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HomeMy WebLinkAbout04-0915PETITION FOR PROBATE and GRANT OF LETTERS Estate of Stella A. Fitzpatrick No. ~/"~ - 0 9 / 5'-- also known as To: Deceased. Social Security No. 158-12 - 54 ~ 5 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the executor in the last will of the above decedent, datedDo~o~mber 1 .. 1988 and codicil(s) dated N/A Register of Wills for the County of Cumberland Commonwealth of Pennsylvania in the named (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in Cumberland ~ C@unty, Pennsylvania, with her last family or principal residence at 232 Four ~easons ~,ane Enola, PA 17025, East Pennsboro Township (l~st street, number, Twp. or Boro.} Decedent. then 89 years of age, died September 21e 2004 ,~ Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: ~,~ Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) 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: HOHE WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will ~ffd codidl(s) presented herewith and the grant of letters Testamentary u.,; .. theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) Eric Brian Ceja, c~ rp~ .... ~ Court ...... "-~' .... PA ~-7~ ~303 OATH OF PERSONAL REPRESENTATIVE CONLMONWEALTH OF PENNSYLVANIA COUNTY OFf ss Thc petitioner(s) above-named swear(s) or affirm(s) that thc statements in thc foregoing petition arc truc and correct to thc best of thc knowledge and belief of petitioner(s) and that as personal reprcsen- tativc(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed _ga, n~ subscribed _ ~ before m~ this /~'~ --' day of [ Estate of Stetla A. Fitzpatrick , 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 December 1 .. 1988 described therein be admitted to probate and filed of record as the last will of Stella A_ Fi ~7. p~ri ~k and Letters T~s~ment_~ry are hereby granted to l~.-c~c- Rr~an Ceja__, Sr. 19 ,, in consideration of the petition on FEES Probate, Letters, Etc .......... $ Short Certificates( ) .......... $ Renunciation ................ $ $ TOTAL ~ $ Filed ................................... Register of Wills 2773f ATTORNEY (Sup. Ct. I.D. No.) 400 South State Road Mary.~vi 1 l ~.: PA 17053 ADDRESS (717) 957-3474 PHONE certify that the information here given is correctly copied from an original certificate of death duly filed with me as P, egistrar. The original certificate will be forwarded to the State Vital Records Office lk~r permanent filing. Fee for this certificate, $2.00 WARNING: It is illegal to duplicate this copy by photostat or photograph. // Local Registrar P 10719532 No. H1~5 143 Rev 2/87 TYPE/P~tlRT IN NAME OF DECEDENT (First. Middle. Last) PERMANENT BLACK INK 1. AGE (Last Birthday) COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH STATE FlEE NUMBER SOCIAL SECURITY NUMEER Stella >atrick zFemale a. 158 -- 12 -- 547! 8 9 Yrs DATE OF BIRTH BIRTHPLACE (Cily and (Month. Day, Yea0 Slate or Foreign Countly) 2/18/191 ...... [] CITY, BORO, TWP OF DEATH FACILITY NAME (If PiOI instituhon, give street and numhef) Dauphin Co. DECEDENT'S USUAL OCCUPATION Harrisburg, PA DECEDE~T'S MAILING ADDRESS (Street, City/Town. StaLe. ZIp Code) FATHER'S NAME (First, MKldte, Last) (See instructions on other side) Donatic~ [] Buda, [] Cromation E~emo~ei from Slate Other (Spooky) Harrisburg Hospital No~-I YesE'~lfyos. specifyCuban, Mexican, Puerto Rican. otc DECEDENT'S EDUCATION MARITAL STATUS - Marded, YesD ~ ~. ~,.,~,s~.~ Co,... Divorced (Specify) o-~o,~,) ~4~idowed l?~. stole PennsylvaBia ir,. ~ Ye,. deca~nHWedi, (Spec#y) fo. White MOTHER'S NAME (First. Mid(lie, Maiden Surname) Blanche Dajchak IMMEDIATE CAUSE (Final resulting in death) ~ Sequentially ~st conditions if any, leading lo immediate CAUSE (Disease ~ injury resuihn9 o~ death ) LAST WAS CASE REFERRED TO A MEDICAL EXAMINER/CORONER? 2,. Y. [] No ID~ iApproximate PART Ih Other slgmflcanl coloribbons contributing to death, bul nol resulhng in the undedymg cause g,yen in PART I Yes [] Suicide[] C .............. d E][ 3~I~e'd~C~E'~F(IsNpJecUd~YI ........ f ............... ry ..... State) 28b. 29. CERTIFIER {Check only one) *CERTIFYING PHYSICIAN Physician certifying cause of death when anOther physician has pronounced death and complet6d ilea 23) TO the best of my knowledge, death occurred due o the causes s and manner as sated ................................................................. [] *PRONOUNCING AND CERTIFYING PHYSICIAN (Physician both pronouncing ~ath a~J certifying to cause of death) To the best of my knowledge, death Occurred at the time, date. and place, and due to the causes(s) and manner as stated ..................... ~ *MEDICAL EXAMINER/CORONER (item 27) Type or P~u~~.- V - On the basis of examination and/or investigation, In my opinion, death occurred at the time, date, and place, and due to the Causes(s} and ~1 .~ ~ ~,,,,~-v,~_ vd--~ ~ . ,,,? .................................................................................................................................................................... u .. 0"~ e~eL~ c. J2.rLd REGISTRAR'S SIGNATURE AND NUMBER DA1 E FILED {Month D~f~, Yearj.,~ twp city/boro LAST WILL AND TESTAMENT OF STELLA A. FITZPATRICK T Steila A. Fitzpasrick, of 232 Four Seasons Lane, Enoia, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my Last Will and Testament, he~eby ~evoking all Will~ and codiciis heretofore made by me. ITEM I. I direct that all my debts and funera'il expenses, including my cemetery lot and gravemarker and all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my death as part of the expense of the administration of my estate. ITEM II. I make the following bequests: specific devises and A. My car to my daughter, Theresa Jean Ceja. B. My household goods to my grandson, Eric Brian Ceja, ITEM III. I devise and bequeath all the rest, residue and ~:emainder of my estate of every nature and whereever situate as ~ollows: A. One-third to my daughter Theresa Jean Ceja. B. One-third to my grandson, Eric Brian Ceja, Sr.. C. One-third to Commonwealth National Bank IN TRUST [or thc use and benefit of my great-grandson, Eric Brian Ceja, Jr., pursuant to the terms of a trust agreement executed February 27, 1979, between Stella A. Fitzpatrick and the Commonwealth National Bank and as the trust was amended subsequent to that date and prior to the execution of this will. Should the aforsaid bequest to the trust fail for any ceason, I devise and bequeath the one-third for Eric Brian Ceja, Jr. to him directly if he is over twenty-five years of age. If he is under twenty-five years of age, then to Commonwealth National Bank IN TRUST for Eric Brian Ceja, Jr. until such time as E~ic Brian Ceja, Jr. attains the age of twenty-five. ITEM IV. I direct that any and all Inheritance, Estate and Transfe~ taxes imposed upon my estate passing under my Will or otherwise, shall be paid out of the principal of my residual estate. ITEM V. I appoint my grandson, Eric Brian Ceja, Sr. Executor of this my Last Will and Testament. In the event of his renunciation, death, resignation or inability to act for any reason whatsoever, I appoint Commonwealth National Bank, Executor of this my Last Will and Testament. I relieve my Executor from the necessity of posting security in connection with his duties as such in any jurisdiction in which he may be called upon to act. IN WITNESS WHEREOF, I have hereunto set my hand to this my Last Will and Testament, which consists of .~ pages, to each of which I have affixed my signature this / day of , , one thousand nine hundred and eighty-eight (1988). COMMONWEALTH OF PENNSYLVANIA :  : ss :: COUNTY OF _~.~ : ~e~St~lla A ~i~z~%a't~ick(I and~~0~/~/~~' , a~d ~( ~'~_~__.~ (~. ~ [~j~/~ , ~he~ ' ~t~sta{r~xv~n~ the w~tn~s~s ~e~pe~tiVe~%, whosel~a~mes are signed to th~attached or lorego~ng instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her last will and that she had signeJ willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the will as witness and that to the best of their knowledge'the testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Testatrix Witness Witness Subscribed and sworn to and acknowledged before me by Stella A. Fitzpatrick, Testatrix ii ~_s~c{~ed .and sworn to and ackr~ow/L~,dged ~f_o~ m~ by ]wit~sses lhi~ ~]~ day of ~ My ~mm[ssion Ex~r~ July 19, 19~ ~ CERTIFICATION OF NOTICE UNDER RULE 5.6 Name of Decedent: Stella A. Fitzpatrick Date of Death: September 21, 2004 Will No.: 2004-00915 To the Register: I certify that notice to beneficiaries and heirs required by Rule 5.6 of the Orphan's Court Rules, in the form prescribed by Rule 5.7, was served on or mailed to the following beneficiaries of the above-captioned estate on November 29, 2004. Name Address Eric Brian Ceja, Sr., 536 Thrush Court, Harrisburg, PA 17111-5303 Eric Brian Ceja, Jr., 312 Spring Lane, Enola, PA 17025 Theresa Ceja, 1108 Yverdon Drive, Wormleysburg, PA 17043 Mellon Bank, Trustee for Eric Ceja, Jr., 1735 Market Street, P.O. Box 7899, Philadelphia, PA 19101, ATTN: Marie Gatti, #1930256 Notice has now been given to all persons entitled thereto under Rules 5.6 and 5.7, except Date: November 29, 2004 Capacity: Signature: ~/~ ~_~ Name: Wii'l~am C. Dissinger Address: 400 South State Road Marysville, P~'~705~ Telephone: (717) 957-347~i" Personal Representative ~ Counsel for Personal Repr~_~sentative COr,1MON\VEALiH Of PENNSYLVAN;A DEPARTME'\. T O~ REVENLE I::JUREAU OF NDIVI=:;UAL TAXES DEPT. 280601 HAF.'RISBURG. PA 17123-060' REV 1162 EX{11 96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT CEJA ERIC BRIAN SR 536 THRUSH COURT HARRISBURG, PA 17111-5303 -- nn to..(\ ESTATE INFORMATION: SSN 158-12-5475 FILE NUMBER: 2104-0915 DECEDENT NAME: FITZPATRICK STELLA A DATE OF PAYMENT: 01/18/2005 POSTMARK DATE: 01/18/2005 COUNTY: CUMBERLAND DATE OF DEATH: 09/21/2004 NO. CD 004844 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1,938.98 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: E CAJA CHECK# 4844 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS $1,938.98 GLENDA FARNER STRASBAUGH REGISTER OF WILLS ~~c,oc, .- COMMONWEALTH OF . /.. PENNSYLVANIA . ':1 .:e.lii. '., DEPARTMENT OF REVENUE . 3' DEPT 280601 , . ' HARRISBURG, PA 17128.0601 ,0.-,' .-J'- REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 04 0915 CG\JN", COQ~ YEA~ w " "'-'" u"'''' W~U ",00 u"'~ ~"' ~ << fM..15E~ .... Z W Cl W () W Cl DECEDENT'S NAME (LAST, FIRST. A~D MIDDLE INITIAL) Fitzpatrick. Stella A SOCIA, SECURITY NUMBER 158-12-5475 DATE OF DEATH (MM-DO.vFAR) 09121/04 DATE OF BIRTH (MM-OD-YEAR) 12/18/14 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER flF APPliCABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST. AND MIDDLE INITIAL) o 1. Original Rev,m"\ 04 Limited Estate o 6 Decedent Die': Testate ',"\\a~\: cOPY oIV,"!li o 9. Litigation Proceeds Receivea' o 2 Supplemental Retum o 43. Future interest Comprorlise (r'ate dCeati alte' 12-12-02) o 7 Oecedert Mairtained a living Trust (.~tta:r ~'~y 01 ;I\'~;\'I o 10. Spousal Poverty Credit !Cdle or death belw&el12.31.91acc! 1-1-95) o 3 Remainder Return (dale d jeal~ r;';Gr 10 12-n02' o 5 Federal Estate Ta1: Return Required -0" 8 Total Nurr:ber of Safe Deposit Boxes o 11, Election to taK IJ[1der See 91'i3(A:IIAtlilrh s,;" c >--- z w c z o ~ '" w '" '" o u THIS SECTION MUST BE COMF'LETeD. ALL CORRESPONDENqE AND CON~IOENTIAL TAX INFORMATION SHOULD BE OIRECTED TO: NAME COMPLETE MAILING ADDRESS William C. Dissinger Dissinger & Dissinger FI~M ~AME '; \ ",~:,\,;,~.t'\H) . Attorneys at Law DISSinger & DISSinger 28 North 32nd Slreet TELEPHONfNUMBER Cam Hill PA 17011 (717) 975-2840 P , 1 Real Estate (Schedule A) (1) 2 Sloc~s ane Bonds (Scheelile Bj (2) Closely Held Corporation, Partt1ership or Sole.Proprietorship (3) 4 Mortgages & Notes Receivable (Schedule D) (4j 0.00 " -, 0.00 0.00 0.00 9,642.78 0.00 41,314.78 (8) 7,263.19 605.92 (11) (12) (13) (14) '----, z o < ..J :::::J .... n: <X: () w c:: 5 Cash, Bank Deposits & Miscellaneous Personal Property (ScheduleFI (5) 6 JOi~tly Owned Property (Schedule F) o Separate Billing Requested 7 Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) (6) I)) 8 Total Gross Assets I,tola) Lines 1-7) 50,957.56 9 Funera; Expet:ses & AOfTinistrative Costs (Schedule H) (9) <Q Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (101 11 Total Deductions (total lines 9 & 1D;, 7,869.11 43,08845 0.00 12 Net Value of Estate (Line 8 minus Line 11) 13 Charitable ard Governmenta'r Bequests/See 9113 Trusts for which an elecllon to tax has rot been made (Schedule J) 14 Net Value Subject to Tax (Line 12 ~irus line :3) 43,088.45 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o ~ .... :::::J ll. :E o () X ~ 15 Amount of Lille 14 taxable at the spolisal tax rate, or transfers under See, 9116 (a](12) 0.00 x 0 (15) 0.00 116) 1,938.98 (17) 0.00 1'8) 0.00 (19) 1 ,938.98 16 Ar,lountof Line 14 taxable at lineal rate 43,08845 x 045 1) Amounl of Line 14 taxable at sibling rate 000 x 12 18 Arnou:ltof L:ne 14 taxable al collateral rate 000 x 15 19 Tax Due 200 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANsWeR ALl. QUESTIONS ON REVERSE slOe AND ReCHECK MATH < < Decedent's Complete Address: STREET ADDRESS 232 Four Seasons Lane CITY Enola I STATE PA I ZIP 17025 Tax Payments and Credits: 1,. Tax Due (page ~ line 19) 2 CreditsrPaymenls A. Spousal Poverty Credit S. Prier Payments C,OiscoIJlit (1) 1,938.98 0.00 0.00 0.00 3 InterestlPef'lalty if applicable o Interest E. Penally Tolal Credlls I A + B + C ) (2) 0.00 0.00 0.00 TolallnteresVPenalty ( 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 B Enler Ihe lotal of line 5 + 5A. ThIS IS Ihe BALANCE DUE. (3) 0.00 (4) 0.00 (5) 1,93898 (5A) 0.00 (58) 1,93898 5 If Line 1 -+ line 3 is greater than line 2, enter the difference This is the TAX DUE. A. Enter the interest 0\\ the tax due. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Yes o o o o ....0 o ........0 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Did decedent make a transfer and a retain the use or income of the property transferred', b retain the right to designate who shaIl 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 deatll occurred after December 12,1982, did decedent transfer property withili olle year of death without receiving adequate consideration? ,. 3 Did decedent own an "10 trust for" or payable upon death bank account or secur'lty al his or her death?.. 4. Did decedent own an Individual Retiremel\t Account, annuity, or other non-probate property which contains a beneficiary design.ation? . No IE 123 00 ~ o o Under penalties of perjury. I declare that I have examined this retu{(\, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correcl and complete Declalalion ol preparer other than the personal representalive is based on allin/ormation of which preparer has aoyknowledge SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ....I... ADDRESS ~ ~ c:.. 536 Thrush Court, Harrisburg, PA 171((?5303 SIGNATURE OF PREPAMTHER HAN REP~ TlVE ADDRESS 28 North 32nd Street, Camp Hi , PA 17011 DATE /-/7,oJ DATE I~ 17.as- For dates of death on or after JUlY 1, 1994 and before January i 1995. the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 PS S9116 (3)(1.1) (i)1 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 survlVing spouse is D% 172 P.S. S9116 (a) (1,1) Oi)] The statute does not exemot a transfer to a surViving spouse from tax, and the statutory requirements for disclosure of assets and filing a lax return are still applicable even If the SJfW/lng spoJse 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 ~Nenty-one years of age or younger at eeath to or for the use of a natural parent an adoptive parent. ora sfepparenf of the child IS 0% 172 P.S. s9116(a)(1.2IJ The tax rate imposed on the net vai:.JB of transfers to or for the use of the decedent's iinea~ beneficiaries is 4,5%, except as noted in 72 P.S, S9116(t2) (72 P.S. s9116(a)(1)] The tax rate imposed on the net vaiue of transfers to or for the use of the decedent's siblings is 12% 172 P.S. 1j9116(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-15GB EX+ (6-93) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Stella A Fitzpatrick FILE NUMBER 21-04-0915 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 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. Account #2423620216 with Mellon Bank (copy of statement of date of death value is attached) 7,177.73 600.35 2. Account #100034700 with Waypoint Bank (copy of statement of date of death vaiue is attached) 3. Miscellaneous personal property 1,50000 300.00 4. Springdale Arms (secunty deposit returned) 5. Corn cast Cable credit 10.35 6. Mellon Pria Trust Account 54.35 TOTAL (Also enter on line 5, Recapitulation) $ (if more space IS needed, Insert additional sheets of the same size) 9,64278 HEV,151D EX+ (6"98) . COMMONWEALTH OF PENNSYLVANIA iNHERITANCE TAX RETUIiN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISe. NON-PROBATE PROPERTY ESTATE OF Stella A. Fitzpatrick FILE NUMBER 21-04-0915 This schedule must be completed and filed if the answer to any of questions 1 through 4 011 the reverse side of the REV-1500 COVER SHEET is yes DESCRIPTION OF PROPERTY ITEM ,NCLUOE THE NA~lE or THE TRA,~SFE"EE, TrlEIR RELATIONSHIP ~o :lECEC}ENT ;'''ID DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE NUMBEF THED,\TEOfT'<ANSfEI\ A"TACHACODYOF;HE DEED FO.I\ REAL ':STATE VALUE OF ASSET IN1EREST rlFAPPLlCABLEj VALUE 1 Account #10170683BN5 with Mellon Bank under a revokable deed of trust 41,31478 100 0,00 41314.78 dated 2/27/79 as amended 12/1180 (copy of deed and amendment attached) TOTAL (Also enter on line 7 Recapitulation) $ 41,31478 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-99) _ '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Stella A. Fitzpatrick FILE NUMBER 21-04-0915 Debts of decedent must be reported on Schedule I. ITEM NUMBER A DESCRIPTION AMOUNT FUNERAL EXPENSES: Hoover Funeral Homes - the $785.56 represents funeral and burial fees unpaid by Pa Funeral Trust (copy of statement attached) 785.56 B 1 ADMINISTRATIVE C05TS: Personal Represenlalive's Commissions 3,057.45 Name of Personal Representa\\\le(s) Eric B. Ceja, Sr. Social Security Number(s)fEIN Number of Personal Representative(s) 196-48-3421 Street Address 536 Thrush Court City Harrisburg Year!s) Commission Paid 2005 State PA Zip 17111 2 Attorney Fees 3,057.45 3 Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 0.00 Claimant Street Address City Stale Zip Relationship of Claimant 10 Decedent 4 Probale Fees 149.00 5. Accountant's Fees 000 6 Tax Return Prepare(s Fees 000 7 Cumberland Law Journal 75.00 8. The Patriot-News Co. 138.73 TOTAL (Also enter on hne 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size} 7,25319 REI/-1512EX+ (12-011 * SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Stella A. Fitzpatrick FILE NUMBER 21-04-0915 RellQrt debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH PPL Electnc Utilities Corp 38.28 2. East Pennsboro Ambuiance Service 435.00 3. Verizon 20.70 4 Associa!ed Cardiologists 100.00 5. Comcas! Cable 11.94 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert add'ltional sheets of the same size) 605.92 REV.1513 EX+ 19,00,1 * SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNEYLVANI.I'\ INhERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Stella A. Fitzpatrick FILE NUMBER 21-04-0915 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not list Trustee/s) OF ESTATE I TAXABLE OISTRlBUTIONS [include outright spousal distributiorls, aDd transfers under See 9116 (al (12)( 1 Eric Bnan Ceja, Sr. grandson 14,362.82 536 Thrush Court, Harnsburg, PA 17111-5303 2 Eric Brian Ceja, Jr. great-grandson 14,362.82 312 Spring Lane, Enola, PA 17025 (via Mellon Bank Trustee for Eric Brian Ce]a, Jr 1735 Market Street, PO Box 7899, Philadelphia, PA 19101 3. Theresa Jean Ceja daughter 14,362.82 1108 Yverdon Drive, Wormleysburg, PA 17043 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE. ON REV.1500 COVER SHEET \I NON-TAXABLE DISTRIBUTIONS A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE NONE 0.00 B CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS NONE 0.00 TOTAL OF PART 11- ENTER TOTAL NON.TAXABLE DISTRIBUTiONS ON LINE 13 OF REY.1500 COYER SHEET $ 0.00 (If more space is needed, insert additional sheets of the same size) F. @ Mellon November 4, 2004 Re: Stella A. Fitzpatrick, Dec'd., Trust under Deed - # 10 170683BN5 William C Dissinger, Esquire Dissinger and Dissingr 400 South State Road Camp Hill, PA 17053 Dear Mr. Dissinger: We acknowledge receipt of your letter of October 28,2004 advising us that you represent the Estate of Stella S. Fitzpatrick. Mrs. Fitzpatrick had a revocable deed of trust of which Mellon Bank is trustee. A copy of the trust agreement is enclosed for your records. The exact title is Stella A. Fitzpatrick, Mellon Bank, N.A., Trustee under Agreement dated 2/27/79. Enclosed is a current asset list indIcating the interest rate on the Mellon Short-Term U. S. Government Securities Fund and Money Market Demand Account. Enclosed in triplicate is the date of death value. We have requested an income accrual for the trust. As soon as the amount has been determined, we shall let you know. The other account that you requested information on is a checking account. We have forwarded a copy of your letter to Reberta Good in our Camp Hill office. Under the provisions of Mrs. Fitzpatrick's amendment dated 12/1/88, if Eric Brian Ceja, Jr. is under age 25, $15,000 is to be held in this trust for his benefit. One-third of the remainder is to be distributed to Mrs. Fitzpatrick's daughter, Theresa Jean Ceja and one-third is to be distributed to her grandson, Eric Brain Ceja, Sf. According to our records, Eric, Jr. is age 23 1 note that under Mrs. Fitzpatrick's will, one-third of the residue of her estate is to pour over into this trust for the use and benefit of Eric, k Could you give me an approximate amount that wc can expect to recei ve. At your convenience could you provide me with the current addresses for Theresa Ceja and Eric, JL I shal! then contact the interested parties to obtain their social security numbers. Sincerely, d:::,'?/1/~v Assistant Vice President Enclosures Pri\c/ic H;'c/l'..'/ Jl'iil'{'.!L'/!/('i:.' 1'7-'5 :\Iarkd Sl:;;;'l'[ . PO. B,)\ iS9'l . PhilJJt'~;'lni:l. P.-\ !();I)I-78,:)lj cc: Mr. Eric Brian Ceja, Sr. IS~S! ;..;rl:,-56S'J Ofrll.:t .J,. .\le!!on Fil!Uiluu! COII/IJiIi,'" n ...: TRUST AGREE~ENT 3ET\VEEN STELLA A. FITZPATRICK, SETTLOR, fu~D THE CO~~ONWEALTH NATIONAL BANK, TRUSTEE, DATED FEBRUARY 21, 1979 KNOW ALL PERSONS BY THESE PRESENTS, that in consideration of the mutual convenants of the parties hereto, this Agreement is entered into this 21~, day of February 1979, between STELLA A. FITZPATRICK, of New C~berland, Cumberland County, Pennsylvania, hereinafter called the Settlor, a:1d THE CO"lMONWEALTH NATIONAL Bfu~K, 10 South ~Iarket Square, Harrisburg, Dauphi~ County, Pennsylvania, hereinafter called the Trustee, as :ollows: ONE: TRUST PROPERTY. The Settlo= has ~ransferred and delivered to the Trustee all the property descri~ed i~ the attached Schedule A, which, together with all other property hereafter transferred and delivered to the Trustee by Settler or by a~y other person, pursuant hereto, shall constitute the Trust Estate, and shall be held, administered and distributed as provided in this Agreement. T<tIO~ DISPOSITI\~ PROVISIONS. The T=ustee shall a?ply and distribute the net income and the principal of the Trust Estate as follows: (a) The Trustee shall pay the net income, ~uart8rly or, upon ~equest, monthly, ~o tne Settlor for life and shall pay to Settlor such portions of principal as Settlor may from time to time request. Furthermore, in the event of Settlor1s disability, the Trustee shall pay for the benefit of Settlor such amounts of iucorne and principal as may be required for her proper and adequate support, including but ~ot limited ~o Dedical a~d hospitalization costs. (b) Upon Settlor's death, the entire principal and all accumulated but undistributed incone then held by the Trustee shall be distributed promptly to Settlor's grandson, Eric Brian Ceja, if he has reached thirty-five (35) years of age. (c) If Settlorls grandson, Eric Brian Ceja, has not reached the age of thirty-five (3S) years at the time of Settlor's death, the Trustee shall apply and distribute the net income and the principal of the Trust Estate as follows: (i) The Trustee shall pay the net income to Settlor's grandson, Eric Bria~ Ceja, quarterly or, ~pon request, ~onthly until he reaches his thirty-fi:th (33th) birthday, at which time the entire principal and all acc~~~lated hut undistributed i~cone then held by the Trustee shall be distributed to him. (ii) Additionally, the Trustee, in its absolute and unfettered discretion, ~ay i~vade the principal of the Trust Estate, upon request by Settlor1s grandson, Eric Brian Ceja, and pay to him such anounts as the ~=~stee deems appropriate to assist his purchase of a residence or other worthwhile personal or business investments. The Settlor intends by this ?rovision to require the Trustee to evaluate the soundness of any proposed i~vestnen~ by Settlor's grandson, Eric Brian Cejc, o2rore distri~uti~~ to hi~ a~v =unds from the Trust Estate for that purpose. (iii) ~.. the event of the disability of Settlor's grandson, Eric Bria~ Ceja, the Trustee shall pay for his benefit such amounts of income and principal of the ~rust Estate as may be required for his proper and adequate su~port, inCluding but not limited to medical and hospitalization costs. (d) If Eric 3rian Ceja shall have predeceased Settlor, or if ~e should die prior ~~ h~s attaining t~e age of thirty-five (35) years and receiving the entire Trust Estate, the Trustee shall dis- tribute t~e then existing Tr~st Estate to his survivi~g issue in equal -2- shares per stirpes, subject to the provisions of Paragraph THREE below. (e) If Settlor's grandson, Eric Brian Ceja, should die with- out issue surviving him, the Trustee shall distribute the then existing Trust Estate to the surviving brothers and sisters of Settlor in equal shares. THREE: MINORITY PROVISION. Any share of the Trust Estate which becomes distributable to a minor shall be held in trust by the Trustee during minority. The Trustee shall apply such amounts of income and principal as it, in its sole discret~on, deems proper for the support, education and welfare of such minor, and shall accumulate any unexpended balance of income. Such amounts may be applied directly or may be paid to the person with whom such minor resides or who has the care and control of such minor, without the intervention of a guardian. The Trustee shall not be obliged to supervise or inquire into the appli- cation of such amounts by such person, and the receipt of such person shall be a complete release of the Trustee. Should the share of a minor, in the sole opinion of the Trustee, be or become too small to warrant continui~g such fund in trust, or should its administration be or become impractical for any other reason, the Trustee, in its sole discretion, may pay such share, absolutely, to the parent or other person maintaining said minor or may deposit such share in the minor's name in a savings account in a bank or savings institution of its Choosing, payable to the minor at majority. FOUR: DISABILITY PROVISION. If any beneficiary of the Trust Estate shall, i~ the sole opinion of the Trustee, oe or become :r.entally or ;:.':"';ysically incapa- citated by reason or illness, accident or otherwise, the Trustee may -]- apply either inco~e or principal for t~e support and welfare of such beneficiary directly! or to the person who has the care and control of such beneficiary, without the intervention of any guardian and without any obligation to supervise application of said amounts in any way. FIVE: POWERS OF THE TRUSTEE. In addition to the powers conferred by case law, by statute and by the other provisions hereof, the Trustee, and its successors, shall have the fOllowing discretionary powers applicable to all real and personal property held by it, including property held for minors, all real and personal ~roperty being referred to in this Section as the Trust Estate, which powers shall be effective without court order and shall exist u~til actual distribution: (a) To retain any property received by it, including its own s~ock; {b} ~o invest and reinvest all or any part of t~e Trust Estate in such stocks, bonds, securities a~d other property, real or personal, as i~, in its sole discretion shall deem proper, including its corr~on trust =~~ds, without regarc to statutes limiting the property whic~ a =~duciary may purchase: (e) To sell, transfer, exchange or otherwise dispose of, any part of ~he ~rust Estate, for cash or on terms, ~ublicly or privately, or to lease, even for a term exceeding five (S} years or the duration of this trust, without liability on the purchasers or lessees to see to the application of t~e ?=oceeds, and to give options for these purchases without the obligation to repudiate them in favor of a higher offer: -4- (d) ~o execute and deliver any deeds, leases, assign- ments or other instrunents as may be necessary to carry out the provisions of this trust; (e) To borrow money, including the right to borrow from itself, and to mortgage or pledge as securltYi (f) To assume continuance of the status of any bene- ficiary with regard to death, marriage, divorce, illness, incapacity and the like in the absence of information deemed reliable without liability for disbursements made on such assumption; (g) To make any distribution hereunder either in kind or in money, or partial2..:.: in kind and partially in money. Distribution in kind shall be made at the market value of the property distributed, and the Trustee may, in its absolute discretion, cause the share distributed to any distributee to be composed of property like to or different :rom that distributed to any other distributee; (h) ~o exercise any subscription right i~ connection with any security held he~eunder, to consent to or participate in any recapitalizatio~, reorganization, consolidation or merger of any corporation, compa~y or association, the securities of which may be held hereunder, to delegate authority with respect thereto, to deposit investments u~der agreements, to pay assessments, and generally to exercise all rights of investors; (i) 70 permit the proceeds of any insurance policy to remain with the issuing insurance company for the benefit of any income beneficiary under any optional method of settlement allowed by the issuLng cOm?a~Yi (jl ':'0 If.vest in endo'....TI!ent, insurance or annuity poli- cies on t~e li~es of beneficiaries hereunder; (k) To co all other acts in its judgment necessary or -0- desirable for t~e proper management, inves~~e~t and distribution of the Trust Estate. SIX: TAXES. - All estate and inheritance taxes that become payable by reason of the Settlor's death in respect to the property passing under this Agreement shall, to the extent possible, be paid by the Settlor's estate and not from the property passing under this Agreement. To the extent that taxes, including interest and penalties, shall be paid from the property passing under this Agreement, ~o beneficiary shall be required to refund any part thereof. SEVEN: P~OTECTI\S ?ROVISIO~. All i~come or princi?al held for the use and benefit of the beneficiaries 0: this trust shall ~ot be in any way or manner sub- ject to antici~ation, assignment, ?ledge, sale or transfer, nor shall any such interest, while ih the possession of the Trustee, be liable for or subject to the debts, contracts, obligations, liabilities or torts of any beneficiary, or to attacr~ents, execu- tions or sequestrations under ~rocess of law. EIGHT: RESIG~.;'TIO:;; A:~D C00<IPENSATIO)J OF TRUSTEE. The T~ustee may resign duri~q the lifetime of t~e Settlor upon thirty (30) days' ~ritten notice to the Settlor. ~ successor trustee may be a?poi~ted by the Settlor, and such successor trustee shall succeed to all the duties and all the powers, including dis- cretionary powers, herein granted to the Trustee~ In the even t of the appointment 0: a successor trustee by a Court with jurisdiction over the Tr~st Estate, such successor trus~ee shall also succeed to all the duties a~d all the ?owers, includi~g discretionary powers, hereiJ gra~ted t8 tte T~~stee. T~e me~~er Dr consolidation of any corporate trus~ee snail ~ot affect its duties and powers. -6- The Trustee shall receive fair and reasonable compensation hereunder. NINE: ABSENCE OF BOND FOR TRUSTEE. The Settlor's express intent is that the Trustee shall serve without bond of any sort in any jurisdiction. The Trustee may make expenditures for and distributions to persons under disability of any sort without the intervention of a guardian. TEN: REVOCATION During Settlor's lifetime, she may, by written instrument filed with the Trustee, revoke this trust, in whole or in part. upon paying the sums due the Trustee for its services hereunder. or may from time to time alter or divest the interest of or change the beneficiaries of this trust without limitation in any respect, and may otherwise modify this trust, but no modification shall increase the duties of the Trustee without its consent. ELEVEN: TRANSACTIONS WITH ESTATE OF SETTLOR. Without liability for loss, the Trustee shall have the power to lend money to the Settlor's estate, with or without security, and to pay the expenses of Settlor's last illness and burial and any taxes, federal, state or other, imposed On Settlor's estate. IN WITNESS WHEREOF, the Settlor has hereunto set her hand and seal, a~d the Trustee has caused these presents to be executed by duly authorized officers and its corporate seal to be hereunto affixed the day and year first above written. 0S: ~;/L~~~~tLt~ /'77ff{.",(. :.:(;,7'i:jc~/wJ (SEAL) STELLA A. FITZPATRICK ATTEST: L'/ /,' L- /? /'7'':''-::; ,;/;.' -/ /' {A3sistant) Secretary THE COMMONWEAlTH NATIONAL BANK By 4tC.U ) C.( '- ,~) / (Vice) President / I , .J..CO R?O RATE SEAL) -7- COMMON'flEALTH OF COUNTY OF c<!l PENNSYLVANIA --/ V' 55. On this, the d 7 '?- day of ~~, 1979, before me, the undersigned officer, personally appeared STELLA A. FITZPATRICK, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. '-~Ll.~ 2. N~t;-iI Public ~ My Commission Expires: /) ^ ~ n ..~ /," / 'J d C ~/ './ ) COMMONWEALTH OF PENNSYLVANIA 55. COUNTY OF DAUPHIN who On this, the / day of (;~GLv.;;L , 1979, before me. undersigned officer, personally appeared ~. Lv. ~!J oj, 0 ~ ,(/,)}(I ";, y- acknowledged ~self to be Jj Y;;i.uv " ~,,_l:; of THE COMMONlVEALTH NATIONAL BANK, a national banking association the organized and existing , and that,~, as such under the laws of the United States of America, 7~' 1 . '1 ,: 'f'~ , being authorized so to do, executed the foregoing instrument for the purfose ~ contained by signing the name of the association by ~self therein as rU . " ".-; 'k.u./ r/lL~ IN WITNESS WHEREOF, I hereunto set my hand and official seal. ,<it/- Notary (, Public ;/ l >,'e~_l My Commission Expires: -",' --".' . ''''',+l;:7 :"t)'I~RY p..-":~'~,f. ...~.,.)\; .,' ..'1..,"./ ,',:j.', c. . .....,. .. :;,i~FS jA~ 1: .. '----',"J:-" !>,.SD(.I~tlnr. ~. "',~. ,n SCHEDULE A Cash in the amount of $37,000 delivered to The Commonwealth National Bank on February 6, 1979, pursuant to a temporary Trust Agreement of that date, plus any and all income, net of expenses and fee, earned from that date to the date of this Agreement. i\MENDMEtiT TO TRUST AGREEMENT BETWEEN STELLA A. FITZPATRICK, SETTLOR AND COMMONWEALTH NATIONAL BANK, TRUSTEE DATED FEBRUARY 27, 1979 Know all per-sons by these presents that in consider-ation of the mutual covenants of the par-ties hereto, this Amendment is entered the day of ~ ~ __ ,., ,- , 1988, between Stella A. Fitzpatrick of 232 Four Seasons Lane, Enola, Cumberland County, Pennsylvania, hereinafter- called the Settlor-, and the Commonwealth National Bank, LO South Market Squar-e, Harrisburg, Dauphin County, Pennsylvania, hereinafter- called the Tr-ustee as follows: I. TRUST PROPERTY Settlor has tr-ansfer-ed and delivered to the trustee the additional sum of $15,000.00 to be added to the trust property and to cons t i tu te a pert ion of the trust esta te and this sum shall be held, administered and distr-ibuted as pr-ovided in the Tr-ust Agr-eement and this amendment. II. DISPOSITIVE PROVISIONS Settlec her-eby deletes subparagraph (b), subparagraph (c) and its subparts, and subparagraphs (d) and (e) under paragr-aph t'..JO of the r:,.ust Ageement dated Februar-y 27, 1979, which is captioned nJ(): DISPOSITIVE PROVISONS, and the following language is inser-ted in place thereof: (b) Upon Settloc's death, if Ecic Bdan Ceja, Jr. is under twenty-five yeaes of age, $15,000.00 shall be set aside in this tcust foe Eeic Beian Ceja, Jr. and managed pursuant to the tenns of the tt'ust agt"eement and this amendment. If he is over twenty-five yeacs of age, the $15,000.00 shall be di.stributed to him at Settlors death. One-thied of the eemainder of the trust funds shall be distributed promptly to Settlo'C's daughter The'Cesa Jean Ceja, and one-third of the 'Cemainder of the teust funds shall be distributed to Settlor's grandson, Eric Beian Ceja, Se.. Upon such distribution, Eric Brian Ceja, S'C. and Theresa Jean Ceja shall cease to be beneficiaries under this trust. Foe purposes of determining the amount of disteibuti.on to which they are entitled, the date of Settloc's death is the date on which those funds shall be dete,nnined. Any increases to the trust property as a result of Settlor's death or received subsequent to the date of Settlor's death, shall not be held for the benefit of Edc Brian Ceja, Sr. or Theeesa Jean Ceja, but shall be held for the benefit of Eric Bcian Ceja, Je.. (c) If Settloe's great-grandson Eric Brian Ceja, Jr. has not reached the age of twenty-five at the time of Settlor's death, the trustee shall apply and distribute the net income and the peincipal of the trust estate for the purpose of paying fot" a t'dO yeac or :our yeat:" ::ollege education for Eric Brian Ceja, Jr.. "College education" shall be deemed to include tuition, eoom and board only. The trustee shall pay the sums directly to the school where Ecic Bcian Ceja, Jr. is enrolled and/or to the peovidee of eoom and board. The trustee shall not be obliged to supervise oe inquiee into the application of such amounts by such institution or [leovider, and the receipt of such institution or provider shall be a complete release of the teustee. Howevee, in the event of the t.otal disability, at any time, of Ecic Beian C'-'Ja, Jc. the trustee shall pay for his benefit such amounts of income and principal of the trust -2- estate as may be ~equired fo~ his p~oper and adequate support, including but not limited to medi~al and hospitalization costs. When Eric Brian Ceja, Jr. is twenty-five years of age, the trust shall terminate and the balance shall be dist~ibuted to him. If Eric Bdan Ceja, Jr. is twenty-five years of age or olde~ at Settlo~s death, the balance of the trust shall be dist~ibuted to him and the trust shall terminate. (d) If Eric 8dan Ceja, Jr. predeceases Settlor or dies before attaining twenty-five years of age and before receiving the entire trust balance, the trustee shall dist~ibute the then existing trust balance to his issue per sti~pes in equal shares, but if he is not survived by issue, then the trust balance shall be distributed equally between Eric Brian Ceja, Sr. and Theresa Jean Ceja or the survivor of them,. and if Eric 8rian Ceja, Sr. and Theresa Jean Ceja predecease Eric Brian Ceja, J~., then the balance shall be distributed equally among the su~viving brothers and sisters of Settlor. If Eric Bt"1an Ceja, Sr. or Theresa Jean Ceja predecease Settlor, their share of this trust shall continue in trust under the trust Agreement and this Amendment for the benefit of Eric Brian Ceja, Jr. and be distributed to Eric Brian Ceja, Jr. in acco~dance with the T~ust Agreement and its Amendments. III. MINORITY PROVISION Settlor hereby Agreement dated February MINORITY PROVISION. deletes parag~aph 3 of the Trust 27,1979, which is captioned THREE: " , , -3- IN WITNESS WHEREOf, the Settlor has hereunto set her hand and seal to these amendments to her original trust Agreement dated february 27, 1979, and does in all other aspects, ratify and reaffirm the Agn:ement that she executed between herself and Commonwealth National Bank, Trustee on february 27, 1979. //,7/ c7 /) ~~ T~ , ./ -, (' ,/ .\7;- (,: < Stella A. .. .___" "r . i-t . ,/~, -4JJ, ._~ ~ -1' (.( {~~'{ /[ 1 ~ f( Fitzpatrick !/R: /j J;q Witness I!),(~ ~ YuL' Witness Commonwealth National Bank By _~ h1 &e-- ~ 0Jf~' ii , , , -4- COMMONWEALTH OF PENNSYLVANIA ss COONT' 0' 'j!i lIif ' On this /-~t- di y of -X f.// (1/ ))/ /Vt 1988, before me a Notary Public, personally appeared Stella A. Fitzpatrick known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. . . . . In witness whereof, I hereunto set my hand and seal. //;" ~ary J ('o.lo)..a.--;..'; SDi':J Chr[slJne A. Za.;i(;(), :'l~ary p~;c Ma<ysvi:!e Borough. Perry County My Cornmis~cn E;:piras JU:y 19, 1:9~1 " ;i I' COMMONWEALTH OF PENNSYLVANIA ss I I' COUNTY OF DikcP14/tJ On this day of D~C'.ef)1ber ,1988, before me a / '. ' Notary Public, personally appeared 5htJ(D}; lvi, =rCl6 who acknowledged himself or herself to be a }k"s, uP;<"/aa:? of Commonwealth National Bank, a national banking assoc~ation organized and existing under the laws of the United States of America and that he or she as such 7RPsr {)FP<~c."7Z... being authorized so to do so, executed the forego~ng ~nstrument for the purposes therein contained by signing the name of the association by himself or herself and who is known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he or she executed the same for the purposes therein contained. In witness whereof, I hereunto set my hand and seal. Notary Publ~c ~ :< <~ 0 "' OJ" :< :< :< " '" ~ ~ ;<1< '" " " 0 '" " ~ ~ . ;<I t< e- " " n 0 " H H e- " '" 0 ~ " e-HH " H " 0 ~ '" ~ H':z:2 " " ~" " A ~ H w ~ on" H < :.~ ""., "' '" 000 '" " ~'" " ;: ""' " " H:<:< '" '" ~" H A;<I '" '" '" 0"" e- .., ~;<I " "'''' Cl "0 .., :< .., " "' "' OJ" ",n" on " ~ , 0 N.., i:: '" ~ '" " "''''' ..,'" " ~" '" ,n H " c;:~~ "'~ .., """ H 00 " ,,,v .., "" e-" " 0" " 0", .., <H N "' Z :< " ~ ~ ~ " " 0 < .., " '" '" 0 :< z " H .., .; ~ "' 0 '" 0 ;<I H " H Cl :< " " ~ " < 0 " t< '" .., .., " " ;<I A A ~ .., " '" ,~ H ~ ~~ ." ~ '" .., , "' 0 " .., '" H H H ~ ~" " wO e- ~ WH '" H'" " ~" < H 0 ~ ~~ '" 0 '" '" , '" ~:=: '" ;<I t< 0 O~ A~ w HO N" 0 "e- O~ ~~ '" e "'''' " " n " H t< ;<I "'Z < '" :< " "'''' " " e- '" ~ 0 H A ~ W~ ~ "' 0, A H ~ ~~ ~H ;;; .., , '" - '" W wH A e~ we e- A H H W ~x A ~ '" AO> W ,,~ "'H n A ~ 0 N ~~ ~ A'" N:< '" '" ~~ ~ H '" .., ~ ;<I OH H "0 0 " H ~ "''' 0 ~ 0 '" '''' '" 0 '" '" .; "'''' "'" H '0 '" HO "''' '" OZ H ZZ H ;<I" , '"" 0 "" w H H e- , , , H 0 H W HW ClZ A ~~ ~A W '0 O>~ ~W ,,~ e-, >< HO W W 0 "''' ~ ~ bi:l " " '" H H" , " A , 0 A'O Cl H H A "'H Estate Valuation Date of Death: valuation Date: Processing Date: 09/21/2004 09/21/2004 11/03/2004 Estate of: FITZPATRICK STELLA A T/A Account: 10170683BN5 Report Type: Date of Death Number of Securities: 2 File ID: 06838N5 Shares or Par Security Description High/Ask Low/Bid Mean &/or Div & Int Security Adj'ments Accruals Value 1) 4226.37 (CASH) CASH fu,D CASH EQUIVALENTS 4,226.37 2 ) 2971.828 MELLON FDS TR (585S1X64S) SIT US GV SC M Mutual Fund (as quoted 09/21/2004 by NASDAQ) 12.48000 l1kt 12.480000 37,088.41 Total Value: Total Accrual: Total: $41,314.78 $41,314.78 $0.00 Portfolio Endnotes The breakdown of principal and income for cash and cash equivalents may be ~btained by ordering an El statement from the SEI system. If a Collected and ~ccrued Income calculation is required, a request can be made to the ~istribution Unit and cash and cash equivalents information is provided as a ~ortion of the accompanying calculation. 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) Estate Valuation ,-te of Death: ,-luation Date: cocessing Date: 09/2112004 09/21/2004 11/03/2004 Estate of: FITZPATRICK STELLA AT/A Account: 10170683BN5 Report Type: Date of Death Number of Securities: 2 File 10: 0683BN5 Shares or Par Security Description High/Ask Low/Bid Mean &/or Div & Int Security Adj'ments Accruals Value 1 ) 4226.37 (CASH) CASH AND CASH EQUIVALENTS 4,226.37 2 ) 2971.828 MELLON FDS TR (58551X645) SIT US GV SC 11 l1utual Fund (as quoted 09/21/2004 by NASDAQ) 12.48000 I1kt 12.480000 37,088.41 Total Value: )tal Accrual: Total: $41,314.78 $41,314.78 $0.00 Portfolio Endnotes ,e breakdown of principal and income for cash and cash equivalents may be )tained by ordering an El statement from the SEI system. If a Collected and :crued Income calculation is required, a request can be made to the .stribution Unit and cash and cash equivalents information is provided as a )rtion of the accompanying calculation. 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) Estate Valuation lte of Death: lluation Date: cocessing Date: 09/21/2004 09/21/2004 11/03/2004 Estate of: FITZPATRICK STELLA A T/A Account: 10170683BN5 Report Type: Date of Death Number of Securities: 2 File ID: 0683BN5 Shares or Par Security Description High/Ask Low/Bid Mean &/or Div & Int Security Adj'ments Accruals Value 1) 4226.37 (CASH) CASH AND CASH EQUIVALENTS 4,226.37 2 ) 2971.828 MELLON FDS TR (58551X645) SIT US GV SC N Nutual Fund (as quoted 09/21/2004 by NASDAQ) 12.48000 Nkt 12.480000 37,088.41 Total Value: )tal Accrual: Total: $41,314.78 $41,314.78 $0.00 Portfolio Endnotes le breakdown of principal and income for cash and cash equivalents may be )tained by ordering an El statement from the SEI system. If a Collected and :crued Income calculation is required, a request can be made to the .stribution Unit and cash and cash equivalents information is provided as a Jrtion of the accompanying calculation. 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) @ Mellon P.O. Box 3147 Pittsburgh, PA 15230-9414 December 02, 2004 William C. Dissinger Dissinger and Dissinger 28 North Thirty-Second Street Camp Hill, PA 17011 Estate Of Stella Fitzpatrick Date of Deatl1: 09/2l!2004 SS;-,r 158-12-5475 Dear Sir/Madam: In accordance with your request, the attached information sheet has been provided in the above decedent's name as of his/her date of death. For IL or LC accounts, contact our Loan Department at 1-800-537-5591. For all other inquiries, please call (412) 234-4181. Sincerelv. ~/u1 KathyNa~e )J cD'-C Mellon Private Wealth Operations 154-0650 Page 1 of 2 Purore ~ku/rh J/UilU\!.t'il.'otr PO B\),\ 3J-1-7 . Pjtl~hurgh. P.-\ 152,;O-9..\.1..\. A .Vet/oll Finuncla! CiII/!jlillf,\ ", ~ ...1 @ Mellon Bank Account Number Account Title 2423620216 Stella Fitzpatrick Thursday, December 02, 2004 Date Opened: 01/01/1993 Principal Sal Int from Last as of DDD Posting to DDD $7,17773 $000 Account Type: DD Account Sal as of DOD $7,177,73 YTD Int to DOD $0,00 Page 2 of 2 V1Way~qi!lt 11/2912004 DISSINGER AND DISSINGER 28 N THIRTY-SECOND ST CAMP HILL PA 17011 The information which you requested on the account(s) of STELLA A FITZPATRICK (Social Security Number 158-12-5475) is/are as follows: Date Opened 100034700 SAVINGS 010171 600.29 .06 600.35 Account Number Class of Account Principal Balance Accrued Interest Balance at Date of Death Account Ownership SOLE Name of Joint Owner, if any Date Ownership Was Established 010171 Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established Additional Information Requested ~c.erelY~. LEr~ I ERfN Mv,,, . SENIOR SERVICES REP. PO. Box 1711. HARRISBURG. PENNSYlVANIA 17/05-17/1 Toll FrEE 1-866-WAYPOINT (I-866-929-7646J' IN YORK AR"A 717/"'1<::_"'''''''''' . u_._...___ WARRE,\; R. HOOVER, JR., S~lperuiSDr 6011 Linglestown Road Harrisburg, PA 17112 (717) 632-8888 FWleral Homes & Crematory, me. SHELDON K. HOOVER, Superuisor Route 422 & lucy Avenue PO. Box 475 Hershey, PA 17033 (717) 533-7700 Estate of Stella A. Fitzpatrick C/O Eric B. Ceja 536 Thrush Court Harrisburg, PA. 17111 Funeral Expenses for Stella A. Fitzpatrick Professional Services~ Use of Facilities, Automotive Equipment and Necessary Documents $ 2450.00 Merchandise Selected Star Silver Casket Sentinal Vault 1095.00 990.00 Total Funeral Home Charges $ 4535.00 Total From Pennsylvania Funeral Trust 4043.00 Total Due ....................................................... 0.00 Cash Advances Cemetery Charges opening & closing of grave Casket Spray $160.00 + tax; 169.00 Clergy/Minister Cemetery lowering device greens and tent Patriot News obituary notice Certified Copies of the Death Certificate 10@2.00ea $ 900.00 169.00 100.00 100.00 42.46 20.00 Total Cash Advances 1331.46 Total From Cash Advance Account/ Pennsylvania Funeral Trust $ 545.90 Total Due..................................................$ 785.56 Eric, Cash advances are the only items not guaranteed in a funeral pre- arrangement. These items the funeral home has no control over. Thank You, Clifford D. Forester Sr. FD. WARREN R. HOOVER; JR., Supervisor 6011 LingJestown Road Harrisburg, PA 17112 (717) 652-8888 Funeral Homes & Crematory, Inc. SHELOON K. HOOVER, Supervisor Route 422 & Lucy Avenue P.O. Box 475 Hershey, PA 17033 (717) 533-7700 Estate of Stella A. Fitzpatrick C/O Eric B. Ceja 536 Thrush Court Harrisburg, PA. 17111 Funeral Expenses ror Stella A. Fitzpatrick Professional Services. Use of Facilities, Automotive Equipment and Necessary Documents $ 2450.00 Merchandise Selected Star Silver Casket Sentinal Vault 1095.00 990.00 Total Funeral Home Charges $ 4535.00 Total From Pennsylvania Funeral Trust 4043.00 Total Due ....................................................... 0.00 Cash Advances Cemetery Charges opening & closing of grave Casket Spray $160.00 + tax = 169.00 Clergy/Minister Cemetery lowering device greens and tent Patriot News obituary notice Certified Copies of the Death Certificate 10@2.00ea $ 900.00 169.00 100.00 100.00 42.46 20.00 Total Cash Advances 1331.46 Total From Cash Advance Account/ Pennsylvania Funeral Trust $ 545.90 Total Due .................................................. $ 785.56 Eric, Cash advances are the only items not guaranteed in a funeral pre- arrangement. These items the funeral home has no control over. Thank You, Clifford D. Forester Sr. FD. LAST WILL AND TESTAMENT Of STELLA A. FITZPATRICK I, Stella A. cicz93cricK, of 232 fou~ Seasons Lane, Enola, Cumbedand County, Pennsylvania, being of sound and disposing rn"nd, mcmoey and unde::-standing, do make, publish and declaee this to be my Last Will and Testament, hereby eevoking all wills and codicils he::-etofoee made by me. ITEM I. I dicect that all my debts and funeral expenses, including my cen2tery lot anc g~ave,narker and all expenses of ! my last illness, shall be paid fro~ my residuary estate as soon ~ c.::::: .~ administration of my estate. as peacticable aftee my death as pact of the expense of the , 1\-" '-- l',--' " ITEM I make fo 110'.{ i ng and specific devises the II . bequests: A. My c~r to my daughter, The~esa Jean Ceja. B. My ho~sehold goods to my g~andson, E~ic B~ian Ceja, S"'::'. . . . ~ .;, '- ~..::::: v f' ,.' , ITEM III. I devise and bequeath all the eest, eesidue and :~2main~er of my estate of ~vecy natuce and whe~eever situate as follows; , One-thi-=.-d to my daughtec:- Thec:-esa Jeal1 Ceja. ,'-\.. B. One- th i 'Cd to my gc:-andson, Ec:-ic Beian Ceja, Sr.. ~ One- th i c:-o to Commonwealth National Bank IN TRUST ~ . fo~ th,-, use and benet it of my gc:-eat-gc:-andson, Eric Brian Ceja, J c. t ?uesuant to the tec:-ms of a tc:-ust agc:-eement executed F2b'CC2!:Y 27, 1979, between Stella A. fitzpateick and the Commonwealth National Bank and as the trust was amended su!Jsequent to that date and pc:-ioc:- to the execution of this will. Should the afoc:-said bequest to the tc:-ust fail for any :eason, I devise end !Jequeath the one-third for Eeic Brian Ceja, Je to him di:cectly if he is ovec:- twenty-five yeac:-s of age. If he lS 'under twenty-five years of age, then to COClmonwealth National Bank IN TRUST foc:- Ec:-ic Brian Ceja, Jr. until such time as E,:",ic BriBn Ceja, Jc. attains the age of twenty-five. ITEM IV. I direct that any and all Inheritance, Estate and Tcanst~;- taxes imposed upon my estate pass1ng unGer 8Y Will or otherwise! shall be paid out oE the p~inciral of my 'C8sidual estate. 2 c.; -~l I, i' ,I 11 I: ITE~~ " , . I a2?oint. my gr-andson, Eric Br ian Cejo, Sr. :::xecuto:::- of this my Last will and Testament. In t~e event of nis reil.'''::Dciation, c.eath, resignation or inability to act f6r any ~eason whatsoever, I a?point Co~onwealth National Bank, Executor of this ::<y Last \!ill and Testament. I relieve my Executor rr-or.1 t!--.e necessity of posting securit.y in. connect.ion with his duties as such in any jurisdiction in which he may be callec upon to act. Hi \HTtiESS m-!EREOF, I have hereunto set my hand to this JOy Last Will and Testament, which consists of 1 ~ pages, to each of <...thich I have affixed my signature this day of " ' /' , one thousand nine hundred and eighty-eight (1988). i I ;~-/I.' /-C -;'~ // / /' _ ,I c[I.'-~'~ --:-r //z. / /(.-:-:-:r /' f;~~ St 11 A F' ~<,F- ea. :l.tzpacrlCK 1-/:;" :./1'/ 3 COMMO~~EALTH OF ?ENNSYLVANIA COU~JTY OF ss , and' the testatrix an the ~itnes s respectlve es are signed to th attached 0':: forecoina instrument, be~ng first duly s'.-.'orn, do hereby declare - to the undersigned authority that the testatrix signed and executed the instrument as her last will and that she had signed wi 11 ingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the will as witness and that to the best of their knowledge'the testatrix was at that time eighteen years of age or older, or sound mind and under no constraint or undue influence. .. / ~ .:~(,:.. Testatrlx <------- ~ - --;:- j ~ . .rj:"'< ;,L / / .</. "-----J? ?! (' ~-~ Witness... .--, 1'\ I fill;,. //)u) 1 1 (lUI/ !:;U>..{.1/Y) . li:1../f/}jJ)v'r Wl tness I /, Subscribed and sworn to and acknowledged by Stella A, Fitzpatrick, Testatrix ed -and swam ::' a~JD9bTJfJ~~~ rr.f~q~~{t~( , i; , I i'! 11C, l'k.!ariRi 5;sal Chr:s~l;,;~ A. Z-~.:' '''_~. ;-',- ~j Pub~i-c; Mar-j3'/;;ia 2cel':<;~" P~yri (:our.li Uy 0.:J,<lx,:::sl;n E::^;-~;2'$ ...Juiy 19, 19C"';: 4 Cumberland County - Register Ot WlllE: One Courthouse Square Carlisle, PA 17013 phone: (717) 240-6345 Date: 7/27/2006 DISSINGER MARY A ETTER 400 S STATE ROAD MARYSVILLE, PA 17053 RE: Estate of FITZPATRICK STELLA A File Number: 2004-00915 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted adrninistration. This filing is due by: 9/21/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ,4 .r ~. ~. b- ~h_P J~~~ i>./~1AJ ~r Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 phone: (717) 240-6345 Date: 7/27/2006 CEJA ERIC BRIAN SR 536 THRUSH COURT HARRISBURG, PA 17111-5303 RE: Estate of FITZPATRICK STELLA A File Number: 2004-00915 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 9/21/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ;/ . C,.P" d LAU ~ ~ LVi~ d:-.u.--::J Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel 'II" ".'-- > . o I ' ~~ '- ; ~ Register of Wills of Cumberland County STATUS REPORT U1\TDER Rul~E 6.12 Name of Decedent: <:==-jc II'n I t f-:~ -t(~ t)Cit i 1 ~ /<'- Date of Death: q /.2 I ft'\ ti Estate No.: fJ l,e L/_ 0C t I ( S Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State wh~er administration of the estate is complete: Yes U No 0 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a fmal account \vith the Court? Yes 0 No 01 b. The separate Orphans' Court No. (if any) for the personal representative's account is: t.J / ~.\-- { c. Did the personal r~.esentative state an account infqrmally to the parties in interest? Yes Dc No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed vrith the Clerk of the Orphans' COUerr and may be attached to this report. Date: 7/2 liz' (.. I I L ( 'V\ l {t G't;l Signature ' ( I ,,/"'~' , /\ I\...._ ~'c. .j..L C .. -- '- J-'- L-I.' ) \ l'(! HI Name } "- ,- . ( '\:) ( 'S .s" ,,( <:., ..e ( Q<i) ~ Address J d_~~~0 _S'\- (C1'''j IP l-fl' l ( () 1/1- "7 t l~'1-z~---- ,J ~ ~/ ( ) Telephone No. ...... ~ ,'. . v .../ ..~..;; ( Capacity: 0 Personal Representative BCounsel for personal representative \ '3'V'J