011 Form RW-1 Page 1 of 3 (Dauphin County - Rev. 9~92) PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF THE ESTATE IS NOT COMPLETED, FILE A 6.12 FORM YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Beatrice P. Gallia Date of Death: December 3, 2003 WillNo. 2003-01024 Admin. No. 21-2003-1024 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. State whether administration of the estate is complete: 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. i is Yes, state the following: ao Yes [--] No [~ bo account is: Did the personal representative file a final account with the Court? The separate Orphans' Court No. (if any) for the personal representative's c. Did the personal representative state an account informally to the parties in interest? Yes [~ No [-] d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Name (Please type or print) 3401 North Front Street, P.O. Box 5950 Address Harrisburg, PA 17110-0950 (717) 232-5000 Telephone Capacity: [] Personal Representative [] Counsel for Personal Representative 410863vl Commonwealth of Pennsylvania County of Oath of Personal Representative The Petitioner(s) above-named swear(s) and 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(s) of the Decedent, Petitioner(s) will well and truly administer the.estate according to law. Sworn ,o and affirmed and subscribed ~ ~..~ ~/~~----¢,~ before me this 11th day of 2003. Estate of Beatrice P. Gallia, Deceased also known as Social Security No.: 171-36-6239 DECREE OF REGISTER No. Date of Death 21-2003-1024 December 3, 2003 AND NOW, December 12th ,2003, in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters · Testamentary [] of Administration (c.ta.; d.b.n.c.t,; pendente lite; durante absentia; durante minodtate} are hereby granted to Frank J. Gallia in the above estate and that the instrument(s), if any, dated February 24, 1995 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters .................................. $ Short Certificate(s)...5 ......... $ Renunciation ........................ $ Affidavit ( ) ......................... $ Extra Pages (1~) .................. $ Codicil .................................. $ JCP Fee ............................... $ Inventory & Tax Forms ........ $ Other .................................... $ TOTAL .................... $ Na-i'led Letters to Attorney on 12/12/20{}3 340.00 15.00 Register Of Wills Donna M. Otto, 1st Deputy 10.00 404.00 Attorney: I.D. No.: Address: Telephone: DATE FILED: James A. Ulsh 10169 3401 North Front Street Harrisburg, PA 17110-0950 717-232-5000 December 12th, 2003 Form RW-1 Page 3 of 3 (Dauphin County - Rev. 9/92) 387008vl 105.805 REV 9/86 This is to cerdfy that the information here given is correcdv copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded t~ the State Viral Records Office for permanent "filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Local Registrar Date nt0~ ~43 Rev Z/87 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH ~E~:'l ,; 1,.*,~-~ I,~~,~- I~=-~ ,~..~ ~CE~'SUSU~CU~ 'l ~a[. ............... I~- . v ' ~ ~* Il pco~ 'Z.l Z--L 21-2003-1024 Last Will and Testament OF BEATRICE P. GALLIA I, BEATRICE P. GALLIA, of Camp Hill, Cumberland County, Pennsylvania, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils by me at any time made. ITEM I: I direct that all inheritance and estate taxes becoming due by reason of my death, whether such taxes may be payable by my estate or by any recipient of any property, shall be paid by the Executor out of the property passing under ITEM IV of this Will, as an expense and cost of administration of my estate. The Executor shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. ITEM II: I direct the Executor to pay the expenses of my last illness and funeral expenses from the property passing under this Will as an expense and cost of administration of my estate. ITEM III: If I predecease my husband, FRANK J. GALLIA, I give and bequeath to him absolutely and in fee simple all of my household furniture and furnishings, books, pictures, jewelry, silverware, automobiles, wearing apparel and all other articles of household or personal use or adornment and all policies of insurance thereon. If I do not predecease my said husband, I make said bequest to my children living at the time of my death, to be divided among them as they shall agree. Page 1 ITEM IV: I give, devise and bequeath all the rest, residue and remainder of my estate, not disposed of in the preceding portions of this Will, to my husband, FRANK F. GALLIA, as Trustee (hereinafter referred to as "Trustee"), IN TRUST NEVERTHELESS, to be further divided into two parts, each of which shall be held in trust and constitute a separate Trust Fund to be known as "Trust A" and "Trust B". "Trust A": There shall be placed in "Trust A" that fraction of my residuary estate of which the numerator shall be a sum equal to the largest amount that can pass free of Federal estate tax under my Will by reason of the unified credit and the state death tax credit (provided that the use of this credit does not require an increase in state death taxes) allowable to my estate but no other credit and after taking account of dispositions under other items of this Will and property passing outside of this Will which do not qualify for the marital or charitable deduction and after taking account of charges to principal that are not allowed as deductions in computing my Federal estate tax and of which the denominator shall be the value of my residuary estate. For purposes of establishing such fraction, the values finally fixed in the Federal estate tax proceeding relating to my estate shall be used. I recognize that the numerator of such fraction may be zero (0), in which case no property shall pass under "Trust A" and that said numerator may be affected by the action of the Executor in exercising certain tax elections. "Trust B": The balance of my residuary estate not placed in "Trust A" shall be placed into "Trust B" to be held, administered and distributed in accordance with ITEM VII of this Will. Page 2 Page 3 ITEM V: The following provisions shall apply to "Trust A": (a) The Trustee shall pay to or for the benefit of my husband, FRANK J. GALLIA, all of the income of this Trust in convenient installments not less frequently than annually and so much of the princiapl of this Trust as may be necessary in the sole discretion of the Trustee for the proper support, maintenance and medical care of my said husband. (c) Upon the death of my husband, or upon my death if he predeceases me, the then remaining principal shall be divided into as many equal shares as there are then living children of mine and then deceased children of mine represented by then living issue. The Trustee shall hold one such share as a separate Trust for the benefit of each living child, and one such share as a separate Trust for the benefit of the issue of each such then deceased child, per stirpes. (d) In each Trust thus established for a then living child of mine, the Trustee shall quarterly pay to or for the benefit of such child all of the income and so much of the principal of said Trust as, in the discretion of the Trustee, may be necessary to maintain such child in the proper station in life, including proper support, maintenance, medical care and college or higher education. Upon such child's attaining the age of thirty (30) years, the Trustee shall pay to such child one-half (1/2) of the then principal. Upon such child's attaining the age of thirty-five (35) years, the Trustee shall pay to such child the balance of the then principal. Page 4 Should such child die before final distribution of the assets of the Trust, but be survived by then living issue, the Trustee shall quarterly pay the net income from said Trust to or for the benefit of said issue, per stirpes, living at each time of quarterly distribution; as soon as any one of said issue attains the age of twenty-one (21) years, and in no event later than twenty (20) years following the death of my child, the Trustee shall pay over all of the then assets in the Trust to the then living issue of such deceased Child, per stirpes. Should such Child die before final distribution and not be survived by then living issue, the provisions of subparagraph (g) herein shall obtain. (e) In each Trust established for the benefit of the issue of a deceased child of mine, the Trustee shall quarterly pay the net income to or for the benefit of the issue of such deceased child, per stirpes, living at each time of quarterly distribution; as soon as any one of said issue attains the age of twenty-one (21) years, and in no event later than twenty (20) years following the death of the survivor of my husband and me, the Trustee shall pay over all of the then assets in the Trust to the then living issue of my deceased child, per stirpes. (f) If at any time before final distribution of the assets of any of the Trusts established for my children or issue of deceased children, there are no living beneficiaries of said Trust, the Trust shall terminate, and its assets shall be added to the other then existent Trusts created herein for the benefit of my children or their issue. Provided, that if any of said Trusts herein created has previously been terminated by payment of its principal to its beneficiaries, said beneficiaries who received payment of the principal of that Trust shall collectively be considered an "existent Trust" for the purposes of this paragraph, and one equal share shall be paid directly to such beneficiaries in the same proportion by which they received the principal of the Trust, or, if deceased, to their issue, per stirpes. (g) In the event that I am not survived by my husband or any issue, or in the event them are no issue of mine surviving upon the termination of any Trust, the principal shall be paid to the individuals set forth below in the following percentages: (i) Thirty-Five (35%) Percent to my mother-in-law, MARGARET MARY GALLIA, Old Forge, Pennsylvania; (ii) Thirty-Five (35%) Percent to my mother, ANTOINETTA PREATE, Old Forge, Pennsylvania; (iii) Fifteen (15%) Percent to my husband's sister, MRS. THOMAS LAZ, Canton, Massachusetts; (iv) Seven and One-Half (7.5%) Percent to my sister, MRS. THERESA SIEGEL, Easton, Pennsylvania; (v) Seven and One-Half (7.5%) Percent to my brother, DONALD PREATE, Old Forge, Pennsylvania. ITEM VI: The following provisions shall apply to "Trust B": Page 5 (a) Trustee shall have, hold, manage, invest and reinvest the assets of this Trust, collect the income and beginning at my death pay over the net income in quarterly installments to my husband, FRANK J. GALLIA, during his lifetime. The Trustee shall also, from time to time, pay to my husband such amounts of principal of this Trust, as the Trustee (other than my said husband) deems necessary for the proper support, maintenance and medical care of my husband. (b) The Trustee shall also, from time to time, pay to my husband so much of the principal of this Trust as my said husband may in writing request. (c) Upon the death of my husband, the Trustee shall convey and pay over all of the remaining assets, whether corpus or income, to or for the benefit of such person or persons or corporation or corporations, or the estate of my husband, in such amounts or proportions, and in such lawful interests or estates whether absolutely or in trust, as my husband may have directed, either by instrument filed with the Trustee during his lifetime exercising this Power of Appointment, or by his Last Will and Testament. This Power of Appointment shall be exercisable by my husband alone and in all events. If the above Power of Appointment is for any reason not validly exercised by my husband in whole or in part during his lifetime or in his Last Will and Testament, then upon his death such portion or all of the principal of this Trust or such interests and estates therein as shall not have been validly appointed by my husband shall be transferred to "Trust A" to be held, administered and distributed in accordance with the provisions of ITEM V of this Will. (d) If my husband should not survive me, then the provisions of "Trust B" shall be void, and principal which would have constituted the "Trust B" shall be added to "Trust A" to be disposed of in accordance with ITEM V of this Will. Page 6 ITEM VII: No part of the income or principal of the property held under any Trust created by this Will shall be subject to attachment, levy or seizure by any creditor, spouse, assignee or trustee or receiver in bankruptcy of any beneficiary prior to his or her actual receipt thereof. The Trustee shall pay over the net income and the principal to the parties herein designated, as their interests may appear, without regard to any attempted anticipation, pledging or assignment by any beneficiary under a Trust, and without regard to any claim thereto or attempted levy, attachment, seizure or other process against said beneficiary. ITEM VIII: In the settlement of my estate and during the continuance of the foregoing Trusts, the Executor and the Trustee shall possess, among others, the following powers: (a) To retain any investments I may have at my death, including specifically those consisting of stock of any bank even if I have named such bank as the Executor or Trustee herein, so long as the Executor or Trustee may deem it advisable to my estate so to do. (b) To vary investments, when deemed desirable by the Executor or Trustee, and to invest in such bonds, stocks, notes, real estate mortgages or other securities or in such other property, real or personal, as they shall deem wise, without being restricted to so-called "legal investments", and without being limited by any statute or rule of law regarding investments by fiduciaries. (c) In order to effect a division of the principal of a Trust or for any other purpose, including any final distribution of a Trust, the Executor or Trustee is authorized to make said divisions or distributions of the personalty Page 7 and realty, partly or wholly in kind, and to allocate specific assets among beneficiaries and Trusts created hereunder so long as the total market value of any share is not affected by such division, distribution or allocation in kind. Should it appear desirable to partition any real estate, the Executor or Trustee is authorized to make, join in and consummate partitions of lands, voluntarily or involuntarily, including giving of mutual deeds, recognizances or other obligations, with as wide powers as an individual owner in fee simple. (d) To sell either at public or private sale and upon such terms and conditions as the Executor or Trustee may deem advantageous to the estate or Trust, any or all real or personal estate or interest therein owned by the estate or Trust severally or in conjunction with other persons or acquired after my death by the Executor or Trustee, and to consummate said sale or sales by sufficient deeds or other instruments to the purchaser or purchasers, conveying a fee simple title, free and clear of all trust and without obligation or liability of the purchaser or purchasers to see to the application of the purchase money or to make inquiry into the validity of said sale or sales; also, to make, execute, acknowledge and deliver any and all deeds, assignments, options or other writings which may be necessary or desirable in carrying out any of the powers conferred upon the Executor or Trustee in this paragraph or elsewhere in my Will. (e) To mortgage real estate, and to make leases of real estate. (f) To borrow money from any party, including the Executor or Trustee, to pay indebtedness of mine or of my estate, expenses of administration or inheritance, legacy, estate and other taxes, and to assign and Page 8 pledge assets of my estate therefor. (g) To pay all costs, taxes, expenses and charges in connection with the administration of my estate or a Trust. (h) To make distributions of income and of principal to the proper beneficiaries thereof, during the administration of my estate, with or without court order, in such manner and in such amounts as my Executor deems prudent and appropriate. (i) To vote any shares of stock which form a part of the estate or Trust, and otherwise to exercise all the powers incident to the ownership of such stock. (j) In the discretion of the Executor or Trustee, to unite with other owners of similar property in carrying out any plans for the reorganization of any corporation or company whose securities form a part of the estate. (k) To disclaim any interest in property which would devolve to me or my estate by whatever means, including but not limited to the following means: as beneficiary under a will, as an appointee under the exercise of a power of appointment, as a person entitled to take by intestacy, as a donee of an inter vivos transfer, and as a donee under a third-party beneficiary contract. (1) To do all other acts in their judgment deemed necessary or desirable for the proper and advantageous management, investment and distribution of the estate or Trust. Page 9 ITEM IX: Whenever and as often as any beneficiary hereunder, to whom payments of income or principal are herein directed to be made, shall be under legal disability, or, in the sole judgment of the Trustee, shall otherwise be unable to apply such payments to his own or her own best interests and advantages, the Trustee may make all or any portion of such payments in any one or more of the following ways: (a) Directly to such beneficiary; (b) To the Legal Guardian or Conservator of such beneficiary; (c) To the Trustee, or to another person selected by the Trustee, as custodian under the Pennsylvania Uniform Transfers to Minors Act as to a beneficiary under the age of twenty-one (21) years; (d) To a relative of such beneficiary, to be expended by such relative for the benefit of such beneficiary; or (e) By itself expending same for the benefit of said beneficiary. ITEM X: Any person who shall have died at the same time as I shall have, or in a common disaster with me, or under such circumstances that the order of our deaths cannot be established by proof, or within thirty (30) days of my death, shall be deemed to have predeceased me. ITEM XI: I hereby nominate, constitute and appoint my husband, FRANK J. GALLIA to be the Executor. My husband shall have the power to nominate and appoint a successor Trustee and Executor (individual or corporate) to serve upon his death or his Page 10 inability or refusal to serve as Executor and/or Trustee. In the event of the death or inability or refusal to serve of my said husband prior to his appointment or nomination of a successor Executor and/or Trustee, I nominate, constitute and appoint GARRETT F. GALLIA and LIZA L. GALLIA, to be the successor Executors and Trustees. GARRETY F. GALLIA and LIZA L. GALLIA, or the survivor of them, shall have the power to nominate and appoint a successor Trustee and Executor (individual or corporate) to serve upon their death or inability or refusal to serve as Executor and/or Trustee. In the event of the death or inability or refusal to serve of said successor Executors and/or Trustee prior to their appointment or nomination of a successor Executor and/or Trustee, I nominate, constitute and appoint RONALD W. WALBORN to be the successor Executors and Trustees. The Executor, Trustee and Guardian are specifically relieved from the duty or obligation of filing any bond or other security. IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, consisting of this and the preceding ten (10) pages, at the end of each page of which I have also set my initials for greater security and better identification this 4v~ day of ~~, 1995. BEATRICE P. GALLIA We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above-named Testatrix as and for her Last Will and Testament, in the presence of us, who, at her request and in her presence and in the presence of each other, have hereunto set our hands and seals the day and year first above written, and we certify that at the time of the execution thereof, the said Testatrix was of sound and disposing mind and memory. .(SEAL) Residing at (SEAL) Residing at (SEAL) Residing at ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA ) ) COUNTY OF ~)~' ) SS: I, BEATRICE P. GALLIA, Testatrix, whose name is signed to the attached or foregoing 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. BEATRICE P. GALLIA Sworn to and subscribed be~[ore me this o.~ day of ,19 ~',~- ' ~ Notary Public/ My Commission Expires: (SEAL) AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) )ss: COUNTY OF ) , f~C~ t C ~.~Y.0~¢5c~ and ~FeSq .,~ ~a /~ ,the Witnesses whose names arraigned to the attached or foregoing instrument, being duly qualified according to law, do depose ~d say ~at we were present and saw Testatrix, BEATRICE P. GALL~, sign and execute the instrument as her Last Will ~d Testament; ~at Testatrix signed willingly ~d that she execu~d said Will as her free ~d volunta~ act for the pu~oses therein expressed; that each of us in the hearing and sight of the Testatr~ signed ~e Will ~ Wimesses; and that to the best of our ~owledge the Tes~tdx was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. Witness Sworn to and subscribed bel~ore me this ~ 5/ e-h day of ~ ,19 ~'..<7 Notary Publi~c My Commission Expires: (SEAL) OF BEATRICE P. GALLIA METTE, EVANS & WOODSIDE ATTORNEYS AT LAW HARRISBURG, PENNSYLVANIA 17108-0729 HOWELL C. ME~E ROBERT MOORE CHARLES B. ZWALLY PETER J. RESSLER LLOYD R. PERSUN CRAIG A. STONE JAMES A. ULSH DANIEL L. SULLIVAN JEFFREY A. ERNICO KATHRYN L. SIMPSON P. DANIEL ALTLAND ANDREW H. DOWLING MICHAEL D. REED PAULA J. LEICHT GARY J. HElM THOMAS F. SMIDA JOHN F. YAN1NEK* VICKY ANN TRIMMER TIMOTHY A. HOY JAMES M. STRONG 3401 NORTH lVRONT STREET P.O. BOX 5950 HA_~i~ISBURG, PA 17110-0950 ~ 1~O. 2~1985~5 ~ ~HO~ ~ (~7) 23~5000 (~7) 23~1816 http://www, mette.com KATHLEEN DOYLE YAN1NEK JENNIFER A. YANKANICH RANDALL G. HURST* MARK D. HIPP RONALD L. FINCK SCOT~ C. SEUFERT AMBROSE W. HEINZ OF COUNSEL JAMES W. EVANS MARYLAND BAR March 3, 2004 VIA CERTIFIED MAIL RETURN RECEIPT REQUESTED Donna M. Otto Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Re: Estate of Beatrice P. Gallia File No. 21-2003-1024 Dear Ms. Otto: Enclosed is a check in the amount of $8,750.00 payable to "Register of Wills, Agent" representing a prepayment of inheritance tax in the above-referenced estate. Please issue an Official Receipt for this payment and send it to my attention in the enclosed envelope. Thank you for your assistance. Very truly yours, Lisa J. Knodb,_J Paralegal to James A. Ulsh LJK: Enclosures 392969vl METTE, EVANS & WOODSIDE A PROFESSIONAL CORPORATION ATTORNEYS AT LAW 3401 NORTH FRONT STREET P.O. BOX 5950 HARRISBURG, PA t7! 10-O950 I,,,111,,,111,,,,,,11,,11,1,,I,I Donna M. Otto Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Iii 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 003637 ULSH JAMES A 3401 N.FRONT ST. P.O. BOX 5950 HARRISBURG, PA 17110-0950 DUPLICATE ........ fold ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $8,750.00 ESTATE INFORMATION: SSN: 171-36-6238 F'ILE NUMBER: 2103- 1024 DECEDENT NAME: GALLIA BEATRICE P DATE OF PAYMENT: 03/04/2004 POSTMARK DATE: 03/03/2004 COUNTY: CUMBERLAND DATE OF DEATH: 12/03/2003 iF~EMARKS: SEAL CHECK//166 TOTAL AMOUNT PAID' $8,750.00 RECEIVED BY' GLENDA FARNER STRASBAUGH REGISTER OF WILLS DEPARTMENT OF REVENUE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF ~NDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003637 ULSH JAMES A 3401 N.FRONT ST. P.O. BOX 5950 HARRISBURG, PA 17110-0950 ........ fold ESTATE INFORMATION: SSN: 171-36-6238 FILE NUMBER: 2103- 1024 DECEDENT NAME: GALLIA BEATRICE P DATE OF PAYMENT: 03/04/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 12/03/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 98,750.00 REMARKS: '-~ SEAL CHECK#166 TOTAL AMOUNT PAID: 98,750.00 INITIALS: AC RECEIVED BY' GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS CERTIFICATION OF NOTICE UNDER RULE 5.6(A) Name of Decedent: Date of Death: Will No. To the Register: BEATRICE P. GALLIA December 3, 2003 Admin. No. 21-2003-01024 I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on February 19, 2004 : Name Frank J. Gallia Garrett F. Gallia Liza L. Gallia Frank J. Gallia, Trustee Beatrice P. Gallia Trust Address 181 East Lauer Lane, Camp Hill, PA 17011 835 Olde Trail Road, Hummelstown, PA 17036 25 N. Haven Way, Sag Harbor, NY 11963 181 East Lauer Lane, Camp Hill, PA 17011 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None. Date: February 19, 2004 3401 North Front Street Harrisburg, PA 17110 Address (717) 232-5000 Telephone Personal Representative X Counsel for Personal Representative 390027vl FFICtN. USE ONLY COMMONWEALTH OF PENNSYLVANIA Dt~ARq~I ENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Gallia, Beatrice P DA~ OF DF-~TH (MM-OD-YEAR) DA~ OF BIR3~ (MM-DO-YEAR) 12/03/2003 04/16/1941 F APPLICABLE) SURVIVING SPOUSE~J NAME (LAST, FIRST, AND MIDDLE INITIAL) Gallia, Frank J ~ 1. Odginal Ratum [~ 2. Supplemental Return FILE NUMBER 21 -- 2003 1024 SOCIAL SECURI3~ NUMBER 171-36-6238 ~ RE'~JRN MUST BE FILED IN DUPLICAI~E WITH THE I~F~!-~TER OF WILLS SOCIAL SECURITY NUMBER 208-28-7650 ~ 4. Limited Estate ~ 4a, Futura Interest C~npromlse (date ef death after 12-12-82) ~ 5. Federal Estate Tax Rofum Required ~'~ 9, LItigatina Proceeds Recat veal ~ 10, S pousat Polity Credit (date of death ~)a[ween 12~31.gI and 1.1.~5) r~ 11. Election to tax under Sec. 9t 13(A) NAME James A. Ulsh, Esquire FIRM NAME(IfAppli~ble) ~tte, Evans & Woodside ]~LEPHONE NUMBER 717-232-5000 COMPI.E3~MAILINGADDRESS 3401 North Front Street P.O. Box 5950 Harrisburg, PA 17110 1. Reat Estate (Schedule A) (1) 2. Sthcks and Bonds (Schedule B) (2) 3. Closely Held Co~poration, Pa~nerShiporSole-PropHetorShip (3) 4, Mortg ages & Notes ReceNable (Scheduia D) (4) 5. Cash, Bank Deposits & MiScellaneous Pemonal Property (Schedule E) (5) 6. J~ Ow~ed Property (Schedule F) (6) I I Separate Billing Requested 7.Inter-Vivos Transfers & MIscellane~Ja Non-Probate Property (7) (Schedule G o~ L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Co~ts (Schedule H) (9) 10. Debts of Decedent. Mortgage Liabilities, & Liens {Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11 ) 13. Charitable and Governmental Bequests/Sec 9113 Trusts fo~ which an election to tax has not been made (Schedule J) 373t548.00 2,361.75~ 0.00 0.00 51~264.04 0.00 1,603.17 OFFICIN_ USE ONLY ~;: ~¥ (3) 428,776.96 27,942.42 0.00 (11) 27~942.42 (12} 400,834.54 (13) 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 400,834.54 SEE INSTRUCTIONS ON REVERSE SlOE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 ta~able at lineal rate 17. Am aunt of Line 14 taxable at sibling rate 18, Amount of Line 14 taxable at ~ollateral rate 19. Tax Due 20. 200,425.26 x.O0 (la) 0.00 200~409.28 x.O45 (~s) 9,018.42 0,00 x.12 (17) 0.00 0.00 x,t~ OS) 0.00 (t~) 9,018.42 > ~; BEauRE TO ANSWER~ALI.:;Q~ES~ioNS ON REVERSE SIDE AND ~CH~K~II~T~ ~ < ; 2W4645 10~O Decedent'e Complete Address: 181 East Lauer Lane I Camp Hill Tax Payments and Credits: 1. Tax Due (Page I Line 19) 2. Credits/Payments A. Spousal Poverty Credit 0.00 B. Prior Payments 8 ~ 750.00 C. Discount 450.92 3. Interest/Penalty if applicable D. Interest 0. O0 E. Penalty O. 00 Total Credits (A + B + C) (2) Total InterestJPenalty (D + E) (3) (1) 9~018.42 9,200.92 0.00 182.50 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 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. (5A). B. Enter the total of Line 5 + 5A. 'Fnis is the BALANCE DUE. Make Check Pa, AGENT (5B) 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; ....................... r--] [~ b. retain the right to designate who shall use the property transferred or its income; ......... ~ ~ c. retain a reversionary interest; or ................................ r---] r~ 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? ............................ [] r~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? r--] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which conta ns a beneficiary designation? ................................ r~ r~ IF THE ANSWE .R/T~O ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ~ON~IB[~ FOR C~p Hill, PA 17011v [72 P.S. § 9916 (a) (1,1) (i)]. For dates of death on or after January 1, 1995, the tax rata imposed on the net vetue of transfers to or for the use of the suturing spouse Is 0% [72 P.S. § 9116 (a) (1.1) (ii)] The statute d oas not exempt atran sfer to a surviving spouse flDrn tax, and the statutory red ulrements for disclosure of assets and filing a tax ratum are still appliCable even if the suturing spouse is the only ben eficla~,. For dates of death on or after July 1, 2000: The tax rate im posed on the net value of tran sfera from a deceased child tw~lty-one years of age or you nger at death to or for the use of a natural parent, an edoptiw parent, or a stepparent of the child is 0% [72 P.S. § 9116(a)(1.2)]. The tax rate imposed on the nat value of t ransfe~s to or for the use of the decedeof'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 nat vaJue of transfers to or for the use of the decedent's siblings is t2% (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 blo~d or adoption. 2W4646 1000 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RE, DENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Gallia, Beatrice P 21-2003-1024 Ail r~al property owned ~ely or as a tenant In common must be ~eported at fair manet value. Fair market value ia defined as the price at which property would be exchanged between a willing buyer and a willing seller, n either being compelled to buy or sell. both having reasOnable knowlefige of the relevant facts. Real properly which Is Jolntly.~wned with ~i~ht ~ suwivomhlp must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. 373,548.00 Real property situate in Hampden Township, C~berland County, PA, known as 181 East Lauer Street; tax parcel 10191598039. Value was established by multiplying the assessed value as determined by the C~m~erland County Tax Assessment Office in the amount of $355,760.00 by the Common Level Ratio factor of 1.05 as established by the Pennsylvania Department of Revenue. $355,760.00 x 1.05 = $373,548.00 TOTAL (Aisc enter on line 1, Recapitulation} 373~548.00 2W46952.(X30 {If more space is needed, insert additional sheets of the same size) REV-1503 EX + (1-97) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Gallia, Beatrice p 21-2003-1024 All property Jointly-owned with right of survivorship must be dlscleeed on Schedule F. VALUE AT DATE ITEM NUMBER ~SCRIP~ON 1. 45 shares of co~ stock in General Electric Co. at $29.51 per share 40 shares of common stock in Microsoft Cor~. at $25.845 per share 1,327.95 1,033.80 TOTAL (Also enter on line 2. Recapitulation) $ 2,361.75 2w4696 $.0C0 (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA ~M~ERFFANCE TAX RE11JRN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Gallia, Beatrice P FILE NUMBER 21-2003-1024 Include the ITEM NUMBER 2 3 4 )roceed s of litigation and the date the proceeds w~re received by the estate. All property Jointly-owned with the right of survlvomhlp rnust be disclosed on Schedule F. DESCRIP'I]ON Commerce Bank Checking Account #0512074733 Commerce Bank Savings Account #0616068848 Janney Montgomery Scott Money Market Account #HB23 3521-5896 2002 Mercedes SLK VALUE AT DATE OF DEATH 1,910.30 9,294.34 4,059.40 36,000.00 TOTAL (Also enter on line 5~ Recapitulation) $ 51,264.04 COMMONWEALTH OF PENNSYLVANIA INPIERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE G INTER-~VOSTRANSFERS& MISC, NON-PROBATE PROPERTY FILE NUMBER Gallia~ Beatrice P 21-2003-1024 This schedure must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. 1. Individual Retirement Account, 1,603.17 100.00 0.00 1,603.1' Fidelity Investments Account #2AC-619574; beneficiary was decedent ~ s surviving spouse TOTAL (Arso enter on line 7, Recapitulation) $ 1~603.17 REV-1511 EX+ (1-97) COMMONWEAL1H OF PENNSYLVANIA INHERrTANCE TAX RE~.JRN I%ESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Gallia, Beatrice P 21-2003-1024 Debts of decedent muat be reported on Schedule I. ITEM NUMBER 3 5. 6. 8 DESCRIPTION FUNERAL EXPENSES: Neill Funeral Home, Camp Hill, PA Pesavento Monuments, Scranton, PA - open, close, clean and letter mausoleum Patsel~s - funeral luncheon ADMINISTRATIVE COSTS: Personal Representative's Commissiens Name of Persenal Representative(s) Sociar Security Number(s) / EIN Number of Pe'sonal Representative(s) Street Address City State__ Zip Year(s) Commission Paid: AttorneyFsesName: Mette, Evans & Woodside Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Gallia, Frank J Street Address 181 East Lauer Lane City Camp Hill Relationship of Claimant to Decedent Spouse Probate Fees Accountant's Fees Tax Return Preparer's Fees C~mberland Law Journal - legal notice Sentinel - legal notice State PA Zip 17011 AMOUNT 13,195.90 1,284.00 1,359.83 0.00 8,000.00 3,500.00 429.00 0.00 0.00 75.00 98.69 TOTAL (Also enter on line 9, Recapitulation) $ 27,942.42 2W4SAG 2000 (If more space is needed, insert additional sheets of same size) REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN F~SIDENT DECEDEErT SCHEDULE J BENEFICIARIES ESTATE OF Galli; NUMBER k 2 II. · Beatrice P NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLEDISTRIBUTIONS[includeoutdghtsddusaldistdbuti~s, andtransfers underSec, 9116(a)(1.2)] Gallia, Frank J 181 East Lauer Lane Camp Hill, PA 17011 Beatrice P. Gallia Trust A c/o Frank J. Gallia, Trustee 181 E. Lauer Lane Camp Hill, PA 17011 FILE NUMBER 21-2003-102 RELATIONSHIP TO DECEDENT Do Not List Spouse ~redit Shelter Trust AMOUNTORSHARE OF ESTATE 200,425.26 200,409.28 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1590 COVER SHEET $ 0.0 0 2W46AI 1.000 (If more o~=,~,= is needed, inse~t additional sheets of the same size) REV-1514 EX+ (147) COMMONWEAL'~-I OF PENNSYLVANrA INHERITANCE TAX RE1%IRN RESIDENT DECEDENT ESTATE OF FILE NUMBER Gallia, Beatrice P 21-2003-1024 SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN (Check Box 4 on Rev-1500 Cover Sheet) This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death on or after S-1-89. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. [] Will [] Intervlvos Deed of Trust [] Other LIFE E I'ATEiNTE~E AL~CU~' NAME(S) OF NEAREST AGE AT TERM OF YEARS LIFE ESTATE IS LIFE TENANT(S) DATE OF BIRTI- DATE OF DEATH PAYABLE Gallia, Frank J 03/22/1937 67 ~Lifeor ~mermofYears ~-~ Life or ~-~ Term of Years ~--~ Life or ~-~ Term of Years ~ ,,4, ................................ ~'~ Life or I--I Term of Years ~ ~ from which life estate is payable $ 363,231.37 2. Actuarial factor per appror~riate table .44826 Interest table rate- L_.J 3 1/2% [] 6% [] 10% [] VariabieRate 4.2 % 3. Value of life estate (Line 1 multiplied by Line 2) $ 162,822.09 NAME(S) OF NEAREST AGE AT TERM OF YEARS ANNUITANT(S) DATE OF BIRTH DATE OF DEATH ANNUITY IS PAYABLE ~ Life or ~--~ Term of Years r~ Life or ~ Term of Years ~ Life or ~] Term of Years r~ Life or ~ Term of Years om which annuity is payable $ 2. Check appropriate block below and enter corresponding (number) Frequency of payout - [] Weekly (52) ~--~ Bi-weekly (26)[--] Monthly (12) [] QuarteHy (4) [] Semi-annually (2) [] Annually (1) [~ther ( ). 3. Amount of payout per period $ 4. Aggregate annual payment, Line 2 multiplied by Line 3 5. Annuity Factor (see instructions) Interest table rate [] 3 1/2% [] 6% [] 10% ]--'] Variable Rate % 6. Adjustment Factor (see instructions) 7. Value of annuity. If using 3 1/2%, 6%, 10%, or if variable rate and period payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 $ If using variable rate and period payout is at beginning of period, calculation is: (Line 4 x Line 5 x Line 6) + Line 3 $ NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13, 15~ 16 and 17. (If more space is needed, insert additional sheets of the same size) 2W46AJ 1 000 COi~MONWEAL3~-I OF PENNSYLVAN[4 INHERffANCE TAX RE'RJRN RESIDENT DECEDEh'r SCHEDULE O ELECTION UNDER SEC. 9113(A) SPOUSAL DISTRIBUTIONS1 ESTATE OF FILE NUMBER Gallia~ Beatrice P 21-2003-1024 Do not complete this schedule unless the estate is making the election to tax assets under Section 9113(A) of the Inheritance & Estate Tax Act. If the election applies to more than one trust or similar arrangement, a separate form must pa filed for each trust. This election applies to the Tz~Jst A Cred~.t T~.]st Trust (marital, re~iH~a_!, A, B, By-pass, Unified Credit, etc.) If a trust or similar arrangement meets the requi,~,,~L~ of Section 9113lA), and: a. The trust er similar arrangement is listed in Schedule O, and b. The value of th · tru st or amilar an'angement is entered in whola or in pat as an asset on Schedule O, then the transfero,"s personal representative may specifically identify the trust (all er a fractional portion or pementage) to be Inctuded in the election to have such tnJat or similar property treated as a taxable transfer In this estate. If less th~ the entire value of the trust or similar property Is irtCluded as a taxable t~lnsfer ~1 Schedule O, the person al representative shall be considered to have made the election o~lly as to a Ihastlon of the truat or similar effangement. 'J~e nu melater of this fraction is aqual to the amount of the trust or similar arfan{3ement included as a t~0(able asset on Schedule O. The denominator is e(lual to the thtal ~atue of the trust or similar PART A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's survivincj spouse under a Section 9113(A) trust or similar arranpement. i Beatrice P. Gallia Trust A 363,231.37 Credit Shelter Trust Part A Total $ 363,231.37 PART B: Enter the description and value of all interests included in Part A for which the Section 911 iA} election to tax is being made. I Beatrice P. Gallia Trust A Credit Shelter Trust 363,231.37 Part B Total $ 363,231.37 2W45E21.oo0 (If more space is needed, insert additional sheets of the same size Last Will and Testament OF BEATRICE P. GALLIA I, BEATRICE P. GALLIA, of Camp Hill, Cumberland County, Pennsylvania, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils by me at any time made. ITEM I: I direct that ail inheritance and estate taxes becoming due by reason of my death, whether such taxes may be payable by my estate or by any recipient of any property, shail be paid by the Executor out of the property passing under ITEM IV of this Will, as an expense and cost of administration of my estate. The Executor shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. ITEM II: I direct the Executor to pay the expenses of my last illness and funeral expenses from the property passing under this Will as an expense and cost of administration of my estate. ITEM III: If I predecease my husband, FRANK J. GAIJ.IA, I give and bequeath to him absolutely and in fee simple ail of my household furniture and furnishings, books, pictures, jewelry, silverware, automobiles, wearing apparel and ail other articles of household or personai use or adornment and all policies of insurance thereon. If I do not predecease my said husband, I make said bequest to my children living at the time of my death, to be divided among them as they shall agree. Page 1 ITEM IV: I give, devise and bequeath all the rest, residue and remainder of my estate, not disposed of in the preceding portions of this Will, to my husband, FRANK F. GALLIA, as Trustee (hereinafter referred to as "Trustee"), IN TRUST NEVERTHELESS, to be further divided into two parts, each of which shall be held in trust and constitute a separate Trust Fund to be known as "Trust A" and "Trust B". "Trust A": There shall be placed in "Trust A" that fraction of my residuary estate of which the numerator shall be a sum equal to the largest amount that can pass free of Federal estate tax under my Will by reason of the unified credit and the state death tax credit (provided that the use of this credit does not require an increase in state death taxes) allowable to my estate but no other credit and after taking account of dispositions under other items of this Will and property passing outside of this Will which do not qualify for the marital or charitable deduction and after taking account of charges to principal that are not allowed as deductions in computing my Federal estate tax and of which the denominator shall be the value of my residuary estate. For purposes of establishing such fraction, the values finally fixed in the Federal estate tax proceeding relating to my estate shall be used. I recognize that the numerator of such fraction may be zero (0), in which case no property shall pass under "Trust A" and that said numerator may be affected by the action of the Executor in exercising certain tax elections. "Trust B": The balance of my residuary estate not placed in "Trust A" shall be placed into "Trust B" to be held, administered and distributed in accordance with ITEM VII of this Will. Page 2 ITEM V: The following provisions shall apply to "Trust A": (a) The Trustee shall pay to or for the benefit of my husband, FRANK J. GALLIA, all of the income of this Trust in convenient installments not less frequently than annually and so much of the princiapl of this Trust as may be necessary in the sole discretion of the Trustee for the proper support, maintenance and medical care of my said husband. (c) Upon the death of my husband, or upon my death if he predeceases me, the then remaining principal shall be divided into as many equal shares as there are then living children of mine and then deceased children of mine represented by then living issue. The Trustee shall hold one such share as a separate Trust for the benefit of each living child, and one such share as a separate Trust for the benefit of the issue of each such then deceased child, per stirpes. (d) In each Trust thus established for a then living child of mine, the Trustee shall quarterly pay to or for the benefit of such child all of the income and so much of the principal of said Trust as, in the discretion of the Trustee, may be necessary to maintain such child in the proper station in life, including proper support, maintenance, medical care and college or higher education. Upon such child's attaining the age of thirty (30) years, the Trustee shall pay to such child one-half (1/2) of the then principal. Upon such child's attaining the age of thirty-five (35) years, the Trustee shall pay to such child the balance of the then principal. Page 3 Should such child die before final distribution of the assets of the Trust, but be survived by then living issue, the Trustee shall quarterly pay the net income from said Trust to or for the benefit of said issue, per stirpes, living at each time of quarterly distribution; as soon as any one of said issue attains the age of twenty-one (21) years, and in no event later than twenty (20) years following the death of my child, the Trustee shall pay over all of the then assets in the Trust to the then living issue of such deceased Child, per stirpes. Should such Child die before final distribution and not be survived by then living issue, the provisions of subparagraph (g) herein shall obtain. (e) In each Trust established for the benefit of the issue of a deceased child of mine, the Trustee shall quarterly pay the net income to or for the benefit of the issue of such deceased child, per stirpes, living at each time of quarterly distribution; as soon as any one of said issue attains the age of twenty-one (21) years, and in no event later than twenty (20) years following the death of the survivor of my husband and me, the Trustee shall pay over all of the then assets in the Trust to the then living issue of my deceased child, per stirpes. (f) If at any time before final distribution of the assets of any of the Trusts established for my children or issue of deceased children, there are no living beneficiaries of said Trust, the Trust shall terminate, and its assets shall be added to the other then existent Trusts created herein for the benefit of my children or their issue. Provided, that if any of said Trusts herein created has previously been terminated by payment of its principal to its beneficiaries, said beneficiaries who received payment of the principal of that Trust shall collectively be considered an "existent Trust" for the purposes of this paragraph, and one equal share shall be paid directly to such beneficiaries in Page 4 the same proportion by which they received the principal of the Trust, or, if deceased, to their issue, per stirpes. (g) In the event that I am not survived by my husband or any issue, or in the event there are no issue of mine surviving upon the termination of any Trust, the principal shall be paid to the individuals set forth below in the following percentages: (i) Thirty-Five (35%) Percent to my mother-in-law, MARGARET MARY GALLIA, Old Forge, Pennsylvania; (ii) Thirty-Five (35%) Pement to my mother, ANTOINETTA PREATE, Old Forge, Pennsylvania; (iii) Fifteen (15%) Pement to my husband's sister, MRS. THOMAS LAZ, Canton, Massachusetts; (iv) Seven and One-Half (7.5%) Percent to my sister, MRS. THERESA SIEGEL, Easton, Pennsylvania; (v) Seven and One-Half (7.5%) Pement to my brother, DONALD PREATE, Old Forge, Pennsylvania. ITEM VI: The following provisions shall apply to "Trust B": (a) Trustee shall have, hold, manage, invest and reinvest the assets of this Trust, collect the income and beginning at my death pay over the net income Page 5 in quarterly installments to my husband, FRANK J. GALLIA, during his lifetime. The Trustee shall also, from time to time, pay to my husband such amounts of principal of this Trust, as the Trustee (other than my said husband) deems necessary for the proper support, maintenance and medical care of my husband. (b) The Trustee shall also, from time to time, pay to my husband so much of the principal of this Trust as my said husband may in writing request. (c) Upon the death of my husband, the Trustee shall convey and pay over all of the remaining assets, whether corpus or income, to or for the benefit of such person or persons or corporation or corporations, or the estate of my husband, in such amounts or proportions, and in such lawful interests or estates whether absolutely or in trust, as my husband may have directed, either by instrument filed with the Trustee during his lifetime exercising this Power of Appointment, or by his Last Will and Testament. This Power of Appointment shall be exemisable by my husband alone and in all events. If the above Power of Appointment is for any reason not validly exercised by my husband in whole or in part during his lifetime or in his Last Will and Testament, then upon his death such portion or all of the principal of this Trust or such interests and estates therein as shall not have been validly appointed by my husband shall be transferred to "Trust A" to be held, administered and distributed in accordance with the provisions of ITEM V of this Will. (d) If my husband should not survive me, then the provisions of "Trust B" shall be void, and principal which would have constituted the "Trust B" shall be added to "Trust A" to be disposed of in accordance with ITEM V of this Will. Page 6 ITEM VII: No part of the income or principal of the property held under any Trust created by this Will shall be subject to attachment, levy or seizure by any creditor, spouse, assignee or trustee or receiver in bankruptcy of any beneficiary prior to his or her actual receipt thereof. The Trustee shall pay over the net income and the principal to the parties herein designated, as their interests may appear, without regard to any attempted anticipation, pledging or assignment by any beneficiary under a Trust, and without regard to any claim thereto or attempted levy, attachment, seizure or other process against said beneficiary. ITEM VIII: In the settlement of my estate and during the continuance of the foregoing Trusts, the Executor and the Trustee shall possess, among others, the following powers: (a) To retain any investments I may have at my death, including specifically those consisting of stock of any bank even if I have named such bank as the Executor or Trustee herein, so long as the Executor or Trustee may deem it advisable to my estate so to do. (b) To vary investments, when deemed desirable by the Executor or Trustee, and to invest in such bonds, stocks, notes, real estate mortgages or other securities or in such other property, real or personal, as they shall deem wise, without being restricted to so-called "legal investments", and without being limited by any statute or rule of law regarding investments by fiduciaries. (c) In order to effect a division of the principal of a Trust or for any other purpose, including any final distribution of a Trust, the Executor or Trustee is authorized to make said divisions or distributions of the personalty Page 7 and realty, partly or wholly in kind, and to allocate specific assets among beneficiaries and Trusts created hereunder so long as the total market value of any share is not affected by such division, distribution or allocation in kind. Should it appear desirable to partition any real estate, the Executor or Trustee is authorized to make, join in and consummate partitions of lands, volumtarily or involuntarily, including giving of mutual deeds, recognizances or other obligations, with as wide powers as an individual owner in fee simple. (d) To sell either at public or private sale and upon such terms and conditions as the Executor or Trustee may deem advantageous to the estate or Trust, any or all real or personal estate or interest therein owned by the estate or Trust severally or in conjunction with other persons or acquired afte~ my death by the Executor or Trustee, and to consummate said sale or sales by sufficient deeds or other instruments to the purchaser or purchasers, co~aveying a fee simple title, free and clear of all trust and without obligation or liability of the purchaser or purchasers to see to the application of the purchase money or to make inquiry into the validity of said sale or sales; also, to make, execute, acknowledge and deliver any and all deeds, assignments, options or other writings which may be necessary or desirable in carrying out any of the powers conferred upon the Executor or Tmstee in this paragraph or elaewhere in my Will. (e) To mortgage real estate, and to make leases of real estate. (f) To borrow money from any party, including the Executor or Trustee, to pay indebtedness of mine or of my estate, expenses of administration or inheritance, legacy, estate and other taxes, and to assign and Page 8 pledge assets of my estate therefor. (g) To pay all costs, taxes, expenses and charges in connection with the administration of my estate or a Trust. (h) To make distributions of income and of principal to the proper beneficiaries thereof, during the administration of my estate, with or without court order, in such manner and in such amounts as my Executor deems prudent and appropriate. (i) To vote any shares of stock which form a part of the estate or Trust, and otherwise to exercise all the powem incident to the ownership of such stock. O) In the discretion of the Executor or Trustee, to unite with other owners of similar property in carrying out any plans for the reorganization of any corporation or company whose securities form a part of the estate. (k) To disclaim any interest in property which would devolve to me or my estate by whatever means, including but not limited to the following means: as beneficiary under a will, as an appointee under the exercise of a power of appointment, as a person entitled to take by intestacy, as a donee of an inter vivos transfer, and as a donee under a third-party beneficiary contract. (1) To do all other acts in their judgment deemed necessary or desirable for the proper and advantageous management, investment and distribution of the estate or Trust. Page 9 ITEM IX: Whenever and as often as any beneficiary hereunder, to whom payments of income or principal are herein directed to be made, shall be under legal disability, or, in the sole judgment of the Trustee, shall o~terwise be unable to apply such payments to his own or her own best interests and advantages, the Trustee may make all or any portion of such payments in any one or more of the t'ollowing ways: (a) Directly to such beneficiary; (b) To the Legal Guardian or Conservator of such beneficiary; (c) To the Trustee, or to another person selected b~g the Trustee, as custodian under the Pennsylvania Uniform Transfers to Minor~ Act as to a beneficiary under the age of twenty-one (21) years; (d) To a relative of such beneficiary, to be expended by such relative for the benefit of such beneficiary; or (e) By itsell expending same for the benefit of said beneficiary. ITEM X: Any person who shall have died at the same time as I shall have, or in a common disaster with me, or under such circsamstances that the order of our deaths cannot be established by proof, or wihhin thirty (30) days of my death, shall be deemed to have predeceased me. ITEM XI.: I hereby nominate, constitute and appoint my husband, FRANK J. GALLIA to be the Executor. My husband shall have the power to nominate and appoint a successor Trustee and Executor (individual or corporate) to serve upon his death or his Page 10 inability or refusal to serve as Executor and/or Trustee. In the event of the death or inability or refusal to serve of my said husband prior to his appointment or nomination of a successor Executor and/or Trustee, I nominate, constitute and appoint GARRETT F. GALLIA and LIZA L. GALLIA, to be the successor Executors and Trustees. GARRETr F. GALLIA and LIZA L. GALLIA, or the survivor of them, shall have the power to nominate and appoint a successor Trustee and Executor (individual or corporate) to serve upon their death or inability or refusal to serve as Executor and/or Trustee. In the event of the death or inability or refusal to serve of said successor Executors and/or Trustee prior to their appointment or nomination of a successor Executor and/or Trustee, I nominate, constitute and appoint RONALD W. WALBORN to be the successor Executors and Trustees. The Executor, Trustee and Guardian am specifically relieved from the duty or obligation of filing any bond or other security. IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, consisting of this and the preceding ten (10) pages, at the end of each page of which I have also set my initials for greater security and better identification this ~ day of ~, 1995. BEATRICE P. GALLIA We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above-named Testatrix as and for her Last Will and Testament, in the presence of us, who, at her request and in her presence and in the presence of each other, have hereunto set our hands and seals the day and year first above written, and we certify that at the time of the execution thereof, the said Testatrix was of sound and disposing mind and memory. (SEAL) (SEAL) l ?06. , ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF ) I, BEATRICE P. GALLIA, Testatrix, whose name is signed to the attached or foregoing 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. BEATRICE P. GALLIA Sworn to and subscribed before ~7 Notary Public/ My Commission Expires: (SEAL) AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF ~~ SS: We, ~¢A~tcb t~ ~ {:?].-x , ~"~ ~C'C~ ~d ~F~ ~ ~ ~ /~ , ~e Wi~esses whose n~me~ a~igned to the a?ched or foregoing instrument, being duly quaSfied according to law, do depose ~d say ~at we were present ~d saw TesmMx, BEATRICE P. GALL~, sign ~d execute ~e ins~ment ~ her L~t Will ~d Testament; ~at Tes~ signed willingly and that she execu~d s~d Will as her free ~d volunm~ act for the purposes ~erein expressed; ~at each of us M ~e he~ng and sight of the Tesm~ signed ~e Will ~ Wimesses; and ~at to ~e best of our ~owledge the TesmMx w~ at that time eighth (18) or more years of age, of sound mind and under no constant or undue influence. Wimess , Wime~s Witness ~ Sworn to and subscribed before me this ~5/?'/t day of ~ ,19~. Y Notary Public My Commission Expires: (SEAL) Page 1 of 1 Detailed Results for Parcel 10-19-1598-039. DistrictNo 10 Parcel_ID 10-19-1598-039. MapSuflix HouseNo 181 Direction E Street LAUER LANE Ownerl GALLIA, BEATRICE P Owner2 PropType R PropDesc LivArea 3367 CurLandVal 55650 CurlmpVal 300110 CurTotVal 355760 CurPrefv'al Acreage 0.56 CIGrnStnt TaxEx 1 SaleAmt I SaleMo 6 SaleDa 22 SaleCe 19 SnleYr 95 DeedBkPage 00123-01126 YearBIt 1970 HF File Date HF_Approval_Stntus in the 2000 Tax Assessment Database http://taxdb.ccpa.net/details.asp?id= 1 O- 19-1598-039.&dbselect=O 8/20/2004 Date of Death: 12/03/2003 Valuation Date: 12/03/2003 Processing Date: 08/23/2004 Shares Security or Par Description Sigh/Ask Low/Bid Estate of: Gallia. Beatrice Account: File No. 12003-0001 Report Type: Date of Death Number of Securities: 2 File ID: gallia.bea.estate Mean and/or Div and Int Security Adjustments Accruals Value 1) 2) 45 GENERAL ELEC CO (369604103) COM New York Stock Exchange 12/03/2003 40 MICROSOFT CORP (594918104) COM NASDAQ - Industrial 12/03/2003 29.70000 29.32000 S/L 26.07000 25.62000 S/L 29.510000 1,327.95 25.845000 1,033.80 Total Value: Total Accrual: Total: $2,361.75 $0.00 $2,361.75 Page 1 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.0.4) NEILL Funeral Home Inc. January 27, 2004 Dr. Frank Gallia 181 E Lauer Lane Camp Hill, PA 17011 This is an itemized bill for the funeral of: Beatrice P. Gallia PROFESSIONAL SERVICES AND MERCHANDISE SELECTED Complete Traditional Service ........................ Hairdressing / Color ............................... Additional Transportation ........................... Flower Sales ..................................... Z64 699 IDH VENETIAN BRONZ ..................... Sub - Total $ CASH ADVANCES Death Certificate .................................. $ Honorarium ...................................... Musician/Vocalist ................................. Patriot News ..................................... Altar Service ..................................... Sub - Total $ Total Funeral Charges $ Payment Received $ 3,495.00 75.00 200.00 795.00 7,995.00 12,560.00 30.00 200.00 175.00 210.90 20.00 635.90 13,195.90 (12,115.00) Balance Due on Account (Due date: 01/05/2004) Ref No.: 1002314 $1,080.90 3401 Market Strcel Camp Hill, PA - 1701 ] -4428 tel 7] 7 737-8726 fax 717 73%]859 3501 Dcrry Stred Harrisburg, PA - ]7] ] D1817 tel 717 564-2633 fax 717 561-9918 Member of ALDERWOODS Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of Beatrice P. Gallia No. 21-2003-1024 also known as late of Hampden Township, Cumberland County, PA , Deceased Date of Death December 13, 2003 Social Security No. 171-36-6238 Personal Representative(s) of the above Estate, deceased, vedfy that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedenrs death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. INVe vedfy that the statements made in this Inventory are true and correct. INVe understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: James A. Ulsh, Esquire I.D. NO.: 10169 Address Telephone: /717) 232-5000 3401 N. Front St., PO Box 5950, Harrisburg, PA 17110 Personal Representative:  ra~l~k J. Gallic, ~(ec. u,,fto: Dat~: DESCRIPTION Real Property: Real estate situate in Hampden Township, Cumberland County, PA, known as 181 E. Lauer Lane; tax parcel number 10191598039. Personal Property: 45 sharas of common stock in General Electric Co. at $29.51 per share 40 shares of common stock in Microsoft Corp. at $25.845 per share Commerce Bank Checking Account #0512074733 Commeme Bank Savings Account #0616068848 Janney Montgomery Scott Money Market Acct. #HB23 3521-5896 2002 Mercedes SLK TOTAL 373,548.00 1,327.9~ 1,033.80 1,910.30 9,294.34 4,059.40 36,000.00 427,173.79 VALUE Attach Additional Sheets If Necessa¢'(/ 405346vl NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVTSZON DEPT. 280601 HARRISBURG, PA 17118-0601 JAMES A ULSH ESQ METTE ETAL PO BOX 5950 L~:. Hag PA COMMONHEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOT/CE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR D/SALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-15¢7 EX AFP (02-05) DATE 11-01-ZOOq ESTATE OF GALLIA DATE OF DEATH 12-05-2005 F/LE NUMBER 210$-lOZq COUNTY CUMBERLAND ACN 101 I Aeoun~ Reei~ed BEATRICE P MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF NTLLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THZS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF ZNHERZTANCE TAX APPRAISEMENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF GALLIA BEATRTCE P FILE NO. 21 05-102q ACN 101 DATE 11-01-200q TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATION CONCERNING FUTURE ZNTEREST- SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~e (Schedule A) (1) 2. S~ocks end Bonds (Schedule B) (2) 3. Closely Held S*ock/Par~nershLp Zn*eres* (Schedule C) q. Mor~gages/No~es Rece/veble (Schedule D) (q) S. Cash/Bank Deposi~s/H/sc. Personal Proper*y (Schedule E) 6. JoLn~ly Owned Proper~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To'al Asse~s APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adc. Costs~Misc. Expenses (Schedule H) (9) 10. Deb~$/Hor~gege L/ab/1/~/es/Llens (Schedule Z) (10) 11. To,al Deduc~/ons Ne* Value of Tax Re*urn 375~5q8.00 2~$61.75 .00 .00 51;26q. Oq .00 NOTE: To /nsure proper credi~ ~o your account, subeL~ ~he upper por*Lon of ~h/s fore w/~h your ~ex payment. 27,9q2.q2 .00 (11) 27.942. qZ (12) qOO,83q.5q 15. 1fi. NOTE: ASSESSMENT OF TAX: 15. Aeoun~ of L/ne lq a~: Spousal ra~e 16. Amoun~ of L/ne lq ~axable a~ L/heal/Class A ra~e 17. Aeoun~ of L1ne lq e~ Sibllng re~e 18. Aeoun~ of Line lq ~axable a~ Collateral/Class B ra~e 19. Princ/pal Tax Due TAX CREDITS PAYMENT RECETpT DT$COUNT DATE NUMBER ]:NTEREST/PEN pATD (-) 05-05-200q CD0036~7 ~50.92 ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. (15) 200,q25.26 x O0 = .00 (16) 200,q09.28 x Oq5 = 9,018.q2 (17) . O0 x 12 = . O0 (~8), .00 x 15 = .00 (19)= 9,018.q2 AMOUNT PAZD 8,750.00 TOTAL TAX CREDIT BALANCE OF TAX DUEI INTEREST AND PEN. TOTAL DUE Chari~cable/Governeen~:al Bequest:s; Non-elec~ced 911:5 Trusts (Schedule J) (1:5) . O0 Ne~c Value of Es~:a~:e Sub.~ec~ ~co Tax (lq) Zf an assessment was ~ssued previously, l~nes :Lq, :15 and/or ~6, :17, :18 and :19 reflect f~gures that ~nclude the totaZ of ALL returns assessed to date. 9,200.92 182.50CR .00 182.50CR ( 1F TOTAL DUE ZS LESS THAN $1, NO PAYMENT 15 REQUIRED. IF TOTAL DUE ZS REFLECTED AS A "CREDIT- (CR), YOU NAY BE DUE A REFUND. SEE REVERSE S~DE OF THIS FORM FOR INSTRUCTIONS.) lz605.17 (8) q28,776.96 RESERVATION: PURPOSE OF NOTICE: PAYHENT: REFUND (CR): OBJECTIONS: ADNZN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 12, 1981 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (71 P.S. Section 9140). Detach the top 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 NILLS, AGENT A refund of a tax credit, ahich was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISiS). Applications are available at the Office of the Register of Hills, any of the 23 Revenue District Offices, or by calling the special Z4-hour ansearing service for forms ordering: 1-800-562-Z050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3010 (TT only). Any party in interest not satisfied with the appraisement, a11oeanca, 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. 261011, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17118-0601 Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decadant's death, a five percent (SZ) discount of the tax paid is allowed. The leg 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, 1981 bear interest at the rate of six (6X) percent per annum caZcuIated at a daily rate of .000164. All taxes ahich became delinquent on and after January 1, 1981 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 1981 through ZOOq are: Interest Daily Interest Daily Interest Year Rate Factor Year Rate Factor ~ 201 .0005q8 ~-~'8-1991 11Z .000301 1983 16Z .OOOq38 1992 9Z .000147 1984 11Z .000301 1993-199fi 71 .000191 1985 131 .000356 1995-1998 9Z .OOOZfi7 1986 101 .00027~ 1999 71 .000191 1987 101 .000174 ZOO0 7Z .000191 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID Daily Year Rate Factor ~ 9Z .000247 ZOOZ 6Z .000164 2003 5Z .000137 2004 4Z .000110 X NUI~BER OF DAYS DELZNI;IUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent wiX1 reflect an interest calculation to fifteen (1S) days beyond the date of the assessment. Xf payment is made after the interest computation date shown on the Notice, additional interest must be caXculated. BUREAU OF INDIVI~;'~'X~'i (ii'Cll'::: n': INHERITANCE TAX DIVIS!-QN-"'..J'-"~,!, ,-.,'i ' tl'-..'L \.J PO BOX 280601 t j (\ HARRISBURG~ PA 17128-lJi6I1I- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV-U07 EX AFP [09-041 CI..Eflf\ OP?H,'~',,>,!',S JAMES iC!U'l!sH ESQ' METTE ETAL PO BOX 5950 HBG PA 17110 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 12-13-2004 GALLIA 12-03-2003 21 03-1024 CUMBERLAND 101 BEATRICE P 7rrc, If'; Il..- P-'I",- :',: 39 ..." >.J,.' ,", ,- I. . ~. Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this for.. with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ~~:r&~,r.l5r.A~J..rGl~.6!~...........:rA~!fA~e1r"fA5r.!'A~~.O".A~l:60Jrr...ii...................... ESTATE OF GALLIA BEATRICE P FILE NO.21 03-1024 ACN 101 DATE 12-13-2004 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHEO ESTATE. SHOWN BELOW IS A SUHMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-01-2004 PRINCIPAL TAX DUE:. 9,018.42 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-03-2004 CD003637 450.92 ~ 8,750.00 11-22-2004 REFUND .00 182.50- TOTAL TAX CREDIT 9,018.42 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, see REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A ..CREDIT" (CR).. YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ] '\l..s.~