HomeMy WebLinkAbout04-0309BUREAU OF INDIV[DUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 28060!
HARRISBURG, PA 17128-0&0!
ALEXANDER R DOLATOSKI
3519 LISBURN RD
MECHANICSBURG PA 17055
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRA/SBHENT. ALLONANCE OR DXSALLONANCE
OF DEDUCTIONS, AND ASSESSNENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
:DATE . 05-22-200q
ESTATE 0.~ DOLATOSKI
DATE OF DEATH 02-06-2005
FILE NUMBER
0 TY ~ CUMBERLAND
ACN 05116966
Amount Remitted
HAKE CHECK PAYABLE AND REHIT PAYHENT
REGISTER OF ~ILLS
CUHBEELAND CO COURT HOUSE
ALEXANDER P
CARLISLE, PA 17015
CUT ALONG THIS LINE
RETAIN LOWER PORTION FOR YOUR RECORDS
REV-1548 EX AFP C01-05~
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 05-22-2004
ESTATE OF DOLATOSKI
ALEXANDER P DATE OF DEATH 02-06-2005 COUNTY CUMBERLAND
FILE NO. S.S/D.C. NO. 205-10-4575 ACN
TAX RETURN NAS: CX) ACCEPTED AS FILED C ) CHANGED
05116966
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: WAYPOINT BANK ACCOUNT NO. 500007156
TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ¢ ) TRUST (~ TIME CERTIFICATE
DATE ESTABLISHED 07-15-1998
Account Balance 22,578.09
Percent Taxable X 0.166
Amount Sub§ect to Tax 5,729.76
Debts and Deductions - .00
Taxable Amount 5,729.76
Tax Rate ~ .15
Tax Due 559.46
TAX CREDITS=
NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
NTEREST IS CHARGED THROUGH 05-50-2004
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~
IF TOTAL DUE IS LESS THAN ¢1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" C CA), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THTS FORM FOR INSTRUCTIONS. }
.O0
559.46
9.75
569.21
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 28060I
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAXSEHENT. ALLOHANCE OR DXSALLONANCE
OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
JOXNTL¥ HELD OR TRUST ASSETS
'~ H~R 26 ~1:48
ALEXANDER R DOLATOSKI
$$19 L[SBURN RD
HECHANICSBURG ~[~A 17055
DATE 05-22-2004
ESTATE OF DOLATOSKI
DATE OF DEATH 02-06-2005
FILE NUMBER '2I'Oq*~(~"~
COUNTY CUMBERLAND
SSN/DC 205-I0-4575
ACN 05116964
Amount Remitted
ALEXANDER P
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~l~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
~-:[~%--~--~--~5~=5~¥ ...................................................................................
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 05-22-2004
ESTATE OF DOLATOSKI
ALEXANDER P DATE OF DEATH 02-06-2005 COUNTY CUMBERLAND
FILE NO. S.S/D.C. NO. 205-10-4575 ACN 05116964
TAX RETURN NAS= (X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: WAYPOINT BANK ACCOUNT NO. 591287274
TYPE OF ACCOUNT: C ) SAVINGS ( ) CHECKING C ) TRUST (~ TIME CERTIFICATE
DATE ESTABLISHED 04-22-1996
Account Balance 50,187.82
Percent Taxable X 0.166
Amount Sub§ect to Tax 5,051.40
Debts and Deductions .00
Taxable Amount 5,051.40
Tax Rate X .15
Tax Due 754.71
TAX CREDITS;
NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. HAKE CHECK
OR HONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID
INTEREST IS CHARGED THROUGH 05-50-2004 TOTAL TAX CREDIT I
I
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE
REVERSE SIDE OF THIS FORM INTEREST AND PEN.
TOTAL DUE
* IF PATD AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL TNTEREST. ~
C IF TOTAL DUE IS LESS THAN ~1, NO PAYMENT IS REQUIRED.
ZF TOTAL DUE IS REFLECTED AS A "CREDIT" C CR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
.00
754.71
15.16
767.87
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAXSEHENT. ALLONANCE OR DXSALLO#ANCE
OF DEDUCTIONS, AND ASSESSHBNT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
ALEXANDER R DOLATOSKI
5519 LISBURN RD
MECHANICSBURG
DATE 05-22-2004
ESTATE OF DOLATOSKI
' DATE OF DEATH 02-06-2005
FILE NUMBER ~1- 0~-~0~
COUNTY CUMBERLAND
HAR 26 :48 SSN/DC 205-10-4575
ACM 05116968
Amount Remitted
ALEXANDER P
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1548 EX AFP C01-055
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 05-22-2004
ESTATE OF DOLATOSKI
ALEXANDER P DATE OF DEATH 02-06-2005 COUNTY CUMBERLAND
FILE NO. S.S/D.C. NO. 205-10-4575 ACN 05116968
TAX RETURN WAS: CX) ACCEPTED AS FILED C } CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: WAYPOINT BANK ACCOUNT NO. 591287275
TYPE OF ACCOUNT: C ) SAVINGS ( ) CHECKING C ) TRUST C ~ TIME CERTIFICATE
DATE ESTABLISHED 04-22-1996
Account Balance 22,266.58
Percent Taxable X 0.166
Amount Subject to Tax 5,711.14
Debts and Deductions - .00
Taxable Amount 5,711.14
Tax Rate X .15
Tax Due 556.67
TAX CREDITS-'
NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
PAYMENT
DATE
RECEIPT
NUMBER
DISCOUNT C+)
INTEREST/PEN PAID C-)
INTEREST IS CHARGED THROUGH 05-50-2004
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
AMOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. *
IF TOTAL DUE IS LESS THAN ~1, NO PAYMENT [S REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" C CA), YOU MAY BE DUE A REFUND.
SEE REVERSE STDE OF THIS FORM FOR INSTRUCTIONS. )
.00
556.67
9.71
566.58
CERTIFICATION OF NOTICE UNDER RULE 5.6(al
Name of Decedent: Alexander P. Ilolatoski
Dale of Death:
02/06/03
Will No.
Admin. No. 04-00309
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(0).of the Orphaos' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on 09/30/05 :
Alexander R. Ilolatoski
Address
213 N. 45th Street
Harrisburg, PA 17111
14 S. Union St.
Middletown, PA 17057
~
Paul J. Ilolatoski
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
O~)j 30/ 05
,;,""," ~
Name Stephen J. , . quire
Ad~ress 19 S. Hanover St., Suite 101
Carlisle, PA 17013
Telephone V 17 ) 245-2698
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Capacity: ~ Personal Representative
~C~unsel for personal representative
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Cumberland County - Register Of Wills
One Courtbouse Square
Carlisle, PA 17013
phone: (717) 240-6345
Date: 1/04/2006
HOGG STEPHEN J
19 S HANOVER STREET
SUITE 101
CARLISLE, PA 17013
RE: Estate of DOLATOSKI ALEXANDER P
File Number: 2004-00309
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
wills a Status Report of completed or uncompleted administration.
This filing is due by:
2/06/2006
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
/#~~~
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Personal Representative(s)
Judge
\It
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Alexander P. Dolatoski
Date of Death: 2/6/2003
Will No.
Admin. No. 21-04-0309
Pursuant to Rule 6. 12 of the Supreme Court Orphans I
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1 . State whether administration of the estate IS complete:
Yes No X
2.
If the answer is No, state when the personal
ly elie es that the administration will be
representative
complete:
3 . If the answer to No. 1 is Yes, state the following:
a.
account with the Court?
Did the personal representative file a final
Yes No X
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c . Did the personal representative state an
account informally to the parties in interest ? Yes No X
d . Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Clerk of the Orphans I Court and may be attached to this report
Date: 1/18/2006
Steohen J. Hoag. Esauire
Name (Please type or print)
19 S. Hanover Street, Ste. 101
Carlisle PA 17013
Address
( 717 ) 2452698
Tel. No .
Capacity :
Personal Representative
X
Counsel for personal
representative
" I
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Alexander P. Dolatoski
Date of Death: 2/6/2003
Will No.
Admin. No. 21-04-0309
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphan's Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on 9/23/2005
Name
Address
Alexander R. Dolatoski
Paul J. Dolatoski
14 S. Union Street
Middletown
213 N. 45th Street
Harrisbura
PA 17057
PA 17111
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except:
Date: 1/18/2006
Name: Stephen J. Hoaa. Esquire
Address: 19 S. Hanover Street. Ste. 101
Carlisle P A 17013
Telephone(717) 2452698
Capacity:
x
Personal Representative
Counsel for Personal
Representative
:."] ,
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"V-1SOO EX + (fl..OO)
. COMMONWEALTH OF
. , PENNSYLVANIA
. DEPARTMENT OF REVENUE
DEPT. 280601
- HARRISBURG, PA 17128-0601
REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFACIAl USE ONlY
FILE NUMBER
2 1 -04 0 3 0 9
'"'COOKrYCOiiE -YEAA~ - - iMiER- -
:-
DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL)
Dolatoski Alexander P.
DATE OF DEATH (MM-DO-Year)
DATE OF BIRTH (MM-OO-Year)
2 0 5 - 1 0 - 4 375
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
Z
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02/06/2003 OS/27/1916
(IF APPUCABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST. AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
W
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=!U)
a:~
11.0
00
a:..J
Q.ID
11.
<(
00 1. Original Retum
D 4. Limited Estate
D 6. Decedent Died Testate (Attach copy of Will)
D 9. Litigation Proceeds Received
D 3. Remainder Retum (daleofdealhpriorlDI2-1J..82)
D 5. Federal Estate Tax Retum Required
_ 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under See. 9113(A) (AlIach Sch 0)
D - 2. Supplemental Retum
D 4a. Future Interest Compromise (datil of dealh aIlIlr 12-12-82)
D 7. Decedent Maintained a LivillQ Trust (AlIach copy ofTrustj
D 10. Spousal Poverty Credit (dMI of dealh ~ 12.31-91 and 1.1.95)
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11.
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THIS SECTION MUSTBE COMPLETED. ALL CORRESPONDENCEANO dONFIDENTIAL TAX INFORMATION SHOULD-BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
Ste hen J. Ho Es uire 19 South Hanover Street
FIRM NAME (If Applicable)
TELEPHONE NUMBER
717 245-2698
Carlisle
17013.
9400000 Co OFFICIAlnJSEO~<~
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88.853.24 : ~~ '-R
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1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent. Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Govemmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
(11)
(12)
(13)
44.043.49
138.809.75
(8) 182.853.24
27.392.22
16.651.27
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
(14)
138,809.75
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15. Amount of Line 14 taxable at the spousal tax
rate. or transfers under Sec. 9116 (a)(1.2)
0.00 X _ (15) 0.00
138,809.75 X ~(16) 6.246.43
0.00 X .12 (17) 0.00
0.00 X .15 (18) 0.00
(19) 6.246.43
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20. D
CHECK HE~IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWERALLQUESTIONSONREVERSESIDEANDRECHECKMATH < <
)ecedent's Complete Address:
STREET ADDRESS
3319 Lisburn Road
CITY
Mechanicsburg
STATE
PA
ZIP
. 17055
iax Payments and Credits:
Tax Ooe (Page 1 Line 19)
Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
6.246.43
Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + B +C)
(2)
0.00
Total Interest/Penalty ( D + E) (3)
If Une 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
0.00
0.00
6.246.43
6.246.43
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; ........................................................................... 0 l&l
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 IXJ
c. retain a reversionary interest; or ...................................................................................................... 0 l&l
d. receive the promise for life of either payments, benefits or care? ............................................................. 0 l&l
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?..................... ............................. ........................ ...... ....... ........ 0 l&l
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 l&l
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .............................. ..... ......... ........... ........ ........ .......... ........ ...... ........ 0 IXJ
:: THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
,;der penalties ofpeljury. Ldeclare that I have examined this return, including accompalying schedules and statements. and to the best of my knowledge and belief. it is true, correct and complete.
,claration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
.GNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
1~~~~; 9//6/196
.DDRESS'" 213 . 45th Street
H i
:GNATURE OF SENTATIVE
Jr dates of death on or after July 1, 19S4l"d F~oary. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
2P.S.~9116(a)(1.1)(i)].I\Jtt r. I 9'r 2 j- O(P ~<-
:or dates of death on Of after January 1, 1995, the tax r imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)].
he statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum are still applicable even if
Ie surviving spouse is the only beneficiary.
: or dates of death on or after July 1, 2000:
:1e 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,
; a stepparent of the child is 0% [72 P.S. 99116(a)(1.2)].
11e tax rate imposed on the net value of transfers to or for the use of the decedent's lineal benefidaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. ~9116(a)(1)).
he tax rate imposed on the net value of transfers to or for the use of the decedenfs siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
',dividual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1502 EX + (6-98)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Dolatoski Alexander P 21 04 0309
All real property owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real ro which Is In -owned with ht ofsurvivorshi must be disclosed on Schedule F.
SCHEDULE A
REAL ESTATE
ITEM
NUMBER
1.
DESCRIPTION
3319 Lisburn Road - Real Estate Valued at $188,000.00 Deed bklpg - 260/610
Mechanicsburg, PA 17055 50% owned by Alexander P. Dolatoski
Cumberland County 50% owned by Alexander R. Dolatoski
VALUE AT DATE
OF DEATH
94,000.00
TOTAL (Also enter on line 1. Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
94 000.00
. REV-1508 EX + (6-98)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Dolatoski Alexander P
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21 04
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.
0309
ITEM
NUMBER
1.
DESCRIPTION
Sovereign Bank Savings Account#0430058524
VALUE AT DATE
OF DEATH
85,904.23
2.
Sovereign Bank Checking Account#0032069288
934.38
3.
Sovereign Bank Savings Account#0430058524 Interest 2003
394.21
4.
Sovereign Bank Savings Account#0430058524 Int~rest 2004
216.02
5.
Sovereign Bank Savings Account#0430058524 Interest 2005
169.05
6.
Sovereign Bank Checking Account #0032069288 Interest 2003
1.78
7.
Sovereign Bank Checking Account #0032069288 Interest 2004
1.38
8.
Sovereign Bank Checking Account #0032069288 Interest 2005
1.13
10.
Estate Checking Account#0537047839 Interest 2005
Account established 10/12/05 by closing Checking Account #0032069288
and Savings account 0430058524
Estate Checking Account #0537047839 Interest 2006
23.03
9.
88.42
11.
Refund - Sewer and Refuse
1,119.61
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
88 853.24
. REV-1511 EX + (12-99)
*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Dolatoski Alexander P
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21 04
0309
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
Musselman's Funeral Home
7,625.00
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s) Paul J. Dolatoski
Social Security Number(s)/EIN Number of Personal Representative(s) 186-34-4864
Street Address 213 N. 45th Street
City HarrisburQ State PA Zip 17111
10,971.19
Year(s) Commission Paid:
2.
3.
Attorney Fees Stephen J. Hogg, Esquire
Family Exemption: (If decedents address is not the same as claimants, attach explanation)
Claimant
8,000.00
Street Address
City
Relationship of Claimant to Decedent
State
Zip
4.
Probate Fees
352.00
5.
Accountanfs Fees
6.
Tax Return Preparer's Fees
8.
9.
10.
Advertising:
The Sentinel
Cumberland Law Journal
Filing Inheritance Tax Return and Inventory
Filing First and Final Accounting (est.)
Death Certificates
137.03
75.00
30.00
130.00
72.00
7.
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
27 392.22
~EV-1512 EX + (6-98)
.
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Dolatoski Alexander P.
FILE NUMBER
21 04
0309
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. Freeman Real Estate - Appraisal
VALUE AT DATE
OF DEATH
200.00
2. St. Josephs
100.00
3. PP&L Final Bill
306.38
4. Telephone Bill
163.50
5. U.S.Treasuary (taxes)
3,409.00
6. PA Dept. of Revenue (taxes)
262.00
7. Taxes
160.00
8. Lower Allen Twp. - Ambulance Service
454.40
9. Lower Allen Twp. - Sewer and Refuse
1,146.01
10. Real Estate Tax - 2003 $5070.00 x 50%
2,535.00
11. Real Estate Tax - 2004 $5379.98 x 50%
2,689.99
12. Real Estate Tax - 2005 $4702.20 x 50%
2,351.10
13. Real Estate Tax - 2006 $2907.33 x50%
1,453.66
14. Reimbursement to AI R. DQlatoski for Real Estate taxes paid
1,358.73
15. Lower Allen Twp. - Lien Filing Fee ($123.00 x 50%)
61.50
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
16651.27
~V-1513EX+(l:l-~
.. ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURfJ
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
FILE NUMBER
. lUMBER
I.
AMOUNT OR SHARE
OF ESTATE
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTiONS [include outright spousal distributions. and transfers under
Sec. 9116 (a) (1.2)]
100% of Real Estate located at
3319 Lisburn Road
Mechanicsburg, PA 17055
50% Residuary (after tax)
1.
Paul J. Dolatoski
213 N. 45th Street
Harrisburg, PA 17111
Alexander R. Do:atoski
14 S. Union Stre:.;t
Middletown, PA 17057
Paul J. Dolatoski
213 N. 45th Street
Harrisburg, PA 17111
19,281.66
Lineal
94,000.00
2.
Lineal
19,281.66
3.
50% Residuary (after tax)
Lineal
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTr,:8UTIONS:
A. SPOUSAL DISTRIE'JTlONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND :;JVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART 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)
INVENTORY
Estate of Alexander P. Dolatoski
also known as
Alexander P. Dolatoski
, Deceased
No.21 04 0309
Date of Death 2/6/2003
Social Security No. 205-10-4375
!"oo.)
=
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory i~ge-all of th~
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, th~valuatiol't/)
placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that q~~~wned19
real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of thi$-iA~~m. 1/VilQ
verify that the statements made in this inventory are true and correct. I/We understand that false statements herein ma~:~~bjed-tg the
penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.) () 8 ):31!1
S'2 -"i"1 ::z
:0
--i
J~
Personal Representative:
XJ
-'J" r Ti
!-::.tle::)
\.,:;: C_)
;:'::1 f~~
~<.:: J:::J
C") ,-",\
,~I ~'l-i
-Tl
c'5
fT1
~) (-")
'-:,
Name of
Attorney:
~
Stephen J. HOQQ, Esquire
Paul J. Dolatoski
o
I.D. No.: 36812
Address: 19 S. Hanover Street, Suite 101
Carlisle
Telephone: 7172452698
Dated 9/21/2006
PA 17013
Description
Real Estate located at 3319 Lisburn Rd., Mechanicsburg, PA
Cumberland County
Value
94,000.00
Sovereign Bank Savings Acount#0430058524
85,904.23
Sovereign Bank Checking Account#0032069288
934.38
Sovereign Bank Savings Account#0430058524 interest 2003
394.21
Sovereign Bank Savings Account#1430058524 Interest 2004
216.02
Sovereign Bank Savings Account#0430058524 Interest 2005
169.05
Total
(Attach Additional Sheets if necessary)
182,853.24
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
RW-4
Continuation of Inventory
Alexander P. Dolatoski
21
04
0309
Page 1
Description of Inventory
Description
Sovereign Bank Checking Account#0032069288 Interest 2003
Value
1.78
Sovereign Bank Checking Account#0032069288 Interest 2004
1.38
Sovereign Bank Checking Account#0032069288 Interest 2005
1.13
Estate Checking Account#0537047839 Interest 2005
Account established 10/12/05 by closing Checking Account#0032069288
and Savings account#0430058524
Estate Checking Account#0537047839 Interest 2006
23.03
88.42
Refund - Lower Allen Twp. Sewer & Refuse
1,119.61
Subtotal $
1,235.35
182,853.24
Grand Total $
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
HOGG STEPHEN J
1 9 S HANOVER STREET
SUITE 101
CARLISLE, PA 17013
___n_n fold
ESTATE INFORMATION: SSN: 205-10-4375
FILE NUMBER: 2104-0309
DECEDENT NAME: DOLATOSKI ALEXANDER P
DA TE OF PAYMENT: 1 2/11 /2006
POSTMARK DATE: 1 2/11/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 02/06/2003
NO. CD 007546
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $927.52
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$927.52
REMARKS:
CHECK# 518
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
12-04-2006
DOLATOSKI
02-06-2003
21 04-0309
CUMBERLAND
101
APPEAL DATE: 02-02-2007
( See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE .... RETAIN LOWER PORTION FOR YOUR RECORDS +-
REv:is4;-ii-AFP-(03:o5i-NOTICE~oF-iNHiRiTANCE-TAi-APpiAIiEMENT:-iLLowANci-oi---------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ALEXANDER P FILE NO. 21 04-0309 ACN 101 DATE 12-04-2006
TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT 1 ALLOWANCE OR DISALLOWANCE
r'n rDo~~~c~.foNS AND ASSESSMENT OF TAX
REJ'JRDt vr. ILt \, I
'j'" ""\C'irr- {lC '
\-",c \.:h.J'.... h \~ii
~
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
2006 DEe I I
PH I: 0 I
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
STEPHEN J HOGG ESQ CLERK OF T
19 S HANOVER ST ORPHAN'S caUR
CARLISLE p,cli~oi3\/\.Hn ro. Pf\
ESTATE OF DOLATOSKI
.
REV-1S47 EX AFP (06-05)
ALEXANDER P
1~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
lS. A.ount of Line 14 at Spousal rate (lS)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Aaount of Line 14 taxable at Collateral/Class 8 rate (18)
19. Principal Tax Due
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. ~rtgages/Notes Receivable (Schedule D)
S. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
(1)
(2)
(3)
(4)
(5)
(6)
(7)
94,000.00
.00
.00
.00
88.853.24
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governaental Bequestsj Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
UO)
27,392.22
16.651.27
NOTE:
.00 X
138,809.75 X
.00 X
.00 X
NOTE: To insure proper
credi t to your account 1
subIIit the upper portion
of this fo~ with your
tax paYlIIH\t.
182,853.24
(11)
(2)
(3)
(4)
44.043 49
138,809.75
.00
138,809.75
00 =
045 =
12 =
15 =
.00
6,246.43
.00
.00
6,246.43
U9l=
TAX CRI!.DITS:
"' . . ..... . n........... {+J AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
09-21-2006 CD007229 .00 6,246.43
I
BALANCE OF UNPAID INTEREST/PENALTY AS OF 09-22-2006 TOTAL TAX CREDIT 6,246.43
BALANCE OF TAX DUE .00
INTEREST AND PEN. 927.52
TOTAL DUE 927.52
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR) 1 YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 007229
DOLATOSKI PAUL J
213 N. 45TH STREET
HARRISBURG, PA 17111
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
n____n fold
101
$6,246.43
ESTATE INFORMATION: SSN: 205-1 0-4375
FILE NUMBER: 2104-0309
DECEDENT NAME: DOLATOSKI ALEXANDER P
DATE OF PAYMENT: 09/21/2006
POSTMARK DATE: 09/21/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 02/06/2003
TOTAL AMOUNT PAID:
$6,246.43
REMARKS: PAUL DOLA TOSKI
CHECK# 511
SEAL
INITIALS: WZ
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
HOGG STEPHEN J
19 S HANOVER STREET
SUITE 101
CARLISLE, PA 17013
n______ fold
ESTATE INFORMATION: SSN: 205-10-4375
FILE NUMBER: 2104-0309
DECEDENT NAME: DOLA TOSKI ALEXANDER P
DA TE OF PAYMENT: 01/08/2007
POSTMARK DATE: 01/08/2007
COUNTY: CUMBERLAND
DATE OF DEATH: 02/06/2003
NO. CD 007651
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
03116965 I $195.63
03116963 I $263.91
03116967 I $194.66
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$654.20
REMARKS:
CHECK# 519
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
*'
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
C'-('(""pp.~~~"~~" ;~LLOWANCE OR DISALLOWANCE
;i:-'/.8P..ouue'rlONs;.:'AND ASSESSMENT OF TAX ON
=':-i-:::'::T'JOiN1't:J~i HELD OR TRUST ASSETS
; \L,,\.);......i ; :_1 l ...._.,'.": .~,....
DATE 12-11-2006
8 AM 9 1.8 ESTATE OF DOLATOSKI
2001 JAN - n: 't DATE OF DEATH 02-06-2003
FILE NUMBER 21 04-0309
COUNTY CUMBERLAND
SSN/DC 205-10-4375
ACN 03116965
APPEAL DATE: 02-09-2007
(See reverse side under Objections)
Amaunt Remitted I I
MAKE CHECK PAYABLE AND ReMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX ZlSOb01
HARRISBURG PA 171ZlS-0601
PAUL
213 N 45TH
HBG
CLERK OF
DOLATOSKI ORPHt\N'S COURT
CU' 181"""1'1', ,.,,, in An R'^
S T IV: ")\:J. i.j',i ";.,' I, -,'." , . r.
PA 17111
REV-154lS EX AFP (06-05)
ALEXANDER P
CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS +-
REV=is4S-EX-AFP-C03=Osi--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 12-11-2006
ESTATE OF DOLATOSKI
COUNTY
CUMBERLAND
ALEXANDER P DATE OF DEATH 02-06-2003
FILE NO. 21 04-0309
TAX RETURN WAS:
S.S/D.C. NO. 205-10-4375
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: WAVPOINT BANK
ACN
03116965
ACCOUNT NO.
500007136
TVPE OF ACCOUNT: ()SAVINGS () CHECKING ()TRUST ~ )TIME CERTIFICATE
DATE ESTABLISHED 07-15-1998
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
22,378.09
0.166
3,729.76
.00
3,729.76
.45
167.84
TAX CREDITS:
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAVMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEV ORDER PAVABLE TO:
"REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH 12-19-2006 TOTAL TAX CREDIT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 167.84
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 27.79
TOTAL DUE 195.63
· IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRl, YOU MAY BE DUE A REFUND.
- SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTrON~. 1
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
*'
PAUL DOLATOSKI
213 N 45TH ST
HBG
NOTICE OF INHERITANCE TAX
~~=~~j~~~~S~=E~S~~L~~~:
'~'1C:i,Jp.Xftffi't'''"ELD: OR: TRUST ASSETS
1 ,~.,~ \...01; '...! 1 '"-; I \~..' I ~ 1 .. I. _.... .'.
DATE 12-11-2006
2007 JAN -8 AM 9: II~~T~F o:EATH ~~~~r~~~~3
FILE NUMBER 21 04-0309
CLERK OF COUNTY CUMBERLAND
ORPHAN'S ('IOURT SSN/DC 205-10-4375
CUlAPr:r)!I'" r~ "n n~CN 03116963
IV1S,.~t I')\j\~.j I,.)" n~"\ APPEAL DATE: 02-09-2007
P A 17111 (See reverse side under Objections)
Amount Re.1ttedl I
MAKE CHECK PAYABLE AND REMIT PAYMENT
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE1 PA 17013
REV-1548 EX AFP (06-05)
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
;:JO BOX 210601
HARRISBURG PA 17128-0601
ALEXANDER P
TO:
CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REY=is4i-EX-AFP-C03=OSj--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 12-11-2006
ESTATE OF DOLATOSKI
ALEXANDER P DATE OF DEATH 02-06-2003
COUNTY
CUMBERLAND
FILE NO. 21 04-0309
TAX RETURN WAS:
S.S/D.C. NO. 205-10-4375
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
03116963
FINANCIAL INSTITUTION: WAYPOINT BANK
ACCOUNT NO.
591287274
TYPE OF ACCOUNT: ()SAVINGS () CHECKING ()TRUST ~ )TIME CERTIFICATE
DATE ESTABLISHED 04-22-1996
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
301187.82
0.166
51031.40
.00
51031.40
.45
226.42
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT1 SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS1 AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH 12-19-2006 TOTAL TAX CREDIT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 226.42
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 37.49
TOTAL DUE 263.91
· IF PAID AFTER THIS DATEI SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .
( IF TOTAL DUE IS LESS THAN $11 NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRJ1 YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTTnN~_ 1
J"
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'*
PAUL DOLATOSKI
213 N 45TH ST
HBG PA 17111
NOTICE OF INHERITANCE TAX
APPRAIS~E~~:~~~rOllJ)ISALLOWANCE
OF DEDUC~'/~JASje!snoo OF TAX ON
.JoiNtrbY:: fE~(OR', ,r'R\I$"T ASSETS
'.--.. , ".~",'; ".' :.. .".:, I
DATE 12-11-2006
2007 JAN -8 A~>>l1TiF o~EATH ~~~:~~~~~3
FILE NUMBER 21 04-0309
CLERK OF COUNTY CUMBERLAND
ORPHAN'S CO~/DC 205-10-4375
CUMBFpl/:\itj en ~ APPEAL DAT:~116g~?09-2007
(See reverse side under Objections)
Amaunt Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE1 PA 17013
REV-1548 EX AFP (06-05)
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX za0601
HARRISBURG PA 171Z8-0601
ALEXANDER P
CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +--
REY=is4i-EX-AFP-lo3=Osi-----..-------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE O!F
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 12-11-2006
ESTATE OF DOLATOSKI
ALEXANDER P DATE OF DEATH 02-06-2003
COUNTY
CUMBERLAND
FILE NO. 21 04-0309
TAX RETURN WAS:
~.S/D.C. NO. 205-10-4375
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
03116967
FINANCIAL INSTITUTION: WAVPOINT BANK
ACCOUNT NO.
591287275
TYPE OF ACCOUNT: ()SAVINGS ( ) CHECKING ()TRUST CC )TIME CERTIFICATE
DATE ESTABLISHED 04-22-1996
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
221266.38
0.166
31711.14
.00
31711.14
.45
167.01
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT1 SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS1 AGENT."
TAX CREDITS:
PAYMENT
DATE
RECEIPT
NUMBER
DISCOUNT (+) AMOUNT PAID
INTEREST/PEN PAID (-)
2-19-2006 TOTAL TAX CREDIT .00
TLIHED ON THE BALANCE OF TAX DUE 167.01
INTEREST AND PEN. 27.65
TOTAL DUE 194.66
INTEREST IS CHARGED THROUGH :
AT THE RATES APPLICABLE AS O~
REVERSE SIDE OF THIS FORM
ill IF PAID AFTER THIS DATEI SEE RE'~RSE FOR CALCULATION OF ADDITIONAL INTEREST. .
( IF TOTAL DUE IS LESS THAN $11 Nr. PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A ......REDIp. ( CRJ 1 YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM F') TN~TRllrTTnN<:: 1
,..
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 1/25/2007
HOGG STEPHEN J
19 S HANOVER STREET
SUITE 101
CARLISLE, PA 17013
RE: Estate of DOLATOSKI ALEXANDER P
File Number: 2004-00309
.Me
>~
...eo
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 administration.
This filing is due by:
2/06/2007
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.
r~~
....w~
-~
;,0''''
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: 1/25/2007
DOLATOSKI PAUL J
213 N. 45TH STREET
HARRISBURG, PA 17111
-.1._
RE: Estate of DOLATOSKI ALEXANDER P
File Number: 2004-00309
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 administration.
This filing is due by:
2/06/2007
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.
-~..
.......
A:l~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
12-04-2006
DOLATOSKI
02-06-2003
21 04-0309
CUMBERLAND
101
APPEAL DATE: 02-02-2007
( See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
9Y!_~~9~~_!~~~-~~~~------~-__~~!!!~_~9~~~_~9~!!9~_~9~_Y9Y~_~~~9~P~__~____________________
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ALEXANDER P FILE NO. 21 04-0309 ACN 101 DATE 12-04-2006
TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX Z80601
HARRISBURG PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
~~. r",. ..tIg;r~~ 9F. INHERITANCE TAX
h=CCM~t4)S~~~"Jl! (~-LOWANCE OR DISALLOWANCE
-.'C(:::;cGfjJ~c:r.~~~ AND ASSESSMENT OF TAX
i ~' "._ ,!! ',_, ' '..: ..... ' . ';'; 'I
2006 DEe -4 PH 3: 26
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
STEPHEN J HOGG ESQ
19 S HANOVER ST
CARLISLE
CLERK OF
OHl"1p'-lt,r'J"'" r.'(jl iPT
l I", ,) \..I'-..r' 1"""'1 j
ClJf'..,/'-'--';i ~ .--' '-j
PA 17013
ESTATE OF
DOLATOSKI
.
REV-1547 EX AFP (06-05)
ALEXANDER P
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
(1)
(2)
(3)
(4)
(5)
(6)
(7)
94,000.00
.00
.00
.00
88.853.24
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(10)
27,392.22
16.651.27
UlJ
(2)
(13)
(14)
NOTE: I~ an assessment was issued previously, lines
re~lect ~igures that include the total o~ ALL
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
AX CREDITS:
NOTE: To insure proper
credit to your account,
sub.it the upper portion
of this fora with your
tax pa~t.
182,853.24
44.043 49
138,809.75
.00
1381809.75
14, 15 and/or 16, 17, 18 and 19 will
returns assessed to date.
.OOXOO=
138,809.75 X 045 =
.00 x 12 =
.00xI5=
(19)=
DATE
09-21-2006
+
INTEREST/PEN PAID (-)
.00
AMOUNT PAID
6,246.43
NUMBI:R
CD007229
BALANCE OF UNPAID INTEREST/PENALTY AS OF 09-22-2006 TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
· IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
.00
61246.43
.00
.00
6,246.43
6,246.43
.00
927.52
927.52
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
REV-1470 EX (6-66)
'*
INHERITANCE TAX
EXPLANA TION
OF CHANGES
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
PO Box 280601
HARRISBURG PA 17128-0601
DECEDENTS NAME
REVIEWED BY
ITEM
SCHEDULE NO.
F
Alexander P. Dolatoski
FILE NUMBER
Anita McCully
2104-0309
101
ACN
EXPLANATION OF CHANGES
The accounts reported by Waypoint Bank were jointly held prior to the decedent's death,
therefore the surviving joint owners are being billed directly for the decedent's interest in
these accounts.
ROW
Page 1
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Alexander P. Dolatoski
Date of Death: 2/6/2003
Will No.
Admin. No. 21-04-0309
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1 . State whether administration of the estate IS complete:
Yes No X
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete: February 16. 2007
3. If the answer to No. 1 is Yes, state the following:
a.
account with the Court?
Did the personal representative file a final
Yes No X
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes X No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Clerk of the Orphans' Court and may be attached to this report.
Date: 1/29/2007
Steohen J. Hogg. Esauire
Name (Please type or print)
19 South Hanover Street, Suite 101
Carlisle PA 17013
Address
( 717 ) 2452698
Tel. No.
Capacity:
Personal Representative
x
Counsel for personal
representative
h""' ._,
II:J :Ci
C'AJ
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
U ....IVIDUAL ~,",r\rD (\;:::C\('t: ('.~ INHERITANCE TAX
BURE. OF Inu \it::.\..Ajt~: C I),' 'i,)\... -" RECORD ADJUSTMENT
~~":~~T~:~~O~AX DIVISION I \::, _ ~ \:~,-'r; \'-Ie JOINTL Y HELD OR TRUST ASSETS
HARRISBURG PA 17lZ8-060l 'r'.L'~ :., . '-'
*'
REV-1604 EX AFP (03-05)
'loan DEe -8 Pl'\ \2: 09
C \I ,"-
CLEni" \:<~'l nT
oPHt,N'c:,' i)J\\
:~~~A~~~:u:.t't&SKm~""I" c'!\
MECHANICSBURG PA 17055
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN.lDC
ACN
11-28-2006
DOLATOSKI
02-06-2003
21 04-0309
CUMBERLAND
205-10-4375
03116964
Allount Relli tted
ALEXANDER P
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE
--+ RETAIN LOWER PORTION FOR YOUR RECORDS
+-
--------------------------------------------------------------------------------------------------------------------------------------------------------
REV-1604 EX AFP (03-05)
-- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __
DATE 11-28-2006
ESTATE OF DOLATOSKI
ALEXANDER P DATE OF DEATH 02-06-2003
COUNTY
CUMBERLAND
FILE NO. 21 04-0309
ADJUSTMENT BASED ON:
S.S/D.C. NO. 205-10-4375
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
ACN
03116964
FINANCIAL INSTITUTION: WAYPOINT BANK
ACCOUNT NO. 591287274
TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST (X) TIME CERTIFICATE
DATE ESTABLISHED 04-22-1996
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
30,187.82
0.166
5,031.40
.00
5,031.40
.45
226.42
NOTE: TO INSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBMIT THE UPPER PORTION
OF THIS NOTICE WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS
AT THE ADDRESS SHOWN ABOVE.
MAKE CHECK OR MONEY ORDER PAYABLE
TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH 12-13-2006 TOTAL TAX CREDIT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 226.42
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 37.23
TOTAL DUE ?.L':l .LC
· IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
('6
BURE~U OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX Z80601
HARRISBURG PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
REV-1604 EX AFP (03-05)
ALEXANDER R DOLATOSKI
3319 LISBURN RD
MECHANICSBURG PA 17055
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
11-28-2006
DOLATOSKI
02-06-2003
21 04-0309
CUMBERLAND
205-10-4375
03116966
Allount Relli tted
ALEXANDER P
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE
--+ RETAIN LOWER PORTION FOR YOUR RECORDS
+-
REV-1604 EX AFP (03-05)
-- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __
DATE 11-28-2006
ESTATE OF DOLATOSKI
ALEXANDER P DATE OF DEATH 02-06-2003
COUNTY
CUMBERLAND
FILE NO. 21 04-0309
ADJUSTMENT BASED ON:
S.S/D.C. NO. 205-10-4375
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
ACN
03116966
FINANCIAL INSTITUTION: WAYPOINT BANK
ACCOUNT NO. 500007136
TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST (X) TIME CERTIFICATE
DATE ESTABLISHED 07-15-1998
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
22,378.09
0.166
3,729.76
.00
3,729.76
.45
167.84
NOTE: TO INSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBMIT THE UPPER PORTION
OF THIS NOTICE WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS
AT THE ADDRESS SHOWN ABOVE.
MAKE CHECK OR MONEY ORDER PAYABLE
TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH 12-13-2006 TOTAL TAX CREDIT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 167.84
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 27.60
TOTAL DUE 195 titi
. IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. G
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), J
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
BURE~U OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRIS8URG PA 11128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
'*
REV-1604 EX AFP (03-05)
ALEXANDER R DOLATOSKI
3319 LISBURN RD
MECHANICSBURG PA 17055
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
11-28-2006
DOLATOSKI
02-06-2003
21 04-0309
CUMBERLAND
205-10-4375
03116968
AlIOunt R..i Heel
ALEXANDER P
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE
--+ RETAIN LOWER PORTION FOR YOUR RECORDS
+-
-----------------------------------------------------------------------------------------------------------------------------------------------------
REV-1604 EX AFP (03-05)
-- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __
DATE 11-28-2006
ESTATE OF DOLATOSKI
ALEXANDER P DATE OF DEATH 02-06-2003
COUNTY
CUMBERLAND
FILE NO. 21 04-0309
ADJUSTMENT BASED ON:
S.S/D.C. NO. 205-10-4375
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
ACN
03116968
FINANCIAL INSTITUTION: WAYPOINT BANK
ACCOUNT NO. 591287275
TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST (X) TIME CERTIFICATE
DATE ESTABLISHED 04-22-1996
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
22.266.38
0.166
3.711.14
.00
3.711.14
.45
167.01
NOTE: TO INSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBMIT THE UPPER PORTION
OF THIS NOTICE WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS
AT THE ADDRESS SHOWN ABOVE.
MAKE CHECK OR MONEY ORDER PAYABLE
TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH 12-13-2006 TOTAL TAX CREDIT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 167.01
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 27.46
TOTAL DUE 194.47
III IF PAID AFTER THIS DATE. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. l
( IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). D
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
REV-1470 EX (6-88)
.
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG PA 17128-0601
DECEDENT'S NAME
Alexander P. Dolatoski
FILE NUMBER
REVIEWED BY
Colin O'Malley
ACN
2104-0309
03116964,03116966,
03116968
ITEM
SCHEDULE NO.
EXPLANATION OF CHANGES
The above accounts have been adjusted to reflect the 4.5% lineal tax rate.
ROW
Page 1
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
.
PAUL DOLATOSKI
213 N 45TH ST
HBG
NOTICE OF INHERITANCE TAX
APPRAISEHENT, AL~OYANCE OR DISALLOWANCE
D~ ~" ",rt,~" P4 CA, IItD,,-ASSESSHENT OF TAX ON
.Ilt..9. ,\ ~i. V. ',ltELD OR TRUST ASSETS
,'";r:r'C'T\ ',j \;i I'
iiL',)," i c,. '.' ,." ,.. DATE 12-11-2006
ESTATE OF DOLATOSKI
"00' DEe -8 PM 12: 01 DATE OF DEATH 02-06-2003
L 0 FILE NUMBER 21 04-0309
COUNTY CUMBERLAND
CLERK OF SSN/DC 205-10-4375
ORPr!l\~\!'S snURT ACN 03116963
. ,'r':~~' '; 'r~ - p.~ APPEAL DATE: 02-09-2007
PA 171 N.LJ\:i:~ . , " ' I I' (See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
REV-1548 EX AFP (06-05)
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
ALEXANDER P
CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS +-
REY=is4S-EX-AFP-lo3=Osi--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 12-11-2006
ESTATE OF DOLATOSKI
ALEXANDER P DATE OF DEATH 02-06-2003
COUNTY
CUMBERLAND
FILE NO. 21 04-0309
TAX RETURN WAS:
S.S/D.C. NO. 205-10-4375
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
03116963
FINANCIAL INSTITUTION: WAYPOINT BANK
ACCOUNT NO.
591287274
TYPE OF ACCOUNT: ()SAVINGS () CHECKING ()TRUST ~ )TIME CERTIFICATE
DATE ESTABLISHED 04-22-1996
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
30,187.82
0.166
5,031.40
.00
5,031.40
.45
226.42
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH 12-19-2006 TOTAL TAX CREDIT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 226.42
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 37.49
TOTAL DUE 263.91
· IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT"" ( CRl, YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. l
~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
I",r ~
ACC\/"\C I \',.
BUREAU OF INDIVIDUAL TAXES-rnpor.\\ UrOvl.. ',,"NOTICE OF INHERITANCE TAX
INHERITANCE TAX DIYISION nCv'.." \ J~~ ('.t:APp,~~~EMENT. ALLOWANCE OR DISALLOWANCE
PO BOX 280601XOP"'DEoUCTIONS. AND ASSESSMENT OF TAX ON
HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS
lUGn DEe -8 Pl" \2: 01
.
REY-15~8 EX AFP (06-05)
PAUL
213 N 45TH
HBG
ClE~,\r~ Q~\ \81
DB.. . p,,\ -\..'~. \~. \) S u';. ".:::-. \ . n '\
S~OLAC~.l(:l:" ., ; , ,h
PA 17111
12-11-2006
DOLATOSKI
02-06-2003
21 04-0309
CUMBERLAND
205-10-4375
03116965
APPEAL DATE: 02-09-2007
(See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSNI'DC
ACN
ALEXANDER P
CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS +-
REY=is4S-EX-AFP-lo3=Osi------------------------____________________________________________
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 12-11-2006
ESTATE OF DOLATOSKI
ALEXANDER P DATE OF DEATH 02-06-2003
COUNTY
CUMBERLAND
FILE NO. 21 04-0309
TAX RETURN WAS:
S.S/D.C. NO. 205-10-4375
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
03116965
FINANCIAL INSTITUTION: WAYPOINT BANK
ACCOUNT NO.
500007136
TYPE OF ACCOUNT: ()SAVINGS () CHECKING ()TRUST ~ )TIME CERTIFICATE
DATE ESTABLISHED 07-15-1998
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
22.378.09
0.166
3.729.76
.00
3.729.76
.45
167.84
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT. SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS. AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH 12-19-2006 TOTAL TAX CREDIT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 167.84
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 27.79
TOTAL DUE 195.63 ~
If IF PAID AFTER THIS DATE. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. If
( IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR). YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX Z80601
HARRISBURG PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
r nCI~~e~O~~HERITANCE TAX
i=k~M6EttgNt~ .,~LL.OWANCE OR DISALLOWANCE
C~~~~N$~~AMo ASSESSMENT OF TAX ON
1'0:".\.:'''' 'JOtNTL Y HELD OR TRUST ASSETS
*'
REV-1548 EX AFP (06-05)
PAUL DOLATOSKI
213 N 45TH ST
HBG
16Ub nEe -8 PM \2: 01 :~~~TE OF
DATE OF DEATH
CLERK Of FILE NUMBER
l''r, r'f1U'RT COUNTY
ORPt~t\S\ 0 u';:: ,.:, lot SSN/DC
CUI'Jr' , ' " . r, \ ACN
12-11-2006
DOLATOSKI
02-06-2003
21 04-0309
CUMBERLAND
205-10-4375
03116967
APPEAL DATE: 02-09-2007
(See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
ALEXANDER P
PA 17111
CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +--
REY=is4S-EX-AFP-roi=osi--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 12-11-2006
ESTATE OF DOLATOSKI
ALEXANDER P DATE OF DEATH 02-06-2003
COUNTY
CUMBERLAND
FILE NO. 21 04-0309
TAX RETURN WAS:
S.S/D.C. NO. 205-10-4375
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
03116967
FINANCIAL INSTITUTION: WAYPOINT BANK
ACCOUNT NO.
591287275
TYPE OF ACCOUNT: ()SAVINGS () CHECKING ()TRUST ~ )TIME CERTIFICATE
DATE ESTABLISHED 04-22-1996
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
22.266.38
0.166
3.711.14
.00
3.711.14
.45
167.01
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT. SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS. AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH 12-19-2006 TOTAL TAX CREDIT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 167.01
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 27.65
TOTAL DUE 194.66
. IF PAID AFTER THIS DATE. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ·
( IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR). YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
0t
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 2B0601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
*'
REV-1607 EX AFP (03-05)
71'11'11 J": \1 1 6 Ph 12: II J
,-uu h..
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-08-2007
DOLATOSKI
02-06-2003
21 04-0309
CUMBERLAND
101
ALEXANDER P
CLr--:t{ nc
tn" \~,I , _
OCDU'~,~\'~ cnUR\
STEPHEN J HOGG ESQ ,..',':_' "". ~:r: \::\
19 S HANOVER ST CU ' '
CARLISLE PA 17013
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE
-+
RETAIN LOWER PORTION FOR YOUR RECORDS
~
REV-1607 EX AFP (03-05)
---------------------------------------------------------------------------
*** INHERITANCE TAX STATEMENT OF ACCOUNT ***
ESTATE OF DOLATOSKI
ALEXANDER P FILE NO. 21 04-0309
ACN 101
DATE 01- 08-2007
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-27-2006
PRINCIPAL TAX DUE: 6,246.43
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
09-21-2006 CD007229 .00 6,246.43
12-11-2006 CD007546 927.52- 927.52
TOTAL TAX CREDIT 6,246.43
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
II
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
cb
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO 80X 280601
HARRIS8URG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
--.---c.:-~;NiteRJ'TANCE TAX
'stATEMENT-OF ACCOUNT
*'
REV-1607 EX AFP (03-05)
"1''''17 r" r~',"""
LUL. C[0
12
PI-!
,. ....,pATE
i' i ~STATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
02-06-2007
DOLATOSKI
02-06-2003
21 04-0309
CUMBERLAND
03116965
ALEXANDER P
PAUL DOLATOSKI CI"
213 N 45TH ST
HBG PA 17111
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE
-+
RETAIN LOWER PORTION FOR YOUR RECORDS
+-
REV-1607 EX AFP (03-05)
*** INHERITANCE TAX STATEMENT OF ACCOUNT ***
ESTATE OF DOLATOSKI
ALEXANDER P FILE NO. 21 04-0309
ACN 03116965 DATE 02-06-2007
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-04-2006
PRINCIPAL TAX DUE: 167.84
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
01-08-2007 CD007651 27.79- 195.63
02-02-2007 SBADJUST .00 .68
TOTAL TAX CREDIT 167.84
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
II IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN *1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
,j
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
,iIt{Hf,RITANCE TAX
STATEMENT OF ACCOUNT
*'
REV-1607 EX AFP (03-05)
r-E. n 1_"'"
f .. :;;
P;,j I. 2C
II I' _ J
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
02-06-2007
DOLATOSKI
02-06-2003
21 04-0309
CUMBERLAND
03116963
ALEXANDER P
PAUL DOLATOSKI
213 N 45TH ST
HBG PA 17111
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE
......
RETAIN LOWER PORTION FOR YOUR RECORDS
~
---------------------------------------------------------------------------
REV-1607 EX AFP (03-05)
*** INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF DOLATOSKI
ALEXANDER P FILE NO. 21 04-0309
ACN 03116963 DATE 02-06-2007
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-04-2006
PRINCIPAL TAX DUE: 226.42
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
01-08-2007 CDo07651 37.49- 263.91
02-02-2007 SBADJUST .00 .92
TOTAL TAX CREDIT 226.42
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
l! IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENi IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
__ r-
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
lNHEIU TAN,CE ,1 AX
8T AT,EMENt" OF- ACCOUNT
'*
REV-1607 EX AFP (03-05)
PAUL DOLATOSKI
213 N 45TH ST
HBG PA 17111
(:1..
I 2 P i!:~~~~ OF
DATE OF DEATH
(J,'::FILE NUMBER
:-: (XYCOijNTY
ACM',
02-06-2007
DOLATOSKI
02-06-2003
21 04-0309
CUMBERLAND
03116967
ALEXANDER P
') n 11"1
LUU
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE
-+
RETAIN LOWER PORTION FOR YOUR RECORDS
~
REV-1607 EX AFP (03-05)
*** INHERITANCE TAX STATEMENT OF ACCOUNT ***
ESTATE OF DOLATOSKI
ALEXANDER P FILE NO. 21 04-0309
ACN 03116967 DATE 02-06-2007
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-04-2006
PRINCIPAL TAX DUE: 167.01
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
01-08-2007 CD007651 27.65- 194.66
02-02-2007 SBADJUST .00 .68
TOTAL TAX CREDIT 167.01
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
II IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
r!'l
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 2B0601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
--,...(.....:-...;-'", ,.~~,- l"-\('"r,lr.,.- r~.:'-'
" -, lMHE!R,Il'ANCE TAX
(STATE"M'ENT\ OF ACCOUNT
*
?P07 r:-r.Q I') p"
LUc : L"" i. i'l
REV-1607 EX AFP (03-05)
On~iL! ,I, /-. lie'..
;-\I'! :/.',;"'; ,-.
(....,
I-
I...)
I: 2LpATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
02-05-2007
DOLATOSKI
02-06-2003
21 04-0309
CUMBERLAND
03116965
ALEXANDER P
PAUL DOLATOSKI
213 N 45TH ST
HBG PA 17111
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE
~
RETAIN LOWER PORTION FOR YOUR RECORDS
of-
REV-1607 EX AFP (03-05)
---------------------------------------------------------------------------
*** INHERITANCE TAX STATEMENT OF ACCOUNT ***
ESTATE OF DOLATOSKI
ALEXANDER P FILE NO. 21 04-0309
ACN 03116965 DATE 02- 05-2007
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-04-2006
PRINCIPAL TAX DUE: 167.84
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
01-08-2007 CD007651 27.79- 195.63
02-02-2007 SBADJUST .00 .68
TOTAL TAX CREDIT 167.84
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
II IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
c)
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
-,--I1(KERIJ'AHCE' TAX
STA;tEMENt .OFACCOUNT
'*
REV-1607 EX AFP (03-05)
~r('l""!'
LuUt
12
f' ,. D~]"~ Ii.
~tiES~krE OF
DATE OF DEATH
FILE NUMBER
l!'lT
C~UNTY
ACW'\
02-05-2007
DOLATOSKI
02-06-2003
21 04-0309
CUMBERLAND
03116963
ALEXANDER P
PAUL DOLATOSKI
213 N 45TH ST
HBG PA 17111
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE
-to
RETAIN LOWER PORTION FOR YOUR RECORDS
+-
REV-1607 EX AFP (03-05)
... INHERITANCE TAX STATEMENT OF ACCOUNT .**
ESTATE OF DOLATOSKI
ALEXANDER P FILE NO. 21 04-0309
ACN 03116963 DATE 02-05-2007
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-04-2006
PRINCIPAL TAX DUE: 226.42
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
01-08-2007 CD007651 37.49- 263.91
02-02-2007 SBADJUST .00 .92
TOTAL TAX CREDIT 226.42
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
II IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
G
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRIS8URG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
J:C-'I~.te-~~:;r ~NCE TAX
STATEHENTOF ACCOUNT
*'
REV-1607 EX AFP (03-05)
"('0" '-rn I?
l . ~ ; ! ~. ;" tt')'._ .'
L.,.~.._~, '-
fJi"
n
I: EYE
ESTATE OF
DATE OF DEATH
FILE NUMBER
__.COUNTY
ACN
02-05-2007
DOLATOSKI
02-06-2003
21 04-0309
CUMBERLAND
03116967
ALEXANDER P
PAUL DOLATOSKI
213 N 45TH ST
HBG PA 17111
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE
-+
RETAIN LOWER PORTION FOR YOUR RECORDS
~
---------------------------------------------------------------------------
REV-1607 EX AFP (03-05)
*** INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF DOLATOSKI
ALEXANDER P FILE NO. 21 04-0309
ACN 03116967 DATE 02-05-2007
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE.
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-04-2006
PRINCIPAL TAX DUE: 167.01
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
01-08-2007 CD007651 27.65- 194.66
02-02-2007 SBADJUST .00 .68
TOTAL TAX CREDIT 167.01
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
II IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN *1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
t""""""}
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 2B0601
HARRISBURG, PA 1712B-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
DOLATOSKI PAUL J
213 N. 45TH STREET
HARRISBURG, PA 17111
-------- fold
ESTATE INFORMATION: SSN: 205-10-4375
FILE NUMBER: 2104-0309
DECEDENT NAME: DOLA TOSKI ALEXANDER P
DATE OF PAYMENT: 04/18/2007
POSTMARK DATE: 04/18/2007
COUNTY: CUMBERLAND
DATE OF DEATH: 02/06/2003
NO. CD 008045
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $3,592.80
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 522
SEAL
INITIALS: MW
RECEIVED BY:
REGISTER OF WILLS
$3,592.80
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REV-1500 EX + (6-00)
.
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
....
Z
W
C
W
o
W
C
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Dolatoski Alexander P.
DATE OF DEATH (MM-DD-Year)
OFFICIAl USE ONLY
REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
2 1 -0 4 0 3 0 9
"'Coi:iNTYCci1iE -YEAR- - - NuMBeR- -
SOCIAL SECURITY NUMBER
DATE OF BIRTH (MM-DD-Year)
2 0 5 - 1 0 - 4 375
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
02/06/2003 OS/27/1916
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
W
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D 1. Original Return
D 4. Limited Estate
D 6. Decedent Died Testate (Allach copy of Will)
o 9. Litigation Proceeds Received
SOCIAL SECURITY NUMBER
00 2. Supplemental Return
D 4a. Future Interest Compromise (date of death after 12-12-82)
D 7. Decedent Maintained a Living Trust (Attach copy oITrusl)
o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
D 3. Remainder Return (date of death prior 10 12-13-82)
D 5. Federal Estate Tax Return Required
_ 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
THIS SECTION MUST BE. COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO;
NAME COMPLETE MAILING ADDRESS
Ste hen J. Ho Es 19 South Hanover Street
FIRM NAME (If Applicable)
I-
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
TELEPHONE NUMBER
717 245-2698
Carlisle
PA 17013
(1)
(2)
(3)
(4)
(5)
0.00
OFFICIAL USE ONLY
l"'..'
=
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97,420.32
~
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.: -) (-)
c:~) ~h
::c::.,
(6)
::;.J
..,
1..0
N
cr.
(7)
(8)
97,420.32
(9)
(10)
10,450.22
7,129.89
(11)
(12)
(13)
17,580.11
79,840.21
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
(14)
79,840.21
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
0.00 X _(15) 0.00
79,840.21 X .045 (16) 3,592.80
0.00 X .12 (17) 0.00
0.00 X .15 (18) 0.00
(19) 3,592.80
20. 0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Decedent's Complete Address: :-1 , .
STREET ADDRESS
3319 Lisburn Road
CITY I STATE I ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. TaX DUe (Page '1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1 )
3,592.80
Total Credits (A + 8 + C)
(2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
0.00
0.00
3,592.80
3,592.80
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; ........................................................................... 0 [Z)
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 [Z)
c. retain a reversionary interest; or ...................................................................................................... 0 [Z)
d. receive the promise for life of either payments, benefits or care? ............................................................. 0 [Z)
2. If death occurred after December 12,1982, did decedent transfer property within one year of death
without receiving adequate consideration?. ......... ................. ........... .................. .... ....... ........................... 0 [Z)
3. Did decedent own an 'in trust for" or payable upon death bank account or security at his or her death? ................. 0 [Z)
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................... 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.
Under penalties of pe~ury. I declare that I have examined this return, includinQ 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 PERSON RESPONSIBLE FOR FILING RETURN DATE
p~ '" #AI?fl~' 'i/J)/67
ADDRESS . 213 . 45th Street
H Isbur
SIGNATURE OF ROTHER TH ESENTATIVE
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 transfers to orfor the use of the surviving spouse is 0% [72 P .S. ~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 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 parentin common with the decedent, whether by blood or adoption.
~EV-1508Y' '6.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Dolatoski Alexander P.
FILE NUMBER
21 04
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.
0309
ITEM
NUMBER
1.
DESCRIPTION
Waypoint Bank Account #1860010017
2.
Waypoint Bank Account #1860010017 Interest 2003
3.
Waypoint Bank Account # 1860010017 Interest 2004
4.
Sovereign Bank Account #231237295 (formerly Waypoint #1860010017) Interest 2005
5.
Sovereign Bank Account #231237295 Interest 2006
6.
Sovereign Bank Account #231237295 Interest 2007
(Account closed and transferred to estate account)
7.
U.S. Treasury Social Security Jan-April2003
8.
Estate Checking Account #0537047836 Additional Interest 2006
VALUE AT DATE
OF DEATH
89,063.45
361.64
486.23
493.31
544.42
46.37
6,400.08
24.82
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
97 420.32
REV-1511 EX+ (12-99)
. '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Dolatoski Alexander P.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21
04
Debts of decedent must be reported on Schedule I.
0309
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) Paul J. Dolatoski 5,845.22
Social Security Numbe~s)/EIN Number of Personal Representative(s)
Street Address 213 N. 45th Street
City Harrisburg State PA Zip 17111
Yea~s) Commission Paid:
2. Attorney Fees Stephen J. Hogg, Esquire 4,000.00
3. Family Exemption: (If decedents address is not the same as claimants, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountants Fees
6. Tax Return Prepare~s Fees
7. Advertising:
8. Filing First and Final Accounting 100.00
9. Notary 5.00
10. Federal Income Tax Preparation (est) 500.00
TOTAL (Also enter on line 9, Recapitulation) $ 10450.22
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX + (6-98)
<
'*
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Dolatoski AlexamIer P.
FILE NUMBER
21 04
Include unreimbursed medical expenses.
0309
ITEM
NUMBER DESCRIPTION
1. U.S. Treasury Social Security Payback - Jan. - April 2003
2. Bank fee for back statements
3. Real Estate Tax - 2006 - $1381.64 x 50%
5. Real Estate Tax - 2005 (late fee) $30.14 x 50%
VALUE AT DATE
OF DEATH
6,400.00
24.00
690.82
15.07
TOTAL (Also enter on line 10, Recapitulation) $
7,129.89
(If more space is needed, insert additional sheets of the same size)
~":'-~"":'....
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FilE NUMBER
. AIAy::mrlAr P 21 n.:1 o~o~
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not list Trustee(s) OF ESTATE
1. TAXABLE DISTRIBUTIONS Unclude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. Paul J. Dolatoski Lineal 50%
213 N. 45th Street
Harrisburg, PA 17111
2. Alexander R. Dolatoski Lineal 50%
14 S. Union Street
Middletown, PA 17057
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART 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)
SUPPLEMENTAL INVENTORY
INVENTORY
Estate of Alexander P. Dolatoski
No.21
04
0309
, Deceased
Date of Death 2/6/2003
Social Security No. 205-10-4375
also known as
Alexander P. Dolatoski
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no
real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. MWe
verify that the statements made in this inventory are true and correct. I/We understand that false statements hereirfmade are sub~ to the
penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. -.l
Personal Representative:
:.: J
r.<)
Name of
Attorney: Stephen J. HOQQ, Esquire
I.D. No.: 36812
Paul J. Dolatoski
~
:~'1
'..::)
Address: 19 S. Hanover St., Suite 101
Carlisle
Telephone: 7172452698
Dated
f'0
,,+~ '
PA 17013
Description
Waypoint Bank Account #1860010017
Value
89,063.45
Waypoint Bank Account #1860010017 Interest 2003
361.64
Waypoint Bank Account #1860010017 Interest 2004
486.23
Sovereign Bank Account #231237295 Interest 2005
(Formerly Waypoint Acct. #1860010017)
493.31
Sovereign Bank Account #231237295 Interest 2006
544.42
Sovereign Bank Account #231237295 Interest 2007
(Account closed - transferred to estate account
46.37
Total
97,420.32
(Attach Additional Sheets if necessary)
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
RW-4
Continuation of Inventory
Alexander P. Dolatoski
21
04
0309
Page 1
Description of Inventory
Description
U.S. Treasury Social Security Jan - April 2003
Value
6,400.08
Estate Checking Account #0537047836 Additional Interest 2006
24.82
Grand Total $
6,424.90
97,420.32
Subtotal $
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM;
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
DOLA TOSKI PAUL J
213 N. 45TH STREET
HARRISBURG, PA 17111
-------- fold
ESTATE INFORMATION: SSN: 205-10-4375
FILE NUMBER: 2104-0309
DECEDENT NAME: DOLA TOSKI ALEXANDER P
DATE OF PAYMENT: 06/26/2007
POSTMARK DATE: 06/26/2007
COUNTY: CUMBERLAND
DATE OF DEATH: 02/06/2003
NO. CD 008336
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $622.64
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$622.64
REMARKS: RECEIPT TO ATTORNEY
CHECK# 0094
SEAL
INITIALS: AJW
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
06-18-2007
DOLATOSKI
02-06-2003
21 04-0309
CUMBERLAND
101
APPEAL DATE: 08-17-2007
( See reverse side under Objections)
Amount Remittedl I
MAKE CHECK PAYABLE AND REMIT PAYMENT
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 2B0601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT. ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
STEPHEN J HOGG ESQ
19 S HANOVER ST
CARLISLE PA 17013
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
'*
REV-1547 EX AFP (06-05)
ALEXANDER P
TO:
CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +--
REy:is47-Ex-AFP-C03:0Sl-NOTICE-OF-INHERITANCE-TAX-APPRAISEMENT:-ALLOWANCE-OR---------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF DOLATOSKI ALEXANDER P FILE NO. 21 04-0309 ACN 101 DATE 06-18-2007
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Stock/Partnership Interest (Schedule C) (3)
4. Mortgages/Notes Receivable (Schedule D) (4)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
NO. 01
.00
.00
.00
.00
97,420.32
.O~
. a:Q; 0
..-1'ffl
, , J ::r:: r--.
.:;1 ;l::. f-:!
10,450.~.z;9J'
7 .129.?i3~
!~:u:r) "
:o<iS )
15.
(3)
(4)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
(9)
UO)
10.
II.
12.
13.
14.
Debts/Mortgage Liabilities/Liens (Schedule I)
Total Deductions
Net Value of Tax Return
Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
Net Value of Estate Subject to Tax
NOTE: To insure proper
credit to your account.
submit the upper portion
of this form with your
tax payment.
:;::
(';:;:)
~7 ,4.~O~
c:: ;2/ ("")
:or: ':;1) (~
,_.~.>:O
t\,) ;~-i \::J
O'l ,"!~
J.Yc:-.:.)
~17 .Ii~~ 1
791,:&4 '21
;:' _cc!:: ,:;; 0 0
r ".,' r-r-J.
~ 2Ht,-60. 96
. .
NOTE: If an assess.ent was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of !h.b. returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate US) .00 X 00 .00
16. Amount of Line 14 taxable at Lineal/Class A rate (6) 218,649.96 X 045 = 9,839.23
17. Amount of Line 14 at Sibling rate (7) .00 X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate (8) .00 X 15 = .00
19. Principal Tax Due (9)= 9,839.23
TAX CR~DITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
09-21-2006 CD007229 .00 6,246.43
12-11-2006 CD007546 .00 927.52
04-18-2007 CD008045 927.52- 3,592.80
BALANCE OF UNPAID INTEREST/PENALTY AS OF 04-19-2007 TOTAL TAX CREDIT 9,839.23
BALANCE OF TAX DUE .00
INTEREST AND PEN. 662.64
TOTAL DUE 662.64
* IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN *1. NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~-
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
DOLA TOSKI PAUL J
213 N. 45TH STREET
HARRISBURG, PA 17111
-------- fold
ESTATE INFORMATION: SSN: 205-10-4375
FILE NUMBER: 2104-0309
DECEDENT NAME: DOLA TOSKI ALEXANDER P
DA TE OF PAYMENT: 06/26/2007
POSTMARK DATE: 06/26/2007
COUNTY: CUMBERLAND
DATE OF DEATH: 02/06/2003
NO. CD 008341
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $662.64
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$662.64
REMARKS: RECEIPT TO ATTORNEY
CHECK# 0094
INITIALS: AJW
RECEIVED BY:
SEAL
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
L- ...--
Glenda Farner Strasbaugh
Register of Wills
and
Clerk of Orphans' Court
Marjorie A. Wevodau
First Deputy
Kirk S. Sohonage, Esq
Solicitor
Register of Wills and Clerk of the Orphans' Court
County of Cumberland
One Courthouse Square
Carlisle, PA 17013
(717) 240-6345
FAX (717)240-7797
INVOICE
Bill To:
GARY ROTIfSallLD
2215 FOREST HILLS DRIVE
SUITE 35
HARRISBURG, P A 17112-
InvoiceNo:
Invoice Date:
Estate of:
Estate No:
1486
7/2/2007
ALEXANDER P DOLATOSKI
21-04-0309
CJ
Qty
1
Fee Description
PHOT()(X)PIES
Fee Total
12.00 $12.00
...
$12.00
Total:
~(
1?? Val ,e 5\
pr\ A I. . 11 '
J f/(j .~
'V; ~(~ (/f
"
"
Checks should be made payable to the Register of Wills. Terms: Net 30.
. .
Please return. one copy of this invoice with your payment. Thank you.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
_ _,_ NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TI'!~~,S'rr:;;;Ti crF\C~_A~J'RAISEMENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION- --, d ,OF DEDUCTIONS AND ASSESSMENT OF TAX
PO BOX 2B0601
HARRISBURG PA 17128-0601
REV-1547 EX AFP (06-05)
2001 JUN 25 PM 3: 55
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
06-18-2007
DOLATOSKI
02-06-2003
21 04-0309
CUMBERLAND
101
APPEAL DATE: 08-17-2007
( See reverse side under Objections)
Amount Remittedl I
MAKE CHECK PAYABLE AND REMIT PAYMENT
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
ALEXANDER P
CLERK Or
~PHA~l'S COURT
STEPHEN J Ho~~f;~'h" . PA
19 S HANOVER\j~,
CARLISLE PA 17013
TO:
CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS +-
-------------------------------------------------------------------------------------------
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF DOLATOSKI ALEXANDER P FILE NO. 21 04-0309 ACN 101 DATE 06-18-2007
T AX RETURN WAS: (X) ACCEPTED AS F I LED
CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN
1. Real Estate (Schedule A) (I)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Stock/Partnership Interest (Schedule C) (3)
4. Mortgages/Notes Receivable (Schedule D) (4)
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (S)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
NO. 01
.00
.00
.00
.00
97,420.32
.00
.00
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
B.
Total Assets
(B)
97,420.32
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
ClO}
10,450.22
7,129.89
Cll}
Cl2}
Cl3}
Cl4}
17.~80 11
79,840.21
.00
218,649.96
If an assessment was issued previouslY, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
IS. Amount of Line 14 at Spousal rate
16. Amount of Line 14 taxable at Lineal/Class A rate
NOTE:
19. Principal Tax Due
TAX CREDITS:
PAYMENT
DATE
09-21-2006
12-11-2006
04-18-2007
Cl9} =
.00
9,839.23
.00
.00
9,839.23
17. Amount of Line 14 at Sibling rate
lB. Amount of Line 14 taxable at Collateral/Class B rate
ClS}
Cl6}
Cl7}
ClB}
.00 X
218,649.96 X
.00 X
.00 X
00
045 =
12
15
RECEIPT
NUMBER
CD007229
CD007546
CD008045
DISCOUNT (+)
INTEREST/PEN PAID (-)
.00
.00
927.52-
AMOUNT PAID
6,246.43
927.52
3,592.80
BALANCE OF UNPAID INTEREST/PENALTY AS OF 04-19-2007 TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
9,839.23
.00
662.64
662.64
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DU
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TIO[~~(',Q:~r:': r':q.:\(~~ :~' INHERITANCE TAX
INHERITANCE TAX DIVISION 1 _vi I,Lj "'~ ,,- ~ STATEMENT OF ACCOUNT
PO BOX 280601
HARRISBURG PA 17128-0601
'*
REV-1607 EX AFP (03-05)
ZOOl AUG -3 PM 4: 20
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
07-30-2007
DOLATOSKI
02-06-2003
21 04-0309
CUMBERLAND
101
ALEXANDER P
CLERK OF
ORPn~N'S COllRT
~~E:H~:N~V~~~~~' , ir, r'" , 01\
CARLISLE PA 17013
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE
---------------------------------------------------------------------------
.....
RETAIN LOWER PORTION FOR YOUR RECORDS
+-
REV-1607 EX AFP (03-05)
*** INHERITANCE TAX STATEMENT OF ACCOUNT ***
ESTATE OF DOLATOSKI
ALEXANDER P FILE NO.21 04-0309
ACN 101
DATE 07-30-2007
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 06-11-2007
PRINCIPAL TAX DUE: 9,839.23
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
09-21-2006 CDo07229 .00 6,246.43
12-11-2006 CDo07546 .00 927.52
04-18-2007 CDo08045 927.52- 3,592.80
06-26-2007 CDo08341 662.64- 662.64
TOTAL TAX CREDIT 9,839.23
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
II
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. }
~
{ IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 1/15/2008
17013
HOGG STEPHEN
19 S HANOVER
SUITE 101
CARLISLE, PA
J
STREET
'j
I C..J!
,
G)
,...... 'J
(n
RE: Estate of DOLATOSKI ALEXANDER P
File Number: 2004-00309
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:
2/06/2008
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,
f~" ~" ,J~ ?"
""';fA ," ",' "'- j ,i
(,c.~1;?..;t."i: ,,\ ',{ '~~4!.U Jr.r1jdU~4.:...,.,.t/
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: 1/15/2008
213 N. 45TH STREET
HARRISBURG, PA 17111
c_
~
DOLATOSKI PAUL J
... ."'\
'-' .
(,)
~--
U1
RE: Estate of DOLATOSKI ALEXANDER P
File Number: 2004-00309
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 lS due by:
2/06/2008
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,
,l~J, L/f' ,~'. .,
,(~-1t:&\~..~"'l~.{ J,t/da~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Alexander P. Dolatoski
Date of Death: 2/6/2003
Will No.
Admin. No. 21-04-0309
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1 . State whether administration of the estate IS complete:
Yes No X
2 . If the answer is No, state when the personal
representative reasonably believes/tha the administration will be
complete: ~ / 2 / U
3. If the answer to No. 1 is Yes, state the following:
a.
account with the Court?
Did the personal representative file a final
Yes No
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the.,
Clerk of the Orphans' Court and may be attached to this report. /
,
~
, / 4'
IJr
//.
l
Date: 1/21/2008
Signature
Stephen J. Hogq. Esquire
Name (Please type or print)
19 S. Hanover Street. Ste. 101
Carlisle PA 17013
Address
( 717 ) 2452698
Tel. No.
Capacity:
Personal Representative
X
Counsel for personal
representative
ii; : ..'/. ill ,- ~
'. . (;j~ S - iLl.:1
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
DOLA TOSKI PAUL J
213 N. 45TH STREET
HARRISBURG, PA 17111
__n____ fold
EST A TE INFORMATION: SSN: 205-10-4375
FILE NUMBER: 2104-0309
DECEDENT NAME: DOLA TOSKI ALEXANDER P
DATE OF PAYMENT: 05/06/2008
POSTMARK DATE: 05/06/2008
COUNTY: CUMBERLAND
DATE OF DEATH: 02/06/2003
NO. CD 009664
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $11,067.47
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$11,067.47
REMARKS: RECEIPT TO ATTORNEY
CHECK# 0099
SEAL
INITIALS: AKK
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
SUPPLEMENTAL
INVENTORY
REGISTER OF WILLS OFCUNBERLAND COUNTY
COUNTY,PENNSYLV~
COMMONWEAL TH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
} SS
File Number 21
04
0309
Personal Representative(s) of the Estate of ALEXANDER P. DOLATOSKI
deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal assets wherever situate
and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said
inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no real estate outside of the
Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory.
I verify that the statements made in this Inven-
tory are true and correct. I understand that false state-
ments herein are made subject to the penalties of
18 Pa. C.S. ~ 4904 relating to unsworn falsification to
authorities.
}
1~~ J/AJ.4~;
PAUL J~DOLATOSKI
Attorney -- (Name) STEPHEN J. HOGG. ESQUIRE
(Address) 19 SOUTH HANOVER STREET, STE. 101
(Telephone) (717)245-2698
(Supreme Court J.D. No.) 36812
CARLISLE PA 17013
DATE OF DEATH
LAST RESIDENCE
3319 L1SBURN ROAD
MECHANICSBURG PA 17055
mGURESMUST BE TOTALED
DECEDENTS SOC. SEC. NO.
2/6/2003
205-10-4375
PROPERTY AT 3604 MARKET STREET, CAMP HILL, PA 17011
TRANSFERRED MAY 15, 2002
DEED BOK 251, PAGE 5030
r - ------
243,600.00
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-;-'I~
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5
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(Attach additional sheets as needed)
TOTAL:
243,600.00
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election ofthe personal representative include the value of each
item, but such figures should not be extended into the total of the Inventory. (See 20 Pa. C.S. 93301(b))
Form RW-09 rev. 10.13.06
w
". 1-0
..-J
15056041125
REV-1500 EX (06-05)
PA Department of Revenue '*
BureauoflndividualTaxes . INHERITANCE TAX RETURN
PO BOX 280601
Hanisbu/'Q, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Code Year
2 1 0 4
File Number
o 3 0 9
Date of Birth
205104375
o 2 062 0 0 3
05271916
Decedent's Last Name
Suffix
Decedent's First Name
DOLATOSKI
ALEXANDER
MI
P
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
D 1. Original Return
D 4. Limited Estate
D 6. Decedent Died Testate
(Attach Copy of Will)
D 9. Litigation Proceeds Received
D 3. Remainder Return (date of death
prior to 12-13-82)
4a. Future Interest Compromise (date of D 5. Federal Estate Tax Return Required
death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death D 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. 0)
CORRESPONDENT. THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
[ZJ
D
D
D
8. Total Number of Safe Deposit Boxes
2. Supplemental Return
STEPHEN
J .
HOG G I E S QUI R E
Firm Name (If Applicable)
CARLISLE
P A
1 7 0 1 3
-
REGISTER OF WILLS USE QNbY
C') c:::>
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~:o a :!'"'" C)
L_u_~~LED --6--..-[~~ ~~
\D of,
First line of address
1 9
S
HANOVER
ST.
S T E .
Second line of address
City or Post Office
State
ZI P Code
Correspondent's e-mail address:SHOGG@NEXSPOT.COM
Under penalties of pe~ury. 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 PERSON SPO~SIBLE FOR FILlN RETURN DA T~
~ ~ J7^~8
ADDRESS
?./3 1101'+11 'IS'#- of-reel- 1:14rrVldC1;., ,,1 11 J /1
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY,
Side 1
L
15056041125
15056041125
--.I
#
---I
15056042126
REV-1500 EX
Decedenl'flName: ALEXANDER P. DOLATOSKI
RECAPITULA TION
1. Real estate (Schedule A)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1.
2. Stocks ,llld Bonds (Schedule B)
.................................. 2.
3. Closely I told Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3.
4. MortgagllS & Notes Receivable (Schedule D)
........................ 4.
5. Cash, B;ll1k Deposits & Miscellaneous Personal Property (Schedule E) ....... 5.
6. Jointly owned Property (Schedule F) D Separate Billing Requested . . . . . " 6.
7. Inter-Vi'/OS Transfers & Miscellaneous Non-Probate Property
(SchedlJlo G) D Separate Billing Requested. . . . . .. 7.
8. Total Gruss Assets (total Lines 1-7)
........................... 8.
9. Funeral I.xpenses & Administrative Costs (Schedule H) . . . . . . . . . . . . . . .. 9.
10. Debts of Oecedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . 10.
11. Total D9uuctions (total Lines 9 & 10)
. . . . . . . . . . . . . . . . . . . . . . . . . . . 11.
12. Net ValuIJ of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . 12.
13. CharitatJlo and Governmental Bequests/See 9113 Trusts for which
an electilJn to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . 13.
14. Net Valu'1 Subject to Tax (line 12 minus Line 13) .. . . . . . . . . . . . . . . . . 14.
TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount I)f Line 14 taxable
at the S~)()usal tax rate, or
transfer~ under Sec. 9116
(a)(1.2) ^.O _
16. Amount of line 14 taxable
at lineal rate X .O~
17. Amount IJf Line 14 taxable
at siblin(} rate X .12
18. Amount 1)( Line 14 taxable
at cOllalJ,ral rate X .15
o . 0 0
15.
245943.80
16.
o . 0 0
17.
o . 0 0
18.
19. Tax Due
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
'VO~
h<~
I~~
-:z
Side 2
L
15056042126
~ /'
Decedent's Social Security Number
205104375
O. 0 0
o . 0 0
o . 0 0
2 4 3 6 0 o . 0 0
2 4 3 6 0 o . 0 0
1 0 0 3 4 . 0 0
o . 0 0
1 0 0 3 4 . 0 0
2 3 3 5 6 6 . 0 0
233566.00
O. 0 0
11067.47
O. 0 0
O. 0 0
11067.47
D
15056042126
~
,
RE\!-,1500 EX ("""age 3
Decedent's Complete Address:
DECEDENT'S NAME
ALEXANDER P. DOLATOSKI
STREET ADDRESS
3319 Lisburn Road
File Number
21 04 0309
CITY
Mechanicsburg
STATE
PA
l.zIP'
'17055'
Tax Payments and Credits:
1 , Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
11,067.47
Total Credits (A + B + C) (2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund. (4)
5. If line 1 + line 3 is greater than lin.e 2, enter the difference. This is the TAX DUE. (5)
0.00
0.00
11,067.47
(5A)
(58)
A. Enter the interest on the tax due.
B. Enter the total of line 5 + 5A. This is the BALANCE DUE.
11,067.47
PLEASE ANSWER THE FOLLOWING' QUESTIONS BY PLACING AN "XII IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ...................................................................... 0 0
b. retain the right to designate who shall use the property transferred or its income; ............................... 0 0
c. retain a reversionary interest; or ................................................................................................ 0 0
d. receive the promise for life of either payments, benefits or care? ....................................................... 0 0
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... IZJ 0
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......... 0 0
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................. 0 D
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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 three (3) percent [72 P.S. 99116 (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 zero (0) percent
[72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exemot 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 zero (0) percent [72 P.S. 99116(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 four and one-half (4.5) percent, except as noted in
72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 99116(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.
f
. 'REt',-1510 EX .1"(6-98)
*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ALEXANDER P. DOLATOSKI
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
FILE NUMBER
21 04 0309
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 INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1. Property at 3604 Market Street, Camp Hill, PA 17011 493,200.00 50. 3,000.00 243,600.00
Transfered from Alexander R. Dolatoski and
Alexander P. Dolatoski to Alexander R. Dolatoski on
May 15, 2002 - Deed Book 251, Page 5030
TOTAL (Also enter on line 7 Recapitulation) $ 243.600.00
(If more space is needed, insert additional sheets of the same size)
,
. 'RE'q-1511 EX'. (12-99)
*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
ALEXANDER P. DOLATOSKI
FILE NUMBER
21 04 0309
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1,
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) Paul J. Dolatoski 5,000.00
Social Security Number(s)/EIN Number of Personal Representative(s) 186-34-4864
Street Address 213 N 45th Street
City HarrisburQ State P A Zip 17111
Year(s) Commission Paid:
2. Attomey Fees Stephen J. Hogg, Esquire 5,000.00
3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountanfs Fees
6. Tax Retum Prepare~s Fees
7. Filing Supplemental Tax Return and Inventory 30.00
8. Copying fee for deeds 4.00
TOTAL (Also enter on line 9, Recapitulation) $ 10,034.00
(If more space IS needed. Insert additional sheets of the same size)
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
1. TAXABLE DISTRIBUTIONS [include outright spousal distributions. and transfers under
Sec. 9116 (a) (1.2)]
1. ALEXANDER R. DOLOTOSKI - REAL ESTATE Lineal 243,600.00
3604 MARKET ST. CAMP HILL, PA 17011
TRANSFERED 5/15/02 DEED BOOK 251,PAGE 5030
2 ALEXANDER R. DOLOTOSKI - REAL ESTATE Lineal 94,000.00
3319 L1SBURN ROAD, MECHANICSBURG, PA 17055
PASSED BY OPERATION OF LAW DEED BK 260 PG 610
3 ALEXANDER R. DOLOTOSKI 50% OF RESIDUARY Lineal 50%
3319 L1SBURN ROAD (LESS $11,135.12 OWE TO ESTATE)
MECHANICSBURG, PA 17055
4. PAUL J. DOLATOSKI 50% OF RESIDUARY Lineal 50%
213 N 45TH STREET (LESS $654,20 OWED TO ESTATE)
HARRISBURG, PA 17111
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
1:.
KE~'!5;3 rix. i>-.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ALEXANDER P DOLATOSKI
SCHEDULE J
BENEFICIARIES
FilE NUMBER
21 04 0309
(If more space is needed, insert additional sheets of the same size)
.I'
-.'.;
.
. r I · ..
3319 Lisbum Road - Property Taxes after date of death
2003 -
2004 -
2005 -
2005 -
2006 -
2006 -
$5070.00 - Paid in full by Al
$5379.98 - Paid in full by Al
$4702.20 - Paid in full by Estate
$ 30.14 - 2005 late fee paid by Estate
$ 1381.64 - Paid in full by ;Estate
$ 2907.33 - Paid in full by Estate
$ 123.00 - Lower Allen Lien Filing Fee
Total- $19,594.29 - Total Taxes & Fees
$10.449.98 - Paid by Al
. $ 9,441.31
+ $ 1.358.73 - Reimbursed to Al from Estate
$10,503.03
+ $ 1.146.01- Lower Allen Sewer & Refuse paid by Estate
$11,649.05
$ 513.93 - *** Prorated 2003 taxes owed by Estate
$11,135.12 - Amount owed by Al to Estate for taxes and fees paid by
Estate after date of death. Property held in joint tenancy
passes by operation of law to the surviving joint owner.
Although title passes to the surviving joint owner, the value
of the owner's interest in the property is included in his
estate for federal tax purposes. (This does not include Real
Estate & School Taxes or any other bills after date of
death. )
** 2003 taxes - $5070.00/365 days - $13.89/day
January 2003 - 31 days
February 2003 6 days
37 days X $13.89/day = $513.93 owed by estate
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAxES ~ '' ~ ~~;~NHERITANCE TAX
INHERITANCE TAX OIYISION -- S T ATE M E N T O F A C C O U N T
PO BOX 280601 _ [,', ' ,.,
HARRISBURG PA 17128-0601
i~ ~;(-
~~~ n-
~;~~ ~~~ ~
STEPHEN J NOGG ESQ (',' ,'; 'r'
19 S HANOVER ST
CARLISLE PA 17013
REV-1607 EX AFP (03-05)
DATE 06-09-2008
ESTATE OF DOLATOSKI ALEXANDER P
DATE OF DEATH 02-06-2003
FILE NUMBER 21 04-0309
COUNTY CUMBERLAND
ACN 101
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
N01'E: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE -"-1 RETAIN LOWER PORTION FOR YOUR RECORDS ~
---------------------------------------------------------------------------
REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT *~*
ESTATE: OF DOLATOSKI ALEXANDER P FILE N0. 21 04-0309 ACN 101 DATE 06-09-2008
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 06-11-2007
PRINCIPAL TAX DUE:
PAYMENTS (TAX CREDITS):
9,839.23
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID (-) AMOUNT PAID
*** SUMMARY OF LL 005 PAYMENTS ***
05-D6-2008 1,590.16- 22,496.86
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
* IF P,4ID AFTER THIS DATE, SEE REVERSE I TOTAL DUE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST. L
( IF TOTAL DUE IS LESS THAN 51,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU 17AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
20,906.70
11,D67.47CR
.00
11,067.47CR
--
COMMONWEALTH OF PtNNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX
INHERITANCE TAX DIVISION APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
PO BOX 280601 `QF.,DEiDU~CT;IpNS AND ASSESSMENT OF TAX
HARRISBURG PA 17128-0601 _
REV-1547 EX AFP C06-05)
` ~ - ~~ DATE 09-01-2008
ALEXANDER P
~QU~~CI -~ ~~ 8' ~~T
T
O
~
0
E
OF
DEATH 02
-06
2003
FILE NUMBER 21 04-0309
STEPHEN J HOGG ESQ CiL_'w~~ii~. ~, COUNTY CUMBERLAND
19 S HANOVER ST ~~Ff ~;~°,°'.'~,~ ~L~~.~~~T ACN 101
CARLISLE PA „ APPEAL DATE:
n ~ r ~";-1 ~ 10-31-2008
17013 ~~`' ~ `~
(See reverse side under Objections)
Al~ount Re~itted
MAKE CHECK PAYABLE ND REMIT PAYMENT T0:
~ REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
r11T AI flYC TYTC 1 _TYC. .~ ~ DCTATW 1 AWED pOpTT(1Y CflD Vf111R RECORDS ~^
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
DOLATOSKI PAUL J
213 N. 45TH STREET
HARRISBURG, PA 17111
fold
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11-96)
NO. CD 010367
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
ESTATE INFORMATION: SS-v: 205-~0-4375
FILE NUMBER: 2104-0309
DECEDENT NAME: DOLATOSKI ALEXANDER P
DATE OF PAYMENT: 10/07/2008
POSTMARK DATE: 10/07/2008
COUNTY: CUMBERLAND
DATE OF DEATH: 02/06/2003
101 ~ $2,977.64
TOTAL AMOUNT PAID:
REMARKS: RECEIPT GIVEN TO ATTY
CHECK# 525
SEAL
INITIALS: JN
$2,977.64
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
-~, ~~~.!~ NOTICE OF INHERITANCE TAX
BUREAU DF INDIVIDUAL TAXES l ~ APpRAISEMENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION ~- OF DEDUCTIONS AND ASSESSMENT OF TAX
PO BOX 280601 ~ ,_ _ ' _ W. ~ .. ~- -
HARRISBURG PA 17128-0601 REV-1547 EX AFP (D6-05)
~~~~~ ~~~ _5 ~~ ~~: Cjo DATE 09-01-2008
ESTATE OF DOLATOSKI ALEXANDER P
CL~F~~< ~~~-
O~TJI-'r ' ~ ~ r',i ~~ ~1~~
STEPHEN J HO~~`~SQ ~ _ ~ rj P4
19 S HANOVER ST
CARLISLE PA 17013
DATE OF DEATH 02-06-2003
FILE NUMBER 21 04-0309
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 10-31-2008
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE -- RETAIN LOWER PORTION FOR YOUR RECORDS ~-
-------------------------------------------------------------------------------------------
REV-1547 EX AFP C03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF DOLATOSKI ALEXANDER P FILE N0. 21 04-0309 ACN 101 DATE 09-01-2008
TAX RETURN WAS: C X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN N0. 02
1. Real Estate (Schedule A) (1) .00 NOTE: To insure proper
2. Stocks and Bonds (Schedule B) (2) .00 credit to your account,
3.
Closely Held Stock/Partnership Interest (Schedule C)
(3)
.00 submit the upper portion
of this form with your
4. Mortgages/Notes Receivable (Schedule D) C4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) .00
6. Jointly Owned Property (Schedule F) C6) .00
7. Transfers (Schedule G) (7) 243,600.00
8. Total Assets (g) 243, 600.00
APPROVED DEDUCTIONS AND EXEMPTIONS: 10,034.00
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) (LO) .00
11. Total Deductions (11) 10.034.00
12. Net Value of Tax Return (12) 233,566.00
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .00
14. Net Value of Estate Subject to Tax (14) 452,215.96
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15) •00 X 00 _ .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 464,593.76 X 045 = 20,906.70
17. Amount of Line 14 at Sibling rate (17) .00 X 12 _ .00
18. Amount of Line 14 taxable at Collateral/Class B rate C18) .00 X 15 _ .00
19. Principal Tax Due (19)= 20,906.70
rex rv rnrTC.
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID (-) AMOUNT PAID
*** SUMMARY 0 ALL 05 PAYMENTS **
05-06-2008 1,590.16- 22,496.86
13ALANl:t OF UNF'AIU INTEREST/PENALTY AS OF
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
05-07-2008 TOTAL TAX CREDIT 20,906.70
BALANCE OF TAX DUE .00
INTEREST AND PEN. 2,894.28
TOTAL DUE 2,894.28
C IF TOTAL DUE IS LESS THAN $1, N0 PAYMENT IS REQUIRED. ~~,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE (~
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) -~
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'~ ~ " 'I'NHERITANCE TAX
li ',St!/~~EMENT OF ACCOUNT
Lr~~ ~f~y ~ 4~ ~t~ ~ ~ ' ~ 2
(,1 ~n;i ~~.~
,:_ ~ ,~t
STEPHEN J HOGG ES6~~ - '
19 S HANOVER ST
CARLISLE PA 17013
REV-1607 EX AFP C03-05)
DATE 11-03-2008
ESTATE OF DOLATOSKI ALEXANDER P
DATE OF DEATH 02-06-2003
FILE NUMBER 21 04-0309
COUNTY CUMBERLAND
ACN 101
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, P,A 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE -• RETAIN LOWER PORTION FOR YOUR RECORDS ~
---------------------------------------------------------------------------
REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT ***
ESTATE OF DOLATOSKI ALEXANDER P FILE N0. 21 04-0309 ACN 101 DATE 11-03-2008
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-25-2008
PRINCIPAL TAX DUE:
20,906.70
PAYMENTS CTAX CREDITS):
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID (-) AMOUNT PAID
*** SUMMARY OF LL 006 PAYMENTS ***
10-07-2008 4,484.44- 25,474.50
TOTAL TAX (:REDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
~ IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN 81,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
20,990.06
83.36CR
.00
83.36CR
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone:(717) 240-6345
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Date: 1/14/2009 ~:' crt ~?
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HOGG STEPHEN J ,1
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19 S HANOVER STREET :-~~?
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SUITE 101 .E~ ~.~-_7
CARLISLE, PA 17013 ~-
RE: Estate of DOLATOSKI ALEXANDER P
File Number: 2004-00309
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
W_~l.ls a Status Report of. completed or uncompleted administ~-ati_on.
This filing is due by: 2/06/2009
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,
~r•. ''~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Personal Representative(s)
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'; ~`~NrHE~I2L7ANCE TAX
'';` STATEM~N`T OF ACCOUNT
REY-1607 EX AFP (12-OS)
~~r~ ..~1~;~;~ G~ ~'i~ ~~~ S~DATE 01-05-2009
ESTATE OF DOLATOSKI ALEXANDER P
~~~~ 1-~,~,,~ !-~~ DATE OF DEATH 02-06-2003
CG'~,`~ ~ ;_ ,i ~r~T FILE NUMBER 21 04-0309
~~ ~, ~~ COUNTY CUMBERLAND
STEPHEN J HOGG ESq r~ ~ ACN 101
19 S HANOVER ST Amount Remitted
CARLISLE PA 17013
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE '~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1607 EX AFP (12-08) *** INHERITANCE TAX STATEMENT OF ACCOUNT ***
ESTATE OF DOLATOSKI ALEXANDER P FILE N0. 21 04-0309 ACN 101 DATE 01-05-2009
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN 'fHE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-25-2008
PRINCIPAL TAX DUE:
PAYMENTS (TAX CREDITS):
20,906.70
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT _C+)
INTEREST/PEN PAID C-) AMOUNT PAID
*** SUMMARY OF LL 007 PAYMENTS ***
12-18-2008 4,484.44- 25,391.14
TOTAL TAX CREDIT
BALANCE OF 7'AX DUE
INTEREST AND PEN.
* IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DIIE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
C IF TOTAL DUE IS LESS THAN S1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
20,906.70
.00
.00
.00
,, ,
l 1~~
Pa. O.C. Rule 6.12 STATUS REPORT
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Name of Decedent: Alexander P. Dolatoski
Date of Death: 2/6/2003 File Number: 21 04 0309
Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of
the above-captioned estate:
1. State whether administration of the estate is complete :........................ ^ Yes ^X No
2. If the answer is No, state when the personal representative
reasonably believes that the administration will be complete:
March 2009
3. If the answer to No. 1 is YES, state the following:
a. Did the personal representative file a final account with the Court?......... ^ Yes ^X No
b. The separate Orphans' Court No. (if any) for the personal
representative's account is:
c. Did the personal representative state an account
informally to the parties in interest? ...................................... X^ Yes ^ No
d. Copies of receipts, releases, joinders and approvals of formal or informal accounts maybe
filed with the Clerk of the Orphans' Court and maybe attaclxed~to t is report.
;. .
Date: 2/4/2009 "'
Signature of Person Filing this For
~'
Capacity: ^ Personal Representative ^Q Counsel
~ ~ a5 ~Nd~'1nJ
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Form RW-10 rev. 10.13.06
Stephen J. Hogq, Esquire
Name of Person Filing this Form
19 S. Hanover Street Ste. 101
Address
Carlisle Pa 17013
7172452698
Telephone
sr
Pa. O.C. Rule 6.12 STATUS REPORT
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Name of Decedent: Alexander P. Dolatoski
Date of Death: 2/6/2003 File Number: 21 04 0309
Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of
the above-captioned estate:
1. State whether administration of the estate is complete :........................ ^ Yes Q No
2. If the answer is No, state when the personal representative
reasonably believes that the administration will be complete:
By the end of March
3. If the answer to No. 1 is YES, state the following:
a. Did the personal representative file a final account with the Court? ......... ^ Yes ^ No
b. The separate Orphans' Court No. (if any) for the personal
representative's account is:
c. Did the personal representative state an account
informally to the parties in interest? ...................................... ^ Yes ^ No
d. Copies of receipts, releases, joinders and approvals of formal or informal accounts maybe
filed with the Clerk of the Orphans' Court and maybe attached to this report.
Date: 2/3/2010
Signature of Person Filing this F
-~' Capacity: ^ Personal Repr sentative ~ Counsel
'-~' ~~ { ..
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Stephen J. Hoga. Esquire
t'%- "- ~ _.
, . -~--%r- ~' Name of Person Filing this Form
`-~ ~ ~ ~' cL ~~ ~'~ ~ ' 19 S. Hanover Street. Ste. 101
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t'2 Address
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r~ Telephone
Form RW-10 rev. 10.13.06
Cumberland County - Register Of Wil:1s
One Courthouse Square
Carlisle, PA 17013 _
Phone: (717) 240-6345 ~ - t„_ `~' ~~
_.
~~ ~~ _~ ,
ZQ1Q J~i~ ;?7 A~ iO~ 43
Date: 1/27/2010
DOLATOSKI PAUL J
213 N. 45TH STREET
HARRISBURG, PA 17111
RE: Estate of DOLATOSKI ALEXANDER P
File Number: 2004-00309
CLFR~; CF
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: 2/06/2010
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,
~2i1LP~L~ ~~Z'G~~cY°
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
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Date : 1/27/2010 ~ _~" ,,~, ,.,~., ~
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HOGG STEPHEN J
19 S HANOVER STREET
CARLISLE, PA 17013
RE: Estate of DOLATOSKI ALEXANDER P
File Number: 2004-00309
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: 2/06/2010
Please feel free to contact this office with any qua=_stions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
G 1 e ~~~
Clerk of the Orphans' Cour
cc: File
Personal Representative(s)
_._ ~~. ~ _ _. _ T .. ~__ ,_.. ~ __ ___.____ __
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Cumberland County - ~2egister Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345 R~`r,~4~~~ r~~~=}~~ ~~
rte -~~~ 'L."~ 4~~7p-~ C
Date: 1/18/2011
HOGG STEPHEN J
19 S HANOVER STREET
CARLISLE, PA 17013
RE: Estate of DOLATOSKI ALEXANDER P
File Number: 2004-00309
Dear Sir/Madam:
CLERK 0~
QRPH~!'S C~L'RT
CUB F < < r A
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 b~' after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Reg~.ster of
Wills a Status Report of completed or uncompleted administration.
This filing is due by: 2/06/2011
Please feel free to contact this office with any question'you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
~~
~~`(r~G1G~C~i~~~!%u~~a
Glenda Farner Strasl~augh
Clerk of the Orphans' Court
cc: File
Personal Representative(s)
Cumberland County - Register Of Wills ~-T-
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345 ter,, -` r;~"1'~~~
r...., ,., ,', ~-
~~l«
Date: 1/18/2011
DOLATOSKI PAUL J
213 N. 45TH STREET
HARRISBURG, PA 17111
RE: Estate of DOLATOSKI ALEXANDER P
File Number: 2004-00309
Dear Sir/Madam:
CI.ER~ ~~UR~
~~pH,~N~~~~D '~~ ; PPS,
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the belciw listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO. 1, for decedents dying on qr after
July 1, 1992, the personal representative or his counsel, wtithin 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: 2/06/2011
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,
a~~
Glenda Farner Straslb~augh ~~_ =~
Clerk of the Orphans' Court
cc: File
Counsel
Pa. O.C. Rule 6.12 STATUS REPORT
REGISTER OF `WILLS OF CUMBERta41~~t3 ~~ ~ COUNTY, PENNSYLVANIA
Name of Decedent: Alexander P. Dolatoski
Date of Death: 2/6/2003 File Number: ~ 04 0309
Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of
the above-captioned estate:
1. State whether administration of the estate is complete :........................ [] Yes ^X No
2. If the answer is No, state when the personal representative
reasonably believes that the administration will be complete:
By the end of March
3. If the answer to No. 1 is YES, state the following:
a. Did the personal representative file a final account with the Court?......... ^ Yes ^ No
b. The separateOrphans' Court No. (if any) for the personal
representative's account is:
k.
c. Did the personal representative state an account
informally to~the parties in interest? ...................................... [~ Yes ^ No
~y
d. Copies of redeipts, releases, joinders and approvals of formal or informal a~cdunts may be
filed with the Clerk of the Orphans' Court and may be at~ched to this report.
Dare: 2/2/2011
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Form RW-10 '
rev. 10.13.06
Signature of Person Filing this
v
Capacity: ^ Personal Rep esentative C]! Counsel
SteQhen J. Hoqg. Esquire
Name of Person Filing this Form
19 S. Hanover Street. Ste. 101
Address
~rlisle _ IPa 17013
Telephone
r
1505610140
REV-1500 EX (°'.'°'
OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN 2 1 0 4 0 3 0 9
Harrisburg PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
2 0 5 1 0 4 3 7 5 0 2 0 6 2 0 0 3 0 5 2 7 1 9 1 6
Decedent's Last Name Suffix Decedent's First Name MI
D o l a t o s k i A l e x a n d e r P
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
1 a Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death
prior to 12-13~-82)
4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required
death after 12-12-82)
6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL GUKKtSF'UNUtNLt Alvu cunriutry i ~H~ ~ H~ ~nrvrcmr~ i Ivry ~nw~u o~ vir«~, ~ w ~ v.
Name Daytime Telephone Number
S t e p h e n J H o g g, E s q- 7 1 7 2 4 5 2 6 9 8
REGISTER: OF If ILLS USE DNLY
First line of address ~~
~.. _
1 9 S H a n o v e r S t r e e t
~; '
Second line of address
.:-;
S t e
1
0
1 _.
~~ `-'~
~~-=
~ -~, ,
City or Past Gffice State ZIP Code DA1fE FILED ~._
C ar l i s l e PA 170 13
Correspondent's a-mail address:
--
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 PERSON RESP SIBLE FOR FILING RETURN DATE
ADDRESS /
213 North ,~ S~th Street, Harrisbur PA 17111
SIGNATURE OF. EP T REPRESENTATIVE Tom,
ADDRESS `
19 S• Hanove Street, Ste• 101 Carlisle PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610140 1505610140
~_
J
1505610240
REV-1500 EX
Decedent's Name: AleXandet^ P - Dolatoski
Decedent's Social Security Number
2 0 5 1 0 4 3 7 5
RECAPITULATION
1. Real Estate (Schedule A) .................. . ....... . ........ . ....... 1. •
2. Stocks and Bonds (Schedule B) ..... , . , .......... 2. •
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. •
4. Mortgages and Notes Receivable (Schedule D) .. . . ...................... 4. •
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E), ...... 5. 7 5 8 3 • 3 6
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. •
7. Inter-Vivos T~ansl`ers c~ v9is:;ellaneous Non-Probate Property
(Schedule G) ^ Separate Billing Requested ...... 7.
•
8. Total Gross Assets (total Lines 1 through 7) . . .................. . .... . . 8. ? 5 8 3 . 3 6
9. Funeral Expenses and Administrative Costs (Schedule H) ......... . . ...... 9. 3 0 • ® 0
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ....... . ..... 10. •
11. Total Deductions (total Lines 9 and 10) . . . .. . ................... ...... 11. 3 0 . 0 0
12. Net Value of Estate (Line 8 minus Line 11) .......... . .......... . ...... 12. 7 5 5 3 . 3 6
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) .......... . ..... ...... 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) ..... . .......... ...... 14. ~ 5 5 3 . 3 6
TAX CALCULATION -SEE INSTRUCTIONS 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. Amount of Line 14 taxable
at lineal rate X .045 16,
17. Amount of Line 14 taxable
at sibling rate X 12 17.
8. Hn~cunt of Line ~~ f, taxable
at collateral rate X .15 1 g.
19. TAX DUE .................................................... ..19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
1505610240 1505610240
3 0 9. 9 0
3 3 9. 9 0
J
r '
REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENT'S NAME
Alexander P. Dolatoski
--
- ___
STREET ADDRESS
__
CITY __
Tax Payments and Credits:
~ ~ Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
File Number
21 04 0309
__
__
___ -
STATE SIP
3. Interest
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fiii ~~ .~vai c:.. r^age 2, Lire 2C to request„ rEr.,r;d.
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
Total Credits (A + B) (2)
(3)
i~)
,~
(5)
Make check payable to: REGISTER OF WILLS, AGENT
339.90
0.00
o. ~0
39.90
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" orpayable-upon-death bank account or security at his or her death? ... ...... ^ ^
4, Did decedent own an individual retirement account, annuity or other non-probate property, which
contains a beneficiary designation? ............................................................................................ ...... ^ ^
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND F ILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is
3 percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S. §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 21 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 percent [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 percent, 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 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
S ~
REV-1508 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERI Y
~~ ~ H ~ r ~r FILE NUMBER
Alexander P. Dolatoski 21 04 0309
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 VALUE AT DATE
DESC111PTION OF DEATH
1. Refund Attorney Fee 7,500.00
2. Refund Commonwealth of PA 83.36
TOTAL (Also enter on line 5, Recapitulation) $ 7,583.36
(If more space is needed, insert additional sheets of the same size)
REV-151 1 EX+ (10-09)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE CvSTS
tJIAItUf
Alexander P. Dolatoski
ITEM
NUMBER
A.
1.
B.
1
FUNERAL EXPENSES:
City State ZIP
Year(s) Commission Paid:
Decedent's debts must be reported on Schedule i.
DESCRIPTION
ADMINISTRATIVE COSTS:
Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
2, Attorney Fees:
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
Claimant
4
5,
6.
7.
Street Address
City State ZIP
Relationship of Claimant to Decedent
Probate Fees:
Accountant Fees:
Tax Return Preparer Fees:
Filing Supplemental Tax Return and Inventory
30.00
TOTAL (Also enter on Line 9, Recapitulation) I $
30.00
If more space is needed, use additional sheets of paper of the same size.
FILE NUMBER
21 04 030Q
AMOUNT
~ ,
REV-1513 EX+ (01-10)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
~~ ~ H i t ur: -
Alexander P. Dolatoski
NUMBER NAh"~ ANC ADDRESS OF PERSON(S) RECEIVING PROPERTY
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1. Paul J. Dolatoski
213 N. 45th Street
Harrisburg, PA 17111
2. Alexander R. Dolatoski
14 S. Union Street
Middletown, PA 17057
FILE NUMBER:
_ 21 04 0309
RELATIONSHIP TO DECEDENT
Do Mot List Trostee(sj
Lineal
Lineal
AMOUNT OR SHARE
OF ESTATE
~ ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV 1500 COVER SWEET AS APPROPRIATE
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1,
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $,
If more space Is needed, use additional sheets of paper of the same size.
SUPPLEMENTAL INVENTORY
INVENTORY
Estate of Alexander P. Dolatoski
also known as
Alexander P. Dolatoski
Deceased
No. 21 04 0309
Date of Death 2/6/2003
Social Security No. 205-10-4375
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no
real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We
verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the
penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
NamE~ of
Attorney: Stephen J. Hogg, Esquire
I.D. No.: 36812
address: 19 S. Hanover St. Suite 101
Carlisle PA 17013
Telephone: 7172452698
Personal Representative:
Paul J. Dolatoski
Dated 5/10/2011
t~
,. ;
t--~~
--_ __._..._. _..,. ,..,, ,,, ,~.ai ca~a ~c ~u~siuC uie ~ommonweaitn of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
RW-4
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
RE:V-1162 EX~11-96)
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 014464
DOLATOSKI PAUL J
213 N. 45TH STREET
HARRISBURG, PA 17111
-'------ fold
ESTATE INFORMATION: SSN: 205-10-4375
FILE NUMBER: 2104-0309
DECEDENT NAME: DOLATOSKI ALEXANDER P
DATE OF PAYMENT: 05/ 1 3/201 1
POSTMARK DATE: 05/ 1 3/201 1
COUNTY: CUMBERLAND
DATE OF DEATH: 02/06/2003
REMARKS:
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 ~ 5339.90
TOTAL AMOUNT PAID:
;339.90
CHECK# 526
INITIALS: DB
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
CLERK 4~
~~~~~v~s ca~~ pa
STEPHEN J HOGG~. €RL1~~ GO ,
19 S HANOVER ST
CARLISLE PA 17013
~~'~~~~.;~` ~~~~~ ~Q~1~iRITANCE TAX
t~jL~~L~'- r t~~'T~_s"3~I~ENT OF ACCOUNT
~~ ..
,: .
ns lvania ~s ~
pen y
DEPARTMENT OF REVENUE t
REV-1607 EX AFP C12-10)
06-13-2011
DATE DOLATOSKI ALEXANDER P
ESTATE OF
DATE OF DEATH 02-06-2003
FILE NUMBER 21 04-0309
CUMBERLAND
COUNTY
ACN 101
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SAUARE
CARLISLE PA 17013
0 our account, submit the upper portion of this form with your tax payment.
NOTE: To ensure proper credit t Y
~•. RETAIN LOWER PORTION FOR YOUR RECORDS "_~_
LONG THIS LINE ~~~~~~~~~,...^..........••..AX STATEMENT~OF ~ACCOUhIT ~~~ ~ ~~~~•••••••^•••••••••
CUT A *** INHERITANCE T
............................
REV-1607 EX AFP C12-10~
101 DATE: 06-13-2011
eiFXANDER P FILE N0.:21 04-0309 ACN:
,.,.~ T~ n ci~MMARY OF THE PRINCIPAL
ESTATE OF:D~LA~~~^1 ---
THIS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACN IN THE NAME
YMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE.
_ _~ rrwTTllN nF ALL ~A
TAX DUE, Arr~l~•+~ ~~~~ -~
TE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-25-2008
DA 20,906.70
PRINCIPAL TAX DUE:
PAYMENTS CTAX CREDITS:
RECEIPT DISCOUNT C+)
PAYMENT NUMBER INTEREST/PEN PAID C-~
DATE
*** SUMMARY OF ALL 008 PAYMENTS ~**
4,484.44-
05-13-2011
AMOUNT PAID
25,731.04
21,246.60
TOTAL TAX PAYMENT
339.90Ck
BALANCE OF TAX DUE
.00
INTEREST AND PEN.
TOTAL DUE 339.90C'
IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATgENDUE ADREFUNDALSEETREVERSE SIDE OF THIS FORM
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MA
FOR INSTRUCTIONS.
Cumberland County - Register Of Wills
One Courthouse Square ~~;.., ~ ~~-
Carlisle, PA 17013 "" ~~r
:is l l
Phone:(717) 240-6345 ` - ~
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Date: 1/17/2012
HOGG STEPHEN J
19 S HANOVER STREET
CARLISLE, PA 17013
RE: Estate of DOLATOSKI ALEXANDER P
File Number: 2004-00309
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, N0. 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: 2/06/2012
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,
,,.
;r . _.~
~_ , , . ~~
~..
°-'
Glenda Farner Strasba~l'i
Clerk of the Orphans' Court
cc: File
Personal Representative(s)
Cumberland County - Register Of Wills
One Courthouse Square ~ ~ , ~,-
Carlisle, PA 17013 r :~ ~ ~ '~= ~-~~
Phone: (7I7) 240-6345 ~ - ~~ "^
_. ,
Date: 1/17/2012
DOLATOSKI PAUL J
213 N. 45TH STREET
HARRISBURG, PA 17111
RE: Estate of DOLATOSKI ALEXANDER P
File Number: 2004-00309
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, N0. 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: 2/06/2012
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,
~~ n
~i
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
Pa. O.C. Rule 6.12 STATUS REPORT
REGISTER OF WILLS OF Cur~1BERl_AND _ t~'Ot~ ~1TY, PENNSYLVANIA
Name of Decedent: Alexander P. Dolatoski
Date of Death: 2/6/2003 File Number: 21 04 0309
Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of
the above-captioned estate:
1. State whether administration of the estate is complete :.... ................... ^ Yes ^X No
2. If the answer is No, state when the personal representative
reasonably believes that the administration will be complete:
By the end of March 2012
3. If the answer to No. I is YES, state the following:
a. Did the personal representative file a final account with the Court`?......... ^ Yep ^ No
b. The separate Orphans' Court No. (if any) for the personal
representative's account is: -- -~ -
c. Did the personal representative state an account
informally to the parties in interest? ...................................... ^ Yes ^ No
d. Copies of receipts, releases, joinders and approvals of formal or i;~formal accounts may be
filed with the Clerk of the Orphans' Court and may be at hed to this report.
Date: 1/19/2012
Signatu of Person Filing this rm
~~ ~ ~ Capacity: ^ Personal Representative ~ Counsel
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Form RW-10 rev. 10.13.06
St_e~hen J. Hoaa. Esauire
Name of Person Filing this Form
19 S. hanover~,treet. Ste. 101
Address
Carlisle Pa 17013
717242698 -"
Telephone
~'
. ,. ...
DECEDENT'S ESTATE
COURT OF COMMON PLEAS OF
CUMBERLAND CO~.'Ni Y, i'i:NNSYL~'ANIA
ORPHANS' COURT DIVISION
ESTATE OF Alexander P. Dolatc,ski
No. 21-~J4-0309
ra
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~._.
._. DECF,ASED
PETITION FOR ADJUDICATION /
STATEMENT OF PROPOSF.I) Di~w':'RIBUTION
PURSUANT TO Pa. (T.C. Rule 6.9
This form may be used in all cases involving the Audit of the Account of a Decedent's Estate. If
space is insufficient, riders may be attached. Attar°h the spouse's election, if arty; the papers
renui~ec%un-per items 8-19 inclusive; ar•,~any inarumentpertinentto the ad~•~di• ation.
INCLUDEATTACHMENTa AT THE BACK OF THIS FORM.
Name of Counsel: Stephen J. Hogg, Esquire
Supreme Court I.D. No.: 36812
Name of Law Firm:_Law Offices of Stephen J. Hogg
Address: 19 S. Hanover Street, Ste. 101, Carlisle, PA 17013
Telephony: 717-245-2698
Fax: 717-245-0829
FormOC-01 rte. ~0.~3.06 Page 1 of 10
Estate of Alexander P. Dolatoski ,Deceased
1. Name(s) and address(es) of Petitioner(s):
tvame: Paul J. Dolatoski
Address: 213 N. 45th Street
Harrisburg, PA 17111
Identify any executors or administrators who have not joined in the Petition for
Adjudication and Statement of Proposed Distribution and state reason:
Is this the first accounting by this fiduciary? ..................... Q Yes ~ No
If not, identify prior accountings, the accounting periods covered, and the date of
adjudication of the prior accounting.
2. Decedent died on February 6, 2003
~ Letters Testamentary or ~ Letters of Administration were granted to Petitioner(s) on
September 12.2005
Date of Will (f applicable): January 27, 1992
Date(s) of Codicil(s) (if applicable):
Date of probate (f d~erent from date Letters granted):
Was a bond required? Yes Q No If yes, state amount:
Are proofs of advertising of the grant of Letters attached? ......... ~ Yes Q No
Dates of advertising of the grant of Letters: 1 t~/06/05, 10/13/05, 10/20/05, 10/21/05,
10/28/05, 11/04/05
Form OC-01 rev. 10.13.06 Page 2 of 10
Estate of Alexander P. Dolatoski ,Deceased
3. Was decedent survived by a spouse? ............................. ^Yes ~ No
If yes, name of the surviving spouse:
4. Has the surviving spouse filed to take an elective share? ............. Q Yes ~ No
(See Section 2201 et sue. of the Probate, Estates and Fiduciaries Code)
If yes, date of election:
5. In the case of an intestacy, state the names of the decedent's surviving children or
surviving issue of deceased children (f none, so state):
6. Did decedent marry after execution of Will or Codicil(s)? ........... ~ Yes ~ No
Were any children born to decedent after execution of
Will or Codicil(s)? ....................................... . ... ~ Yes ~ No
If yes, give names and dates of birth:
Name:
Date of Birth:
7. If required by the Medical Assistance Estate Recovery Act,
62 P.S. § 1412, was a request for a statement of claim sent to
the Department of Public Welfare? .............................. ~ Yes ~ No
Fo,moc-o~ rev. io.~3.06 .Page 3 of 10
Estate of Alexander P. Dolatoski
Deceased
8. Written notice of the Audit as required by Pa. O.C. Rules 6.3, 6.7 and 6.8 has been or will be
given to all parties in interest listed in item 9 below, all unpaid creditors and all claimants
listed in item 10 below. In addition, notice of any questions requiring Adjudication as
discussed in item 14 below has been or will be given to all persons affected thereby.
A. If Notice has been given, attach a copy of the Notice as well as a list of the names
and addresses of the parties receiving such Notice.
B. If Notice is yet to be given, a copy of th Notice as well as a list of the names and
addresses of the parties receiving such Notice shall be submitted at the Audit
together with a statement executed by a Petitioner or counsel certifying that such
notice has been given.
C. If any person entitled to Notice is not sui, ~lris (e.g., minors or incapacitated
persons), Notice of the Audit has been or will be given to the appropriate
representative on such party's behalf as required by Pa. O.C. Rule 5.2.
D. If any charitable interest is involved, Notice of the Audit has been or will also be
given to the Attorney General as required under Pa. O.C. Rule 5.5. In addition, the
Attorney General's clearance certificate (or proof of service of Notice and a copy
of such Notice) must be submitted herewith or at the Audit.
9. List all parties (charitable and non-charitable) of whom Petitioner(s) has/have notice or
knowledge, having or claiming any interest in the estate as beneficiaries under the Will or
Codicil(s) or as intestate heirs if there is a complete or partial intestacy:
A. State each party's relationship to the decedent and the nature of each party's
interest(s):
in Interest
Paul J. Dolatoski
213 N. 45th Street
Harrisburg, PA 17111
Alexander R. Dolatoski
3319 Lisburn Road
Mechanicsburg, PA 17055
50% of Residuary
Real Estate
(2 properties)
50% of Residuary
Form OC-01 rev. 10.13.06 Page 4 of 10
Estate of Alexander P. Dolatoski
Deceased
B. Identify each party who is not sui juris (e.g., minors or incapacitated persons).
For each such party, give date of birth, the name of each Guardian and how each
Guardian was appointed. If no Guardian has been appointed, identify the next of
kin of such party, giving the name, address and relationship of each.
C. State why a Petition for Guardian/Trustee Ad Litem has or has not been filed for
this Audit (see Pa. O.C. Rule 12.4).
D. If distribution is to be made to the personal representative of a deceased party,
state date of death, date and place of grant of Letters and type of Letters granted.
Form oc-o/ rev. /0.13.06 Page 5 of 10
Estate of Alexander P. Dolatoski ,Deceased
10. Other than the claim for the family exemption, list the names of all known claimants and
the amount of their claims and state whether ea~:h claim is admitted.
Name and Address of Each Claimant Amount of Claim Claim Will Claim
Admitted? Be Paid In
Full?
Yes ~ Yes
~No ~ No
Yes ^ Yes
~No ~ No
Yes ~ Yes
~No Q No
Yes ~ Yes
No ~ No
If the estate is insolvent, attach a schedule setting forth the order of preference under
20 Pa.C.S. § 3392 and the proposed payments.
11. Was family exemption claimed? ................................ Yes ~No
Was family exemption allowed? ................................ Yes ~No
Family exemption claimant's name and relationship:
Name: Relationship:
Farm oc-ol rev. 10.13.06 Page 6 of 10
Estate of Alexander P. Dolatoski
Deceased
12. The amount of Pennsylvania Transfer Inheritance Tax and. additional Pennsylvania Estate
Tax paid, the date(s) of payment(s), and the interest(s) upon which paid, are as follows:
Date Payment Interest
09/21 /06
12/11/06
04/18/07 3,592.80
927.52
13. On the date of death, was the decedent a fiduciary
(personal representative, trustee, guardian, agent under power
of attorney) or surety on the bond of a fiduciary? ................... ~ Yes ~ No
If yes, provide the name of the estate, indicate whether an account has been filed and
confirmed absolutely and all awards performed, or, in the alternative, how the
decedent's estate will be discharged for the decedent's fiduciary administration of the
estate.
14. A. Describe in detail any questions requiring adjudication and state the position of the
Petitioner(s) as to each question:
B. Has notice of the question requiring adjudication been given
to the parties identified in Paragraph 9 above? .................. Q Yes ~ No
15. If Petitioner(s) has/have knowledge that a share has been assigned, renounced, disclaimed
or attached, provide a copy of the assignment, renunciation, disclaimer or attachment,
together with any relevant supporting documentation.
6,246.43
FormOC-01 rev. 10./3.06 Page 7 of 10
G '
Continued Page 7 of 10
12.
Date Payment
06/26/07
05/06/08 11,067.47
10/07/08
05/13/11 339.90
Interest
622.64
2,977.64
Estate of Alexander P. Dolatoski
Deceased
16. Had the decedent been adjudicated an incapacitated person? .......... ~ Yes 0 No
If yes, attach a copy of the Order if available; otherwise state the Court, term, number,
date, and name of Hearing Judge.
17. A. List or attach a separate list of additional receipts and disbursements since the closing
date of the Account.
B. Has notice of the additional receipts and. disbursements been
given to the parties identified in Paragraph 9 above? ............. ~ Yes ~ No
18. If a reserve is requested, state amount and purpose.
Amount:
Purpose:
If a reserve is requested for counsel fees, has notice of the
amount of fees to be paid from the reserve been given to the
parties in interest? ........................................ Yes ~No
If so, attach a copy of the notice.
19. Is the Court being asked to direct
the filing of a Schedule of Distribution? .......................... Yes No
As to real estate only? ........................................ Yes ~ No
Form OC-Ol rev. 10.13.06 Page 8 of 10
f
Estate of Alexander P. Dolatoski
Deceased
Wherefore, your Petitioner(s) ask(s) that distribution be awarded to the parties entitled
and suggest(s) that the distributive shares of income and principal (residuary shares being stated
in proportions, not amounts) are as follows:
A. Income:
Proposed Dtstributee(sJ Amount/Proportion
Paul J. Dolatoski 50% -Residuary
Alexander R. Dolatoski 50% -Residuary
B. Principal:
Proposed Distributee(s) Amount/Proportion
Submitted By:
(All petitioners must sign.
Add additional lines if necessary):
Form OC-Ol rev. 10.13.06
~2~~~~a,8~C,~~d
ame of etitioner: Paul J. Dolatoski
Name of ret~t~oner:
Page 9 of 10
Estate of Alexander P. Dolatoski
Verification of Petitioner
(Verification must be by at least one petitioner.)
Deceased
The undersigned hereby verifies * [that heishe he is rime Executor
of the above-named name of corporation Estate of Alexander P. Dolatoski and] that the facts set
forth in the foregoing Petition for Adjudication /Statement of Proposed Distribution which are
within the personal knowledge of the Petitioner are true, and as to facts based on the information
of others, the Petitioner, after diligent inquiry, believes them to be true; and that any false
statements herein are made subject to the penalties of 18 Pa. C.S. § 4904 ,(relating to unsworn
falsification to authorities).
~~ ~~~~~
Signature of Petitioner
* Corporate petitioners must complete bracketed information.
Certification of Counsel
The undersigned counsel hereby certifies that the foregoing Petition for Adjudication/
Statement of Proposed Distribution is a true and accurate reproduction of the form Petition
authorized by the Supreme Court, and that no changes to the forme been made beyond the
responses herein. ~~
Signature of Cou~el,~or Petitioner
Form OC-01 rev. 10.13.06 Page 10 of 10
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WILL OF
ALEXANDER P. DOLATOSKI
I, ALEXANDER P. DOLATOSKI, of 3319 Lisburn Road, Mechanicsburg,
Cumberland County, Pennsylvania, declare this to be my last Will and
hereby revoke all prior wills and codicils.
1. I direct that all my just debts, funeral expenses, grave-
marker and administrative expenses shall be paid from my residuary
estate as soon as practicable after my death.
2. I direct that all inheritance, estate, transfer, success-
ion and death taxes of any !<ind whatsoever which may be payable by
reason of my death shall be paid out of my residuary estate.
LAW OFFICES OF
STEPHEN J. HOGG
40t E. LOUTHER STREET
CARLISLE, PA 17013
3. I direct that my entire estate be distributed as follows:
A. I leave my entire estate of whatever nature and wherever
situate to my wife, ROSE M. DOLATOSKI, should she survive
me.
B. Should my spouse predecease me, I direct that my estate shall
be divided as follows:
1) I leave to my son ALEXANDER R. DOLATOSKI, 30% of my
interest in the A & M Texaco Station located at 3504
Market Street, Camp Hill, Cumberland County, Pennsylvania;
all the personal property located in the 3rd bedroom, the
kitchen and the basement, except for the itemized trains,
located in the real estate at 3319 Lisburn Road, Mechanics-
burg, Cumberland County, Pennsylvania; and all the certifi-
cates of deposit ~vith the name of Alexander R. Dolatoski
on them.
2) I leave to my son, PAUL J. DOLATOSKI, 100% of my share in
the real estate at 3319 Lisburn Road, Mechanicsburg, Cumb-
erland County, Pennsylvania; 70% of my share of the afore-
mentioned A & M Texaco Service Station; and all the cer-
tificates of deposit with the name of Paul J. Dolatoski
on them.
3) All the rest of my estate shall be divided equally between
my two sons, ALEXANDER J. DOLATOSKI and PAUL J. DOLATOSKI.
C. Should my son PAUL J. DOLATOSKI predecease me, then his share
shall pass to his children equally.
D. Should my son, ALEXANDER R. DOLATOSKI predecease me, then his
share shall go to Paul and Paul's children in equal shares.
J~ .1 ,' / ,~.~,~ ..
+.~~ L-~. ~ ~ ;
_~1=\~~
~~
-
E. I reserve the right to leave a separate memorandum with
my Will listing specific items.
4. I appoint my wife, ROSE M. DOLATOSKI, as Executrix of this
my last Will. If she should predecease me or cease to act in such
capacity, I name my son, PAUL J. DOLATOSKI to so serve.
5. The Executrix of this. Will shall have the power to distri-
bute my estate in kind or in cash, or partly in either.
6. I direct that no Executrix acting under this Will shall be
required to enter bond in any jurisdiction.
IN W ~T,D1~SS WHEREOF, I have hereunto set my hand this ~ t~ay
of t,~t ;ZctG~c , 1992.
~.
ALEXANDER P. DOLATOSKI
LAW OFFICES OF
STEPHEN J. HOGG
401 E. LOUTHER STREET
CARLISLE, PA 17013
~i~J
~~
The preceding instrument consisting of this and two other
pages was on the day and date hereof signed, published and declared
by ALEXANDER P. DDLATOSKI, as and for his last Will in the presence
of us, who at his request, in his presence and in the presence of
each other have subscribed our names as witnesses hereto.
~~
U1W OFFICES CF
STEPHEN J. HOGG
401 E. LOUTHER STREET
CARLISLE, PA 17013
Commonwealth of Pennsylvania
ss
County of Cumberland
I, ALEXANDER:P. DOLATOSKI, the testator whose name is signed to
the attached or foregoing instrument, having been duly qualified accord-
ing to law, do hereby acknowledge that I signed and executed the instru-
ment as my last Will; that I signed willingly and as my free and vol-
untary act for the purposes therein expressed.
/ ~ ' y /.,
ALEXANDER P ' DOLATOSKI
LAW OFFICES OF
'EPHEN J. HOGG
t E. LOUTHER STREET
CARLISLE, PA 17013
Sworn to affirmed and acknowledged befo~ me by ALEXANDER P.
DDLATOSKI, the testator, this I? Th day of - ,.. , 1992.
~~• i
/ :~/
~~~
Notary Pu is/Atto`rney ~!
ACKNOWLEDGEMENT
AFFIDAVIT
Commonwealth of Pennsylvania
ss
County of Cumberland /
We, ~i cau~a~ 1~1 ~Av~ S and vAf'~t~S ~~-~'~ ,
the witnesses whose names are signed to the attached or foregoing in-
strument, being duly qualified according to law, do depose and say that
we were present and saw the testator sign and execute the instrument
as his last Will; that the testator signed willingly and executed it
as his free and voluntary act for the purposes therein expressed; that
each subscribing witness in the hearing and sight of the testator signed
the Will as a witness; and that to the best of our knowledge the testa-
tor was at that time t8 or more years of age, of sound mind and under
no constraint or undue influence. ~ ^ ~/
Sworn to or afl"firmed and subscri~d to before me by witnesses,
this ?? `day of - ~~tir-" '' 1992. ,~ _
`~ /• f
;;
• Notary Pyrilic/Att~ne ~~
~,
PROOF OF PUBLICATION OF NOTICE
IN CUMBERLAND LAW JOURNAL
(Under Act No. 587, approved May 16, 1929), P. L.1784
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ss.
Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and
State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law
Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid,
was established January 2, 1952, and designated by the local courts as the official legal
periodical for the publication of all legal notices, and has, since January 2, 1952, been regulazly
issued weekly in the said County, and that the printed notice or publication attached hereto is
exactly the same as was printed in the regulaz editions and issues of the said Cumberland Law
Journal on the following dates,
viz:
October 21, 28, November 4, 2005
Affiant further deposes that he is authorized to verify this statement by the Cumberland
Law Journal, a legal periodical of general circulation, and that he is not interested in the subject
matter of the aforesaid notice or advertisement, and that all allegations in the foregoing
statements as to time, place and character of publication aze true.
Dolatoski, Alezander P., decd.
Late of Cazlisle.
Administrator: Paul J. Dolatoski,
213 N. 45th Street, Harrisburg,
PA 17111.
Attorney; Stephen J. Hogg, Es-
quire, 19 S. Hanover Street, Suite
101, Carlisle, PA 17013.
., r---
L sa Marie Coyne Editor
SWO TO AND SUBSCRIBED before me this
__ 4 day of November 2005
iVQTARIAL SEAL v
LO1S c. SNvt;Et~, Votary Puh'ic
Ca~!i;fe 3%;re, {::imberl~ind C~~unh•
yi,; %.Off!,';iiC.~<<n ~ri~:ta ~'dr~ll J. 2~i{),~
~....r..........~........., ....--..~........~...... -.~.... ..~..
PROOF OF PUBLICATION
State of Pennsylvania, County of Cumberland
Tammy Shoemaker, Classified Advertising 1~Tanager , of The Sentinel, of the County
and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a
newspaper of general circulation in the Borough of Carlisle, County and State
aforesaid, was established December 13,1$81, since which date THE SENTINEL has
been regulazly issued in said County, and that the printed notice or publication
attached hereto is exactly the same as was printed and published in the regulaz editions
and issues of THE SENTINEL on the following day(s)
October 06,13, 20, 2005
COPY OF NOTICE OF PUBLICATION
NOTICE QE ADMINISTRATION
Letters of Adminkttration on the Esffite of ALEXANDER
P. DOLATOSKI, late of Cumberland County, Carlisle,
PA;deceaaed, have been granted to the undersigned.
An persons krwwing themselves to be indebted to saki
Estate wiN make payment immediately, and those
havktg claims wiN present them for settlement to: .
~ Paul J. Dolatoski
' 213 N. 45th Street
Harrisburg, PA 17111,
Or to:
St1rp/ren J. Hopp, Esquln
19 South Hanover Street, Suite 101
Carl'~sle, PA 17013
Affiant further deposes that he/she is not
interested in the subject matter of the
aforesaid notice or advertisement, and that
all allegations in the foregoing statement
as to time, place and character of
publication are true.
Sworn to and subscribed before me this
26~~ day of October, 2005.
Notary lic
My commission expires: ~~~~~
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Christina L Wolke, Notary Public
Carlisle E3oro, Cumberland Courtly
My Commission Expires Sept ~, 2008
Member. Pennsylvania Association Of Notaries
IN RE: IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF
ALEXANDER P. :ORPHAN'S COURT DIVIDION
DOLATOSKI NO. 21 04 0309
PROPOSED DISTRIBUTION OF $342 655 24
Alexander R. Dolatoski $243,600.00
Real Estate at 3604 Market Street
Camp Hill, PA 17011
Property held in Joint Tenancy with
Right of Survivorship passing by operation of law
Alexander R. Dolatolski
Real Estate at 3319 Lisburn Road
Mechanicsburg, PA 17055
Property held as Joint Tenancy with
Right of Survivorship passing by operation of law by
Deed dated April 13, 1976 more than one year prior
To the date of death $0.00
Alexander R. Dolatoski - 50% Residuary $44,187.16
Less $11,335.12 for Real Estate Taxes paid
by the Estate 2003-2006 and appraisal fee
Paul J. Dolatoski - 50% Residuary $54,868.08
Less $654.20 Inheritance tax paid by
Estate on Joint Account
Total Estate Value: $342,655.24
LAW OFFICES OF
STEPHEN J. NOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
~'3~~, ~~~~ ~~
IN RE: IN THE COUR ~ OF COMMON PLEhS OF
CUMBERLAND CGUNTI", PEaJNSYLVANIA
ESTP.TE OF ~=
~ ~ ~,
~....
ALEX,'~NDER P. ORPHAN'£ COI;RT DIVISION a; . ~ ~'~ -
DOLATOSKI NO. 21-04-0309 ~ ~ ~ o
~~~ ~~ `~`
~~ ~ ~~
FIRST AND FINAL AC::OUNTIEMG f
Of the Estate of A;axandE~ P. ~~olatos~~~, Deceased, Late ~.,f
Cumberland County, PPnn~ylvar.~a.
Filed on behalf of Paul J. Dolatoski, Executor
Date of Death: Fek;ruary 6, 2003
Letters Testamentary Gran*ec:~ SeptE:~laer 12, 2(105
Letters Advertised:
The Sentinel: 10/06/05, 10/13/05, 7 0/20/05
Cumberland Lave Journal: ~0/71~05, 10/28/05, 11/04105
Accounting for the period: F"ebruary 6, 2003
/.:COUNT FINAL AS OF:
LAW OFFICES OF
STEPHEN J. NOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
IN RE: IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF
ALEXANDER P. :ORPHAN'S COURT DIVISION
DOLATOSKI NO. 21 04 0309
Purpose of the Account: Paul J. Dolatoski, Executor offers this
Account to acquaint interested parties with the transactions that have
occurred during his administration of the estate.
The Account also indicates the proposed distribution of the
estate.
It is important that the Account be carefully examined.
Requests for additional information or questions or objections can be
forwarded to:
Stephen J. Hogg, Esquire
19 S. Hanover Street, Suite 101
Carlisle, PA 17013
(717) 245-2698
Attorney for Estate
LAW OFFICES OF
STEPHEN J. NOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
RECEIPTS OF PRINCIPAL
LAW OFFICES OF
STEPHEN J. HOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
CASH
Waypoint Bank Account # 1860010017
Waypoint Bank Acct # 1 Po0010017 2003 Interest
Waypoint Bank Acct # 1 P60010017 2004 Interest
Sovereign Bank Acct# 231237295 2005 Interest
(This account was transferred from 1860010017)
Sovereign Bank Acct# 231237295 2006 Interest
Sovereign Bank Acct # 231237295 2007 Interest
(Account closed - Trf. To Estate Acct.)
Sovereign Bank Savings Account #04:30058524
Sov. Bank Savings Acct.#0430058524 2003 Interest
Sov. Bank Savings Acct#0430058524 2004 Interest
Sov. Bank Savings Acct#0430058524 2005 Interest
Sovereign Bank Checking Accaunt#0032069288
Sov. Bank Checking Acct#U032069288 2003 Interest
Sov. Bank Checking Acct#0032069288 2004 Interest
Sov. Bank Checking Acct#0032069288 2005 Interest
Estate Checking Account#0537047839 2005 Interest
Estate Checking Account#0537047839 2006 Interest
Estate Checking Account#053`7047839 2007 Interest
Subtotal
U.S. TREASURY SOCIAL SECURITY
REFUNDS
Lower Allen Twp. -Sewer & ReYuse
Subtota€
REAL ESTATE
Alexander R. Dolatoski
3604 Market Street
Camp Hill, PA 17011
Property held in Joint Tenancy with Right
Of Survivorship passing by cperation of law
Deeded within one year of date of death
Alexander R. Dolatoski
3319 Lisburn Road
Mechanicsburg, PA 17055
Property held in Joint Tenancy with Right
Of Survivorship passing by operation of law
$ 89,063.45
361.64
$ 486.23
$ 493.31
$ 544.42
$ 46.37
$ 85,904.23
$ 394.21
$ 216.02
$ 169.05
$ 934.38
$ 1.78
$ 1.38
$ 1.13
$ 23.03
$ 113.24
$ 120.23
$ 178,874.10
$ 6,400.08
$ 1,119.61
$ "!,119.61
$ 243,600.00
$ 0.00
by Deed dated April 13, 1976, more than one year
Prior to the date of death
Subtotal $ 243,600.00
TOTAL GROSS ASSETS $ 429,993.79
LAW OFFICES OF
STEPHEN J. HOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
DISBURSEMENTS OF PRINCIPAL
LAW OFFICES OF
STEPHEN J. HOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
EXPENSES AND DISBURSEMENTS
U.S. Treasury Social Security payback
Freeman Real Estate - Apps aisal
St. Joseph's
PP&L Final Bill
Telephone Bill
U.S. Treasury (taxes)
PA Dept. of Revenue (taxes)
Taxes
Lower Allen Twp. - Ambulance
Lower Allen Twp. -Sewer & Refuse
Real Estate Tax - 2003 $5070.00 x 50%
Real Estate Tax - 2004 $5379.98 x 50 ;!°
Real Estate Tax - 2005 $4,70.20 ~: 50'%
Lower Allen Twp. Schoo! Tax - 20t~6 $2,907.33 x 50%
Real Estate Tax - 2006 - $1381.64 x 50%
Lower Allen Twp. -Lien Filing Fee $12:x.00 x 50%
Reimbursement to Alexander R. Dolatoski for Real
Estate taxes paid
Real Estate Tax - 2005 (late fey) $30.14x50%
Back bank statement fee
Inheritance taxes paid on Joint Account #3116963
Estate not responsible for this tax
$ 6,400.08
;~ 200.00
$ 100.00
$ 306.38
$ 163.50
$ 3,409.00
$ 262.00
$ 160.00
$ 454.40
$ 1,146.01
$ 2,535.00
$ 2,689.99
$ 2,351.10
$ 1,453.66
$ 690.82
$ 61.50
$ 1,358.73
$ 15.07
$ 24.00
$ 263.91
LAW OFFICES OF
STEPHEN J. HOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
Inheritance taxes paid on Joint Account #3116965
Estate not responsible for this tax
Inheritance taxes paid on Joint Account #3116967
Estate not responsible for this tax
Subtotal
ADMINISTRATIVE EXPENSES
Musselman's Funeral Home
Personal Representative's Cor+imission
Attorney fees
Probate fees
Advertisement: Cumberland Lave Journal
The Sentinel
$ 195.63
$ 194.66
$24,435.44
$ 7,625.00
$21,816.22
$ 9, 500.00
$ 352.00
$ 75.00
$ 137.03
Inheritance Tax Return Filing Fee $ 30.00
Supplemental Inheritance Tax Return Filing Fees $ 60.00
Final Accounting Filing Fee $ 230.00
Death Certificates $ 72.00
Deed Copies $ 4.00
Notary $ 5.00
Federal Income Tax Preparation 2006 (est.) $ 500.Q0
Subtotal $40,406.25
Inheritance Tax Paid 9/21/06 $ 6,246.43
Inheritance Tax Paid 12/11/06 $ 927.52
Inheritance Tax Paid (4/18/07) $ 3,592.80
Inheritance Tax Interest Paid (6/27/07) $ 662.64
Inheritance Tax Paid (5/6/08) $ 11,067.47
Subtotal $ 22,496.86
TOTAL EXPENSES AND DISBURSEMENTS $ 87,338.55
TOTAL GROSS ASSETS $429,993.79
LESS EXPENSES AND DISBURSEMENTS $ 87,338.55
NET ESTATE AMOUNT FOR DISBURSEMENT $342,655.24
2
VERIFICATION
I, Paul J. Dolatoski, do hereby verify that I am the Petitioner herein,
and that the facts set forth in the aforegoing First and Final Accounting
are true to the best of my knowledge, information and belief, upon
information supplied. I understand that false statements herein are
subjQCt to the penalties of 18 I':~. C.S.A §4904, relating to unsworr.
falsifications to authorities.
Date: 1 1_ ~,~ L ,~~
PAUL J.~LATOSKI
Sworn to or affirmed nd ubscribed to before me by witnesses,
this ~ti-!'h day of ~ ~~ ~~ , 2011.
Notary Public
My Commission Expires: ~~_a~5-,
NOTARIAL SEAL
ANIAHL M PITTS
Notary Public
SWATARA TWP, DAUPHIN COUNTY
M1- Commission Expire: Aup S, 201 ~
LAW OFFICES OF
STEPHEN J. HOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
CONSENT TO DISTRIBUTION
I, the undersigned party in interest in the Alexander P. Dolatoski
LAW OFFICES OF
STEPHEN J. NOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
Estate, aver I have received and read a copy of the attached First and
Final Accounting with a proposed final distribution schedule. I
understand the proposed distribution and have no objection thereto.
Date: 9
~°
~ _
Paul J. olatoski
CONSENT TO DISTRIBUTION
I, the undersigned party in interest in the Alexander P. Dolatoski
LAW OFFICES OF
STEPHEN J. NOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
Estate, aver I have received and read a copy of the attached First and
Final Accounting with a proposed final distribution schedule. I
understand the proposed distribl:t~or and have no objection thereto.
Date: ~'~~ ~l
__
Alexander R. Do atoski
REGISTER OF WILLS
CUMBERLAND County, Pennsylvania
CERTIFICATE OF GRANT OF LETTERS
No . 2004- 00309 PA No . 21- 04- 0309
Es to to Of : ALEXANDER P DOLA TOSKI
!first, Middle, LsstJ
Late Of: 'LOWER ALLEN TOWNSHIP
CUMBERLAND COUNTY
Deceased
Social Security No : 205-10-4375
WHEREAS, on the 12th day of September 2005 an instrument dated
January 27th 1992 was admitted to probate as the last will of
ALEXANDER P DOLA TOSKI
(first Middle, Cast!
late of LOWER ALLEN TOWNSH/P, CUMBERLAND County,
who died on the 6th day of February 2003 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wills in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARY to:
PAUL J DOLATOSKI
who has duly qualified as EXECUTOR(R/Xl
and has agreed to administer the estate according to law, all of which
fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYL VANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 12th day of September 2005.
G~ ~ ~ `~
egrster o l s
i eputy
* *NOTE* * ALL NAMES ABOVE APPEAR (FIRST . MT7T)T,F. T~A.ST )
PROOF OF PUBLICATION OF NOTICE
IN CUMBERLAND LAW JOURNAL
(Under Act No. 587, approved May 16, 1929), P. L.1784
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ss.
Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and
State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law
Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid,
was established January 2, 1952, and designated by the local courts as the official legal
periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly
issued weekly in the said County, and that the printed notice or publication attached hereto is
exactly the same as was printed in the regular editions and issues of the said Cumberland Law
Journal on the following dates,
viz:
October 21, 28, November 4, 2005
Affiant further deposes that he is authorized to verify this statement by the Cumberland
Law Journal, a legal periodical of general circulation, and that he is not interested in the subject
matter of the aforesaid notice or advertisement, and that all allegations in the foregoing
statements as to time, place and character of publication are true.
Marie CovneJ Editor
Dolatoski, Alezander P., decd.
Late of Carlisle.
Administrator: Paul J. Dolatoski.
213 N. 45th Street. Harrisburg,
PA 17111.
Attorney: Stephen J. Hogg, Es-
quire, 19 S. Hanover Street, Suite
101. Carlisle, PA 17013.
WORl~f TO AND SUBSCRIBED before me this
4 day of November. 2005 _
SEAL
i LOlS E. SNYDER, iVotary Puh!ic
C~~!isle Bore, {;umber~and Count
~~~: ~.OrT(ilf8gq~n ~x~,~ra; ti~ r
..................~,..... _._.____ a ~h 5_2Ut?3
PROOF OF PUBLICATION
State of Pennsylvania, County of Cumberland
Tammy Shoemaker, Classified Advertising Manager , of The Sentinel, of the County
and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a
newspaper of general circulation in the Borough of Carlisle, County and State
aforesaid, was established December 13,1881, since which date THE SENTINEL has
been regularly issued in said County, and that the printed notice or publication
attached hereto is exactly the same as was printed and published in the regular editions
and issues of THE SENTINEL on the following day(s)
October 06,13, 20, 2005
COPY OF NOTICE OF PUBLICATION
~~~~~~INN3TRATION
p. DOLATOSKI; of Cumberland CounryL~~~ER
PA; deceased. have been granted to the undersigned.
AN persons knovrfng lhsmseNes to be indebted to said
Eafrate wiN make payment immediately, and those
having claims wip present them for settlement to: ,
.Paul J. Dolatoski
• 2i3 N. 45th Street
Harrisburg, PA 17111
Or to:
So J. ~. Eaqu~
19 Hanover Street, Suite 101
Carlisle, PA 17013
Affiant further deposes that he/she is not
interested in the subject matter of the
aforesaid notice or advertisement, and that
all allegations in the foregoing statement
as to time, place and chazacter of
publication aze true.
~~ ~ ~~~~~
Sworn to and subscribed before me this
26~• day of October, 2005.
Notary lic
My commission expires: q//~~~
COMiv10NWEALTH OF PENNSYLVANIA
No>ariel Seal
Christina L Wdfe, Not2uY Pt,~bl'ic
Carlisle Bao, Cumbl:rhand Co~Y
My Commission E~ires Sept ~ . 2008
Member. Pennsylvania Association Of Notaries
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO 60X 28001
HARRISBURG PA 17128-0601
STEPHEN J HOGG ESQ
19 S HANOVER ST
CARLISLE PA 17013
INHERITANCE TAX
STATEMENT OF ACCOUNT
pennsylvarria
DEPARTMENT OF REVENUE
REV-107 EX AFP (12-10)
DATE 06-13-2011
ESTATE OF DOLATOSKI ALEXANDER P
DATE OF DEATH 02-06-2003
FILE NUMBER 21 04-0309
COUNTY CUMBERLAND.
ACN 101
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax paymont.
CUT ALON6_ THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS _'"~
REV ~1~5=1~ E~C~A~M~~f~~l~~~S3^^^^^^ *** INHE~FI~'A~{VCE ~T~-X STATEMENT ~~Fl~A~COa~I~~~***•••••^•^•••••••••••••
ESTATE OF:DOLATOSKI ALEXANDER P FILE NO.: 21 04-0309 ACN: 101 DATE: 06-13-2011
THIS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. BELOW IS A SUMMARY OF THE PRINCIPAL
TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-25-2008
PRINCIPAL TAX DUE: 20,906.70
PAYMENTS CTAX CREDITS):
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
*** SUMMARY OF ALL 008 PAYMENTS ***
05-13-2011 4,484.44- 25,731.04
TOTAL TAX PAYMENT ~ 21,246.60
BALANCE OF TAX DUE 339.90CR
INTEREST AND PEN. .00
TOTAL DUE I 339.90CRI
* IF PAID AFTER THIS DATE. SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM
FOR INSTRUCTIONS.
IN RE: IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF
ALEXANDER P. :ORPHAN'S COURT DIVIDION
DOLATOSKI NO. 21 04 0309
PROPOSED DISTRIBUTION OF $342,655.24
Alexander R. Dolatoski $243,600.00
Real Estate at 3604 Market Street
Camp Hill, PA 17011
Property held in Joint Tenancy with
Right of Survivorship 7assing by operations of law
Alexander R. Dolatolski
Real Estate at 3319 Lisburn Road
Mechanicsburg, PA 17055
Property held as Joint Tenancy with
Right of Survivorship passing by operation of law by
Deed dated April 13, 1976 more than one year prior
To the date of death $0.00
Alexander R. Dolatoski - 50% Residuary $44,187.16
Less $11,335.12 for Real Estate Taxes paid
by the Estate 2003-2005 and appraisal fee
Paul J. Dolatoski - 50% Residuary $54,8E8.08
Less $654.20 Inheritance tax paid by
Estate on Joint Account
Total Estate Value: $342,655.24
LAW OFFICES OF
STEPHEN J. HOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNYSLVANIA
ORPHANS' COURT DIVISION
Docket No: 21-2004-0309
IN RE:
FIRST AND FINAL ACCOUNT OF PAUL J. DOLATOSKI, EXECUTOR FOR THE ESTATE OF
ALEXANDER P. DOLATOSKI, LATE OF LOWER ALLEN TOWNSHIP, CUMBERLAND COUNTY,
PENNSYLVANIA, DECEASED.
AND
PETITION FOR ADJUDICATION/STATEMENT OF PROPOSED DISTRIBUTION
ORDER OF COURT
AND NOW, this 6th day of March, 2012, the herein account is confirmed absolutely and distribution is
decreed in accordance with the proposed schedule of distribution herewith.
BY THE COURT,
Judge
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF RE'JENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0801
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX111-96)
NO. CD 015676
NOGG STEPHEN J
19 S HANOVER STREET
CARLISLE, PA 17013
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
told
ESTATE INFORMATION: SSN: 205-10-4375
FILE NUMBER: 2104-0309
DECEDENT NAME: DOLATOSKI ALEXANDER P
DATE OF PAYMENT: 03/08/2012
POSTMARK DATE: 03/08/2012
COUNTY: CUMBERLAND
DATE OF DEATH: 02/06/2003
REMARKS: RECEIPT TO ATTY
SEAL
CHECK# 3491
101 ~ $101.17
TOTAL AMOUNT PAID:
INITIALS: HEA
RECEIVED BY:
5101.17
GLENDA EARNER STRASBAUGH
REGISTER Of= WILLS
REGISTER OF WILLS
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Pa. O.C. Rule 6.12 STATUS REPORT
REGISTER OF WILLS OF CUMBERLAND _ COI ~NTY, PENNSYLVANIA
Name of Decedent: Alexander P. Dolatoski
Date of Death: 2/6/2003 File Number: 21 04 0309
Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of
the above-captioned estate:
1. State whether administration of the estate is complete:. .................... X^ Yes ^ No
2. If the answer is No, state when the personal representative
reasonably believes that the administration will ~~F complete:
3. If the answer to No. 1 is YES, state the following:
a. Did the personal representative file a final account with the Court?......... X^ Yes ^ No
b. The separate Orphans' Court No. (if any) for the personal
representative's account is:
c. I~id the personal representative state an accow~t
inforn~ally to the parties in interest? ................. .
..... .............. ~ Yes ^ No
d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be
filed with the Clerk of the Orphans' Court and mati° be a~c~d to this report.
Date: 3/8/2012
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Form R11'-10 rein. 10.13.06
Signature of Person Filing this F r
Capacity: ^ Personal Re •esentative " 0 Counsel
Stephen J Hoaa Esauire
:ante of Person Filing this Form
19 S. Hanover Street Ste. 101
Address ~ ~' ~ -- -~
Carlisle Pa 17013
717245.2698
Telephone
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BUREAU OF INDIVIDUAL TAXES rj•i` Y,''-,j• `~-~^I •` ;~-~~~ITANCE TAX
INHERITANCE TAX DIVISION
PD eox 2BO6o1 ~ ' SITA'T..fE+,~lf NT OF ACCOUNT
HARRISBURG PA 17128-0601 ~~- -, `~ `' • --'~
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STEPHEN J HOGG ES~~f'~;,(=~,= I ,:~~.,;~_} ^t',. ry
SUITE 101
19 S HANOVER ST
CARLISLE PA 17013
pennsyLvania ~~ ~-
DEPARTMENT OF REVENUE
REV-1607 EX AFP (12-11)
DATE 04-02-2012
ESTATE OF DOLATOSKI ALEXANDER P
DATE OF DEATH 02-06-2003
FILE NUMBER 21 04-0309
COUNTY CUMBERLAND
ACN 101
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE _ -_ _~_ RE_TAIN LOWER PORTION FOR YOUR RECORDS _ f-
REV-1607 EX AFP (12-11) *** INHERITANCE TAX STATEMENT OF ACCOUNT *~* --
ESTATE OF:DOLATOSKI ALEXANDER P FILE NO.: 21 04-0309 ACN: 101 DATE: 04-02-2012
THIS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. BELOW IS A SUMMARY OF THE PRINCIPAL
TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 10-21-2011
PRINCIPAL TAX DUE:
21.246-6n
PAYMENTS CTAX CREDITS):
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+3
INTEREST/PEN PAID C-)
AMOUNT PAID
~** SUMMARY OF ALL 009 PAYMENTS ***
03-08-2012 4,585.61- 25,832.21
TOTAL TAX PAYMENT 21,246.60
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE
.00
* IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM
FOR INSTRUCTIONS.
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