Loading...
HomeMy WebLinkAbout04-1174Will Estate of Cecilia J. Semvan also known as ., Deceased. SociaI Security No. 189-14-2202 The petition of the undersigned respectfully represents that: Your petitioner(s) is/are 18 years of age or older and the execut above decedent, dated PETITION FOR PROBATE and GRANT OF LETTERS No. To: Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania named in the last will of the February_ 1978 and ~c.~'~:~l(:) Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or prin- cipal residence at lflfl Mnnnt All~n Drive M~chnniveh.roo (l~r All~n) PA Decedent, then 82 years of age, died November 9, 2004 at M~ainh Villa~,; C'umht~rland Cmmty.. Pennsylvania Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated in- competent: Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ 295.000.00 WHEREFORE, petitioner~request(s) the probate of the last will .z.".~ ::'~'.':~!,':) presented herewith and the grant of letters teatamentary . thereon. ~ DebraJ. Mihalich ~1 ~2,-/~'_, ~f'~-~ , ~ ~_~-~ 1065 Orrs Bridge Road ! ' (// ' ~0 ~ ~ Mechanicsburg, PA 17050 :!:!~o_c.~ r~ OATH OF PERSONAL REPRESENTATIVE c,o COMMONWEALTH OF PENNSYLVANIA ~ COUNTY OF CUMBERLAND~ ss The petitioner(~ above-named swear(s) or affirm(s) that the statements in the foregoing petition arc true and correct ~ the best of the knowledge, and belief of petitioner0~ and that as personal law.representative(]~ of the above decedent petit~oner~' wdl' well and truly administer. · the estate according to Sworn to or affirmed and sub=bed 'V before me this ~,~ day of ~ 0/ For the R~gis}er Estate of Cecilia J. Semyan , Dece~,~ ~ r, ~ r~ DECREE OF PROBATE AND GRANT OF LETTERS ?, ~c~© :~ ~ ~ AND NOW,~oe~ ~ ~004 , in cons~derataon of the ~n on th~reve~ ~ side her~f, satisfactory proof having been presented before me, IT IS DECREED t~t the inst~ent~ ~ described ther~n be admitted to probate and filed of record as t~e last will of and Letters ~~~~ areherebygrantedto~_c~- ~q mih~ ~'Ck~ 0 FEES Probate, Letters, Etc .............. $ Shor~ Certlficates 00 .............. $ 30.00 Renunciation .................... $- ...... .......... TOTAL ............. Filed \ '~ - ~'"1 - ~ c~tN~ Richard E. Connell, Esquire (21542) ATTORNEY (Sup Ct I D. No.) 2303 Market Street ADDRESS Camp Hill, PA 17011 PHONE REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA OATH OF SUBSCRIBING WITNESS Estate of Cecilia J. Semyan Richard Snelbaker & A subscribing witness to the Will presented herewith, being duly qualifed according to law deposes and says that he was presem and saw the above Testatrix sign the same that he signed as a wimess at the request of Testatrix in her presence and in the pre~lt~e of the other subscribing witness. Address Sworn to or affirmed and subscribed before me this ~).1 ,-~,~.~ ,2004. {,~ dayof Notary Public / COMMONWEALTH OF PENNSYLVANIA Notadal Seal Susan L. Matrazi, Notary Public Mechanicsburg Boro, Cumberland County My Commission Expires Nov. 24, 2007 Member, Pennsylvania Association Of Notaries OATH OF NON-SUBSCRIBING WITNESS Also known as ,Deceased each) a subscriber hereto, (each) being duly qualified according to law, depose(~ and say(~lhat familiar w~th the s, gnature of eg,/, ~. ~- /.~ ,hD CD (one of the subscribing witnesses to) the codicil/will presented h~rewith an'~th~ehex~ thesignamreonthecodic~l/w~ll,smthehandwntmgof f e e , l, ~ ~J, to the best of,~ ~ lmowledge and belief Sworn to or affirmed and subscribed Before me this ~'3 ~c~-~ da.y, pf or th~ ~.egister ~.x ' - ' -- ~ -~.Ck~ (Address) his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Reg!strar. The original certificate will be forwarded to the State Vital Records Office for permanen('filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P ~08~284.5 No. ocal Registrar COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH White Clerical 100 Mt. Allen Driv~ Oebra LAST WILL AND TESTAMENT I: CECILIA J. SEMYAN, of the Township of Lower Allen, County of Cumberland and Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void all former wills and codicils by me at any time heretofore made. FIRST. I order and direct that all my just debts and funeral expenses be paid by my Executrix, hereinafter named, as soon as conveniently may be done after my decease. SECOND. All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situated~ I give, devise and bequeath unto my daughter, DEBRA J. MIHALICH, absolutely and in fee simple. ~O ~ LASTLY. I nominate~ constitute and appoint my ~. ~er~ DEBRA J. MIHALICH, to be the Executrix of this~ my La§~?~l and Testament, to serve without bond. ~r~- IN WITNESS WHEREOF, I, CECILIA J. SEMYAN, have hereunto set my hand and seal to this, my Last Will and Testament, this day of February, A.D., One Thousand Nine Hundred Seventy-eight (1978] The preceding instrument was on the date thereof signed: sealed, published and declared by CECILIA J. SEMYAN, the Testatrix therein named, as and for her Last Will and Testament, in the presence of us, who, at her request, in~b~resence, and in the have subscribed ou~/~witnesses heret¢ presence of each ether, ~g~-~--~~/ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Will No.: To The Register: Cecilia J. Semyan November 9, 2004 2004-01174 Glenda Farrier Strasbaugh Register of Wills Cumberland County I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on: December 28, 2004. Name Address Debra J. Mihalich c/o 4308 Allen Road Camp Hill, PA 17011 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: N/A Signature: Name: Address: Telephone #: Date: 12-28-04 Richard E. Connell, Esquire 2303 Market Street Camp Hill, PA 17011 717-232-8731 Capacity: X IR ,.o Persona epresentative o ~ era ~ Counsel for Personal Rep~tt~tive c~m ~ ~ COMrl.1C,'\\iV::ALTH OF PENNSYLVANIA J:F'ARHJlENT OF REVENUE BUREAU OF INDIVDUAL TAXES DEPT,280601 HARQrSBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004920 DUPLlCA TE MIHALlCH DEBRA J 1065 ORRS BRIDGE ROAD MECHANICSBURG, PA 17050 -------- fo." ESTATE INFORMATION: SSN, 189-14-2202 FILE NUMBER: 2104-1174 DECEDENT NAME: SEMY AN CECILIA J DATE OF PAYMENT: 02/07/2005 POSTMARK DATE: 02/04/2005 COUNTY: CUMBERLAND DATE OF DEATH: 11/09/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $'24,011.25 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: D J MIHALlCH CHECK# 6768 INITIALS: VZ SEAL RECEIVED BY: REGISTER OF WILLS $24,011.25 GLENDA FARNER STRASBAUGH REGISTER OF WillS LAW OFFICES BALL MURREN & CONNELL , 2303 MARKET STREET CAMP HILL, PENNSYLVANIA 17011 PHIUP j MURREN RICHARD E CONNELL MAURA K QUINLAN TERESA R. MCCORMACK THOMAS A. CAPPER 1717) 232-8731 FACSIMILE 0171 232-2142 WILLIAM BENTLEY BALL (1916-1999) MAILING ADDRESS PO BOX 1108 HARRISBURG. PENNSYLVANIA 17108-1108 February 4,2005 Glenda Farner Strasbaugh Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, P A 17013 RE: Estate of Cecilia J. Semyan Date of Death: 11-9-04 Will No. 2004-01174 Our File No. 2636.1 Dear Ms. Strasbaugh: Enclosed with this letter is a check payable to the "Register of Wills, Agent", No. 6768 in the amount of Twenty Four Thousand Eleven Dollars and Twenty Five ($24,011.25) Cents representing the pre-payment of inheritance tax as follows: Tax (Estimated) Less 5% Discount Estimated tax payment $ 25,275.00 l,263.75 $ 24,011.25 Please issue the appropriate receipt. Very trul.Y/~..rs(~_."J:;; ;/./ -< / (p /1/ 'j:)-{<--~ ~/ Richard E. Connell REClhmp Enclosure cc: Mrs. Debra J. Mihalich (w/out enclosure) . Ij , ~-~~aa ~'N. ;- li'~ 'C"",,,, :CO'll , ffi~:)",,' '!. U,..(/'J<..AU-', ~, ~ ho' ~E," u:!UJ ~ . \~oJ '0:; ~_ li"',J-" ,'14 ; ~ . f f" t.. e , \' Ul (f) :r: ::J C) 0 ::J :r: <{ I- 0::: - - CO (f) ::J <{ 0 - 0::: 0 ...- - l- T 0 (f) I- c:0 - c:0 - O:::(f)ZOc:0 - Ul.-l::J(f)...- - - Z:::!OUlO - ~SO(f)~ - - - u..u..0::J<{ - <{O~~u.. - OO:::.-l Ul - - ZUlO:::,&:....l - - Ull-Ul (f) ....l(f)CO::J::i - C)C)~OO::: (f)Ul::JO<{ - ~O:::O...-O - - 00 0 ,., '"' , 00 0 ,., .... ,., ~ ~ Z S Q .., ~ ~ ~ ~ ~ ::: ~ " Z x ~ o ~ g ?i '" ,z < q ~ ,..l ~ \l. ~ c3 ~ ~ "' (JJ " '" .., :r: ~ .,..! po" \"', ,.:" i' "..1 REV.tlMEX....., W I- "~l:! lilA.g %i..J UA." ~ *' OFFICIAL USE ONLY REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 04 COUNTY CODE YEAR SOCIAL SECURITY NUMBER 1174 NUMBER COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0801 !Z W o W lil o DECEDENT'S NAME (LAST. FIRST. AND MIDDLE INITIAL) Semyan, Cecilia J. DATE OF DEATH (MM-OD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 189-14-2202 THIS RETURN MUST BE FILED IN DUPUCATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 6. Decedent Died Testate (Attach copy 01 Will) 9. Utlgation Proceeds Received 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach copy of Trust) 10. Spousal Poverty Cred~ {dale 01 deeth between 1 .9 1+95 D 3. Remainder Retum (date of death prior to 12~13-82) o 5. Federal Estate Tax Return Required 8. Total Nurnber of Safe Deposit Boxes 1. Original Return 2. Supplemental Return 11/09/2004 09/22/1922 2303 Market Street Camp Hill, PA 17011 (1) None (2) 55,639.08 (3) None (4) None (5) 30,302.95 (6) 486,539.39 (7) None co~ (IF APPUCABLE) SURVIVING SPOUSE'S NAME ( LAST. FIRST AND MIDDLE INITIAL) 4. Lim~ed Estate '1- OIZ wl!l :!z 8~ E Richard E. Connell, Esq. IRM NAME (If applicable) Ball, Murren & Connell LEPHONE NUMBER 717/232/8731 "'-> IAL USE ol'lii'll :::1;:. 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) z o ~ :> I- ~ .. 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointiy Owned Property (Schedule F) o 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) ,-- C.~) I Ul " -"~.. ':-:>0 , .:;::.: . (-~ r I'T) ./_'1 {-.-) ~Tl 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) --J ~ -, U1 W (8) 572,481.42 (9) (10) 14,246.09 8,037.89 (11) 22,283.98 550,197.44 (12) 13. Charitable and Govemmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value SubJect to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RA TE:S (13) (14) 550,197.44 15.Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) z 550,197.44 .045 (16) 0 16. Amount of Line 14 taxable at lineal rate x 1= ~ :> (17) A. 17.Amount of Line 14 taxable at sibling rate x .12 :lI 0 u g 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 24,758.88 20. IBI CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 24,758.88 :opyrlght 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) ~ , " '1' ~, _~_. _....'_~m_^'~~__._...~... ~.._-~,..'''.., --_._,- .",. ". - . '.' '... ' -- ~,"',' ." '. ' ... ,-- ~ '-"'."" "...---.-......... ,~,. , ,.. 'l"",n...rcD-~' ~"~~~~.." -...'.. .. -....... :':~:'. '.-, :-'--':. ""..". .. ! ""._...~..,."'. ,..,.,..... ..".. . .,.... ,,'" ~.....,.., ....,., ...,......". ~ -"".. r ,,,. . .. ",,,.,,,-- ." .=__IJ -. '..... -- cu. :~cffi. ...-, . - . Y="'I". D ~"'_...-'_...,. "........ ..... '.' "..-- . ,..."..... ,Decedent's Complete Address: STREET ADDRESS 100 Mount Allen Drive CITY ISTATE PA I ZIP 17055 Mechanicsburg Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 24,758.88 24,011.25 1,237.94 Total Credits (A + B + C) (2) 25,249.19 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. (4) Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58) 0.00 490.31 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT 1. Did decedent make a transfer and: a. retain the use or income of the property transferred;.................................................................................. b. retain the right to designate who shall use the property transferred or its income;.................................... c. retain a reversionary interest; or.................................................................................................................. d. receive the promise for life of either payments, benefits or care?.............................................................. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?...................................................................................................................... 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?.............................................. ....................................................................... PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS v~ i o o o ~ ~ ~ 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 perjwy, I declare that I have examined this return, induding accompanying schedules and statements, and to the best of my knowledge and bellef,lt Is true, correct and comptete. Declaration of preparer other than the personal representative is basad on all infonnation of whk:h preparer has any knowledge. _~ SIGNA E OF PERSON RESPON~BLE FOR FILING RETURN AODRESS DATE Deb b leb' g~J~i~I~~ ~~~11 ._n~/~TEO~-~ ADDRESS 1., ADDRESS DATE 2303 Market Street Camp Hill, PA 17011 8/3> IDS- 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 or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)J. 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 retum 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)1. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116 (a) (1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. *' SCHEDULE B STOCKS & BONDS OOMMONWEALTH OF PENNSVLVNiIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF . . Semyan, CecllIa J. I FILE NUMBER 21-04-1174 All property jolntly-owned with right of survivorship must be disclosed on Schedule F. _" _.W~.._~___._ ITEM DESCRIPTION UNIT VALUE VALUE AT DATE OF NUMBER DEATH 1 Woolworth Corporation (Now Venator) 23.82 3,715.92 CUSIP 980883 102 156 shares 11/9/04 High 24.00 Low 23.64 Avg. 23.82 2 Savings Bonds (63 total- see Unit Value Colunm) 46,537.64 (See Attached Recap) All Series E In names of Cecilia J. Semyan $100 face value (60) or Michael J. Semyan (who predeceased $1,000 face value (3) Cecilia - Date of Death July 20, 1978) I 3 ManuLife (formerly John Hancock) 45.64 5,385.52 118 shares 11/9/04 High 45.92 Low 45.35 Avg. 45.64 , TOTAL (Also enter on line 2, Recapitulation) 55,639.08 \~ ATTACHMENT TO SCHEDULE "B" - INHERITANCE TAX RETURN CECILIA J. SEMY AN FILE NO. 21 04 1174 ~,_._-'."---'~-' -------- -----r-".~------- ..~---------._._,-,._-,..._._- .-.-.--.------~~----..-'-- J3Md ___ ___________________~_fa.="___~~!ue --- -~(?JVa7f~.n.----D.~~;~d--- M:TS N C.J5 /'11(;3~:/7 T5~-E------------- ---Til ~p~-- i JA19T60 ~ T~~T11~~ H:TS<!Jr c.r.5 M/o3({;a.7357E il/op:o- ;b/p:!~ iWftb~~o _i!.~~_~!=_~~; .._. ~~~~;n.J5..5E:_____==~=_~ 4!/~1~-=- __ -tt 'iI9i~O_ ~~~~E';9d~ [:r..~o.!'._!Fr s ___r;~~ / ~ :i ~O_~_Ll.l.._~___ ! I I~ 0 - ~_ .5p7IJ!!>_ -lL ~!~J & ~rs..~!._!!J5_ ~Olc>/ t:J./()_~J~.L______ _ i ! "iop - --W-t ~ ~~ : 1 ~3,.;('.J~~ C;jS or H::rS C:J.o,Z/o/57/!r, C Ibb - i i ~7c>Z T 1 1,P-'7!7;;' C::rS or f1::r.5 ('.;{o.J./o/j715E I/~io - i i /oi:l7oZ, I 'f~ 7:;1. 11:)5 or CT5 C/o33/57C,(,7E i /b~ - i i st/~ <r~ ' <),j~9)' -/it-~Li.~c:r~__~_Z~:}<f.'i5533~----- -++ 1"10 - I! .7j/l~!.~ 11I~~~ ~:rs_.!.._c~_~_~_/~_3'"!"!_~<i'~~8E _~ I I~~ - --1+ !t-.~ ~_~ "----I f.-~.~t~ M.TS er CJ"o c.tCJ3<fn5/5/E I lOp - ~.. 5i13<JJ. 'Jyj1f,9~ If T5-;;- C ~C-16 3- 5~~ i-:i<~o--E- ____d - -i- ~ --I ... ..1 A3 9:J. i-T wtqJ: tV.;JSorCrS C/oJb;!'''I'I''55€ ! Ilop- Irsl(3r9~ i: if3,9;1. ~J.L_or--(j=-"5 Clo.396~8'f30t: 11/1.,,,10 - r-~3q^ - lI-3~.:g /I1:rs or C:TS e./c3'1C,/3/(,tJ5c IIliai6 - ,f!j3'1:: ''/'.111- I1TS or C::r5 Co /6 3 9fq~~~ 11 / c_ ~-1-41~ I I :It ~ju_J~_ i[~3Ta~ l'f<J"1_e.r-.._C:J5 Clo39(,(,_'935c !. i I~.f ~. ~_ II. .Jr. f. f_~__+.~.i..-1.'ti.~.~.' Ob' M::rS or c:rs CltJ39 t,'9tDfrllc_ :~-{~f-- I! o~l~lo~__ +l~l o_a-, 1'1;]"5 cr C:rS C lo39t.?2:1.9Se , ! /1":0 - ! i ip(~r;8 ! i ~v, ~J! [H.T5 -cr c rs --- (! /639 ~? <j. 0, 78 E - i II~ia - ' ~ *-~o~--rr ;;1t1"8 H::TSor ~::r5 CIO<f-;'7o'i~/3e 'i ~~o- 1 .i~ob~ 11 Y'~s!o8 ~----- .--------------- ---rr+r-t-+-- -T-r~t;;- ___-'_+-__-'+-L_ ,~~:~~~~t:!H:i:::~ ---= :I~~ -: · t~- W*~10~ ------ -------~_______________~--------- ,-'--1- -+__1-+______ t-- ~-- -'1'-;-- ---- -r---r -.--. I1fS t>r C:J5 C/O'YI./:<fcO/O'$ e i i /0:0 - j,~oNJ'; ~Y'~,o8 ff.J"5 fJ('_C:J,5 CIO'YV:J.(,,;J..7SS _I: -l-LI~~p -.. ~,,('~}O.! ___ . 't~.5+~~ ~~~__~;:N~?J~_-__ -jl1'E - ~-~ _rI~~~ ~j::;-~i~ ~~;~f~ii;t:~n- .. Tt-~~t~--+ t~f$u i i X+~jf~: I N:r5 or C.r.5 C /05/ () 31 'i 5;;. c i I /1010, - I i .1/{., ~'i- T 1 W!'liIlo'11 ATTACHMENT TO SCHEDULE "B" - INHERITANCE TAX RETURN ffA~ CECILIA J. SEMY AN FILE NO. 21 04 1174 iJ-;;~d______~~~===~~=~~~-====~=~_~ f"~~e- Va /ue. -~~ 7~jt-f!-~= -=~7i~~~u__ tlf.:r-.5-_o,,--_Q..:J~____ c I()07~3~,-{59E___ __ -W +,10 -_ i i 11lt, ?~_ __ )__~~*-~_, fI1J"6 or ('3""5 C./oI33J.9r;<I<{E i! ~o,b I! .1"ifA'f "'''':JIJ.'1 MJ5 or -C3-(j--C-;-;15673--;;J:5E---- ---l1---~TI ~- -- Tr SI ~ i;; · I ~;~-S~ ;';i~_()r ~C-JS__~ 10/587'''' e ------------ .. It ~ -- _i i l' i?-~ r--- TrJY~_~~ NJS or CSS t!. 1C/5 879;<o9~ : : l!pfo TT 11/9 ~4, ! ' 7'tt;1Sb tlJ"S oc...Cr!5 __c.I3!~7S733?li___~__ --14-~~b -rrl ! ~~~_ ,; ~~'{~6{., I'f.TS or e:rs c IOltfo,ac Y'I!f€ II /tJ~ I ,S~9i6(P ! i 'S':~tiS6 /1!_!~.-.. _iJ.r-.~ :r5.__ (! I. ". I a-_? 0 3. 53..?_,€_ ------- ! I., ~.. .4 $/!91sZ ::',-~=i..~I6'" _ 5._~ 11~_Cf'__C:J.S _JL!c,;'''-_'-~J(.,J..3~ I i II,,~ i I bi/~j[~ __ ~-+_~ ~6.. M:r5 or c:rs ~/O;(6'3<t7'13E i ! I~~ I i .5!/911~ I ! i../</~6~ t4:rs of' c:::rs Clo:<'o.r;);J,71~E i i /106 i i $/19j& i i ii(<, S6> ~i~ ()_"-_t..::r.~==~/O;(~_3_~S}JI5_E -- -- -w.. (ft r-- Tr~}c~ 2: ~~~!o.. /'!.-!:.<!._~!. c:rs C.16;J,~ .3.:t!."lfD E __ I ! I~~ - +L ~4otf"- _rH_t%j'.rD I'f.:rs _or c:r~_ c /63{3 rod. o </-3 E" I~p __ t-- J. L~tf~~- -+-+_ S11~ 11</ f1:T.5 ()f CJ"S (! lo~;(3(;"Iq.;l./ E i : /P~ - i 1 ~;:5 ~'t ; I I:l508'1 M:rS or CJ"S C. 10';'3 N7 7'>'1- e ! i liob I 17;'?~ % i i ~f6V'~fJJ ~:r-1_or _E;J~I~~S_"655~'{e !+fU- i~ ~1~~ ---Ii t~/j9-~ ,Af:["<1o,..g;:jS___t;J6;lSO'_?3A c,!!-_____ __ -+ ~~ f-- itt. I..~. (Jet --r~.t.." ~.~.i~.-.. ~.jOX fI1,jO Of CIS C. /a:(~791 0 '2.3t:. ! /:op . 15:~7 6'/ i' <ti5~iO<j -t1-/TS--;;' C.rS tla~(,;793~75c - Ijo~ ~ i1 J,:(ri;'ir;-~~~oq ,,!:r~~~C:rS _ e.16;l.qqoJ</1.5C' l~-?i"-~--I-l! ~J!70'l Ji'~1-~f !i:r~_or_C:JS_~..!..c:..;l.~!.0'fO?9! __+ t~~_ Lr-~~r~Y- JL~~_(J'I I1..TS or'CJ5-.f!o3015/189c _~___ ... I /!~ 1 5if~~ -11- !'~~+~~~~_ 1'1:rs._!!:_C':rs C I03D IS'-/- 4{1J1c E___ rt I'I~b t---- W-r- 3['?il7~_'t ----11- ~~..{1~ j11:J5 or C:.TS C/03?;b7J.3:l3E ;~I-- ! I Sj/i31<f;l. i i Y'J~19J. H.[.5 0':.. t;r5 Clo3307'!Q79E I i ,i<9b,- i j 1j!/~1<r:{ i : "IJ8i9]' *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONALPROPERTV COMMONWEAL lH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER 21 .04. 1174 ESTATE OF . . Semyan, CecIlIa J. Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER I Waypoint Bank - Acct. # 586524870 DESCRIPTION VALUE AT DATE OF DEATH 29,802.95 2 Personal Effects 500.00 TOTAL (Also enter on Line 5, Recapitulation) 30,302.95 *' SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER 21-04-1174 ------------------ -- ESTATE OF Semyan, Cecilia J. If an asset was made joint within one year of the decedent's date of death, It must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A Debra J. Mihalich C/O 4308 Allen Road Daughter Camp Hill, PA 17011 B Lori K. Mihalich C/O 4308 Allen Road Granddaughter Camp Hill, PA 17011 C Lisa M. Mihalich C/O 4308 Allen Road Granddaughter Camp Hill, P A 17011 JOINTLY OWNED PROPERTY: .--- ----------~._- - ___0______"-"___'-0 . - DESCRTpTION OF PROPERTY ITEM LETTER DATE Include name of financial institution and bank account number DATE OF DEATH %OF DATE OF DEATH NUMBER FOR JOINT MADE or similar identifying number. Attach deed for jointly-held real VALUE OF ASSET DECO'S VALUE OF TENANT JOINT estate. INTEREST DECEDENTS INTEREST 1 A 02/05/2000 PNC Bank - Cert. of Deposit 96,932.94 100% 96,932.94 Account # 31600177983 2 A 03/01/1977 PNC Bank - Checking 89,586.03 100% 89,586.03 Account # 5140159366 3 A 09/20/1999 Waypoint Bank - Cert. of Deposit 4,335.72 100% 4,335.72 Account # 3000014683 4 A 12/28/1995 Waypoint Bank - Cert. of Deposit 38,471.19 100% 38,471.19 Account # 8000016636 5 A 03/27/2000 Wachovia Bank N.A.- Cert. of Deposit 100,186.53 100% 100,186.53 Account # 247412061117146 6 A 03/27/2000 Wachovia Bank, N.A.- Checking 15,162.76 100% 15,162.76 Account # 1010008160795 7 A 03/07/1974 Members 1st Federal Credit Union 142.65 100% 142.65 Account # 15862-00 8 A 02/01/200 I Members 1st Federal Credit Union 4,000.88 100% 4,000.88 Account # 15862-04 9 A 03/08/2000 Members 1st Federal Credit Union 79,418.39 100% 79,418.39 Account # 15862-44 10 A M&TBank 10,477.20 100% 10,477.20 Account # 31003914613714 Total of Continuation Schedule(s) 47,825.10 TOTAL (Also enter on line 6, Recapitulation) 486,539.39 *' SCHEDULE F JOINTLY-OWNED PROPERTY continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER 21-04-1174 ESTATE OF Semyan, Cecilia J. If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. JOINTLY OWNED PROPERTY LETTER DATE DESCRIPTION OF PROPERTY %OF ITEM Include name of financial institution and bank account number DATE OF DEATH DATE OF DEATH NUMBER FOR JOINT MADE ~r similar identifying number. Attach deed for jointly-held real VALUE OF ASSET DECD'S VALUE OF TENANT JOINT estate. INTEREST DEC_EDENI'S INTER~I)T -------- ......... II A Various Savings Bonds 42,743.10 100% 42,743.10 Series E or EE (SEE ATTACHED) ((2) $10000 face value EE bonds; (103 ) $100 face value EE bonds; (25) $50 face value E bonds.) 12 B Savings Bond V2350460EE 5,082.00 50% 2,541.00 ($5000 face value) I3 C Savings Bond V2350461EE 5,082.00 50% 2,541.00 ($5000 face value) Page 2 of Schedule F \~~ ATTACHMENT TO SCHEDULE "F" - INHERITANCE TAX RETURN CECILIA J. SEMY AN ;3Md C:T.5 or OIM X~/9of.{-73€c ---~----- .------- {_.J5_!! or"" )< )U9oC{.7~ Etf____ C:r5 dr U<M V7.36CJ'fC,O€E Cf5 or C-/I1fr1 V:l35o<f.6Ice (55 or tJJ"lvT---~ c1 /)535'1:1 3.ie C::rS Dr OIM ,,:10990/8"78Se -- c:r5 or IJ:TM J..)./'Y/335905c C~S or ryrl1 ,t. 2.1"1/3559 'f3E f-:TS or DTM /.. ~/YI33591~c ~_,_'."-.'------ e::r.s or O::rM i.;1't13~'tCJllfe ----.. ~5 "I' 03'/11 /.;1I"1t3(,3.6/9E C:J5 or IXTM /..;?NI3t3if3/E" ----- t:1"5 or 0;;1\1 J.,Vr/3'39!J1E' C-;fS or O'J"M I- A 1"1 /.3CP "I~3'oe ~r5 ~~-,J::J~ /..~/!(3~399td CIS or P:J"M /. :J./'Y/;]G8 ~?J9t: C;:rS or /Y:f1'1 J. .!1.17308tD3C, E C..-J5 or OYM /-. ;l.c99o/87y.{p E C;r6 cr ();J7VJ ,,::.;(n3ot8<;:<3c e.T5 or /JIM t..:<t73CJ~ffLI3'ft! e.:r5 tJf' Q:Jf'1 J-.::l13~/(.,;;{!f~:J..€ C;T5 or O:J/l1 J..!1./84/7,/,o33E W (Jr P:JM J.h9t'{o/c;U~E CJ5 or 'arM /.:< 19 8'!o:ZoICJ E CJ"S or f.JJ"fl1 J..;( 198 'Io,t.C!/9E ------- CoTS or O::rM L .::l19 3'10 ID 79 tf CS.5 or D':Jf11 t.:l 19 'i!<f.0;J.l.!;l. 10 E C:T5 cr /XTM ,,:U98''fO).V5/C ~------------- C:TS or f)T/'1 J-.:<19b",/-0:J.V6<tc FILE NO. 21 04 1174 ---- - ;:"ce. I/ed ue. &demfJ {. ~" Va 11Ie. V ) I~~ - , L II, ~ ~4'J - ! I ~ II ~ f,c - ~ 1 ~ rt - ~ ~.oe-=u I 56~ - n_ l~~l~- I If ob,o - ! l5 ,~17 - ! 1216Jj;l ----- --;-ll6f~ - -- t~ i~~;;, 11~1~~ 10 ! ! . I J _I--I-j-+-I '"fr I ij 0 - 1!r ~D i /,116 10 I i ~ - I /r~-;O "-IT 'i~ /0 ---rr L5 - /J'~ 70 I1rlJ ~-- I i Ij~ - /~ /,;lv, I /!fl2~- ! I 16b /in).:? I 1'fI:j'r1:J.. - - --- -- -n --~ I- ) ~ I .<':< ft - /i~.3 7~ rt !fl---- --I-~JV:l.:< -- 11 J~g '7-;' - --- --- II 15"10 I I~~~;J. I -~J+7'z I Sp - Ji~'~i9 311 t+'! Ilxi,1 iff - -+- --. -- 1--- , -f-:,-~-~-- 5~ - I /119 30 I--LJ /i'l~Jo It 0 - / 7'~ j-o ! r M~ 30 ~: ~ ;I~::= r i::: l?b - __ /1'/i9 :1'0 i I If ~;{, 30 i '6E _~ I /7, tDuU (~~ 301 i i 6b 11717 9'"1 n_llfb'i'i ! ~o - /71791 i1 ;rn, 'ty I 5p - /717 9'1 i i A~ d i: i6~ - I /l7j7 9'1- - , l~ ~-lf I I I I _~_ -lfl: __ /~~ .{.7. ~ I /!j?i 7_ I 1~0 - I /17~ :a i i ~3i'i11_ r;, IuM-t Earned V o!o~- ~I, tI- Jv~ :r ATTACHMENT TO SCHEDULE "F" - INHERITANCE TAX RETURN - FOc.e~7~-;'----l?ed€Mli~ .. _ r;t/eJ'~j.u- l/o./tJ e, ~r/led-- ~/!Y -I -- - A lit{ - i ' ':l/i'l- , ,I I A/il{- I 1I1~r- ;.rt1.~f '~. 37 :II{- / ytl :ti ~~.i." lJl~7~ I ~ 3:7 If T ~r?.7'1 ! ~3f.--1'- Ii I!ii'p.'f ~3i7~<f i /fi7~7' ..;'i:?f:I {,4 /:7tz ,<I A~~,Lj i 1!717..4Y ~~ ''I I ~7~ ~Tj ,~.: "'I i /i1~ (.,'/ , I:U"Lj , I 17~ 6</ .:/l.7~.~ 'I II * i/I i ~:t~ ~y IL ~ l:.?~y i ~::~~:t+~~~ .:( IIJ'f3~ ! I II ~+..l! ! :fM.../i._~_ ) fI ~ _) ~~~._tJ. _. 4 Ai;J,!!f ~~~~~b' Ii Ii!; tJ I ~6'i' ~U ~;~ ~ ~ I I /i,"f ~li ~~-=- I L~';<( - ~r 1 IV I I /:fDi'f 'T ~---+-I-~---- ilfY I i ~6iy- ~/fI --- ..J ~- ~ IjV -r-+- /~ I 'T lfl,- II ,: /f6irl- I; CECILIA J. SEMY AN j;J~~t!__====---_ CJ"S or fXJl'1 ~.< 7;/;l II 3S5t: CS-S or !JTM {! ~'ftf, '8(Jo'fe-t: ~ ::f.5or tJ:rf11 C G, tj Mf II~ lEe C'.;r5 or IJJ'M (}.(P<f~'iJl{;{Oct: ~:r5 "r /J-TM ~ t-,'I('~3o,3tn= c;r5 or O:rM C ~1..f6!r 1<{3 6ti" e:r.5 lit. O-:TM C "<ft:,3.;:(.o:z..eE t..rS or tJ.Tfl1 t,(P79/oo7E€ ------ C.::rS or QJ"M ~ (P'f6 frlo3EE c::rs or I:J:JM Z '7 t /1;1, /1::&------- CSS or (.);:JiI1 C ~79c '~7ee -- --.. <:::::rS or (J;JM ~ 6.790 73SE'/3 -~._-_...- C.TS or f);JM CfD79'o '7 iLff3€ t.:TS or Q:IM ~ (P? 'to & 17EE C:rS or o:r1'1 C (. '790 ? 3-c elf C;jS or OJ"fI1 C /8~o"7~3 Ee f-- C"f5 or MI'1 (.I J- M (. 35/ e c c.:rS or /J<:JM C/~60 ~331 ee --,------- C.S5 or /JJ"~ C IlfCJo~ <176 Etf e:rs or tJTH (! I~ 0 o~ 5~:J. e€ ~;TS or IXTM C 1300 ~ ,::<3eE r::r5~r D;jM t!./9191 n3€E (!:r5 or (.JIM C 1919/93S€E {!.:r.5' of f)TM ~ I 9/90l.ota, E~ 1--"'______ ~o-.s or lxTM C/9/9;1.0tD7€e- t!.::r 5_'!."----.P:r!"_ (} 1 f / ~ ;J. I;{ 1 e E C;:rS",. OJ"M ~/919:<:t..3'1EE j CJ:5 -or - IJ:Jf\1- C 19/9:< ~ 11~ E6_H==~-- r-T ~;fS-.9r DJ'MH C33(P~7~7!1Etf _~ c,.T.5 or O:JJI1 C 3 3(P;1.,? (P 17 e- € I i C;rs or /JIM C-336:).773Lf GG" " ,I , I I /" b - lOP - I/o~ - jyC10 - II IPP ...1010 ~.. -1-- 100 - Ic,o - I lob- .010 - /00 - i" ,,- I~ ') - .- l'Op - /010 - i .1_ I I"p - i ~o~- i I~oio- ! j Ilop- I I~ClIo- --- ' -ti i j1 . ---- - - t-r-- It~~ _ , )d~- , t---- Ilob - I , 7~[o - IIC!O - ----r--- 1010 I/ibPI-1I FILE NO. 21 04 1174 ~~~ ATTACHMENT TO SCHEDULE "F" - INHERITANCE TAX RETURN -- Face U/IIe. . ~dem{)r;.,;_~~~_ J:,,/eJ'e$!- I V:/ae.- -- brned---j I' ~ ~ ~ 0 i I ,1~ ~ ! ob 1-0 i , /j'eJ;M> ()b ;<.0 I ! M~;!o I '06 .M i! ~~ OW : : 1111 ;J,t.f I I I~V;;'I' ~J1/ ~'I _. I i 13i1 ~'i f-ll~ ~ r- -: /i3~' WI - _~1.I zJl ~ 'f I /,~II t, <f Ilu~t.j I li7.:! (.,1./ __1.-_ I I I 1 (,'-1 I i Ij1J,I 61.} 17:1 ~'f I /1;(:, ~'f r-'-.- 00 - m ~t.f i · J!?ifi .1'00- 11/~t.j' ".4' ~<; __ __ _ 10'" - I"'~ 7}. ~-ft z.~ /00 - I I 16'11;;'" Nfl 7';" I /~, - 1'1. 7;1. [A 1 ~ 7;J.... 100 - {,fl7:1. II )l<!7,J... -f---- _ /,ob - 'r 7~ ~~ . , II~ 7P! II!)~- /6ff'1J.. I! "'':'01)" , 0' - 1'[<( 7;).. I ~ 1ft 7;1.. O() - ~7 :lo i 11017 ;u, If) - /'6? ow_ I I~V~ ClP - I 1517,Jo )oI7~1 /op - II .1)1 010 i II 017 .:lo i lOP - ;r..t~ I 11017 t2a Ill'P - '/~!7~ ! )d, tflo i ' I/O:l - 1!1~ lie. _~ r4..i Ie:, I"''"' -- 1 ; I~.l.z lfo--! --1~~ /4> -I-~ , i I"P - 16,:;' I' I I~..( I~ I I"~ I Mr. 1 ~ I ,.1()~ I~ j Ibh -11' /6'J.? /(" " /,~:;{ ICe - I I .n__.' rt--- i Alll,o - rTT ki...< 1(" i 1,6.':1./0 _. f-- );;)0 r-- _ --1ft ~ ~I ~, ;J..c I .~9 'io .-r-I-l . ---~ i__ tic --f--L~- j~ Jo Ii I f~ ~_ I 'iOlO I I ~'1W ~ I I f9i?;lo -- CECILIA J. SEMY AN ..6Mci (;::r,5 or OJ M t 3 J (,::J.. 7 7 a 7 c E C:r5 of' fJ.:rJVl C 33 6.),711'77 ElF i-=----"-- -- 1~J'"'5or D-SM t'Yf'Y'YY71'fE/f" r~3"5 or IJTM ~;1. t, 37G 77 / t:-~ i~::fj or DJ'fv1 ~V/~'Y,{7"S G"{; ICr5 0(' D:J"M C'!LY'i'!? ~ 'I EE !~j--5 6r O:JM C 41'i'l'f ?(,S ElF f-=--' C.:r5 or tJTM C "11"'1'11967 et:! c::rs or tJ:TM C Y I'I,{ S 309 €r= CsS ", (.)::rH (! "IN"! 5'11 'd €E 0".5 or lJ:J1'1 (}</1''N709S CC" CJS or .o:JM C53l./5(f'Y'{5 f:!6 (!.:rS or O::JfI1 C 531S1r55;Z Eli" C:rS .,,. O:Jtt1 CSffllJ.. flf.t,() €E" e.:rS or arM C Sf! /1;;' 9' 103 cc C::r5 or o:r M C !iff 1/3 0 15 ElF C;TS or OrM C (,19,1. 00 'W, etf C::fS Dr OSM Cb1Q/91J/9 H. c.;:jj .r (.JJfI1 e., 19/'1 !f / ~ Eli c.rS or OJ' M ~ ~ /9/9 9'17 EG" C:1S or IJrfl1 C(j,tfo9tflfofo €G ,CS"S or .oYM CMro't'f509 ee f--"---=- C:55 or 0:;11 C'.~(J(J<tlf";;''' e€ C':J"5 ",r {);J M C 7573 ~ 1'39 e6 C::r5 or arM C75?39:<.;'t€t3 iCfS or IY.J'M C 7 5739;{ 6!f eE I _..0_.____.._ IcJ's (Jf" t.zf1'1 t 7rr18037~ ([if e;;s .,r rJ:rM c.7J'nfO'i95 €E C.fS or a:rM c. 78IffO~;l.9 €E C;:fS or OJM e. 731b07 57 138 tj'S or r.r.fM C 7"tJ I g-o 'j Ii E€ C:5'S or OJ!I1 C 8 1 ;1.'fo ~ 5'f G€ C:rS or DT'M C '?I / :? '/-0'38 S Eti C0"5 of lXJ"1'1 C 3'113/?t:,o e€ -~-~---~- C::f.5 0" O:TM C. n;;tjo 515 e~ )010 - ~"O - ;06 - ;~f- I ~do I Ilop- ;'o~ - j- '(!l~ - I IIO~ - /'.>r:,- /"''0 - FILE NO. 21 04 1174 ATTACHMENT TO SCHEDULE "F" - INHERITANCE TAX RETURN ~~~ CECILIA J. SEMY AN FILE NO. 21 04 1174 ~ond__-___-----~--=--=------~tr~ (/Q/u~__= 7(~::; _ :z:n;:;~~ ~:J"..s._(j( IJfM C8/J.'fNJ.gelf___m___! l ~"io-___ ~+A1~~=_lL~~ ~::r.~__.o!..{Jjfl1 ~ t!;;'<f~705 6rE________ .iCL '~f -: /'fl? ~_ --J I j4?~ C-:r5 Dr OJfI1 C ~ 1l.'fQ 'if 15 e-E j I _ of"..... ' /'1'- ~.. ! 1 ~9 ;.0 CJ5 10(' {JjM c~/,.{L.//o3lfeE" I lOP - 1'f:9;lo_+ -m~~ ;;-5 ~ f)JM --~i51/5 Jotc Ec I Iplp - -- I /ir~ ~~ I I 1?1~ ib ,C<J5 Dr arM C85//S305e€ I /Iob ~- II Ir~;{(f : '*;J.fJ tl}''L!!~M C 351151.('-/11;13' ! /b~ - I I 1!$'~I~r i I~~;,r C;J5 10(' ();TM C ?51/5 59~ EE-~--- I ! 11010 - - i ~r~.( ~ ~~ .:?-~ c.::rS"r cxJM C/CJ7:l3'fo33-i7-- !r~p Ir~~'iJ il ~~~~ c.rSor tlSM tlo?~33"~Et' 1/101'- i /1t'F;/~ ! !'316;(r CJ"$ or iJ;J,A1 C/o7;{3'37'f?lEE -- I flop - /r~:<1; [I ftf,.\b' ~S Of_tJ3fl1l t/~D30~y.95ee __ !_/Iop __ -+ /:~l1 '/0 II 19~ ~o CS;)orJ)';S'fV! CI).,070<f-7/5l3"c IT * ~__~3.40 11 !9[s'f0 C r5 or O:.fM cu. 351'+/4 foeti i !OID - ~l!'P 'fD 1_ j 1913 '/0 {!:JS lOr {):J~ t/;J.35lf7'f?'1Ee i Me - /~i3lfCf-_ u_J~~'fO CS5 D--;-t:5::FM C/;l.tf33393'1e-e ~oo- I '1IJL{O lll~3~o C.:J5 or (trfl.1 e/~?~701f6,3Ee /I~p - ,~~~ Il~~L,i'fO CTS Of /J::n1 t/J.7070 9ff7€C 10;:' - M~'fo: I ~'fO ~:rS orO; H O;J,,&'~5(, 775 Ce- oc> - I Ir\'f;; <,10 TT1-1:; '/0 C::rS or DJIV/ C 13 0, 530 't 32. eEo~ - :lit. '/0 f7/p 'fo C:TS or ttrfl1 C /3~9J..f9~~JEE liok:> - /1'f'fO I 17~'1o c..:1'S 0(' IJTtl1 ~/3 99' '17o;{ 0 eE ;top - I I!;;' &, '16 I 17~ </0 C:J,5orl):JM C-1'IM/J.inE€ <,10- .:(~S'o i'o~o ~_ or (.JJ"M C 1Cfl1353?75cE /~P - /~~ <to r7~I<{O I I ~:JS or /J'.T/I1 C /Sn 09(., 6Cj€€ ,00 - I i.:l3~,J.. 7139,,2.1 '_'___~__'___~_.____._'.....___ ___ -1-- - ~ I I CsS br ~ C. (s 1 73lf 18't cE ~ojc - I ~~ 9'.:1. 739;J" cr5 or OJM C/5J.S3J7/'ScE ________________ /tl_~~_ J ~ 9~ 17~~.,( _C.:r.5 lOr IJrM C IS'l/~ 3717Ec * - -f-~ I~ 9.7. I, .3 9J. C:r5 lOr OJM C/'Sl",;(/976geE "10 I ~)~ 9:1.. I-{I _I'r~ 1;{ c.:rs or O;J/l1 ~/5896'18'73EE /tlf - Nf39A It 1'51,)" Cs5 or O:J'fV1 CISff9SLf795t?E I<)F -- j.,j<j;{ 111'39:/ ~_cr o;rM c.(~I.fK/0;?15e€ IClP- ~,/V~ II 7J~~ C;r-Sor tJ.JM C/(,,'1fJ5~f.,8'eE i loP- /;/"18 l' 1~/lf8' C::r5 6f f):J~ C. [(P74fL./o 775e6" Ii 10iO - ~,;(II<.f~ 1, qfr m er IJJ/Vl e/~'i"i93o_CJ~e i I ,,~- )4/~ i 11 'iff C.:r5 of' n'J"M C/(P'i'S:? 7777 II lob - ~;J.l/vi T 1/~&- ,.cS5 _or aJ""M eI73(P~7'if<jfr€e___ ---Ll d"? ~.__ ji )~I!<;y ! i7/<f,r *' SCHEDlI..E H FUN:RAI.. EXPENSES & ADlIINSlRAl1VECOSTS COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER 21-04-1174 ESTATE OF Semyan, Cecilia J. Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT FUNERAL EXPENSES: Malpezzi Funeral Home (12/14/04) - 9,856.94 2 Wisniewski Memorials - Brass Plate-Grave Marker 100.00 3 Funeral Luncheon 107.17 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 0.00 Social Security Number(s) / EIN Number of Personal Representatlve(s): Street Address City Year(s) Commission paid State _ Zip 2. Attorney's Fees BALL, MURREN and CONNELL 2,750.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent Probate Fees Probate Fee and Short Certificates State Zip 4. 310.00 5. Accountanfs Fees 6. Tax Retum Preparer's Fees Barbush and Hoffman 475.00 7. Other Administrative Costs 1 Cumberland Law Journal (legal advertising) 75.00 2 Sentinel (legal advertising) 122.51 Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) 449.47 14,246.09 . Schedl.E H FuleraI Expel 1005 & Am *Mdi\leCostsconlhJect COMMONWEALlH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER 21-04-1174 ,m _ pm_____ ESTATE OF Semyan, Cecilia J. 3 Ball, Murren and Connell - reimbursement for advance costs: Reproduction; Postage; Fax 253.99 4 Travel Expenses - Executor Tolls, Mileage and Lodging (one night) 136.oI $136.01 5 Postage 59.47 Page 2 of Schedule H *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA WHEAITANCETAX RETURN RESIDENT DECEDENT I FILE NUMBER 21-04-1174 ESTATE OF . . Semyan, CecIlIa J. Include unreimbursed medical expenses. ITEM NUMBER 1 DESCRIPTION AMOUNT Messiah Village OctoberlNovember Statements 7,785.20 2 Alert Pharmacy 252.69 TOTAL (Also enter on Line 10, Recapitulation) 8,037.89 , . SCHEDULE J BENEFICIARIES REV.U13 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Semyan, Cecilia J. I FILE NUMBER 2] -04-1174 RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE ""N^" I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 Debra J. Mihalich Daughter All with exception of2 C/O 4308 Allen Road bonds jointly owned by Camp Hill, PA ]70]] decedent with following beneficiaries and listed on Schedule "F" 2 Lori K. Mihalich Granddaughter ] savings bond jointly owned with decedent 3 Lisa M. Mihalich Granddaughter ] savings bond jointly owned with decedent 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET . ," LAW OFFICES SNELBAKER. ;CALEB II< ELICKER LAST WILL AND TESTAMENT I, CECILIA J. SEMYAN, of the Township of Lower Allen, County of Cumberland and Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void all former wills and codicils by me at any time heretofore made. FIRST. I order and direct that all my just debts and funeral expenses be paid by my Executrix, hereinafter named, as soon as conveniently may be done after my decease. SECOND. All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situated, I give, devise and bequeath unto my daughter, DEBRA J. MIHALICH, absolutely and in fee simple. IASTLY. I nominate, constitute and appoint my daughter, DEBRA J. MlHALICH, to be the Executrix of this, my Last Will and Testament, to serve without bond. IN WITNESS WHEREOF, I, CECILIA J. SEMYAN, have hereunto set my hand and seal to this, my Last Will and Testament, this day of February, A.D., One Thousand Nine Hundred Seventy-eight (1978) (! ~/_~~ (SFAL) The preceding instrument was on the date thereof signed, sealed, published and declared by CECILIA J. SEMYAN, the Testatrix therein named, as and for her Last Will and Testament, in the presence of in the presence of /I ..., .' LAw OFFICES BALL, MURREN & CONNELL 2303 MARKET STREET CAMP HILL, PENNSYLVANIA 17011 PHIUP J. MURREN RICHARD E. CONNELL MAURA K. QUINlAN TERESAR.McCORMACK THOMAS A. CAPPER (717)232-8731 FACSIMILE (717) 232-2142 WILLIAM BENTLEY BALL (19111-1999) MAILING ADDRESS, P.O. BOX 11 ClB HARRISBURG, PENNSYLVANIA 17108-1108 HAND DELIVERED August 5, 2005 Glenda Farner Strasbaugh Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, P A 17013 RE: Estate of Cecilia J. Semyan Date of Death: 11-9-04 Will No. 2004-01174 Our File No. 2636.1 Dear Ms. Strasbaugh: Enclosed please find, in duplicate, the Inheritance Tax Return (with copies of decedent's Will attached) for Cecilia J. Semyan. Please date-stamp the additional copies of the Return for our records. Also enclosed, please fmd the Estate Inventory. Finally, enclosed is a check in the amount of$30 for the filing of the Inheritance Tax Return and the Inventory. ~ Richard E. Connell REC/hmp Enclosures cc: Mrs. Debra J. Mihalich (w/enclosure) ~ , Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of Semyan, Cecilia J. also known as , Deceased No. 21 - 04 - 1174 Date of Death 1119/2004 Social Security No. 189-14-2202 Debra J. Mihalich The 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 located 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 the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. l!We verify that the statements made in this Inventory are true and correct. l!We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Attorney: Pe__Rop_~ ~ ~ Signature: ':' _ . (,1 Debra J. Mi ch v Signature: I.D.No.: 21542 Signature: Address: 2303 Market Street CampHill,PA 17011 Address: c/o 4308 Allen Road Camp Hill, PA 17011 Telephone: 717/232/8731 Telephone: 717/433/4896 g!d/a';- Dated: Personal Property Woolworth corporation (Now Venator) CUSlP 980883 10 2 156 shares 1119/04 High 24.00 Low 23.64 Avg. 23.82 3,715.92 Savings Bonds (63 total- see Unit Value Column) (See Attached Recap) In names of Cecilia J. Semyan or Michael J. Semyan (who predeceased Cecilia - Date of Death July 20, 1978) (:) 'C_J _lJ I, '0 t-'" 'J~J /" -)C) ;1/ ,...., C'=- f::;;;:,::) CJl ~:i '-"-I 'XJ . I"'. ,c-:> ,_"~J ,n, ..-,-1 , c--} n, CJ1 CJ {- ....., ,..--... ""46 531.64 ';'1 ::::: ' ~,'. -~ ~~~ In (J _. f"l :;r':lJ ,-- c."3 I en w ManuLife (formerly John Hancock) 118 shares 1119/04 High 45.92 Low 45.35 Avg. 45.64 5,385.52 (Attach additional sheets if necessary) Total Personal Property and Real Estate $85,942.03 ~ Register of Wills of Cumberland County, Pennsylvania INVENTORY continued Estate ofS~!l!YlI!l-,-Cecilia J. also known as No. 21 - 04 - 1174 Date of Death 11/9/2004 Social Security No. 189-14-2202 . Deceased 29,802.95 Waypoint Bank - Acct. # 586524870 Personal Effects 500.00 Total Personal Property $85,942.03 2 ATTACHMENT TO SCHEDULE "B" - INHERITANCE TAX RETURN \~ CECILIA J. SEMY AN FILE NO. 21 04 1174 I3Md . ----- ~------------------- hc~.-Vcd;;;--- f};dtM~Z~~--= =J:;,(;r!..fi.-=~ --- --- --- --- - - - _______________un_ --- ----------- u_ ..-- I/a'j;-e--.-- ---br;ed M:r5 ()( C:J5 M/O.Jt!;;1.735t;,-E-----------1-T/~!c_g~-r-I11/B19T6o- r}(~O-?!G'; ,Af!:-!__~~__~ .r~__ M 1 ~3 c<; .3 7 .3 s.2.~____ _.. un i !I Cl.~;.'O - _ i~.I.- I~.,+.~j~-o i~ ~ 0 ~.~! _~~_ M;J.5 o>r CJ"5 MffJ3C.1..7.J5SE ! 1/0[,,10 -,-" i Is 11.5'11&;0 . i~",(C91~o --- ------------.--------- - i-t- -.--t- -- 1-- .. Turf .... .--i- ~---t--- C::rS or H:r5 C ~ () 1 ~;( 10 ~'-I7 e I I I~b - i i ,5:0'71f(rs, , i "I37,1?& 2~ :~.n~~~---- ~~:~tf~ ~J;~~ ~--~=--- .::;;~ -=---+t-~~rJ~ =l-l+-5;+~-~~- e:r~or__M:J5___(;{" ~C:l.j7Jf E__ I ~~ =_ ___l..Lt7b~~7.3 __ 'I %g~_~~ ~-:r~~r-.._f1~~___.c ;<c~Lo/57J;I, E _ __ 4 i <Ol~ -~+bttf~.]' · I 'Y~~jL<L r;_.r5._~r M:r 5 C. :< 03. f 6 l~? 3 3 f _ ______ i I 4~~,O- ___L L 5f-,31~ "~-fi '.~~-- 8_. i t,:rS u M:TS ~;(O~51/t6o'ft:: i 1/''''0 II jfo3T7~ i ~;(!7(o 7'y5 or-;:1f5 e~()~5115(,(j5"e-----I-Tr~t--tt~7~f- i ~-~ i~ Z~ :; S: eC:: ~~~ ;;3'/'~ it ~:~ i I- ~;~ :;- i J ~~1F ~-';;-;~ ~;:~:~:~a/~~_~-=-"-: L~:'~:- - H~g ..-Hf~~~ 1'1:T5 "r c::rs c ItJ35Q.;l.:{ ;/:(() C I Irp : jf;,J 9J.. ! I "I.3:39J.. I'1T5 01' CYS 0035 o;1.'{ ff90 If I /;ob - i I~/~?~ I: "'I.3.~ 9:1.. M;-5-~~-CJ"SC-I03(.,~4-158tjt:~-T~1~o ---- : i ~fl3 ~~ --t[~ti..z. ;'.rs--;~C:rS- C/o-31,:l.V'{-~551E~---- ! ! Ir~~=- I~LJ 9~ T: ~J(j9;l. !iT L__~~:J~~_~~~ ;t!l <; 30.f3"_ I I 1[010 __ __ J 1'~;!~ ~t <;f.ra M /I1:T5 6r c-:r5 e./cJ<f~I3/~o5c II tido - 115!/[i3'1 t I tf.'f:Jj'f 11:r5.._~_c.05 c../o3 9fc,4,l.fJ.1J( If ._-1-- II. Ii.... I;.~...O- _. II ~.~./lt.-~84 I f-- ~..~..'Y1.~..~'3......a.-..~ 1'1J"5 er C:T5 C!o39("'935c IIu/bb - I' ~or~ i i ~o/LOb' JI1:T.5 or CT5 C/D394,{,96,l/le i I &t i I b1t)~ _ ! 4-~ ,b~ "e~_~r CfS (./o39'72_~9St: I__J~/!"jo+-- II i~f>:~_<!. i '5:''vf.:51''3'i . I'1f5 6f Cr.5 ~/639~7~'f73t3" ! i lie!" I ! l~joroY Irll)1~~68 H:r.s"':-e:r~/a'!no~/3L_.__ _l~~~t - il.f~i~ - !: ;'J,e1a~_ !!.!..f.._~r c-g-6 c IO'l:l?~:l J.'YJ. C ~_ )do - __ 1+ {",q:'IOb'_ i '($1~~ I _fl!.:rs _~~ c :r..~_ .... ~/o'!.-3 7/ '(~~ ?E_____ ... __ -u- 4~o ==- ~ I {;''O CJ ~_ 1'(~.~.~. !!.:TS 6!....C;J5 _~~X:z.?!_76~c c __.____ --w-- ,)_~l~-= j T ~ff .~. - ,<lY:f!.. M:rS cr C:J5 C/O "'''I;l, leD 1 oB tf i : !C!OI - ! ! ~~C! tier : YY'jf 08 I1J:L_tJrE~-l'(')<t'!3(,,;J..7~S c..______ u : ~o" - $~Cc'tf ~-~L~{'1~~O~ fV/,J'S or C;JS t./o'l'lJ.t,S3?1 F ! i h)o - I ! ~:lI06~ ---H--1-- 'i~,Slo'if -;;;J-5---;;:-~S5~L/~<{Z;7r;,ror;;-"c--------. ---li-/blo=--; r5T~~- i i <;,,1~17~ ~~ :;~%~~=~;:i~t:~1t:~-=----- .:.H ~th~~i f-i~+H-!~~ IN:rS or ero C/oSjD3/'fS:J..c 11/:0:0,- il j/fea!"''f:i 'I!'I'/[o~i ATTACHMENT TO SCHEDULE "B" - INHERITANCE TAX RETURN J-~~ CECILIA J. SEMY AN FILE NO. 21 04 1174 - ---- - -- - -- ---- ----'-----.~--~-..-- r-----~-.-.-----.- --~----..-..-.--- r-------.---.--..n (.1oflQ_ __ _ __ . ________________ . race (/a II/e._ ;f~u:tt------p ;:,,~__ '!'1.r~...~!...._~T..~___.i!.!!_?]~3<fL.f59tf.___ _ ~_I,I I!,"~ -:._ ___ ~ : 111./1~,' ~'f ___D.! .1,'_ 2t~p~.i~<f.i !l1I5 or C'J"S Clo/33J.'fY"/'{E I; ~o~ I: ,s/'r;.<J <.),VJJ.'-I ---~----_._---------------- j~- -IT r-- -,.' '-- -- ~-..,-~-+_._---- M~s.._~__<::~~_nc.!.~~n3 oJ. ~~_________ !! If~ ! : $':9 ~lO ---L~-~~-% 11 T~_o.r~!~____f..!() 15 ? 7~!.!. be_ _p I~ -Lf.- ~( J_~ ~~_ ~y-,-+~~ N.:r5 cr CSS C /015379;<09& : i li~io I ! :iim~" ! : ~~<YiSIQ N.rS or CJS C/o/'if7S7'337€ I I~b II 5,1956> i' V"f<t!# -;;3-5 ,,-;:-c:is c. 1013 roo "{~!r€---- I ~~b n I~9iSz r'~~S0 Zt:~'}:r~ ::;:9,:~~~~~ I : :t?F~ : I :;~~ -~j-j~~: I'1:1-S-;;"--C:1-S ~ IO.:uJ(.-;;;i;;i{---- i ! 16~ - I i ~i5~ i . ~~~(" !!..~~ or ~ !~_~~!< 0 3 ;j;? 7 7 ~ E____ 1-__ .II liop - 1-++- ~!,'f j (" 1-' ! : ~~(I ${g !!~~.!._':.__t..:[5 _.i./o:(~_~.!...35E __ i-L_~o~-+=__ ---lL ?t.l~~ I , ~~~!:~ /'1...rs.n~r C;jS CI6:t-7.3-7~O/~~__ i i I~E- JI 6t.;?o~O I 7'!~~~~ !f.j5 _or C:J~__-.f.!!:3:{_36>.J. (!)~~ C ___ i Ibp ~_ 1-1 tl~r f'l I o/:6j~ "d"L ff:T.5 Dr C;J5 ~ 16~:l3(p",q';(16 : Ib~ - I r ?~:5 8'1 ! 4508'1 M:rS ~f' C.T5 C. 1 a;/,3 ~q7 7 b<f e __. 1 /oh -=-_ -lJn 17~~ 9lO ! 1 1~t~- M:r~ cr C:rS CI o:tS () 6S 5 ~y e i , i~ = i1 ~~ % ____ J j--t~_~1~ 1j.:["~_c':..!l::!..S ~ 16;;'5t)'ft3.U~ e __ _~_I_/!O~~:=_ 1-_ 1 i_ ~~p o't ii, .~~;ll_of lI1~_()r C'3"S c.IO:{~79'D!3€ _ i A'~ __ 11 ~~-tf-~+L-~~~iOj- M:r5or" c.rs t'O':U~793'75t: I! /Iob ~ itJ:Wo7' ! i Y'~~r'-! ~!,"S{)r c;:rs__ ~ ICJ;{C,qOJ'I3_S_c __ U I 11016 -= ++-~,;?i7~'f --j~~~dd~-t t'/..!:-?.. ~ r f :s:..~ C! 1 () ;. ~ '1 () 'f (J 7 9:- _ Jr, ~_b=- __ ++- ~t4z, f!...'!._rl" -+_ ~.~ej"o..'!. J1.TS or'tTS C/03cJl5/,!_89/: +11~ -1~'~ - II ~r<'~~'1_~LJi~~<"'f 1'1:rs..3!:_J.:JS Clo3oI5'-/-4/(jfaE ___Il tee- =_ 11l1i~i70'fW,_ <./~~I~ 1'1:0 or (l..r.:; C/63?;o7:t3:t3E I : If~ - I: sl'i3 If;' ! ! i1?'I~~ H.:r5 or CJ'"5 C 1()3307<f 979 € I i I! 010 1 - : , j"[,~ <;~ I I 'f3'8! 92. 10-10-2005 SEMYAN 11-09-2004 21 04-1174 CUMBERLAND 101 APPEAL DATE: 12-09-2005 ( 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 9~!_~~9~~_!~~~_~~~~______~___~~!~!~_~9~~~_~9~!!9~_E9~-!9~~_~~99~~~__~-------------------- REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX CECILIA J FILE NO. 21 04-1174 ACN 101 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX ZB0601 HARRISBURG PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ..-. ..--_'-~I,,,r ,.....,.'. ",:~,,,r.'":"i \ "II~Ol;U;EOF INHERITANCE TAX - . APl'RA:tSEHE~T" ALLOWANCE OR DISALLOWANCE . OF DEDUCTIONS AND ASSESSHENT OF TAX n,~ - ~ 'I. ,-.Q : r:U DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN RICHARD E CONNELL BALL HAL 2303 MARKET ST CAMP HILL ESQ PA 17011 ESTATE OF SEMYAN REV-1547 EX AFP (06-05) CECILIA J TAX RETURN WAS: (X) ACCEPTED AS FILED DATE 10-10-2005 ) CHANGED 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. Hortgages/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) .00 55.639.08 .00 .00 30.302.95 486.539.39 .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) 14,246.09 8.037.89 (11) (12) (13) (14) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 572,481.42 22.283 98 550,197.44 .00 550,197.44 NOTE: If an assessment was issued previously, lines 14, 15 and/or 1&, 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) 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 TAX CREDITS: .00 X 00 = .00 550,197.44 X 045 = 24,758.88 .00 X 12 = .00 .00 X 15 = .00 (19)= 24,758.88 (+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02-04-2005 CD004920 1,237.94 24,011.25 TOTAL TAX CREDIT 25,249.19 BALANCE OF TAX DUE 490.31CR INTEREST AND PEN. .00 TOTAL DUE 490.31CR . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. (ji IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) LAw OFFICES BALL, MURREN & CONNELL 2303 MARKET STREET CAMP HILL. PENNSYLVANIA 17011 PHIUP J. MURREN RICHARD E. CONNELL MAURA K. QUINLAN TERESAR.McCORMACK THOMAS A. CAPPER (717) 232-8731 FACSIMILE (717) 232-2142 WIlliAM BENTLEY BALL (1916-1999) MAIUNG ADDRESS: P.O. BOX IIOB HARmSBURG. PENNSYLVANIA 17108-1108 October 25, 2005 Glenda Farner Strasbaugh Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, P A 17013 RE: Estate of Cecilia J. Semyan Date of Death: 11-9-04 Will No. 2004-01174 Our File No. 2636.1 Dear Ms. Strasbaugh: As required by the Supreme Court Orphans' Rule 6.12, enclosed please find a Status Report pertaining to the above-named individual. Richard E. Connell REC/hmp Enclosure cc: Mrs. Debra J. Mihalich (w/enclosure) PLEASE FILE TIDS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE EST ATE. IF EST ATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION STATUS REPORT UNDER RULE 6.12 Name of Decedent: Cecilia J. Semyan Date of Death: November 9, 2004 Will No.: 2004-01174 Admin. No.: 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 x No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is yes, state the following: A. Did the personal representative file a final account with the court? Yes 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 mterest? Yes X No D. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Or.p and attached to thIS report. /-~ . Date: I D/dS'loS- I . Signature c:) Richard E. Connell, Esquire Name (Please type or print) 2303 Market Street, Camp Hill, P A 17011 Address (717) 232-8731 Telephone No. 1.-. '-..-.' CapacitY;, Personal Representative X Counsel for Personal RepreSCnl..111 \ I: RW.-27 ~1; BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX Z80601 HARRISBURG PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE "'\~C("'.(\,DG:::O, CiNtEJi'!i:TANCE TAX 1\ 'Vl \....jl~,. ~.. ~:[-/'!,-.$..';rAT'E...,I:.~T OF ACCOUNT *' REV-1607 EX AFP (03-05) t'lnr,;:; LUlu D\' 1'). 0-' 28 rl'l,J' DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11-07-2005 SEMYAN 11-09-2004 21 04-1174 CUMBERLAND 101 CECILIA J RICHARD E CONNELL ESQ BALL ETAL 2303 MARKET ST CAMP HILL PA 17011 Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS +- REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF SEMYAN CECILIA J FILE NO.21 04-1174 ACN 101 DATE 11-07-2005 THIS STATE"ENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NA"ED ESTATE. SHOWN BELOW IS A SU""ARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAY"ENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 10-03-2005 PRINCIPAL TAX DUE: 24,758.88 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02-04-2005 CD004920 1,237.94 24,011.25 10-21-2005 REFUND .00 490.31- TOTAL TAX CREDIT 24,758.88 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAY"ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. ) OW'