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HomeMy WebLinkAbout02-0780Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of J Anthony Cunio No. O~rQ~ ` / ~~ also known as Joseph Anthony Cunio J Anthony Cunio _ _ ,Deceased Social Security No. 007109218 Philip G Cunio Petitioner(s), who is/are 18 years of age or older, apply(ies) for (COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut or named in the Last Will of the Decedent, dated 04/09/2002 and codicil(s) dated State relevant circumstances, e.g., renunciation, death of executor, etc Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: ^ B. Grant of Letters of Administration (c.t.a., d.b.n.c.t.a.: pendente life, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: Decedent was domiciled at death in Cumberland County, Pennsylvania, with hislher last family or principal residence at _130 Brookwood Drive, North Middleton Township, Carlisle, PA 17013 (list street, number and municipality) Decedent, then 84 years of age, died August 3 , 2002 , at Sarah Todd Nursing Home (Location) Decedent at death owned property with estimated values as follows: (if domiciled in PA) All personal property ......................................... $ 150,000.00 (if not domiciled in PA) Personal property in Pennsylvania .................... $ (If not domiciled in PA) Personal property in County .............................. $ Value of real estate in Pennsylvania ........................................................................................ $ Total ..................................................................................................................... $ 150,000.00 Real Estate situated as follows: Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Signature Typed or printed name and residence - L--s----~ Phili G Cunio 130 Brookwood Drive Carlisle PA 17013 RW-7 /7-~- 3 (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Oath of Personal Representative Commonwealth of Pennsylvania COUnty Of Cumberland The Petitianer(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of PetititS~r(s) and that, as personal representative(s) of the Decedent, Petitioner(s) wilt well and truly administer the estate ac , " g tcJ~Xaw. Sworn to and affirmed and subscribed me this 28th day of Donna M. ip G Cunio Estate of J Anthony Cunio Deceased No. 21-2002-780 also known as .loseoh Anthonv Cunio Social Security No: 007109218 Date of Death: 08/03/2002 AND NOW, August 28th, 2002 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ~ Testamentary f] of Administration (c.t.a., d.b.n.c.t.; pendente life; durante absentia; durante minoritate) are hereby granted to Philip G Cunio in the above estate and that the instrument(s), if any, dated April 9, 2002 described in the Petition be admitted to probate and filed of record as the last Wili of Decedent. FEES ~ L , _ y j GCS' ~ Letters .................................... $ 235.00 / l~l Register of Wills Short Certificate(s) ~?~ ~~ $ 6 00 Donna M. Otto -1st DEputy - .. . Renunciation .......................... $ Affidavit ( ) ....................... $ Extra Pages (4 x $3) .............. $ 12.00 Codicil ................................. $ JCP Fee ................................. $ 5.00 Attorney: Marielle F Hazen f nventory & Tax Forms ............. $ I.D. No: 68003 Other ...................................... $ Address: 845 Sir Thomas Court, Suite 12 Harrisburg PA 17109 TOTAL ........................... ..$ 258.00 Telephone: 717-541-5550 DATE FILED: August 28th, 2002 MAILED LE'3"PERS 'Ib A~I2IV1J'Y ON 8/28/2002 RW-7A DECREE OF REGISTER 1[15.805 RF-A ]IRC, Thts is to certify that the information here given is a>rrectly copied from ~^ original cerritlcate of death duly filed with me as local Registrar. The original cerritlcate will be forwarded to the Stare Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 s`1 j< "" 1~. "'.. ^.I' ... .. .. Local Registrar '~ ~ 84652© NL>. QUG 0 < <i7iJ2 Late I43Her. 2/07 COMMONWEALTH Of PENNSYLVANIA • DEPARTMENT Of HEALTH • 4tTAL RECORD5 CERTlFlCATE OF DEATH STATE FKE WIY9EB NAME OF DECEDENT IFesr. Miade. Last SEX i SOCIAL SECURITY NUMBER DATE OF OEATN,MCnvr. Day.'Marl I. Joie h An.thany Cun~a ,,Ma,2e ]. 007- ]0 - 4218 •• ~-3-02 AGE(Laa BuMayl UHDERIYEAR UNDERIDAY GATE OF BIRTH BIRT}IpLACE (Cay xd PLACE OF DEATH IChxk aW'nne-xe /ISIruclorean and stlel Mordlts r Days IFOUn ~ Mkwlta rMOnp'. ~Y ~AtaN S181e d Faegn Caawy) HOSPITAL: OTHER: ~~ _--. - ,f Yq, r - ~l--tt L~ Inpatient ^ ERIOrapatiaN ^ DOA ^ Iw r.~ ~ Raswance ^ S eca l L I Y :. ,. 1-25-18 {_aWhenCe, MA - p _ y ~,, COUNTY OF OfeATH CTiI'. BORO, iYVP OF OEATN FAC1l.fiY NAME IK nd nsFnawn. yVa Street and nrenber! WAS OECEDE HT OF HISPANIC ORKi W1 RACE - American 4ldian. Black. Who. etc. i I No YM ^ M yes, apedY CrANUr. ~ ISpechl Cumben.E'and .~ Ccvt~-c.~s-fie Sanah Todd Nun~s~.ng Home s ~ """°`~"•"" e (Uh~ ~ . DECEDENT'S USUAL OCCUPATION k KIND OF BUSINESSIINWSTRY a No13 DECEDENT EVER IN DECEDENT'S EDUCATION MARfTAL STATUS-YaniW ,,. . . SURVIVING SPOUSE (Give leMtlvaxk ddN dare moat tl woraiug We; rlo not yar b p ) U. S. ARMED FOLIC 57 rxY h cam NevN Mar(ied, widowed. Oiv rcW ul i C l ' Nwae. g,va ma~wnnarnel • a a . n~~s~en M~ ou~ Re~~ ~ Yea^ np~ o pe NmenurylSecandary agage y E F 1412) 2 °•"'" 6 M ~ d ~o A~' H C . I,a. .g . „b. ,z. ,] cvtn e ,,, 1 . un ma ,,, DECEDENT'S MAILWG ADDRESS (SYeM. GYyTp•rn. SMp,Lp Code) DECEDENT'S ddYe#on 7w~ N. M~ IT c ^v J ll dt PA 130 Bnoohwaad Dn~ve . .,.r a. a edera yv n ACTl1AL IT..S1at. Did M, PA 11013 Ccve~~~3~e RESIDENCE ac.d.M naa~e'na ~ d , t ~ .o.da+Ea.d Cumben.?and T Na, ^ .. ~ watdn.adM auras ol. cYyiboro ITb. Caen 17d. FATHER'S NAME (Fast. Midde. Last) MOTHER'S NAME IFesl. Mwda. Madan Swnamel ,.. John Cun~,a „• Ccuen~.e waneheh.tex WFOfiMANTS NAME Rypd(ikv) - INFORMANT'S MAtLWO AQORESS (Street. Ciryrbert,SWa, Zp COda) .. ,,.. Ph.i.E'~. Cun.ca sob. 130 Bnavfzwaod nave Ccu~~~ke PA 17013 METHOOOF DISPOSRION DATE OF DISPOSITION a •NMna Wfwmel~y' Crogratory PtJLGE qF DIgpp/Ss~~ y y SPP~`n'e LOCATION-CiryyTown, Slat., Zp Coda - Burlel^ GarnaWn~j RanaralbanSlau^ Ddnatian^ ah.rls e ir / ~ IMO^a'•DaY~arl , ~ , , wOIMrP1xa ma~~.vn Joc.cezy . p yL c at.. 7 -(,; Z alb. - „~ U Pa Chema~tOn :la. HUlth-lbbUh PA 17109 ' SKiFlATUREOFFUNE RVK:ELICENSEEfM EASONACTINLiASSUCH IK:ENSENUMBEA NAME ANDADORESSOFFAC11.t1Y hems an ~ oe.ce y a ~•. ~Q,fa~ n i ,tb. „~. 4100 Jone~•town Raad Hcvt~.i~sbwc A 17104 Complete isms 2Jac Ny n cenw~ b tM bast d m knowledge, death occwred al the Iona, date and place stead. LICENSE NUMBER GATE SIONEO /atya(cun r rat avaaabN at limo of death m ' unay ans. of loam. ISiQrWlwe~pol~ ~ R ~ - IMmri. OaX Yaarl ~ n - 5a 3 ~9 - ~ 17a. -IL L ~ `f'L ,W ~]e. _ 3 ~ _ • Yarns 2e~26 mwl W compNlrM by TIME OF OE/Ty4 DATE P ONOUNCED DEAD (MOnn. Day, Yeah VAS CASE REFERRED TO MEDICAL EXAMIfJEPoCORONERT Parson wfn prorrouncaa death. L,A{ 1 f'~ ,~1. Ya• 4~ 1~ ! r lr~ W ^ ~ usf Z ~O~ 3 ~ J p M. :S. 7 r 2a. > ZT. PART l: ENw the daeaaae, kr(rrrlei or wmpfications whtM eased the death. Do rtal enter Iha mode of , such as cards a respiratory arrest, shack a mart M7ura. t Appro:imata PART X: Dltwr srgdflcaN candlibns cdrUNxding b dean. lrW Lint a^N aw cauw onaauylitw. ~kearval belwwn rottwdYng Ntha uridertyurg caws gnen:r PART I. OrraM and dean lLWEOIATE CAUSE F~mY 1 _ dmease dr cond8ion D, ~ ~ ~ resdsrq ur deaml`-- a. L(( VW"w ~~CC.. I q1E IOrA AS.A~O•IJ•SEpOIiE1V~y~~.~OF): ~ ~ `p ~ S t ~ 1 M `~ equa.xiaYy Mst condaiorn b.- L /j_VZ __ IAA w~`•~ Y any, hadutg b knnweyu ( WIE TO AS A CONSEQUENCE OF} 1 caress. ENa IINDERLYIND 1 ~ c CAUSE (DiSHasa«aywy t Ol1E lO LOR AS A CONSEQUENCE OF7: eaWanp n down) LAST I d. t WAS AN AUTOPSY YJERE AUTOPSY FWDINQS MANNER OF DEATH GATE OF INJURY TIME OF WJURY MIJURY R WORKT DESCRIBE HOW INJURY OCCURRED. PERFPHME07 AWµABLE PRIOfiTO IIAmm. DaY. Year) COMPLETON OF CAUSE OF UE QH7 ^ Nal al ~ Il tai . w dm a Yaa ^ ~ ^ Accident ^ PerMing Inve9ligallOn ^ Ws ^ Fla Yea ^ Nd [~ Sricide ^ Could rust t>e derermmed ^ 70e. M. Oe. 34Q, PUCE OFINJURY -AI home, term, areal. lactory, office LOCATION (Strew. CAy/ban. Slala) ]M. 28b. Z9. buadurq, etc. ISpeahl ]Ile. ]01. CERTIFIER (Check oNy onel SIGNATU ANOTITIE OF CE I ER 'CERTit-VINO PHYSICIAN IPhysran cerWya.g cause d deae; wne~ arblher physran has yono~rrxd deaN arw completed ngn 231 To lhabaal of m kno Md d ..r w pe, Y eath occurred dub WCauae(a)and manna a•~taled ..................................................... ]lb. _ ' LICENSE NUMBE DATE STONE fM9nn. Day ffirl PAOHOUNGNO ANO CERTIFYlNO PHYSICIAHIPhysa:un bun yonwncrg dean anaudaye,g mcausad deaml To lha best of my knowMtlga, dsam occurred allM Yme,dale, arW Plan,arW dw fa tM causelel and manne(as elated ... ... .................. ^ (~ (~ \''J / L~L/ ~ L1 ~Q ~ ~_ ]ld. ~CU/~L-' __. »~_~!~ i . ~ ~~ • ~ NAME AND DDRESS~PE SSON W HOCOMPLETEO GAUSEOF DEATH * • 'yEpICAL EXAMINEAICORONER a n~T (hem 27) Typa a PtiM i~ .~ a .,r ~ (t T1 tJ E y 1~ 11 )) ~J On the beets o1 taaminetlon andlw imeatlgation, in my opinion, death occurred al the Ilma, date, and place, aruL due to Iha cause(s) and manner as stated ^ .n - ~ ~ Z Y 54l T'~; K, }`C~ ...............~............_...................................................................... l}) REGIST4AR'S SIGNATURE AND NU/jIOE~, i / ' DATE FILED (MONK. Oay. Year I ~'L~± j .: y,~ :f ~~ ~J // ,, / f '':~~ s. ~ 1~'1 1 = ~~_ .~ em. ~ ~.. r_,- .. ,_ ~n ~ , x-,'ai s----- _ »_ _ ~.. ~~.. ~. _' - ~ 7 !tires Z LAST WILL AND TESTAMENT OF J. ANTHONY CUNIO 21-2002-780 I, J. ANTHONY CUNIO, of Cumberland County, Pennsylvania, declare this to be my Last Will and Testament. I revoke all other Wills and Codicils that I may have previously made. Article I My just debts and expenses of my last illness, funeral, and administration of my estate shall be paid by my Executor from the principal of my residuary estate as soon as practicable after my death. Article II All inheritance, estate, and succession taxes (including interest and penalties thereon, but not: including any generation skipping tax) payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement from any person. This provision is not a waiver of any right which my Executor has to claim reimbursement for any such taxes which become payable as the result of any property over which I have the power of appointment. Article III I give, devise and bequeath in accordance with any memorandum which I have either handwritten or signed, located with my Will or with my valuable papers and found within 30 days of the probate of my Will. Gifts may only be to persans who survive me or to organizations which exist at my death, and if there is a conflict, the memorandum having the latest date shall govern. Article IV All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give, devise and bequeath to my son, PHILIP G. CUNIO, of Cumberland County, Pennsylvania. In the event that PHILIP G. CUNIO predeceases me or fails to survive me by thirty (30) days, I give, devise, and bequeath the remainder of my estate, of whatsoever nature and wheresoever situate to my daughter-in-law, SHARON L. CUNIO, of Cumberland County, Pennsylvania. If any of my beneficiaries predecease me or fail to survive me by thirty (30) days, I give, devise and bequeath his or her share to his or her issue who survive me, per stirpes, or if he or she have on issue, the share(s) are to be added equally to the other shares. Article V Except as otherwise provided in this Will, I have intentionally failed to provide for any other persons or relatives, whether claiming to be an heir and/or relative of mine or not. Insofar as I have failed to provide in this Will for any of my relatives, and/or issue now living or later born or adopted, such failure is intentional and not occasioned by accident or mistake. -2- Specifically, CAROLE A. CUNIO is not to inherit any monies or property, personal or real, under the terms of this Will. Article VI I nominate, constitute, and appoint my son, PHILIP G. CUNIO, Executor of my Last Will and Testament. I direct that my Executor be permitted to serve without bond and in addition to those powers granted by law, I grant him power to distribute in cash or in kind in like or in unlike shares and to file any qualified disclaimer I could have filed if living. My Executor shall receive reasonable compensation for services rendered to my estate. Article VII In addition to the powers conferred by law, I authorize my Executor, in his absolute discretion: (a) to retain in the form received and to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estate, (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, (f) to file any federal income tax return for any year for which I have not filed such return prior to my death, -3- (g) to make distributions in cash or in kind, or in both, and to determine the value of any such property, (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Executor; and to pay from my estate reasonable compensation for all their services, (i) to conduct alone or with others, any business in which I am engaged in, or have an interest in at time of my death, and (j) to receive reasonable compensation in accordance with their standard schedule of fees in effect while their services are performed. IN WITNESS WHEREOF, I, J. ANTHONY CUNIO, hereby set my hand to this my Last Will and Testament, onT,.~ {` 1 , 2002, at Harrisburg, Pennsylvania. ~~ . ANTHONY IO ~~ In our presence, the above-named J. ANTHONY CUNIO signed this and declared this to be his Last Will and Testament, and now at his request, in his presence, and in the presence of each other, we sign as witnesses. Name I~-ti Address ~~ ~~~~~~c~s C-{-:. 5-~~ ~bC~ 2R i ~~-~C R~-- ~ -71 C~ -4- I, J. ANTHONY CUNIO, Testator, who signed the foregoing instrument, having been duly qualified according to law, acknowledge that I signed and executed this instrument as my Will, and that I signed it willingly as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by J. ANTHON ~ ~UNIO, the Testator, on ,2002. tary Public . ANTHONY IO NOTARIAL SEAL JESSICA A. HOLLAND, NOTARY PUBLIC CITY Of HARRISBURG, DAUPHIN COUNTY MY COMMISSION EXPIRES MARCH 4 2006 We, the undersigned witnesses who signed the foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the Testator sign and execute this instrument as his Will; that he signed and executed it willingly as his free and voluntary act for the purposes therein expressed; that each of us in his sight and hearing signed the Will as witnesses, and that to the best of our knowledge, that he was at that time eighteen (18) years or more of age, of sound mind, and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me by I~ Y ~. C~C'I~ and i b~, _. ~~:.-a r.~~ witnesses, on , 2002 i . ~~o Wi ess Wiliness tart' Public NOTARIAL SEAL JESSICA A. HOlLANO, NOTARY PUBLIC CITY Of HARRISBURG, DAUPHIN COUNTY MY COMMISSION EXPIRES MARCH 4 2006 -5- BEFORE THE REGISTER OF WILLS, CUMBERLAND COUNTY, PENNSYLVANIA CERTIFICATION OF NOTICE UNDER RULE 5.6(al Name of Decedent: J Anthony Cunio Date of Death: 08/03/2002 Will No. 2002-00780 Admin. No. 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 09/04/2002 Name Address Philip G Cunio 130 Brookwood Drive Carlisle PA 17013 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: Date: 09/04/2002 .,~~. Signature Marielle F Hazen Name: Jan L Brown & Associates Address: 845 Sir Thomas Court. Suite 12 Harrisbura PA 17109 Telephone(717) - 5415550 Capacity: Personal Representative X Counsel for Personal Representative ESTATE OF IN THE COURT OF COMMON PLEAS J. ANTHONY CUNIO, :CUMBERLAND COUNTY, PENNSYLVANIA Deceased : N0.2002-00780 ORPHANS' COURT DIVISION NOTICE OF ELECTION AGAINST DECEDENT'S WILL TO THE CLERK OF THE ORPHANS' COURT DIVISION OF CUMBERLAND COUNTY, AND PHILIP G. CUNIO, EXECUTOR OF THE ESTATE OF J. ANTHONY CUNIO, DECEASED: NOW, this 3~~ day of '~c.1~r- , 2002, in accordance with the provisions of Chapter 22 of the Probate, Estate and Fiduciaries Code, I, Philip G. Cunio, Power of Attorney for Alma H. Cunio, widow of J. ANTHONY CUNIO, deceased, do hereby elect on behalf of Alma H. Cunio to take against the Will of her husband, J. ANTHONY CUNIO, who died August 3, 2002, and against all of the conveyances of J. ANTHONY CUNIO falling within the scope of 20 Pa. C.S. Section 2203, and I hereby claim Alma H. Cunio's elective share of such estate and conveyances. :.~-? r r / _~.____-._..., ?J;i'Gl~`t//lam ~.1~'""..- PHILIP G. CUNIO, Power of Attorney for Alma H. Cunio -1- COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN ;, y c~I ON THIS, the L: SS: day of L~~~' `~- , 2002, before me a Notary Public for the Commonwealth of Pennsylvania, personally appeared G. PHILIP CUNIO, known to me to be the person whose name is subscribed to the within Notice of Election Against Decedent's Will and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. ~1'~a~ jyI /~~~ NoNo ary Public Notarial Seal Melissa M. HiY, Notary Public City Of Harrisburg, Dauphin County My Conxnission Fires May 23, 2006 Mertiber, PenneyNarre Assocrafion Of Nc~aries -2- JAN L. BROWN 8~ ASSOCIATES ATTORNEYS AND COUNSELORS AT LAW OLDE ENGLISH GAP 845 SIR THOMAS COURT SUITE 12 HARRISBURG, PA 17109 EMAIL: jlbassoc@ptd.net JAN L. BROWN* MARIELLE F HAZEN** "CERTIFIED ELDER LAW ATTORNEY BY THE NATIONAL ELDER LAW FOUNDATION October 11, 2002 Register of W;tls Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Re: Estate of J. Anthony Cunio File No. 2002-00780 Gentlemen or Ladies: TELEPHONE (717) 541-5550 FACSIMILE (717) 541-9223 `ADMITTED IN PA AND DISTRICT OF COUJMBIA Enclosed for filing is a Notice of Election Against Decedent's Will together with a check in the amount of $15 to cover the filing fee. Please time stamp and return our file copy of this document. A return envelope is provided. If you have any questions, feel free to contact this office. Sincerely, ,-- ~ > ~~,~~~ Brenda F. Kephart Legal Assistant bfk Enclosure REV-1500EX+(6-00) '* COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE OEPT.280601 HARRISBURG, PA 17128-0601 REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT w .... :ll:::!iU) " ."" w"" ,,00 ,,"''''' "Ill .. < I- Z W C W U W C DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Gunia J Anthon a/k1a Gunia Jose h Anthon DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) OFFICIAL USE ONLY ......----. 08/03/2002 01/25/1918 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL) Gunia Alma H [X] 1. Original Return D 4. Limited Estate [X] 6. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received D 2. Supplemental Return D 4a. Future Interest Compromise (date of death after 12-12-82) D 7. Decedent Maintained a Living Trust (Attach copy ofTrusij o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1.1-95) J7 2{ -S- -3 FILE NUMBER 21-020780 ""'CciUNTY"'COOE ---YEAR- -- 'NrnmR-- SOCIAL SECURITY NUMBER o 07- 1 0 - 9 2 1 8 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 3. Remainder Return (date of dealh prior to 12-13-f12) D 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes o 11. Ele<:!on to tax under Sec. 9113(A) I_h 50h 01 z o i= ;:!: :J II.. :IE o U S .... z w c z o .. '" w '" '" o " NAME Marielle F Hazen FIRM NAME (If Applicable) Jan L Brown & Associates TELEPHONE NUMBER 717-541-5550 COMPLETE MAILING ADDRESS Harrisbur 845 Sir Thomas Gourt Suite 12 PA 17109 z o ~ :J l- ii: <C U w ~ 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) (6) D Separate Billing Requested OFFICIAL USE ONLY 5,945.80 150,391.94 0.00 , ______J (1) (2) (3) (4) (5) 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. Debls of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus line 11) 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made (Schedule J) (8) 156,337.74 5,183.55 4,425.99 (11) (12) (13) 9,609.54 146,nll.20 14. Net Value Subject to Tax (line 12 minus line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 48,909.40 X ~(15) 97,818.80 X .045 (16) X .12 (17) X .15 (18) (19) (14) 146,728.20 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 HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 4,401.85 4,401.85 Decedent's Complete Address: STREET ADDRESS 130 Brookwood Drive North Middleton Township CITY I STATE I ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 4,401.85 220 09 Total Credits (A + 8 + C) (2) 220.09 3. InteresUPenalty it applicable D. Interest E. Penalty TotallnteresUPenalty (0 + E) (3) 4. It 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 8ALANCE DUE. (58) Make Check to: REGISTER OF AGENT 4,'i81.76 4,181.76 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; ............................................ . ........................... D ~ b. retain the right to designate who shall use the property transferred or its income; ........................................ D ~ c. retain a reversionary interest; or ........... ...................... ........................ .......................................... 0 lKJ d. receive the promise for life of either payments, benefits or care? ............................................................. D ~ 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration?.................................................. ............................................ D ~ 3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. D ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...... ................................................. .............................................. 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. Under penalties of peijury, 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 PER .SPO~IBLI)POR FILING RETURN --' ~;/,~- AODRESS 130 Brookwood Drive Carlisle PA SIGNATURE OF PREPARER aT ADDRESS Suite 12 PA 17109 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 (al (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)]. 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)(I.2)J. 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)(I)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV.'~"'.".". COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN N NT SCHEDULE B STOCKS & BONDS ESTATE OF Gunio J Anthonv a/k/a Gunio Joseoh Anthonv All property jointly-owned with right of survivorship must be disclosed on Schedule F. FILE NUMBER 21 02 0780 ITEM NUMBER 1. DESCRIPTION Nationwide Financial Services Inc (NFS) 217 shares @$27.40 VALUE AT DATE OF DEATH 5,945.00 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 5 945.80 '''''''''''',0>'. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Cunio J Anthonv a/k/a Cunio Joseoh Anthonv 21 02 0780 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 1. DESCRIPTION VALUE AT DATE OF DEATH 150,373 94 Prudential Financial Account No. 044-335999-33 2 Carlisle Hospital; patient refund 18.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets ot the same size) 150391.94 "'''''',.".,,'. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Cunio J Anthonv a/k/a Cunio Joseoh Anthonv 21 02 0780 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) Social Security Number{s) I EIN Number of Personal Representative(s) Street Address City State lip Year{s) Commission Paid: 2 Attomey Fees Jan L Brown & Associates 4,690.00 3. Family Exemption: (If decedent's address is not the same as claimanfs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills, Cumberland County 258.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Cumberland Law Journal; legal advertising 75.00 8 The Sentinel; legal advertising 103.55 9 Register of Wills, filing fee spousal election 15.00 10 Register of Wills, filing fee Inventory and Inheritance Tax Return 25.00 11 Register of Wills; filing fee Family Settiement Agreement 17.00 TOTAL (Aiso enter on line 9, Recapitulation) $ 5 183.55 (If more space IS needed, insert additional sheets of the same size) ,,",~"""."~"'. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Cunio J Anthonv a/k/a Cunio Joseoh Anthonv SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. Sarah A Todd Memorial Home outstanding nursing home bill FILE NUMBER 21 02 0780 AMOUNT 4,425~99 TOTAL (Also enteron line 10, Recapitulation) $ (If more space is needee, Insert additionai sheets of the same size) 4425.99 R'V_1513'X.(9* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Cunia J NUMBER I. SCHEDULE J BENEFICIARIES ./1_1., r"nln NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [indude outright spousal distributions, and transfe", under Sec. 9116 (al (1.2)] Alma H Cunio; one-third (1/3) spousal election 1000 West South Street, Carlisle, PA 17013 2 Philip G Cunio 130 Brookwod Drive, Carlisle, PA 17013 FILE NUMBER ?1 n? RELATIONSHIP TO DECEDENT Do Not List Trustee(s) wife son 0780 AMOUNT OR SHARE OF ESTATE $48,909.40 100% residue 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) LAST WILL AND TESTAMENT OF J. ANTHONY CUNIO 21-2002-780 I, J. ANTHONY CUNIO, of Cumberland County, Pennsylvania, declare this to be my Last Will and Testament. I revoke all other Wills and Codicils that I may have previously made. Article I My just debts and expenses of my last illness, funeral, and administration of my estate shall be paid by my Executor from the principal of my residuary estate as soon as practicable after my death. Article II All inheritance, estate, and succession taxes (including interest and penalties thereon, but not including any generation skipping tax) payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement from any person. This provision is not a waiver of any right which my Executor has to claim reimbursement for any such taxes which become payable as the result of any property over which I have the power of appointment. Article ill I give, devise and bequeath in accordance with any memorandum which I have either handwritten or signed, located with my Will or with my valuable papers and found within 30 days of the probate of my Will. Gifts may only be to persons who survive me or to organizations which exist at my death, and ifthere is a conflict, the memorandum having the latest date shall govern. Article IV All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give, devise...and bequeath to my son, PHILIP G. CUNIO, of Cumberland County, Pennsylvania. In the event that PHILIP G. CUNIO predeceases me or fails to survive me by thirty (30) days, I give, devise, and bequeath the remainder of my estate, of whatsoever nature and wheresoever situate to my daughter-in-law, SHARON L. CUNIO, of Cumberland County, Pennsylvania. If any of my beneficiaries predecease me or fail to survive me by thirty (30) days, I give, devise and bequeath his or her share to his or her issue who survive me, per stirpes, or if he or she have on issue, the share(s) are to be added equally to the other shares. Article V Except as otherwise provided in this Will, I have intentionally tailed to provide for any other persons or relatives, whether claiming to be an heir and/or relative of mine or not. Insofar as I have failed to provide in this Will for any of my relatives, and/or issue now living or later born or adopted, such failure is intentional and not occasioned by accident or mistake. - 2 - Specifically, CAROLE A. CUNIO is not to inherit any monies or property, personal or real, under the terms of this Will. Article VI I nominate, constitute, and appoint my son, PHILIP G. CUNIO, Executor of my Last Will and Testament. I direct that my Executor be permitted to serve without bond and in addition to those powers granted by law, I grant him power to distribute in cash or in kind in like or in unlike shares and to file any qualified disclaimer I could have filed ifliving. My Executor shall receive reasonable 'corrlpensation for services rendered to my estate. Article VII In addition to the powers conferred by law, I authorize my Executor, in his absolute discretion: (a) to retain in the form received and to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estate, (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, (f) to file any federal income tax return for any year for which I have not filed suchretum prior to my death, - 3 - (g) to make distributions in cash or in kind, or in both, and to determine the value of any such property, (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Executor; and to pay from my estate reasonable compensation for all their services, (i) to conduct alone or with others, any business in which I am engaged in, or have an interest in at time of my death, and (j) to receive reasonable compensation in accordance with their standard schedule of fees in effect while their services are performed. IN WITNESS WHEREOF, I, J. ANTHONY CUNIO, hereby set my hand to this my Last Will and Testament, on ,,-c,~1 '1 I , 2002, at Harrisburg, Pennsylvania. J .9- u_~~ .ANTHONY 0 In our presence, the above-named J. ANTHONY CUNIO signed this and declared this to be his Last Will and Testament, and now at his request, in his presence, and in the presence of each other, we sign as witnesses. .N~!!l~ Address ~~M.OerjF{) .10.--" r;1<L- 04':) S'r~::,C+.~ rnQQich.RG P74- 17JCCl_ / fztt' ~~~ AI:" ~ :. L 7 ' .j?~ (")'07 -4- )(y':':;~~~ - -:. -;<-~: .:. 4l~'j~I . ';,c~~:\1:,~~J~&'::~;~ I, J. ANTHONY CUNIO, Testator, who signed the foregoing instrument, having been duIy qualified according to law, acknowledge that I signed and executed this instrument as my Will, and that I signed it willingly as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by J. ANTHO~ ,G.UNIO, the Testator, _on ~ '-1 ,2002. ~~H~NY~Ir' , .~ NOTARIAL SEAL JESSICA A. HOLLANO. NOTARY PUBLIC CITY OF HARRISBUI<<l, DAUPHIN COUNTt MY COMMISSION EXPIRES MARCH 4 2006 We, the undersigned witnesses who signed the foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the Testator sign and execute this instrument as his Will; that he signed and executed it willingly as his free and voluntary act for the purposes therein expressed; that each of us in his sight and hearing signed the Will as witnesses, and that to the best of our knowledge, that he was at that time eighteen (18) years or more of age, of sound mind, and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me by. {f:\ tf':'j ~, c:;h-im :~e~~;:'~;~ ,2002. ~}--1. Q&~f) Wilhess U /{!~ L7~. . WI ess ~1J QJl 4<. rfJ,t&ni tary Public NOTARIAL SEAL JESSICA UO\.I.AIID. NOTMI'f ?\llllC - 5 - CITY OF HARRISBUI<<l. DAUPHIN COuNTt t.\'I COM"l\s~iON EXPIRES MARCH 4 2006 BEFORE THE REGISTER OF WILLS, CUMBERLAND COUNTY, PENNSYLVANIA INVENTORY Estate of Cunio, J Anthony No. 2002 00780 also known as Cunio, Joseph Anthony Date of Death 08/03/2002 J Anthony Cunio ,Deceased Social Security No. 007109218 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/VNe 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. Personal Representative: Name of Attorney: Marielle F Hazen Philip G Cunio I.D. No.: 68003 Address: 845 Sir Thomas Court Suite 12 Dated 10/28/02 Harrisburg PA 17109 Telephone: 717-541-5550 Description Nationwide Financial Services Inc (NFS) 217 shares @ $27.40 Prudential Financial Account No. 044-335999-33 Carlisle Hospital; patient refund (Attach Additional Sheets if necessary) Total Value 5,945.80 15U, 373.94 18.60 156,337.74 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. RW-4 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES Li"EPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) N0. CD 001789 MARIELLE F HAZEN ESQUIRE 845 SIR THOMAS COURT HARRISBURG, PA 17109 ACN ASSESSMENT AMOUNT CONTROL NUMBER fold ESTATE INFORMATION: ssN: oo~-io-s2i$ FILE NUMBER: 2102-0780 DECEDENT NAME: CUNIO J ANTHONY DATE OF PAYMENT: 10/30/2002 POSTMARK DATE: 10/29/2002 counlTY: CUMBERLAND DATE OF DEATH: 08/03/2002 101 ~ 54,181.76 TOTAL AMOUNT PAID: REMARKS: MARIELLE F HAZEN ESQUIRE SEAL CHECK#10$ INITIALS: JA RECEIVED BY: MARY C. LEWIS 54,181.76 REGISTER OF WILLS REGISTER OF WILLS NEW RECEIPT - VOID RECEIPT CD 0001787 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES D'PT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EIX111-96) NO. CD 001 .787 MARIELLE F HAZEN ESQUIRE 845 SIR THOMAS COURT HARRISBURG, PA 17109 fold ESTATE INFORMATION: ssN: oo7-io-s2ia FILE NUMBER: 2102-0780 DECEDENT NAME: CUNIO J ANTHONY DATE OF PAYMENT: 10/30/2002 POSTMARK DATE: 10/29/2002 couNTY: CUMBERLAND ~ DATE OF DEATH: 08/03/2002 REMARKS TOTAL AMOUNT PAID: MARIELLE F HAZEN ESQ IRE CHECK# 108 INITIALS: JA SEAL RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS 57,181.76 NEW RECEIPT CD 0001789 ACN ASSESSMENT AMOUNT' CONTROL NUMBER FAMILY SETTLEMENT AGREEMENT AND FINAL RELEASE IN THE ESTATE OF J. ANTHONY CUNIO, DECEASED KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, J. ANTHONY CUNIO, late of North Middleton Township, Cumberland County, Pennsylvania, deceased, died testate on August 3, 2002, having first made his Last Will and Testament, which was duly executed April 9, 2002, and is duly recorded in Cumberland County Courthouse, Register of Wills, File No. 2002-00780; WHEREAS, the said J. ANTHONY CUNIO, by the aforesaid Last Will and Testament, named PHILIP G. CUNIO as Executor of his Last Will and Testament; WHEREAS, Letters Testamentary on the estate of said decedent were duly issued by the Register of Wills of Cumberland County, and Letters were granted to PHILIP G. CUNIO, hereinafter called Personal Representative; WHEREAS, ALMA H. CUNIO, surviving spouse of said decedent, filed a Notice of Election Against Decedent's Will with the Clerk of the Orphans' Court of Cumberland County on October 15, 2002, in which she elected to take aone-third ('/3) share of decedent's estate; WHEREAS, the said Personal Representative has gathered the assets of the estate of the said decedent, and the assets consist of personal property to a total value of $156,337.74 as set forth in Exhibit A, which is a statement of account of the said Personal Representative, and which is attached hereto and made a part hereof and marked Exhibit A; WHEREAS, the balance for distribution as shown in the said statement marked Exhibit .~ has been distributed as herein indicated in accordance with the terms of the Last Will and Testament of the said decedent and pursuant to the Notice of Election; -1- NOW, THEREFORE, KNOW YE, that we, ALMA H. CUNIO and PHILIP G. CUNIO, being the beneficiaries and heirs of the said decedent, and being those persons entitled to inherit under said Last Will and Testament and said Notice of Election, do hereby acknowledge that we have this day had and received from the aforesaid Personal Representative, in full satisfaction and payment, all sum or sums of money, legacies, bequests and devices as are given, devised and bequeathed to us, which amounts we have received this day, and which amounts are set opposite our names in the table and schedule of distribution in said statement attached hereto and marked Exhibit A; AND, we do hereby stipulate that in order to avoid the expense and time involved in the filing of a formal account and schedule of distribution, we agree that no account is necessary, and we do hereby agree that we do consent to distribution being made without the filing of an account and schedule of distribution, the same to be with the same force and effect as if it had been filed and confirmed by the Orphans' Court Division of the Court of Common Pleas, Cumberland County Branch. THEREFORE, we and each of us do hereby remise, release, quit claim and forever discharge the said Personal Representative, PHILIP G. CUNIO, his heirs, executors, administrators and assigns; JAN L. BROWN & ASSOCIATES, attorneys at law; and JAN L. BROWN, ESQUIRE and MARIELLE F. HAZEN, ESQUIRE of and from the said estate and from all actions, suits, payments, accounts, reckoning, claims and demands whatsoever for or by reason thereof, or for any other use, matter, cause or thing whatsoever touching upon the estate of the said decedent; and each of us do further hereby covenant and agree that should any liability come due to the estate of the said decedent after the signing of this agreement, each of us do -2- hereby covenant and agree with each other and the aforesaid Personal Representative that we will contribute pro rata our share of the estate to satisfy any and all claims, demands, suits or causes of action which may be successfully prosecuted against the said estate or the aforesaid Personal Representative after the signing, sealing and delivery of this Family Settlement Agreement and Final Release. IN WITNESS WHEREOF, we have hereunto set our hands and seals this ,;~ is day of ~~.~~--~-1 , 2002. \ r. /~ ~ ' ~ ~ Witness n ~~ /~ i~ Witness ~~'.~ ; -l~ 1 l'-' CJ L LMA H. CUNIO, by Philip . Cunio her Power of Attorney ~~ ~. < < `P ILIP G. CLJNIO COMMONWEALTH OF PENNSYLVANIA COUNTY OF ~QU-pyl ~ r~ On this the ~-~ SS: day of l1 ~' ~0 I`J~-~Ci , 2002 before me, a Notary Public, the undersigned officer, personally appeared PHILIP G. CUNIO, known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. NOtAR1A1. SERI ~SICA A. NOlLANO, NQIARY M!'BIN; dry QF IUNiRtSBURO, ®AIfPHtN COUNTI- IS 1 N PfRES MARCH ~ 2006 -3- STATEMENT OF ACCOUNT OF THE ESTATE OF J. ANTHONY CUNIO Assets (date of death values) Stocks Cash, Bank Deposits & Miscellaneous Personal Property TOTAL Expenses Administrative Costs Debts Inheritance Tax TOTAL TOTAL AMOUNT TO BE DISTRIBUTED $ 5,945.80 150,391.94 $156,337.74 $5,183.55 $4,425.99 $4,181.76 $13,791.30 X142,546.44 DISTRIBUTION TO BENEFICIARIES Name Amount Alma H. Cunio ('/3 spousal election) -Preliminary Distribution $ 9,957.00 -Final Distribution 38,952.40 Philip G. Cunio (100% residue) 93,637.04 ~ 142,546.44 *Actual cash distribution may be increased or decreased based on interest accrued, market value of assets, presentation of an obligation and/or payment of additional charges. Exhibit "A" l~ ~i~~~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 MARIELLE F HAZEN JAN L BROWN & ASSOCS 845 SIR THOMAS CT 12 HBG PA 1/1.09 REV-1547 E% AFP (01-02) DATE 12-16-2002 ESTATE OF CUNIO J A DATE OF DEATH 08-03-2002 FILE NUMBER 21 02-0780 _ COUNTY CUMBERLAND ACN 101 Amount Remitted 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-1547 EX AFP (O1-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF CUNIO J A FILE N0. 21 02-0780 ACN 101 DATE 12-16-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) .00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) 5,945.80 credit to your account, 3. Closely Held Stock/Partnership Interest [Schedule C) (3) .00 submit the upper portion 4. Mortgages/Notes Receivable (Schedule D] (4] .00 of this fora with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) [5) 150,391.94 tax payment. 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) .00 8. Total Assets (g) 156,337.74 APPROVED DEDUCTIONS AND EXEMPTIONS: 5,183.55 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 4.425.99 11. Total Deductions [11) 9.609.54 12. Net Value of Tax Return (12) 146,728.20 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00 14. Net Value of Estate Subject to Tax (14) 146,728.20 NOTE: if an assessment was issued previously, lines 14, 15 andior 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) 48,909.40 X 00 _ .00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 97,818.80 X 045. 4,401.85 17. Amount of Line 14 at Sibling rate (17) .00 X 12 - .00 18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 - .00 19. Principal Tax Due (19)= 4, 401 .85 BY 05-03-2003*. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN 51, NO PAYMENT IS RE@UIRED. 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.) STATUS REPORT UNDER RULE 6.12 ~f ~~ Name of Decedent : J Anthony Cunio Date of Death : 08/03/2002 Will No .2002-00780 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 State whether administration of the estate is complete Yes .~S- 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 ~_ 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 . Date : ~ .~~ ~~ ~. `--_~ Signature rielle F Hazen Name (Please type or print ) 845 Sir Thomas Court Suite 12 Harrisburg PA 17109 Address ( 717) 5415550 Tel . No . Capacity : Personal Representative ~_ Counsel for personal representative ~r BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 MARIELLE F HAZEN JAN L BROWN & ASSOCS 845 SIR THOMAS CT 12 HBG PA 17109 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REY-1667 E% AFP (O1-D3) DATE 02-18-2003 ESTATE OF CUNIO J A DATE OF DEATH OS-03-2002 FILE NUMBER 21 02-0780 COUNTY CUMBERLAND ACN 101 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 fore with your tax payment. CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1607 EX AFP (01-03) *** INHERITANCE TAX STATEMENT OF ACCOUNT *~* ESTATE OF CUNIO J A FILE N0. 21 02-0780 ACN 101 DATE 02-18-2003 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: 12-16-2002 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): 4,401.85 PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID 10-29-2002 CD001789 220.09 4,181.76 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. * IF PAID AFTER THIS DATE, SEE REVERSE I TOTAL DUE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( 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. ) 4,401.85 .00 .00 .00 PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable tc: REGISTER OF WILLS, AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: COMMONWEALTH OF PENNSYLVANIA. REFUND (CR): A refund df a tax credit, which was not requested on the Tax Return, nay be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax^ CREV-1313). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices or from the Department's 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / dr speaking needs: 1-800-447-3020 CTT only). REPLY T0: Duestions regarding errors contained do this notice should be addressed to: PA Department of Revenue, Bureau df Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. PENALTY: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6%) percent per annum calculated at a daily rate df .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 20% .000548 1987 9% .000247 1999 7% .000192 1983 16% .000438 1988-1991 11% .000301 2000 8% .000219 1984 11% .000301 1992 9% .000247 2001 9% .OOD247 1985 13% .000356 1993-1994 7% .000192 2002 6% .000164 1986 1D% .000274 1995-1998 9% .000247 2003 5% .OOD137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation data shown an the Notice, additional interest must be calculated. BUREAU OF INDIVIDUAL TAXES INHERITANCE TA% BIVISION DEPT. 288681 HARRISBURG, Pp 17128-8b81 MARIELLE F HAZEN JAN L BROWN 8 ASSOCS 845 SIR THOMAS CT 12 HBG PA 17109 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REV-Ap EX ffP [O1-00 DATE ESTATE OF DATE OF DEA' FILE NUMBER COUNTY ACN r- 02-18-2003 CUNIO J A ~H 08-03-2002 21 02-0780 CUMBERLAND 101 Anount Ranittad 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 Porn with your tax payment. CUT ALONG THIS LINE------- RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1607 EX AFP (01-03) ~[** INHERITANCE TAX STATEMENT OF ACCOUNT ~[** ESTATE OF CUNIO J A FILE N0. 21 02-0780 ACN 101 DATE 02-18-2003 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOMN BELON IS A SUNMARY OF iNE PRINCIPAL TAX DUE, APPLICATION OF ALL PAVNENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-16-2D02 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): 4,401.85 PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID 10-29-2002 CD001789 220.D9 4,181.76 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. ^ IF PAID AFTER THIS DATE, SEE REVERSE I TOTAL DUE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( 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 DF THIS FORM FOR INSTRUCTIONS. ) 4,401.85 .00 .00 .00