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Home My WebLink About03-0958 Social SeCUrity No.-. 1 81 - 22 - 2 ~ 0 feceased' The petition of the undersigned respectfully represents that: Your petitioner($~, who is/al~.,~ 8 years of age or older an the execut or in the last will of the above decedent, dated Auqus t 1 9, :amkx~~d PETITION FOR PROBATE and GRANT OF LETTERS Estate of Rosemarie A. Cronin NO. ~:~ l- ~,~' q~ also known as To: Register of Wills for the County of Cumberland ~ommonwealth of Pennsylvania in the ,19n~n~ed h (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumber 1 a nd County, Pelaosylvania, with _ _ er last family or principal residence at 7 Gale Circ!ee Camp Hill, PA 17031 .. East Pennsboro Township (list street, number and muncipality) Decendent, then 73 years of age, died October 16 ~ 2003 at Holy Spirit Hospital, East Pennsboro Township, Cum'6erland'Co., Except as follo%vs, 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: none Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (If not.domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in, Pa.) -Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: 75,000.00 PA WHEREFORE, petitioner(~) respectfullyffequ, est(s) tile probate of the last will presented herewith and the grant of letters. ~:esEamenEary theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) /{ . ' 1 400 ~h'~/tham Road Camp Hi-il, ~ 17011 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERL/~Dy sS The petitioner(~t 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(~ and that as personal represen- tative(X) of the above decedent petitioner(s~ will well and truly administer the estate according to law. Sworn to or affiF~e~ and subscribed { before me this day of ~ ~ovember ~ L~_2Jl{13 % '~~~egister No. c~J- 0~) -' q..~ Estate of~~~ ~ (~ ~~ t , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated ~- lc? - lc?c/c/ described th~erein be a~to probate and fried of record as the last will of and Letters are hereby granted , in consideration of the petition on FEES Probate, Letters, Etc .......... Short Certificates( ) .......... ~ionV,~.c~.. ~:~,~.. TOTAL Filed ~.z .~.~..~ ~. ~% ................. Richard L. Placey 07232 ATTORNEY (Sup. Ct. I.D. No.) 3631 N. Front Street Harrisburg, PA 17110-1533 ADDRESS (717) 236-9577 PHONE his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded t~ the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Local Registrar P 9648713 0Or 18200:1 No. ~ Date 05143 Rev. 2/87 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH * VITAL RECORDS CERTIFICATE OF DEATH AGE(LasIB~.ay) ~ UNDER1YE~ UNDERIQAY DATE OF BIRTH BIRTH~CE ":' ~ L ~ ' [" 181 2~ 2302 {'.(~lObf'~ M~s Days Houm I Mnues I ~th, Day Year) ~ Sae~F~e~n~un~) IHOSPIT~: OTHER' COUNt•F DEATH I C]~ BORn ~ ......... '- r- ~. J ~ ~ " ~ spm~ ~ I ~ . --.., ..~ ur u~/m ~ACILI~ ~ME (if not ins~tu~n, give str~ and numar) ]WAS DECEDENT OF HISP~IC ORIGIN? I ~CE - ~n thdmn. Slack, W~ta, DECEDENTS USUAL OCCUPATION I KIND OF BUSINESS INDUSTRY~MAe nc~c ........... z I ~, I 10. ~l~ L~ DECEDENT'S MAILING ADDRESS (Street, City/Town, State, Zip Code) J DECEDENT'S · IACTUAL 1?a-BIBle PR Did 17=.~] Yes. decadentlivadin E~st Pennsboro 7 Gale Circle iRESiDENCE decadent twp. · I (See instructions 16. Ccmlp Hlll,Pa 17011 livein, No. dec~.~t~,ad o. other ~e) ~7~. Cou.~ CLlnber].and ~ow.~p? ~?d. [] .,t~in sc~ust,r~,s oi I ~ FATHER'S NAME (First. Middle, Last) clty/b(xo. I MOTHER*S NAME (First. Mlddid, Maiden Surname) I~NFORMAN~'SNAME {Typ.~ph,~) I~g. Ol'ive B~qJOe j =0.~ohn C o Cron±n I~.FoR~s MAILING ADDRESS (Street, City/Town, State, Zip Code) J=0~. 7 c~!e e~r~_.le C,-.iip H~]i, Pa 170~1 03 1-113,~ I,=.Gate Cemetery I~',. Mechan±csburg, pe 17055 a -- Oth~ 21a, e (Specify) . 20, 2003 O~ Heaven /G AS SUCH / LICENSE NUMBER22b. 011654-r, ~ NAME AND ADDRESS OF FACILITY2 ~9n~ ,-u=-~-~- .... ~--'~,~- .... " .......... I L,CENSE NUMBER ~D^TE SmED I I (Mo~th, Day, Year) · 23b. 23c pleted by TiME OF DEATH I DATE PRONOUNCED DEAD (Month, Day, Year) I WAS CASE REFERRED TO A MEDICAL EXAM{NER/CORONER? d~eese or co•diem & q.F./ ,, resulting in death) --~e. a. j'~/l~ q..~ 4' ' : onset and debt, Sequentially list co.did•ns b. DUE TO (OR AS A CONSEOUENC~:~=): / cause. Enter UNDERLYING t CAUSE (Disease o,- inju~/ c. resulting on death ) LAST d. PERFORMED?WAS AN AUTOPSYI°"°FcA•SKIAVAILABLE PRIOR/•WERE AUTOPSY FINDINGS INatura'l MANNER OF DEATH[] Homicide E]II(DA~E ..... DO~ INyeJ~Ry I TiME OF NJURy*B I INJURY AT WORK? I DESCRIBE HOW N JURY OCCURRED Yes[] NO[]I Y''I--I "oD Is.~. [] Could not be detarminad 0~ 13Ob.__ = 3Oc. 30d. · ERTIFYING PHYSICIAN (Physician ce~ify' cause of dealh wh n ' - ... TIT CERTIFIER ~otheb~,tofmyknowl~g. de.th occu~mged due to the .... ee.'=°~nthc~gl~aa~Y~'ermtallnha-sprgn°unceddea h aodc°mpietadltem 23) -- ~ 'PRONOUNCING AND CERTIFYING PHYSICIAN (Physician both pronouncing death and •ratifying to cause of death) I LICENSE NUMBER J DATE SIGNEDi(MonU~,Da¥, Year) 'MEDICAL EXAMINERJCORONER NAME AND ADORE.SS OF PERSON WHO CO~PLETE[~ C,~[JSE O~ D~TH OnthlballlolaslmlnalloRand/orlnvesBga~lon, lnmyoplnion, dea~h ...... d st the time, data, andpI ..... dduetoth ....... (s and (ltem27)Typ~orPnn! /0~- ~.~'~1 3~ ~.ma..~r ee .tal~d ................................................................. ~ ................................................................................... [] R EGISTRA~~~ 32. LAST WILL AND TESTAMENT OF ROSEMARIE A. CRONIN I, ROSEMARIE A. CRONIN, now of Camp Hill, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament and hereby revoke all prior Wills and Codicils made by me. ITEM I. I direct that all of my just debts and funeral expenses, including the cost of my gravemarker, if any, shall be paid from my residuary estate as soon as practical after my decease as a part of the administrative expenses of my estate. ITEM II. I give and devise all of my estate of every nature and wherever situate to my son, DALE E. STIPE, or his issue, per stirpes. ITEM III. If any income or principal shall be payable to any person who shall be under the age of twenty-five (25) or who shall be incapacitated for any reason, my personal representative, as trustee, shall hold such income and principal and shall apply such income and principal to the health, maintenance, support and education of such person until age twenty-five (25) or during incapacity, without the appointment of any guardian or committee or any authority of court, and shall be entitled to make direct application hereunder or to make application by payment thereof to the parent or other person in charge of such person, or to his or her guardian or to a custodian under the Uniform Transfers to Minors Act, or to the person. Any remaining income and principal to which such person shall be entitled shall be paid and distributed to such person upon attaining age twenty-five (25) or termination of incapacity. ITEM IV. I appoint my son, DALE E. STIPE, Executor of this my Last Will and Testament. Should he fail to qualify or cease to act in such capacity, I then appoint my husband, JOHN C. CRONIN, Contingent Executor of this my Last Will and Testament. No bond shall be required by my personal representative in any jurisdiction. ITEM V. In addition to the powers given by law to my personal representative(s) and trustee(s) [hereinafter fiduciaries] in the administration of my estate and of any trust(s) created herein, they shall have the following discretionary powers applicable to all real and personal property held by them, including property held for minors, effective without court order until actual distribution. A. To retain any property owned by me at my death and to invest any funds held by them in any stocks, bonds, notes or other securities or property, real or personal, including common trust funds, mutual funds and money market deposit accounts operated or offered by my corporate trustee, if any, or any affiliate of it. B. To sell or otherwise dispose of any property, real or personal, at any time forming a part of my estate or the trust estate, for cash or upon credit, in such manner and on such terms as they see fit, and no one dealing with the fiduciaries shall be bound to see to the application of any monies paid. 2 ~afie A. Cronin ~ C. To manage, operate, repair, improve, mortgage or lease for any term [even if beyond the duration of the trust(s)] any real estate at any time held or owned by them as fiduciaries. D. To hold investments in the name of a nominee and exercise and dispose of warrants. E. To engage in litigation and compromise, arbitrate or abandon claims and property. F. To conduct any business in which I am engaged or in which I have an interest at the time of my death for such period as the fiduciaries deem advisable, with the power to borrow money and to pledge the assets of the business and to do all other acts which I, in my lifetime, could have done, or to delegate such powers to a partner, manager or employee without liability for any loss occurring therein. G. To allocate items of receipt or disbursement between principal and income as the fiduciaries deem equitable regardless of the character given such items by law; to distribute in cash or kind or partly in each at valuations fixed by the fiduciaries. H. To borrow money, including the right to borrow from any corporate trustee, if any, and to mortgage or pledge as security or to hold its own stock if a corporate trustee. I. To join in any merger, reorganization, voting trust plan or other concerted action of security holders, and to delegate discretionary duties with respect thereto. J. Should the principal of any trust herein provided for be or become too small in tmstee's opinion so as to make establishment or continuance of the trust inadvisable, my trustee(s) may make immediate distribution of the then remaining principal and any accumulated or undistributed income -~os~e,,~arie A. Cronin outfight to the person or persons and in the proportion they are then entitled to income. Upon such termination, the fights of all beneficiary(ies) who might otherwise have an interest as succeeding income beneficiary(ies) or in remainder shall cease. K. In general, to exercise all powers in the management of the assets of my estate or the trust estate which any individual could exercise in the management of similar property owned in his own right, upon such terms and conditions as the fiduciaries may deem best, and to execute and deliver all instruments and to do all acts which the fiduciaries may deem necessary or proper to carry out the purposes of this will or any trust(s) created herein. L. To apply income or principal to which any beneficiary is entitled, directly for his or her comfort, maintenance and support, should the fiduciaries deem such beneficiary incapable of receiving the same by reason of age, illness, infirmity or incapacity, or to pay the same to such person or persons as the fiduciaries select to disburse it, whose receipt shall be a complete acquittance therefore without the intervention of any guardian. M. To assume continuance of the status of any beneficiary with reference to death, marriage, divorce, illness, incapacity or other change in the absence of information deemed reliable without liability for disbursements made on such assumptions. N. All principal and income shall, until actual distribution to any beneficiary, be free of the debts, contracts, alienations and anticipations of any beneficiary, and the same may not be liable for any levy, attachment, execution or sequestration while in the hands of any beneficiary, and the 4 Ros~narie A. Cronin same may not be liable for any levy, attachment, execution or sequestration while in the hands of any fiduciaries. of IN WITNESS WHEREOF, I have hereunto set my hand and seal this / ~ -- day ~td £/¥ ? ..... ,1999. e A. Cronin ~ The preceding instrument, consisting of this and four other typewritten pages, identified by the signature of the testatrix, as on the day and date thereof signed, published and declared by Rosemarie A. Cronin, the testatrix3t, h. erein name~d,.ars and for her last Will, in the presence of us, who, at her request, in her presence aj;/d ~ t~6Sen~ oflf each other, subscribed our names as witnesses hereto. / 5 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA: · SS. COUNTY OF DAUPHIN : I, ROSEMARIE A. CRONIN, 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, that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. Roserharie A. Cronin - ' testatrix, this Swor~r affirmed to and~cknowledged,,before me, by Rosemarie // q day of .,~/, ~, c_,/_fig- ,1999. A. Cronin, ' ~ N~taryPublic My Commission Exl~es: NOTARIAL SEAL ] HOLLY S. KIRK, Notary Public AFFIDAVIT I Harrisburg, Dauphin County ]My Commission Expires Feb, 15 2003 COMMONWEALTH OF PENNSYLVANIA: · SS· witnesses whose names are signed to the a~ached or foregoing instrument, being duly~ualified according to law, do depose and say that we were present and saw testatrix sign and execute the instrument as her last Will; that she signed willingly and that she executed it as her free and volunm~ act for the pu~oses therein expressed; that each of us in the hea$ing a~sight_~ the testatrix signed the Will as witnesses; and that to the ~st of our ~owle~ th~eshtrix w~m that time 18 or more years oeag~, ofsou.a mind and under no con~Vn~fid~in~n~~- Sw°rn t° and subscribed bef°re me this-/ V day °f J. Harrisburg, Dauphin County My Commission Ex ' ommiss~on Ex~ires F~b. 15, 2003 LAST WILL AND TESTAMENT OF ROSEMARIE A. CRONIN Richard L. Placey, Esquire LAW OFFICES 200 NORTH THIRD STREET POST OFFtC~ BOX ~ HARRISBURG, P~NNSYLV~IA 1~10~-0099 (717) 236-9577 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Adtninistration No.: Rosemarie A. Cronin October 16, 2003 2OO3-0O958 To the Register: I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court Rules was given to the following beneficiaries set forth on the attached list on November 20, 2003. Notice has now been given to all persons entitled thereto under Rule 5.6(a). ~~ ey t~oPr ~~lta;eeYE,s tEa~eqUlre 3631 North Front Street Harrisburg, PA 17110 (717)236-9577 Date: November 20, 2003 ESTATE OF ROSEMARIE A. CRONIN NOTICE GIVEN TO: Dale E. Stipe 1400 Chatham Road Camp Hill, PA 17011 John C. Cronin 7 Gale Circle Camp Hill, PA 17011 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ~3UREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003430 PLACEY RICHARD L ESQ 3631 NORTH FRONT STREET HARRISBURG, PA 17110-1533 ........ fold !ESTATE INFORMATION: FILE NUMBER: DECEDENT NAME: DATE OF PAYMENT: POSTMARK DATE: COUNTY: CUMBERLAND DATE OF DEATH: 1 O/16/2003 ACN A~ SSESSMENT CONTROL NUMBER ~ 101 SSN: 1 2103-0957 CRONIN ROSEMARIE A 01 / 12/2004 00/00/0000 AMOUNT $4,200.00 REMARKS: TOTAL AMOUNT PAID: $4,200.00 SEAL CHECK# 1 O04 INITIALS: AC RECEIVED BY' GLENDA FARNER STRASBAUGH DEPUTY REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ¢JUREAU 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 003462 PLACEY RICHARD L ESQ 3631 NORTH FRONT STREET HARRISBURG, PA 17110-1533 fold ESTATE INFORMATION: SSN: 181-22-2302 FILE NUMBER: 21 03-0957 DECEDENT NAME: CRONIN ROSEMARIE A DATE OF PAYMENT: 01 / 12/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 10/16/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $4,200.00 TOTAL AMOUNT PAID: $4,200.00 REMARKS: SEAL CHECK# 1004 INITIALS: AC RECEIVED BY: GLENDA FARNER STRASBAUGH 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. REV-1162 EX(11-96) CD 0O3464 PLACEY RICHARD L ESQ 3631 NORTH FRONT STREET HARRISBURG, PA 17110-1533 ........ fold ESTATE INFORMATION: SSN: 181-22-2302 FILE NUMBER: 2103-0958 DECEDENT NAME: CRONIN ROSEMARIE A DATE OF PAYMENT: 01/21/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 1 O/16/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $4,200.00 REMARKS' TOTAL AMOUNT PAID: RICHARD PLACEY, ESQ $4,200.00 SEAL CHECK//1004 INITIALS: AC RECEIVED BY: GLENDA FARNER STRASBAUGH DEPUTY REGISTER OF WILLS REGISTER OF WILLS REV-1500 EX (6 00} COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 _ 03 0958 COUNT'( CODE YEAR NUMBER Ltl O X DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) CRONIN, Rosemarie A. DATE OF DEATH (MM-DD-YEAR) 10/16/2003 I DATE OF BIRTH (MM-nD-YEAR) 12/15/1929 SOCIAL SECURITY NUMBER 181-22-2302 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER John C. Cronin r~1. Original Return E~4. Limited Estate [~]6. Decedent Died Testate (Altach copy olWill) ~'~9. Litigation Proceeds Received ~'J2. Supplemental Return [~4a. Future Interest Compromise (date of death after 12-12-82) '-"] 7. Decedent Maintained a Living Trust (Attach copy of Trust) []10. Spousal Poverty Credit (dale of death between 12-31-91 and 1-1-95) --]3. Remainder Return (dale of death prier to 12-13-82) ['--~ 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes [~11. Election to tax under Sec. 9113(A)(A,ach Sch OI THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME I COMPLETE MAILING ADDRESS Richard L. Placey, Esquire I 3631 Nodh Front Street FIRM NAME (~f Applicable) Placey & Wright Harrisburg, PA 17110-1533 TELEPHONE NUMBER (717) 236-9577 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Modgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Properly (Schedule F) (6) --] Separale Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Properly (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Modgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 0.60 .... 0.00 53,442.07 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) 109,132.03 18,094.88 0.00 (11) 18,094.88 (12) 91,037.15 (13) 0.00 (14) 91,037.15 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .0 (15) 16. Amounl of Line 14 taxable at lineal rate 91,037.15 x .0 45 (16) 0.00 4,096.67 O.00 0.00 17. Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 20. [] 4,096.67 > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH Decedent's Complete Address: ISTREETADDRESS I '~'~'~"'~ I STATEpA Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Povedy Credit B. Prior Payments C Discount 0.00 4,200.00 204.83 InterestJPenalty if applicable 0.00 D. Interest E. Penalty 0.00 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 If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (1) Total Credits ( A + B + C ) (2) Total Interest/Penalty ( D + E ) (3) (4) (5) (5A) (5B) Make Check Payable to: REGISTER OF WILLS, AGENT iqOtl 4,096.67 4,404.83 0.00 308.16 0.00 0.00 0.00 IF THE ANSWER PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the properly transferred; .......................................................................................... [] [] b. retain the dght 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 care? ...................................................................... [] [] If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. [] [] Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] [] Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ [] [] 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 know~edge and belief, it is true. correct and complete. DecleratK)n,~f preparer other than the per.so.,,oaJ, repr~f.,.~entative is based on all information of which preparer has any knowledge. SIGNAT0~ PERS N S E F lNG RETURN DATE Da e E St pe, Executor, cio Placel~ Wrict~ff~,"3631 N~'-~F'roja~ Street, Harrisburg, PA 17110-1533 SIGNATU~ oF'PREPARER 0'i:~ I~AN R~ ~AT~E - ...... DATE01/27/04 Richard L. Placey, Esquire, Placey & Wright, 3631 ~21"'Front Street, Harrisburg, PA 17110- 5 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 RS. {}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 RS. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 RS. §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. REV-1503 EX+ (6-98~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER ROSEMARIE A. CRONIN 21-03-958 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 6,240.40 $500.00 Series EE U.S. Savings Bonds (See valuations attached) TOTAL (Also enter on line 2, Recapitulation) $ 6,240.40 (If more space is needed, insert additional sheets of the same size) Savings Bond Calculator Page 1 of 1 10/2003 Up date Help Savin¢ Series Denomination Bonds $ 500 Serial Number Issue Date ti Bonds Total Price 11 $2,750.00 Serial Number Issue Date Series Denom D18557785EE 03/1989 EE $500 D18557669EE 02/1989 EE 500 D18557561EE 01/1989 EE 500 D18557456EE 12/1988 EE 500 D18557323EE 11/1988 EE 500 D18557206EE 10/1988 EE 500 D18557081EE 09/1988 EE 500 Dl1955353EE 08/1988 EE 500 Dl1955242EE 07/1988 EE 500 Dl1955131EE 06/1988 EE 500 ViewAll I << P,e,r Viewing Bonds 2-11 Total Interest $3,490.40 Issue Price Interest Value $250.00 $311.20 $561.20 250.00 311.20 561.20 250.00 311.20 561.20 250.00 311.20 561.20 250.00 311.20 561.20 250.00 322.40 572.40 250.00 322.40 572.40 250.00 322.40 572.40 250.00 322.40 572.40 250.00 322.40 572.40 Total Value $6,240.40 Interest Rate 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.O0% 4.00% 4.00% YTD ln~ $198. Next Final Accrual Maturit3 03/2004 03/201~ 02/2004 02/201c~ 01/2004 01/201[ 12/2003 12/201~ 11/2003 11/2011~ 04/2004 10/201~ 03/2004 09/201~ 02/2004 08/2011~ 01/2004 07/201 ~ 12/2003 06/201 ~ Note Description NI Not Issued NE Not Eligible for Payment P5 Includes 3-month interest penalty ME Matured (Exchangeable for HH) MN Matured (Not Exchangeable for HH) Please rate this service. (Please print and/or save this page before submitting your survey) Service Excellent Good Fair Poor Savings Bond Calculator Submit Survey I Reset http://wwws.publicdebt.treas.gov/BC/SBCPrice 1/6/2004 REV-1508 EX+ (6-98) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ROSEMARIE A. CRONIN SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-03-958 ITEM NUMBER 1. Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. DESCRIPTION M&T Bank Certificate of Deposit 31003910394912 Principal - $3,762.57 Interest - $ 6.14 M&T Bank Certificate of Deposit 31003910394938 Principal - $2,964.77 Interest - $ 2.84 PNC Bank Checking Account 5140062142 Principal- $12,933.03 Interest - $ .53 PNC Bank Savings Account 5003148548 Principal - $29,774.64 Interest - $ 5.04 Miscellaneous Personal Effects (See bank letters attached) TOTAL (Also enter on line 5, Recapitulation) $ VALUE AT DATE OF DEATH 3,768.71 2 967.61 12,933.56 29,779.68 NO VALUE 49,449.56 (If more space is needed, insert additional sheets of the same size) M&T Bank 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-! 2 Placey & Wright Attorneys At Law 3631 North Front Street Harrisburg, PA 17110-1533 Phone (302) 934-2909 F ax (302) 934-2955 December 15, 2003 Re: Estate of Rosemarie A Cronin Social SecuriW: 181-22-2302 Date of Death: October 16, 2003 Dear Sir or Madam: Per your inquiry dated November 19, 2003, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Account Number Ownership (Names oJ) Opening Date Balance on Date of Death Accrued Interest Total 2. Type of Account Account Number Owners,hip {7games Opening Date Balance on Date of Death Accrued ]nterest Total Certificate of Deposit 31003910394912 Rosemarie A Cronin 07/21/99 $3,762.57 $ 6.14 Certificate of Deposit 31003910394938 Rosemarie d Cronin 08/25/99 $2,964. 77 $ 284 For further account information, closures and/or reimbursement of funds please call the West Shore Office at #717-737-2308. Please be advised, there was no safe deposit box found for the above decedent. Sinc~erely, ~ Records Management PNCBA ~anuao.' ~ 2003 Richard L. Placey 3631 North Front $~reet Harrisburg, PA 17110-1533 Estate ef Rosemarie A. Cronin, deceased SSN: 181-22-2302 DOD: 10/16/2003 Dear Mr. Place5,: k~ response to yom request for Date of Death balances for the castomer noted above, our records show the following: Che~ktag Account Account #$140062142 ROSEMAR_~ A CRONIN DOD balance: $12,933.03 ~- $.53 accrued inte~es; Established 06/01 / 1966 Savings Account Account #50031419545 ROSEMARI~ A CRONIN DOD balance: $29,774.64 + S5.0,* accrued interest Established i 1/0~2000 Please note tha~ this office only provides dine of death balances fer deposit acco,rots (IR.As, CDs, Checking and Savings ac, counts). We do not process any financial tran,action~ or provlde statements. If you ne~d asslsta~ce with any of these items, please tall 1-888-PNCBANK (1-888-762-2265) or stop by your local P.,NC i~uLk brancl~ office. Sincerely, Rachelle Wells 1-800-762-1775 P%PFSC-0q-F 500 first Ave IJitt~imrgh PA 15219 Member FDIC TOTAL REV-1510 EX+ (6-98~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER ROSEMARIE A. CRONIN 21-03-958 This schedule 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. DESCRIPTION OF PROPERTY ITEM iNCLUDETHE NAME OFTHE TRANSFEREE, THEIR RELATIONSHIPTO DECEOENTAND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBEE THE DATE OF TRANSFER. ATrACHACOPYOFTHEDEEDFORREALESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE VALUE 1. Principal Financial Group Annuity Contract No. 5310081. Beneficiary Estate of Rosemarie A. Cronin. Transferred October 16, 2003. 20,231.09 100% 20,231.C 2. Principal Financial Group Annuity Contract No. 5310083. Beneficiary Estate of Rosemarie A. Cronin. Transferred October 16, 2003. 33,210.98 100% 33,210.c. (See letter attached) TOTAL (Also enter on line 7 Recapitulation) $ 53,442.07 (If more space is needed, insert additional sheets of the same size) Financia/ Group December 2, 2003 Principal Life Insurance Company Princor Financial Services Corporation RICHARD PLACEY 3631 N FRONT ST HARRISBURG, PA 17110-1533 Annuitant- Rosemarie Cronin Contract No. 5310081-5310083 Dear Mr. Placey, Thank you for letting us know about the death of Rosemarie Cronin. We know this can be a difficult time and hope this letter will help explain the choices you have regarding this annuity contract. The beneficiary named to receive the settlement is Estate of Rosemarie Cronin. To receive benefits, the following are needed: · Complete the enclosed Beneficiary Statement form. · The date of death values for contract 5310081 is $20,231.09 and contract 5310083 is $33,210.98. However the claims will not be paid using the date of death values. The contracts are Variable Annuity contracts and the date of death value will be the value of the contracts or the "good order date" once all the correct paperwork has been received. If you have questions, please feel free to contact a Customer Service Representative at 800-852-4450, Monday through Friday, 7 a.m. to 7 p.m., CST. Sincerely, Rosie Thompson RIS Annuities Registered Representative - Princor 1-800-852-4450 x78965 Your representative David Edwards A827-00051 6717-4 The Principal Home Office: Des Moines, Iowa USA 50392-1770 (800) 852-4450 Securities offered through Princor Financial Serwces Corporation, member NASD and SIPC, Des Moines, IA 50392-0200 FAX (515) 248-9800 Principal Life and Princor are companies of the Principal Financial Group. REV-1511 EX+ (12-99~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF ROSEMARIE A. CRONIN FILE NUMBER 21-03-958 Debts of decedent must be reported on Schedule ITEM NUMBER 5. 6. 7. DESCRIPTION FUNERAL EXPENSES: Myers-Hamer Funeral Home Gate of Heaven 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 Fees Placey & Wright Family Exemption: {If decedent's address is not the same as claimant's, attach explanation) Claimant John C. Cronin Street Address 7 Gale Circle City Camp Hill State PA Zip 17011 Relationship of Claimant to Decedent Spouse Probate Fees Cumberland County Register of Wills Accountant's Fees Tax Return Preparer's Fees Prudential Insurance Company- premium due on policy Messiah Village - debt of decedent Shepherdstown Physicians o debt of decedent PARSE - debt of decedent Placey & Wright - reimb, of costs advanced Cumberland Law Journal - estate advertising - $75.00 Patriot-News Company - estate advertising 87.91 Cumb. Co. Registter of Wills - shod certificate 3.00 Reserve for future costs, taxes and expenses TOTAL (Also enter on line 9, Recapitulation) AMOUNT 8,306.00 700.00 0.00 2,500.00 3,500.00 155.00 1,017.50 378.00 20.00 352.47 165.91 1,000.00 $ 18,094.88 (If more space is needed, insed additional sheets of the same size) REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE BENEFICIARIES ESTATE OF ROSEMARIE A. CRONIN J FILE NUMBER 21-03-958 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Dale E. Stipe 1400 Chatham Road Camp Hill, PA 17011 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Son AMOUNT OR SHARE OF ESTATE Entire Estate 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 0.00 TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space is needed, insed additional sheets of the same size) LAST WILL AND TESTAMENT OF ROSEMARIE A. CRONIN I, ROSEMARIE A. CRONIN, now of Camp Hill, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament and hereby revoke all prior Wills and Codicils made by me. ITEM I. I direct that all of my just debts and funeral expenses, including the cost of my gravemarker, if any, shall be paid from my residuary estate as soon as practical after my decease as a part of the administrative expenses of my estate. ITEM II. I give and devise all of my estate of every nature and wherever situate to my son, DALE E. STIPE, or his issue, per stirpes. ITEM III. If any income or principal shall be payable to any person who shall be- under the age of 'twenty-five (25) or who shall be incapacitated for any reason, my personal representative, as trustee, shall hold such income and principal and shall apply such income and principal to the health, maintenance, support and education of such person until age twenty-five (25) or during incapacity, without the appointment of any guardian or committee or any authority of court, and shall be entitled to make direct application hereunder or to make application by payment thereof to the parent or other person in charge of such person, or to his or her guardian or to a custodian under the Uniform e A. Cronin - Transfers to Minors Act, or to the person. Any remaining income and principal to which such person shall be entitled shall be paid and distributed to such person upon attaining age twenty-five (25) or termination of incapacity. ITEM IV. I appoint my son, DA~LE E. STIPE, Executor of this my Last Will and Testament. Should he fail to qualify or cease to act in such capacity, I then appoint my husband, JOHN C. CRONIN, Contingent Executor of this my Last Will and Testament. No bond shall be required by my personal representative in any jurisdiction. ITEM V. In/addition to the powers given by law to my personal representative(s) and trustee(s) [hereinafter fiduciaries] in the administration of my estate and of any trust(s) created herein, they shall have the following discretionary powers applicable to all real and personal property held by them, including property held for minors, effective without court order until actual distribution. A. To retain any property owned by me at my death and to invest any funds held by them in any stocks, bonds, notes or other securities or property, real or personal, including common mast funds, mutual funds and money market deposit accounts operated or offered by my corporate tnlstee, if any, or any affiliate of it. B. To sell or otherwise dispose of any property, real or personal, at any time forming a part of my estate or the trust estate, for cash or upon credit, in such manner and on such terms as they see fit, and no one dealing with the fiduciaries shall be bound to see to the application of any monies paid. 2 Ro~marie A. Cronin C. To manage, operate, repair, improve, mortgage or lease for any term [even if beyond the duration of the trust(s)] any real estate at any time held or owned by them as fiduciaries. D. To hold investments in the name of a nominee and exercise and dispose of warrants. E. To engage in litigation and compromise, arbitrate or abandon claims and property. F. To conduct any business in which I am engaged or in which I have an interest at the time of my death for such period as the fiduciaries deem advisable, with the power to borrow money and to pledge the assets of the business and to do all other acts which I, in my lifetime, could have done, or to delegate such powers to a partner, manager or employee without liability for any loss occurring therein. G. To allocate items of receipt or disbursement between principal and income as the fiduciaries deem equitable regardless of the character given such items by law; to distribute in cash or kind or partly in each at valuations fixed by the fiduciaries. H. To borrow money, including the fight to borrow from any corporate trustee, if any, and to mortgage or pledge as security or to hold its own stock if a corporate trustee. I. To join in any merger, reorganization, voting trust plan or other concerted action of security holders, and to delegate discretionary duties with respect thereto. J. Should the principal of any trust herein provided for be or become too small in tmstee's opinion so as to make establishment or continuance of the trust inadvisable, my trustee(s) may make immediate distribution of the then remaining principal and any accumulated or undistributed income -Ros¥~arie A. Cronin outright to the person or persons and in the proportion they are then entitled to income. Upon such termination, the fights of all beneficiary(ies) who might otherwise have an interest as succeeding income beneficiary(ies) or in remainder shall cease. K. In general, to exercise ail powers in the management of the assets of my estate or the trust estate which any individual could exercise in the management of similar property owned in his own right, upon such terms and conditions as the fiduciaries may deem best, and to execute and deliver all instruments and to do all acts which the fiduciaries may deem necessary or proper to carry out the purposes of this will or any trust(s) created herein. L. To apply income or principal to which any beneficiary is entitled, directly for his or her comfort, maintenance and support, should the fiduciaries deem such beneficiary incapable of receiving the same by reason of age, illness, infmnity or incapacity, or to pay the same to such person or persons as the fiduciaries select to disburse it, whose receipt shall be a complete acquittance therefore without the intervention of any guardian. M. To assume continuance of the status of any beneficiary with reference to death, marriage, divorce, illness, incapacity or other change in the absence of information deemed reliable without liability for disbursements made on such assumptions. N. All principal and income shall, until actual distribution to any beneficiary, be free of the debts, contracts, alienations and anticipations of any beneficiary, and the same may not be liable for any levy, attachment, execution or sequestration while in the hands of any beneficiary, and the Ros~lmarie A. Cronin same may not be liable for any levy, attachment, execution or sequestration while in the hands of any fiduciaries. IN WITNESS WHEREOF, I have hereunto set my hand and seal this / t~ day of ~ ~ ?,,v ~.L~. , 1999. Roshnade A. Cronin "-- The preceding instrument, consisting of this and four other typewritten pages, identified by the signature of the testatrix, as on the day and date thereof signed, published and declared by Rosemarie A. Cronin, the testatrix)~erein name3~,.~s and for her last Will, in the presence of us, who, at her request, in her presence ao'.d Sa tl~e~presen~ ogf each other, subscribed our names as witnesses hereto. ? -ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA: :SS. COUNTY OF DAUPHIN : I, ROSEMARIE A. CRONIN, 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, that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. Rosefiaarie A. Cronin testatrix, this Swor~t~r affirmed to and acknowledgecLbefore me, by Rosemarie A. Cronin, day of .,~ ,~/0 ~ ,1999. .~- · l~ ~ ~ ~ ~N~m~ Public My Commission Exl~res: NOTARI/~.L [ HOLLY S. KIRK, Notaq Public AFFIDAVIT ] Harrisburg, Dauphin County [My Cornrnission Expires Feb. 15, 2003 COMMONWEALTH OF PENNSYLVANIA: 'SS. COUNTY OF DAUPHI]~L.-.. ~ : witnesses whose names are signed to the attached or foregbing instrument, being duly qualified according to law, do depose and say that we were present and saw testatrix sign and execute the instrument as her last Will; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hea~[ing and sightol~the testatrix signed the Will as witnesses; and that to the best of our knowlecl~'e tl~e/fe~'tatrix wa~ ~t that time 18 or more years of age, of sound mind and under no c°n~strai~ht °~O/'~du6(infi~ence'//~ Sw°rn t° and subscribed bef°re me this //~' davy of / ./., ;,,!' lXtOt~ry ff]~_~ S. KIRK. Notary Public J .... Harrisburg, Dauphin County My Commission ExEs' 0mm/ssi0n., ..... Exp res Feb. 15, 2003 BUREAU OF ZNDZV*rDUAL TAXES TNHERTTANCE TAX nTVTSTON DEPT. 180601 HARRTSBURG, PA 17118-0601 RICHARD L PLACEY 3651N FRONT ST HBG CONNONNEALTH OF PENNSYLVANTA DEPARTNENT OF REVENUE ZNHERZTANCE TAX STATEMENT OF ACCOUNT ESTATE OF DATE OF DEATH FZLE NUHDER /~COUNTY ACN 08-09-200q CRONZN 10-16-2003 21 03-0958 CUHBERLAND 101 Amount Rem 'i 'l:'l:ed REV-1607 EX AFP C01-D3) ROSEHARZE A HAKE CHECK PAYABLE AND RENZT PAYHENT TO: REGTSTER OF NTLLS CUHBERLAND CO COURT HOUSE CARLTSLE, PA 17013 NOTE: To insure proper credi~c ~o your account`, submi~ ~he upper portion of ~his form wi~h your ~ax paymen~c. CUT ALONG THZS LZNE ~ RETAZN LONER PORTZON FOR YOUR RECORDS *-~ REV-1607 EX AFP [01-03) ~## ZNHERZTANCE TAX STATEHENT OF ACCOUNT ~ ESTATE OF CRONTN ROSEHARTE A FZLE NO. 21 03-0958 ACN 101 DATE 08-09-200q TH'rS STATENENT ZS PROVZDED TO ADVZSE OF THE CURRENT STATUS OF THE STATED ACH ZN THE NAHED ESTATE. SHO#N BELOIf ZS A SUNHARY OF THE PRZNCZPAL TAX DUE., APpLTCATZON OF ALL PAYNENTS`, THE CURRENT BALANCE`' AND,, ZF APPLZCABLE`, A PROJECTED ZNTEREST FZGURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 0~-26-200~ PRZNCZPAL TAX DUE: ........................................................................................................................................................................................................................... PAYHENTS (TAX CREDZTS): ~,096.67 PAYMENT DATE 01-12-200q 07-22-200q RECEIPT NUMBER CDOO3q6q REFUND DZSCOUNT (+) ZNTEREST/PEN PAZD (-) 20q.83 .00 AMOUNT PAZD q,ZO0.O0 103.33- ZF PAZD AFTER THZS DATE`, SEE REVERSE S/DE FOR CALCULATZON OF ADDITIONAL /NTEREST. ZF TOTAL DUE 1S LESS THAN $1`, NO PAYHENT IS REQUZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDZT' TOTAL TAX CREDZT q,301.50 BALANCE OF TAX DUE ZOq.83CR ZNTEREST AND PEN. .00 TOTAL DUE ZOq.83CR YOU NAY BE DUE A REFUND. SEE REVERSE STDE OF THTS FORN FOR TNSTRUCTTONS. PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION STATUS REPORT UNDER RULE 6.12 Name of Decedent: Rosemarie A. Cronin Date of Death: October- 16, 2003 Will No.: 2003-00958 Admin. No.: 21-03-958 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, ! report the fo/lowing with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes x No If the answer is No, state when the personal representative reasonably believes that the administration will be complete: If the answer to N~. 1 is yes, state the following: A. Did the personal representative file a final account with the court? Yes No B. The separate Orphans' Court No. (if any) for the personal representative's account is: Date: 10/21/04 (MAH:rmt/AM3) Did the personal representative state an account informally to the parties in interest? Yes X No Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Co and ichard L. Plac~y Name (Please type or print) 3631 N. Front Street Harrisburg, PA 17110-1533 Address (717)236-9577 Telephone No. R.W. - 27 Capacity: X Personal Representative Counsel for Personal Representative CERTIFICATION OF NOTICE UNDER RULE 5.6(nl Name of Decedent: ~ ~ Date of Death: o°- / 3 - 2 rOLO Will No. To the Register: Admin. No. I certify that notice of (beneficial interest) ~ required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on -~LE?_~'-"~-- "&O.,'.~ ~/- : Ad--ess Notice has now been given to all persons entitled thereto under Rule 5.6(a) except__ Date: /,/~ / 2-- 0 t/~- Signature Name Address Teleph°neOCT) 5/~Z 7~D 7 Capacity: _ Persona/Representative .. _Counsel for personal representative j~~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 I OFFICIAL USE ONLY INHERITANCE TAX RETURN ~LE.UMGE. RES DENT DECEDENT ol, /_ O //" O O COUNTY CODE YEAR NUMBER I'-- Z ILl LU UJ DJ DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) DATE OF DEATH MM-DB-YEAR) / SOCIAL SECURITY NUMBER THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S ~ME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER - _ [~1. Original Return []4. Limited Estate [~]9. Litigation Proceeds Received [~2. Supplemental Return [~] 4a. Future Interest Compromise (date of death abet 12-12-82) [~]7. Decedent Maintained a Living Trust (A~ch copy el Trust) [~10, Spousal Poverty Credit (date of death belween 12-31 91 and 1-%95) FIRM NAME (ffApplJcable) TELEPHONENUMBERTI~7 '~3~ 7~)~'7 COMPLETE MAILING ADDRESS [~3. Remainder Return (date of death prior to 12-13-82) [~5, Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes [~11, Election to tax under Sec, 9113(A) (Attach Sch O) 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietarship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6, Jointly Owned Property (Schedule F) (6) [~ Separata Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probata Properly (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9, Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) OFFICIAL USE ONLY (8) (11) (12) (13) / ?? Z',/3 (14) SEE INSTRUCTtONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .0 (15) 16. AmountofLine 14 taxable at lineal rate f/ ? ~'¢¢/ /3 x .0~c~' (16) 17. Amount of Line 14 taxable at sibling rate x ,12 (17) 18. Amount of Line 14 taxable at collateral rate x 15 (18) 19. Tax Due (19) ?z.- Decedent's Complete Address: I STREETADDRESS ~"'L~'~'~/:~* }~ O/~ T' CITY Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Cmdgs/Payments A. Spousal Pove~y Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable D, Interest E. Penalty J STATE PR Total Credits ( A + B + C ) (2) Total Interest/Penalty ( D + E ) 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 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. j z,P I "'70 (1) ~)~, ~'~.~ A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) ~) (4) (5A) (5B) ,¢'¢, ¢' Z- '1 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; .......................................................................................... [] [] b. retain the right to designate who shall use the property transferred or its income; ............................................ [] [] c. retain a reversionary interest; or .......................................................................................................................... [] [] d. receive the promise for life of either payments, benefits or care? ...................................................................... [] [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probata 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 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE //-//- / ?o2,_¢' DATE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. {}9116 (a) (1.1} (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfem to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a} (1.1) (ii)]. The statute ¢g~ not exemct 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 parant in common with the decedent, whether by blood or adoption. REV-1~13 EX+ (9-OO~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I 1. TAXABLE DISTRIBUTIONS [inciude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] FILE NUMBER RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE 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 FART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE,.~OF--~C-~ FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT FUNERAL EXPENSES: 5. 6. 7. ADMINISTRATIVE COSTS: Pemonal Representative's Commissions Name of Pemonal Representative (s) Social Sesu rib/Number(s) / EIN Number of Pemonal Representative(s) Street Address City State Year(s) Commission Paid: Attorney Fees Family Exemption: (If decedents address is not the same as claimant's, at, ch explanation) Claimant Zip Street Address Rela§onship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees State Zip TOTAL (Also enter on line 9, Recapitulation) $ ~5:2~', dO (If more space is needed, inserL additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONALPROPERTY FILE NUMBER include the proceeds of libation and the date the proceeds were received by the estate. All property jointly.owned with the right of survivorship must be disclosed on S~hedu~e F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH g ZOo ~? TOTAL (Also enter on line 5, Recapitulation) (if more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2806(31 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV 1162 EX{11 96) NO. CD 004616 KREPS DEBBIE 5535WESTBURY DRIVE ENOLA, PA 17025 ESTATE INFORMATION: SSN: 176-16-9692 FILE NUMBER: 2104-0958 DECEDENT NAME: WOODWARD SARA E DATE OF PAYMENT: 11 / 12/2004 POSTMARK DATE: 11/12/2004 COUNTY: CUMBERLAND DATE OF DEATH: 08/13/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I 989.92 TOTAL AMOUNT PAID: 989.92 REMARKS: SEAL CHECK# 0991 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF TNDTVTDUAL TAXES INHERTTANCE TAX DTV/STON DEPT. 180601 HARRTSBURG, PA 17118-0601 COHHONt/EALTH OF PENNSYLVANZA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '04 ' .... _~ '~ ,~uv -c) ~:~ S :23 RICHARD L PLACEY 3631N FRONT ST HBG P~ 1711 O- 1533 REV-16n7 EX /~FP {n1-03) DATE 10-12-200q ESTATE OF CRONZN DATE OF DEATH 10-16-2003 FILE NUMBER 21 03-0958 COUNTY CUMBERLAND ACN 101 I A~oun~ ROSEMARIE A MAKE CHECK PAYABLE AND REMIT PAYHENT TO: REGISTER OF NI'LLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To Ansure proper credit ~o your account, submit the upper portion of this for. with your tax payment. CUT ALONG TH'rS L/NE ~ RETA'rN LOt/ER PORT'rON FOR YOUR RECORDS ~ REV-1607 EX AFP (01-03) #~ 'rNHER'rTANCE TAX STATEHENT OF ACCOUNT ESTATE OF CRONZN ROSEMARTE A FILE NO. 21 03-0958 ACN 101 DATE 10-11-200q THIS STATEMENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACM ZN THE NAMED ESTATE. SHO#N BELOI,/ TS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS., THE CURRENT BALANCE, AND, ZF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTMENT: 0R-19-200~ PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): q,096.67 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 20q.83 01-12-200q 07-ZZ-200fi 09-21-200~ CDOO3q6q REFUND REFUND .00 .00 q,200.O0 103.33- 20q.83- IF PAID AFTER THIS DATE, SEE REVERSE S/DE FOR CALCULAT/ON OF ADDITIONAL /NTEREST. ZF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE 1S REFLECTED AS A 'CRED/T' (CR), TOTAL TAX CREDIT q,096.67 BALANCE OF TAX DUE .00 /NTEREST AND PEN. .00 TOTAL DUE .00 YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF TH*rs FORM FOR TNSTRUCT*rONS. ) PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGTSTER OF #TLLSj AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: COMMONNEALTH OF PENNSYLVANTA. REFUND (CR): A refund of a tax credit, which was not requested an the Tax Return, amy be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications are available at the Office of the Register of Wills~ any of the 23 Revenue District Offices or from the Department's Z4-hour answering service for forms ordering: 1-800-$6Z-Z050; services for taxpayers eith special hearing and / or speaking needs: 1-800-447-30Z0 (TT only). REPLY TO: guestions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Reviee Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid eithin three (3) calendar months after the decedent's death, a five percent (5Z) discount of the tax paid is allowed. PENALTY: The 15Z 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. INTEREST: 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, 198Z bear interest at the rate of six (6Z) percent par annum calculated et a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 19BI through ZOO4 are: Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year 1982 20Z .0005~8 1988-1991 llX .000301 2001 1983 16Z .000438 199Z 9Z .000247 Z00Z 1964 11Z .O0030X 1993-1994 7Z .00019Z 2003 1985 13Z .000356 1995-1998 9Z .0002~7 2004 1986 lOX .000274 1999 7X .O0019Z 1987 92 .000247 2000 8Z .000219 Interest Daily Rate Factor 9X .000247 6Z .000164 5Z .000137 4Z .000110 --Interest is calculated as folloes: ZNTEREST = BALANCE OF TAX UNPAZD X NU~IBER OF DAYS DELZNQUENT X DAZLY ZNTEREST 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 mede after the interest computation date sheen on the Notice, additional interest must be calcuZated.