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HomeMy WebLinkAbout02-1169PETITION FOR PROBATE and GRgqANT OF LETTERRS Estate of ANNA MAE FUKO No. O~ ~ ~ ~ ~ ~ ' also known as ANNA M. FUKO To: Doruia M. Otto, First Deputy Register of Wills for the Deceased. County of Cumberland in the Social Security No. 311-O1-6702 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the executrix (al erna e) named in the last will of the above decedent dated November 27 , 192_ and codicil(s) dated N/A; The designated Executrix~Priscilla L Straka, haG executed a Renunciation in favor of Elavna M Ri~hard~, the ali-arnai-a Executrix nd votr PetitinnPr (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at 1000 W South St.., Carli~l~, PA 1 7(11 ~ (list street, number and muncipality) Decendent, then 85 years of age, died October 24 ~- 2002 , x~ , at Sarah A Todd Memorial Home r Carl i ~1 e.,,silm}~rlancl Cebtrtl=,~, Pa. Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: None Decendent at death owned property with estimated values as fallows: (If domiciled in Pa.) All personal property $ 46 ,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 $ 0 situated as follows: N/A WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters TESTAMENTARY (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. V^I v U ~ ,' `'j~ ~~/ II v C .w 'LG r' ~ I~1 ~C X11 rY ! (.~?~' ,d N J, v~ E1M. Richards xv ~.0 212 Clover Lane N 0. Palmyra r PA 1 70 78 ~. ~ o c ou OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA 1 ~s COUNTY OF Cumberland f The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmeti~and subscribed bef re me this " ~ day of ' ~j i 2002 Registe 7_ ///- ~{ /( yp(~ -~y) ) I ~t C,Y .,, /t C.~ /r l ~ L~C~Qi!LC ~ Vj Elayn M. Richards ~' c >; 0 y No. 21-02-1169 Estate of ANNA MAE FUKO a/k/a ANNA M 'FUKO ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW DECEMBER 30th ~ ~~' R7eg~is/er o~ ills _ ~}~c'fiae~ Ei .~~Snt~ll' G Es it ; C ~ ~, I.D'~' #19212 the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated November 21., 199? described therein be admitted to probate and filed of record as the last will of ANNA MAE FUKO, a/k/a ANNA M. FUKO ; and Letters TESTAMENTARY are hereby granted to ELAYNA M . RICHARDS , Executrix . FEES Probate, Letters, Etc......... . Short Cenificates(6) ......... . >~~'#~~'~tA~ 5.5....1....... . TOTAL _ Filed DECEMBER. ,3,0.,, . 20.Q2. . ~ 80.00 S 18.00 ~ 5.00 ~ 1~ S 128.00 ~~ 2002, in consideration of the petition on ATTORNEY (Sup. Cc. I.D. No.) 201 South Railroad St., P.O. Box 113 -~Y~ PA ~ ~n~R_m 13 ADDRESS 717/838-1385 PHONE MAILED LETTERS TO ATTORNEY DECEMBEF„ 30, 2002 21-02-1169 ,~ REGISTER OF WILLS OF Chu NTY OATH OF SUBSCRIBING WITNE~ f ,,, (each) a subscribing witness to the law, depose(s) and say(s) that the testat ,sign the same and that present and saw signed as a witness at the request of testat in h presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before me this day of 19 A Register (Name) (Address) (Name) (Address) REGISTER OF WILLS OF L~. ~-~i ~.1 ~ ~ ~ CI COUNTY OATH OF NON-SUBSCRIBING WITNESS 7 ~-. , ra (each) a subscriber hereto, (each) being duly qualified according to aw, depose(s) and say(s) that ~,~ ~~ ~ E_ ~ ~ti~'--~, familiar with the signature of _ ~ k+-r ~>: '~'~ q f% ~tJ K t, codicil testat=~_ of (one of the subscribing witnesses to) the will presented herewith and codicil that `t-~~ ~ 4~~ ~ believes the signature on the will is in the handwriting of to the best of ~,<<'" knowledge and belief. Sworn to or affirmed and subscribed before ~ . GX me this ~~ day of ~ c~ ,ri ~~~~~ Register codicil will presented herewith, (each) being duly qualified according to _ ,~ C~ P~ ~~ !Name) ~~ (Addre~~ ~ ~! ~` ~~ ~ (Name) c'.1..1. C'_Ic3JGR,.... Lti'-'Z. ~~ht_I^'V-~ p_/~ ~>:~ 'r1(~~''-Y~ (Address) 21-02-1169 REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA R E N U N C I A T I O N Estate of Anna Mae Fuko, a/k/a Anna M. Fuko, Late of Carlisle, County of Cumberland and Commonwealth of Pennsylvania, Deceased No . 21-02-1169 The undersigned, PRISCILLA L. STRAKA, a surviving daughter and a designated Executrix of the above Decedent, hereby renounces the right to administer the estate and respectfully requests that Letters Testamentary be issued to Elayna M. Richards, the alternate Executrix designated in Decedent's Last Will And Testament. WITNESS my hand this /~ =~ day of ~~, 2002. Priscilla L. Straka 1619 Teel Rd. Pen Argyl, PA 18072 Sworn to or affirmed and subscribed bef re me this ~` day of ~.~y~~{ p~~ 2 0 0 2 . Notary P lic My Comm'ssion pires: Not~~ri~ai Sas Ann D. Bellafatto, Notary i'ub:ic Easton, Northampton Ciouni°:+ My Commission t.xpires lV1a,y ~~, ;'t.?(33 r 21-02-1169 LAST WILL AND TESTAMENT I, ANNA MAE FUKO of the County of Northampton, and Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare the following as and for my Last Will and Testament, hereby revoking and making null and void any and all former Wills by me at any time heretofore made, viz: ITEM I. I direct that all my just debts and funeral expenses including my grave marker shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM II. I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as part of the expense of the administration of my estate. ITEM III. I order and. direct my hereinafter named Executrix to convert my entire estate into cash as soon as it may be convenient after my decease, and to that end I hereby authorize, direct, and empower my said Executrix to sell all of the real estate of which I may die seized at either public or private sale or sales, for the best price or prices obtainable Page 1 of 6 therefor, and to give good and sufficient deed or deeds therefor, in fee simple, to the purchaser or purchasers thereof. The money so obtained from the conversion of my estate, I give and bequeath unto my children, in equal shares. In the event any of my children should predecease me and leave children him or her surviving, I give and bequeath the share of said deceased child to his or her children. In the event any of my children should predecease me and leave no children him or her surviving, I give and bequeath the share of such deceased child to my surviving children, in equal shares. ITEM IV. Should any of my beneficiaries mentioned in this, my Last Will and Testament, entitled to a share of my estate not have attained the age of twenty-one (21) years at the time of my death, I give, devise, and bequeath the share of such beneficiary to my hereinafter named Trustee, in separate trust, to hold, manage, invest and reinvest the amount so received, and the accumulation of income thereon, and to use and apply from time to time such portion of income and principal thereof as it thinks proper for the beneficiary's comfortable support, maintenance, and education, without regard to his or her ability to provide such support or education, including college, trade schools, nursing, or other higher learning. When the beneficiary whose proceeds are held in trust reaches the age of Page 2 of 6 twenty-one (21) years, his or her share of the principal and interest shall be distributed to him or to her. ITEM V. I appoint the MERIDIAN BANK as Trustee of the trusts created by this, my Last Will and Testament. ITEM VI. I direct that my said Trustee, in addition to and not in limitation of any authority given by law or by this Will shall have the following powers: (a) To sell, mortgage, lease, alter, improve, partition and exchange all or any of the real estate which constitutes a part of the said trust, for such prices and upon such terms as to cash and credit as they may deem best, and to grant and convey good and sufficient title, without liability on the part of the purchasers or other persons so dealing with the Trustee to see to the application of the purchase or consideration moneys. (b) To purchase or otherwise acquire real estate and to exercise the same powers thereover as hereinbefore provided with respect to the other real estate of the said trust. (c) To retain all stocks, bonds and investments owned by me and to invest and reinvest in other stocks, bonds and investments, without being confined to what are known as "legal investments", and to sell and transfer the same, either in person Page 3 of 6 or by attorney, without liability on the part of the purchasers to see to the application of the purchase or consideration moneys. (d) To borrow money and pledge any stocks, bonds or other personal property of the trust as security therefor, without liability on the part of the lender to see to the application of said money. (e) To purchase securities at a premium, to amortize the premium out of income, or to charge the same to principal or income, or partly to principal and partly to income, at such times and in such amounts as they may deem best. (f) To exercise any option to subscribe for stocks, bonds or other investments. (g) To join in any plan of lease, mortgage, consolidation, exchange, reorganization or foreclosure of any corporation in which the trust may hold stocks, bonds or other investments. (h) To retain indefinitely any part of the trust estate, real or personal, which is or may become unproductive, or, in the discretion of the Trustee, to make sale thereof. The Trustee in its discretion may pay the carrying charges and expenses of property during any year in which it is unproductive out of other principal of the trust estate, or out of income or Page 4 of 6 other principal, or partly out of such principal or income, and it may from time to time reimburse principal or income for the whole or part of said charges and expenses. The Trustee may apportion the proceeds of sale of unproductive property between principal and income according to law, or, in its discretion, it may pay proceeds into principal without apportionment. ITEM VII. I appoint my daughter, PRISCILLA L. STRAKA as Executrix of this, my Last Will and Testament. In the event I am not survived by my said daughter, PRISCILLA L. STRAKA, or she fails to qualify or ceases to act as Executrix of my estate, I appoint my daughter, ELAYNA M. RICHARDS as Executrix of this, my Last Will and Testament. ITEM VIII. I hereby direct that no Executrix shall be required to give any bond in any jurisdiction and that if, notwithstanding this direction, any bond is required by any Law, Statute, or Rule of Court, no sureties shall be required thereon. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of this and five. ( 5 ) other pages, this ~~7 day of ~d7-t+~~A. D. , 1992 . GiC~,,t, /'~'~rE,L ~,~,~~ ( SEAL ) Anna Mae Fuko Page 5 of 6 SIGNED, SEALED, PUBLISHED and DECLARED by ANNA MAE FUKO, Testatrix above named, as and for her Last Will and Testament, and we at her request, in her presence, and in the presence of each other, have subscribed our names as attesting witnesses thereof. / l f/~/ / Address ~ 7 ~(A.t,~h !11 . V ~, Address X4"7 S . S ~ Sf. , o~.Q.1~L~i~ P~ n, i~ l/I ~ '''~y~-- Addre s s ~ Y ? ~ ~ ~ ~/, /,~ .e ~urr~, i /s! Page 6 of 6 b x 0 z rn J N J N A J r to oc z A O ~ z o 'ti C z '° "~ m y ~ [=1 roe' ~xx U x a ~ ~ m bN O N U Ct! z z ~1 ..r A t7 ~ a z fi z ~ ~ 0 t~ rn (D N ~--~ N !~ ~ ~R ~K CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Anna Mae Fuko, a/k/a Anna M. Fuko Date of Death: October 24, 2002 Wi 11 No . 2302-0218 Admin . No . To the Register: 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 January 13 , 2003 Name Penelope F. Munsch Luana G. Rabbett E.layna M. Richards Priscilla L. Straka Address 1700 Pinetown Road Wellsville, PA 17365 125 East St. Windsor, CT 06095 212 Clover Lane Palmyra, PA 170'78 1619 Teel Rd. Pen Argyl, PA 1807 Notice has now been given to all persons entitled therei~o under Rule 5.6 (a) except: none. mate : January 13, 2003 Signature ~~~` Name : Michael H . Small , Escxu_ire Address: 201/203 S. Railroad St. Palmyra, PA 17078 Tele.: (717) 838-1385 Capacity: Personal Representative X Counsel for Fer~zona w. Representative 41 ~ M O h p oM ~ O , ona:n~' .Z ~~~ a.~-.Ct:o-.~ df nN0 O~ M 0 . v? I Z¢ /~ oTc ~ n: ~_~ 0 ~~-- ~- ~~~~ ~~ ~_- - M O - -, ~ r ~~ W O ~ N O ' o w ~ O 2 O J C a M ~ ~ s N s o ~ a~ H ~ O ~ ~ ~ ~ .C V ~ O ~ O ) 3 a o' O ~ W M ~ a ~i o ~ o ~. r r E w a ~--1 H 3 O vWj r', W ~7 ?+ a ~ ~ ~Wo 0 0 ~ '~ ~wzNa a~aa~~ W~ WUa~ ~ ~ O U ~.~ ~.~ ~.~ p, P' x a„ .+ ~ 'Y Law Offices of FAF~RELL & SMALL MICHAEL H. SMALL JOSEPH MICHAEL FARRELL 201/203 South Railroad Street P,0. Box 113 Palmyra, Pennsylvania 17076-0113 717-838-1385 717-534-2946 FAX 717-838-7215 January 21, 2003 Cumberland County Register of Wills Attn: Cheryl Cumberland County Court House One Court House Square Carlisle, PA 17013 In re: Estate of Anna Mae Fuko, a/k/a Anna M. Fuko PA Inheritance Tax Deposit Dear Cheryl: In regard to the above-captioned Estate, you will find enclosed herewith Estate Check No. 5 payable to the "Register of Wills, Agent" in the amount of $1,575.00. This is submitted as a deposit payment on the anticipated inheritance tax liability in this Estate. To record this payment within the discount period for this Estate, I am requesting that the postmark date of January 21, 2003 be noted as part of the procedure for your receipt and processing of this payment. Also, I have enclosed a copy of the check which I am requesting that you please clock- stamp and return to me in the enclosed self-addressed, stamped envelope. Thank you for your assistance in this matter! Very truly yours, ,- ~ ~ ~ A Mi ael H. Sma 1, Esquire ~~ CCC ~J~ MHS/pab Enclosures cc: Elayna M. Richards, Exec. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SMALL MICHAEL H ESQ P O BOX 113 201 /203 SOUTH RAILROAD STREET PALMYRA, PA 17078 --- fold ESTATE INFORMATION: SSN: 3~1-0~-6702 FILE NUMBER: 2102-1 169 DECEDENT NAME: FUKO ANNA MAE DATE OF PAYMENT: 01 /22/2003 POSTMARK DATE: 01 /21 /2003 couNTY: CUMBERLAND DATE OF DEATH: 10/24/2002 REV-1162 EX111-961 N0. CD 002073 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ $1,575.00 TOTAL AMOUNT PAID: REMARKS: ELAYNA M RICHARDS C/O MICHAEL H SMALL ESQUIRE CHECK# 5 SEAL INITIALS: CW RECEIVED BY: DONNA M. OTTO 51,575.00 DEPUTY REGISTER OF WILLS REGISTER OF WILLS f ~~ OC lL . ~¢ m ''m¢ a~i ~+ fl. . --- ~ ~~ _ __ a d -_ 1- /~ G W ~ / ~ V ~~~ --~ ~ ~ W ~~~ ~~ -~- , 1` ~m ~~ ~ _ ~ ~~ ~• ~ ~~ _ ~ ~' ~ Oti ~ M L~~ -' ¢ ~~ a ' n. i ~O M ~ -~ a m ~ s ~ t~ ~~ r~ ^~ W Q O~I ~ N o ~' ~ O ml O M w H m e • • e N ~O r~ Z Q ^' ll ~ ~ C W .A ° y v- o a-~ ~ ~ N ~ p • - v a~ N ~ W Y Z .~ ~ ,. m 7 ~ N •'~O Y» W W K ~ ~ ~ ~ O W m ~ w~ _ „ 3 ~ e 117 (~ -~ d ~j rl 1'~ O 1~ u O ", E ad S~o_~ s ~ryo =v ~ryo ~a LL~y `1~E WGZ at Ewa E ~ E f ~ O_ y v ~2 N r ~ ,ai a E a ~` y oy d a~ G ~z a 0 S 0' IJ'J O F- ~E~ Q U C o ~ ~ N ~a CJ ~ >~_ ~y d m 0 ~q ~E ~ li Cm m M ~ Yq Dm E Xn LLJ a~ ,~~ li m I' A9 a .2 d O! ~ .` LL ~ ~ I ~z € v ^ . w -` a, =1 N 31c C 133d i 0 H rv dd~, l=~ ~o C_ y ~ c V u~ a ,. W r N ~~ r^ ~I ~~ W I C ICI w-J o. 3S ~ 2 LL P ~. a°i r ~ u d ~ a fir; U ~~ L n ~ N L m a S := ~ E C o ~n z 3a3H '~. ~~. 11 ~ 31 C'~~j W UO r~ W :l] v e Q7 .5 E >° 1 N O £ Ea da T o ~ I ~ ~ ~~ `o ~ U o 9LL°`,~~ a i °x~'~mm a o, ~ ~ U r m C~ O N'~ _ Y ~ m O~iJ mi 3~~~ _ - ~I CLL P'S '4u ', °° o ~ z ,.. h ~ E T y a ~..I s C ~ ~ E o = r = l6 r '~`- i C E C Q N Nam„ ° I o Z ~o ^ r C4 ~z M a a ~ H ~3 `emu rv E V}}~ r` F p}~ 1. ~ a wa ~_ L ,~~-. ^ s ~? U OQ~ U m U 2~ @a i~ a~ ~~ m L~~ a IV L~ - m h jai ~ ® - ~ E I~ M r; C? ri a N I a f 1 a d 5 m a ~ °a suol;an.l;sw uoi;eai~dde >lai;s pue ~aad ~o~ >laeq aas "Q3033N H~f10d ON N Jrt J cE~ ~ m ~ So ~ K a «r 0 o ~ > w ~ c " 3 0 ~ s em« d 'q _ I$?; _o ~~ o~ ~ ~ E c `I ~o h ~_ N ~' d Q m S '~. Law Offices of MICHAEL H. SMALL JOSEPH MICHAEL FARRELL FAI~I3ELL & SMALL 201/203 South Railroad Street P.O. Box 113 Palmyra, Pennsylvania 17078-0113 717-838-1385 717-534-2946 FAX 717-838-7215 April 17, 2003 VIA FEDERAL EXPRESS! Cumberland County Register of Wills Attn: Cheryl Cumberland County Court House One Court House Square Carlisle, PA 17013 In re: Estate of Anna Mae Fuko, a/k/a Anna M. Fuko PA Inheritance Tax Return - File No. 21-02-1169 Dear Cheryl: In regard to the above-captioned matter, I am submitting herewith for filing and/or payment the following items: 1. Estate Check No. 9 payable to the Register of Wills in the amount of $15.00 as payment of the filing fee for the PA Inheritance Tax Return. 2. Estate Check No. 10 payable to the Register of Wills, Agent in the amount of $175.68 as payment of the balance due on the PA Inheritance Tax Return. 3. The original and one (1) copy of the PA Inheritance Tax Return. 4. My file copy of the PA Inheritance Tax Return which I am requesting that you time-stamp and return in the enclosed self-addressed and stamped envelope. Thank you for your assistance in this matter! Very truly your c~ . Michael H. Sma Es ire / MHS/pab Enclosures cc: Elayna M. Richards, Exec. (w/encs.) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 / '1- 1/ / - 'I REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT REV-1500EX+(6-00) OFFICIAL USE ONLY J;; FILE NUMBER 2 1 -0 2 1 1 6 9 COUN'TYCODE --YEA~ - - NUMBER- - DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL} ~ Z W C W U W C FUKO, ANNA MAE DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) SOCIAL SECURITY NUMBER 311-01-6702 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 10/24/2002 10/12/1917 SOCIAL SECURITY NUMBER W 0- ~~CI) 0."" w&U :I: a:: 9 0"-11I "- " (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL) o 3. Remainder Return (date of death prior to 12-13-82) o 5. Federal Estate Tax Return Required 2- 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) N/A (R] 1. Original Return o 4, Limited Estate [KJ 6. Decedent Died Testate (Attach copy of Will ) D 9. litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date ofdeath after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copy of Trust) o 10. Spousal Poverty Credit (date of death between 12.31.91 and 1-1-95) THIS SECTlONMUST BE COMPLETED, ALL CORRESPONDENCE AND CONFIDENTIALTAXINFORMATlON SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS Michael H. Small, Esquire 201 South Railroad Street FIRM NAME (If Applicable) FARRELL & SMALL P.O. Box 113 TELEPHONE NUMBER 717/838-1385 Palm ra PA 17078-0113 0- Z W C Z o "- '" w '" '" o o z o i= <( ...J :J ~ ii: <( u W 0:: z o i= <( ~ :J D. :!! o U ~ ~ 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts forwhicl1 an election to tax has not been made (Schedule J) OFFICIAL USE ONLY 48,878.46 (8) 48,878.46 4,952.88 3,179.59 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) 19, Tax Due X (15) 40,745.99 x ,045 (16) X .12 (17) X .15 (18) (19) (11) (12) (13) (14) 8,132.47 40,745.99 40,745.99 1,833.57 1,833.57 20. [8] CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 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 o d . C Add ece ents omplete ress: STREET ADDRESS 000 W S h S 1 est out treet CITY . I STATE PA I ZIP 17013 Carlisle Tax Payments and Credits: 1 Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 1,833.57 1,575.00 82.89 3. InteresUPenalty if applicable D.lnterest E. Penalty Total Credits (A + B + C) (2) 1,657.89 TotallnferesUPenalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 175.68 175.68 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ........................................................................... 0 I2SJ b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 I2SJ c. retain a reversionary interest; or ...............................................................,...................................... D [2Q d. receive the promise for life of either payments, benefits or care? ............................................................. 0 I2SJ 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration?,.......................................... ................................................... 0 [2S] 3. Did decedent own an "in trus!for" or payable upon death bank account orsecurity at his or her death? ................. 0 I2SJ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .......................................... ................ ....................... ...................... 0 [Z] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN OATE t\l~...c-. 1Y\. e,; Ro dt" I (/lj.fr. Lj -Ii, -D3 AODRESS Elayna M. RiJ;ards, Executrix 212 Clover Lane, Palm ra, PA 17078 SIGNATURE OF PARER OTHER THAN REP ENT T E ADDRESS Michael H. Sma", Esquire Attorney for Estate For dates of death on or after Juiy 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 PS. ~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)]. 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)]. 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. -. 0_-. LAST WILL AND TESTAMENT I, ANNA MAE FUKO of the County of Northampton, and Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare the following as and for my Last will and Testament, hereby revoking and making null and void any and all former wills by me at any time heretofore made, viz: ITEM I. I direct that all my just debts and funeral expenses including my grave marker shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM II. I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as part of the expense of the administration of my estate. ITEM III. I order and direct my hereinafter named Executrix to convert my entire estate into cash as soon as it may be convenient after my decease, and to that end I hereby authorize, direct, and empower my said Executrix to sell all of the real estate of which I may die seized at either public or private sale or sales, for the best price or prices obtainable Page 1 of 6 therefor, and to give good and sufficient deed or deeds therefor, in fee simple, to the purchaser or purchasers thereof. The money so obtained from the conversion of my estate, I give and bequeath unto my children, in equal shares. In the event any of my children should predecease me and leave children him or her surviving, I give and bequeath the share of said deceased child to his or her children. In the event any of my children should predecease me and leave no children him or her surviving, I give and bequeath the share of such deceased child to my surviving children, in equal shares. ITEM IV. Should any of my beneficiaries mentioned in this, my Last will and Testament, entitled to a share of my estate not have attained the age of twenty-one (21) years at the time of my death, I give, devise, and bequeath the share of such beneficiary to my hereinafter named Trustee, in separate trust, to hold, manage, invest and reinvest the amount so received, and the accumulation of income thereon, and to use and apply from time to time such portion of income and principal thereof as it thinks proper for the beneficiary's comfortable support, maintenance, and education, without regard to his or her ability to provide such support or education, including college, trade schools, nursing, or other higher learning. When the beneficiary whose proceeds are held in trust reaches the age of Page 2 of 6 twenty-one (2l) years, his or her share of the principal and interest shall be distributed to him or to her. ITEM V. I appoint the MERIDIAN BANK as Trustee of the trusts created by this, my Last will and Testament. ITEM VI. I direct that my said Trustee, in addition to and not in limitation of any authority given by law or by this will shall have the following powers: (a) To sell, mortgage, lease, alter, improve, partition and exchange all or any of the real estate which constitutes a part of the said trust, for such prices and upon such terms as to cash and credit as they may deem best, and to grant and convey good and sufficient title, without liability on the part of the purchasers or other persons so dealing with the Trustee to see to the application of the purchase or consideration moneys. (b) To purchase or otherwise acquire real estate and to exercise the same powers there over as hereinbefore provided with respect to the other real estate of the said trust. (c) To retain all stocks, bonds and investments owned by me and to invest and reinvest in other stocks, bonds and investments, without being confined to what are known as "legal investments", and to sell and transfer the same, either in person Page 3 of 6 or by attorney, without liability on the part of the purchasers to see to the application of the purchase or consideration moneys. (d) To borrow money and pledge any stocks, bonds or other personal property of the trust as security therefor, without liability on the part of the lender to see to the application of said money. (e) To purchase securities at a premium, to amortize the premium out of income, or to charge the same to principal or income, or partly to principal and partly to income, at such times and in such amounts as they may deem best. (f) To exercise any option to subscribe for stocks, bonds or other investments. (g) To join in any plan of lease, mortgage, consolidation, exchange, reorganization or foreclosure of any corporation in which the trust may hold stocks, bonds or other investments. (h) To retain indefinitely any part of the trust estate, real or personal, which is or may become unproductive, or, in the discretion of the Trustee, to make sale thereof. The Trustee in its discretion may pay the carrying charges and expenses of property during any year in which it is unproductive out of other principal of the trust estate, or out of income or Page 4 of 6 other principal, or partly out of such principal or income, and it may from time to time reimburse principal or income for the whole or part of said charges and expenses. The Trustee may apportion the proceeds of sale of unproductive property between principal and income according to law, or, in its discretion, it may pay proceeds into principal without apportionment. ITEM VII. I appoint my daughter, PRISCILLA L. STRAKA as Executrix of this, my Last Will and Testament. In the event I am not survived by my said daughter, PRISCILLA L. STRAKA, or she fails to qualify or ceases to act as Executrix of my estate, I appoint my daughter, ELAYNA M. RICHARDS as Executrix of this, my Last Will and Testament. ITEM VIII. I hereby direct that no Executrix shall be required to give any bond in any jurisdiction and that if, notwithstanding this direction, any bond is required by any Law, Statute, or Rule of Court, no sureties shall be required thereon. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last will five (5) other pages, this and Testament, consisting of this and t/ . ~7 day of ~~~~A.D., 1992. ~ h~4.Ld~ Anna Mae Fuko (SEAL) Page 5 of 6 SIGNED, SEALED, PUBLISHED and DECLARED by ANNA MAE FUKO, Testatrix above named, as and for her Last Will and Testament, and we at her request, in her presence, and in the presence of each other, have subscribed our names as attesting witnesses thereof. / . / ~/v'/ ~. <~-~-~ I / D!1cu\ ,1'\. SLLl..'{.ili~ Address ;) C/ '/ ~.A'~J/~ Address ,) '1'7 -S C' f~ " ~ ,'T) ,ill,R,'~), j'f/ t '.' --.. /.- (~."~1...'" ,.-.. ...........- .: / " ,< . ,-:-;;:l::r-r.l~ -;-;'(.<1.-<-,. Address ,', ~ / ., />'(. P t/. /1.;: ./ ,,/i.: ~".-(;{ t-;>i " I'~/ Page 6 of 6 REV-1508 EX + (1_97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FUKO ANNA MAE FILE NUMBER 21 02 1169 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 6,400.68 2. First Union Crown Classic Banking Checking Account #1000310507072 See Verification attached First Union Savings Account #3014228691815 See Verification attached 42,457.48 3. Highmark - Health Insurance Premium Refund See Verification attached 20.30 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 48,878.46 f_Ne WACHOVIA Reference ID: 506152 First UnionlWachovia Attn: Balance Confirmation Services POBox 40028 Roanoke VA 24022-7313 J .nuary 22, 2003 FARRELL & SMALL 201/203 SOu;rH RAILROAD STREET PO BOX 113 PALMYRA, PA 17078-0113 SUBJECT: Veriflc.tion I Confirmation of Account and B.lance Information provided for: Customer: ANNA MAE FUKO (SSN# 311-01-6702) Date of Death: November 24, 2002 DeDosit Account Information Account Account Date of Death Average Date Maturity Interest Accrued YTD Date Type Number Balance Balance. Opened Date Rate Interest Interest Paid Closed CHECKING 1000310507072 $6,399.60 211/1971 $1.08 $14.24 111412003 LEGAL TITLE: ANNA M. FUKO SAVINGS 3014228691815 $42,413.37 10/30/1998 $44.11 $615.86 1114/2003 LEGAL TITLE: ANNA M. FUKQ . Due to system limitations. we can only provide a twelve month average balance on depository accounts. . Date of death balance does not include accrued interest. . If date of death occurrs on a weekend or a holiday. date of death balance does not include any transactions that were C, made during that time period. 11Ai.{.a:=>~ l.f ~Ii; So~ells Servicenter Associate January 22, 2003 (540)563-7323 Phone Number abs; at 000671 +1 I GHf\.MRK '>.0. lI1>X %OJt\Q~9 Camp Hill, 1711119.00119 'lh;tII\1.-\H:)( RESLR\;t>:S lilt: kU;1I1' 10 }It:"1 \fr"- Ill,.; IU:L\H 11.-\1"1.(-". U)l'Y OF 11\ \oOH"..S INVOICE NO. P.O. NuMBER DATE VOuCHER GROSS AMOUNT DISCOUNT NET AMOUNT ~EFUND 2002-12-11 00442509 20.30 0 .00 20.3 He 11th Insurance f remium Refund -~_._---- I -.._--------~.- I--TCJT ALAMOU NT -- tiNDL CHECK NO PAY DATE I VENDOR NO _. VENDOR NAME .__ I 30361750 2002-12 26 I ANNFUK0001 I ANNFUKOO01-001 20.30 -------. PLEASE CASH OR DEPOSIT CHECK PROMPTLY 0000072 :/1 :l.~ II 'It 1:1"'__':.I~lj'I;l"I_:'l--w...~~~~~r.s.!."'JU I _ ';I.i;i:""_$l.;j;i"~;i ~,;"Zmj.i~~ll~~:::~~:;:'~tol <ffIGHMl\RK. l'NCIllANIK J[ANN[T'lE. P.l\, J!Q..:!~ ..B (amp Hill, I"A 170~9.00K9 CIIECI( NO 30 36 1 7 5 0 'Wf'", I t lJO/l.,.jRS "'."'1) J/J n-_Nf.~ ANNA M. FUKO 212 CLOVER LANE PALMRYA. PA 17078 DATE GF CHlCK MO Dp,Y YR 12/26/2002 DJLtAftS .~_=-=]_~E~TS .~l 8( CA:>HfD WITHIN Ii MONTHS ! \ d. .l"LlllORI/...1l SIGt\An;RJ.; Highm'3.rll,IM. II' ~o ~ b ~ 7 SO II' ':0 I, l ~o ~ b 271: 000 2 ~ 5 ~ 20811' REV-1511EX+(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FUKO ANNA MAE FILE NUMBER 21 02 1169 Debls of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES 1. Falk Funeral Home - Balance due on Funeral Bill - See copy attached 79.35 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Numbe~s) I EIN Number of Personal Representative(s) Street Address City Stale Zip Year(s) Commission Paid: 2. Attorney Fees Farrell & Small 4,500.00 3. Family Exemption: (If decedenfs address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees (Initial Probate Fees - $128.00) 128.00 5. Accountant's Fees Duane E. Herman, CPA 50.00 6. Tax Return Preparer's Fees 7. The Sentinel - Legal -- Estate Notice 105.53 8. Cumberland Law Journal -- Estate Notice 75.00 9. Register of Wills - Filing Fee for Inheritance Tax Return 15.00 TOTAL (Also enter on line 9, Recapitulation) $ 4,952.88 (If more space is needed, insert additional sheets of the same size) L-. E' / ~ rJz~~.J ~F:ulAL ~~~~ '-:;:.,_:::- -- II):) \I..in :'tret'1 PI'llIJ:.J)llr~. P.\ ISO::; :2!.-),o-I).;)I);-n \\""rld \ride ,rd. \dd/"l':-i~: hup://w\\'\\'.l!rid.l'll/ll ("1I111il uddn':-i:-;: IlWlll(lrial.g:rH~I"1t.t TlIlJ Fn'l~ if ;':"':om :(l7--tR:iO I)"lllld \1 hllk 1:.\\ Frail!.: J. hill... F,J). :,1'PFH\'J~( III December 1, 2002 STATEMENT DATE: October 24, 2002 FUNERAL ARRANGEMENTS FOR... Anna Fuko STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED Please refer to the original agreement for a complete explanation of all charges PROFESSIONAL SERVICES. STAFF, FACILITIES, AND ALL EQUIPMENT NAME OF PACKAGE IF SELECTED: FULL SERVICE CREMATION WITH BURIAL OF CREMAINS URN SELECTED: Mackenzie burial urn TOTAL FUNERAL HOME CHARGES CASH ADVANCES Certified Copies of Death Certificate (15) @ $2.00 each Church Honorarium Cumberland County Coroner's cremation authorization fee Cemetery fee: opening, closing, service Monument foundation completion Flowers as ordered TOTAL CASH ADVANCES TOT AL COST OF ARRANGEMENTS PRE-NEED POLICY PROCEEDS BALANCE DUE ACCEPT ANCE SIGNATURE ON FILE... Elavna Richards RELA TIONSHIP OF SIGNER... Dauf!hter STATEMENT TO HI!: SI!:NT TO: Mrs. Elavna Richards 212 Clover Lane Palmvra, P A 17078 .AI ~. ';.':6 \ \:7 .., - - t'\:''- ."." . J ;,.. .((~. ", \ 1 -- 'I-' H 18 .\!.lill Stn~et ('V , llt'lll,rto\\'/I. P.\ 130;):; . '): \"\ . :()10' g;{8.{)1<J1 \ F",,"k J Falk I'D. DOllrli.'\1. Fulk F D ~l_ PFH\I:-:nR $1184.00 $115.00 $30 00 $100.00 $25.00 $460.00 $150.00 $79.50 $1299.00 $844.50 $.2143....5.U ~$2064.15 $79.35 Thank you for pla~ing your trust in us. It is our sincere hope that all of the services and merchandise we provided ucecded your expectations. For your convenience, payment may be made with cash, personal ~heck, MasterCard, Visa, Discover Card, estate dIeck, or limited insurance assignment. '. /~' ,/ RECEIPT FOR PAYMENT ------------------- ------------------- Cumberland County - Reqister Of Wills Hanover and Hiqh Street Carlisle, PA 17013 Recetpt Date 12/30/2002 Rece~pt Time 09:57:55 Recelpt No. 1031523 FUKO ANNA MAE File Number 2002-01169 Remarks ELAYNA M RICHARDS CW ------------------------ Distribution of Receipt ------------------------ Transaction Description Payment Amount Payee Name PETITION FOR PROBA SHORT CERTIFICATE RENUNCIATION EXECU EXTRA PAGES JCP FEE 80.00 18.00 5.00 15.00 10.00 CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN BUREAU OF RECEIPTS & CNTR M.D Check# 3881 Total Received.... ..... $128.00 $128.00 FROM: BILL TO: -. Duane E. Herman, CPA 4999 Louise Drive, Suite 101 Mechanicsburg, PA 17055 Anna M F uko c/o Elayna Richards, 212 Clover Lane Palmyra, PA 17078 For the preparation of Pennsylvania individual income tax return for the year 2002. Statement of Charges Tax return preparation fee Sub- ToIal TOTAL 4/1/2003 50.00 50.00 50.00 / I CUMBERLAND LAW JOURL'\'AL 2 LIBERTY AVENUE CARLISLE, P A 17013 FEBRUARY 7,2003 Cumberland Law Journal is published every Friday by the Cumberland County Bar Association and is designated by the Court of Common Pleas as the official legal publication for Cumberland County and the legal newspaper for publication of legal notices. TO. Michael H. Small, ESQUIRE Anna Mae Fuko aka Anna M. Fuko, ESTATE RE: Lega] advertisements must be received by Friday Noon. All legal advertising must be paid in advance. Make all checks payable to: Cumberland Law Joulllal. --------------------------------------------------------------------- ---------------------------------------------------------------------- Advertisement inserted on following dates: JANUARY 24, 3], FEBRUARY 7, 2003 Advertising Cost Proof of Publication Second Proof Request Payment received Total Amount Due Payment received by $ 75.00 $ 0.00 $ 0.00 $ 0.00 ------------- S 75.00 --------- --------- PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929), P. L.1784 STATE OF PENNSYLVANIA : ss. COUNTY OF CUMBERLAND : Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, V1Z: JANUARY 24, 31, FEBRUARY 7, 2003 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter ofthe aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. Fuko, Anna Mae. alkla Anna M. Fuko. dec'd. Late of Carlisle. Executrix: Elayna M. Richards. 212 Clover Lane, Palmyra, PA 17078. Attorney: Michael H. SmaIl, Es~ quire. 201/203 South Railroad Street, P.O. Box 113. Palmyra. PA 17078-0113. SWORN TO AND SUBSCRIBED before me this 7 day of FEBRUARY. 2003 lj ,J. '!. t, \::-.< L <- L'-.:, . ,//) lol;li', ,e',j ,~ptary, ' "" \.' ~ITTANCE ADDRESS GAL I BilL TO . E SENTINEL - LE FARRELL & SMALL R.O. BOX 130, CARLISLE, PA 17013 AD NUMBER I CLASS SALESPERSON BILLING DATE LINES 237241 10 PUBLIC NOTICES c31 01/31/03 29 AD DESCRIPTION START DATE SlOP DATE ESTATE NOTICE NOTICE IS HEREBY GIVE 01/15/03 01/29/03 PUBLICA liON INSERTIONS RATE NET AMOUNT GROSS AMOUNT 3 THE SENTINEL - LEGAL 3 LGL 99.18 TOTAL AD CHARGE 99.18 3 2002 PROOF OF PUBLICATION 01PRF 6.35 DAYS RUN PURCHASE ORDER PAY THIS AMOUNT 105.53 126.64* Anna Mae Fuko RETAIN THIS PORTION FOR YOUR RECORDS . AFTER 0.3/02/03 MESSAGE: Thank you for advertising with The Sentinel. Deadlines for in-column legal advertisements: Monday is Friday at 11 a.m.; Tuesday is Friday at 4 p.m.; Wednesday is Monday at 12 Noon; Thursday is Tuesday at 12 Noon; Friday is Wednesday at 12 Noon; Sunday is Thursday at 12 Noon. If you have any questions regarding your Legal bill please call Lori Saylor 243-2611 ext. 201 Fax your legals to 243-3754, attention Lori Saylor You can also EMAIL yourlegaltoClassifiedads:ads@cumber1ink.com. Please send a cover letter including your name and address as an attachment DETACH AND RETURN THIS PORTION WITH YOUR PAYMENT THE SENTINEL. LEGAL k POBOX 130 CARLISLE PA 17013 Anna Mae Fu 0 . . AD NUMBER CLASSO START DATE STOP DATE 237241 PUBLIC NOTICES 01/15/03 01/29/03 AD DESCRIPTION BILLING DATE TELEPHONE NUMBER ESTATE NOTICE NOTICE IS HEREBY GIVE 01/31/03 717-838-1385 GROSS AMOUNT OF 126.64 DUE AFTER 03/02/03 TOTAL AMOUNT DUE 105.53 FARRELL & SMALL 201/203 SOUTH RAILROAD ST POBOX 113 PALMYRA, PA 17078-0113 1",111",111",1",11"1,11"",,11,,,11,1,1,1 ENTER AMOUNT ENCLOSED $105.53 20200000002372410000000000000001266400000105536 PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland. Lori Saylor, Classified Advertising Manager of THE SENTINEL, of the County and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a newspaper of general circulation in the Borough of Carlisle, County and State aforesaid, was established December 13th, 1881, since which date THE SENTINEL has been regularly issued in said County, and that the printed notice or publication attached hereto is exactly the same as was printed and published in the regular editions and issues of THE SENTINEL on the following dates, viz Copy of Notice of Publication ESTATE NOTICE Notice is hereby given tha~ letters Testamentary on the' Estate of ANNA MAE FUKO, alkJa ANNA M. FUKO, late of Carlisle. Cumberland County, Pennsylvania, deceased,have been granted to the under- signed Executrix~ All persons, therefore indebted to said estate are requested to make immediate payment, and those having just claims. will please present the same~. duly authenticated, for settle. ment, without delay. Elayne M. Richards 212Ctover Lane Palmyra, PA 17078 Executrix Michael H. Small, Esquire 201/203 South Railroad Street. P,O. Box 113 Palmyra, PA 17078-0113 Counsel January 15,22 & 29,2003 Affiant further deposes that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statement as to time, place and character of publication are true. ~A: ~b1- January 29, 2003 Sworn to and subscribed before me this 29th day of January, 2003. ~ ;t~IiC My commission expires: ("--N;;,;!' Se~! ---1 t;\l13nay L- Meug':"f,. ~.:o,.ary P,.J'cj~: 1 ("'c'rl;clp Gor(, Cu;,'):;erla:'YJ CaUrilY .....fA ..;>_ _ _ ' _ '._ _, ,. _Y' My Ccrrm;;;s~oq E)(plr8~~ Ji:r:8.:. c'.OI.,;:) -.---.--- Meniber, Per nSY:'v:;:h3 !.,:;~;Y!::::tiOi1 cf r joL~rir:s REV-1512 EX + (1.97) COMMONWEALTH OF PENNSYLVANIA lNHERl1 ANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF FUKO ANNA MAE FILE NUMBER 21 02 1169 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 121.59 1. PharMerica - Pharmacy/Medical bill 2. United Church of Christ Homes/Sarah A Todd Memoriai Home - Balance due 3.058.00 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 3,179.59 6 Ji i iil i o ,~ ~ ~ '~ ~ PHARMERICA ~JI.> IIII 1871 Leflhand Circle Longmont, CO 8050 I ADDRESS SERVICE REQUESTED 3304 1 MB 0.309 ANNA FUKO ClO Elayna Richards 212 Clover Lane Palmyra PA 17078-3016 - - = - = 1,.,11111.111,.,'".11"1",'1,111111,.11,11,.,,,11,,1,1,1,,'1 January 07, 2003 The above account remains seriously past due. We bavc attempted to work witb you to bring this account current. If we do Ol)t recri\'t a satisfactory response or pa)'ment in full b)' Jaml3T}' 21, 2003, 'we may he forced to proceed with further collection activity and or discontinuation of pharmacy services. If you have applied for Medicaid, please contact our office to provide us with an update on yonr Medicaid eligibility, To ensure tbat your payment is posted accurately, please return the bottom portion of this notice with your payment in the enclosed envelope. We offer you the option of paying by credit card or check by phone. If you choose to pay utilizing one of these methods, please complete the back of this notice, and return in the enclosed envelope. Check by phone users must also relurn a voided check. This is an important maltcr. Please take care of it today. We can be reached at 800-352-9161. Sincerely, PharMerica PLEASE RETURN BOTTOM PORTION WITH PAYMENT - Do not staple -. - - - ~ - ~ - - - - - - . - - - - - - - - - - - - - - - - - .- - - - - - . - - - - - - - - - - - - - - - - . - - - - - - - - - - - . . . - - - - - ANNA FUKO C\O Elayna Richards 212 Clover lane "' . . Palmyra PA 17078-3016 S,f:'~ ,.f: \}.~.::. .~~', ':. --.. SARAH A. TODD MEMORIAL HOME ANNA FUKO 5702.Q1.11747 I TOTAL AMOUNT DUE $121.59 PHARMERICA P.O, BOX 6413 CAROL STREAM IL 60197-6413 1.11"1'."."111,1,.1,.,',11",',,',,,11,,11,,,,11.,1'.1.1.,1 AMOUNT ENCLOSED 1$ 121.59 o Check iflhchack of this form has lx't:n cornpld('( 5702010101070407000121593 Statement United Church of Christ Homes Sarah A. Todd Memorial Home 1000 West South Street Carlisle, PA 17013 Statement Date: 01/10/2003 Elayna Richards 212 Clover Lane Palmyra, PA 17078 Due Date: 01/24/2003 Re: Anna M Fuko Account Nr: 101320 -------------------------------------------------------------------------------- Date Description Days Quant Rate Charges Payments Balance -------------------------------------------------------------------------------- BALANCE FORWARD 3,058.00 3,058.00 NOTE: Please remit by 1/24/2003,the Last amount printed on the stmt. Please include Acct Nr. from statement on MEMO LINE of your check. payments after 12/31/02 do not reflect on statement. Beginning 7/1/02 a $10 fee will be CHARGED for RETURNED Checks. MEDICAL ASSISTANT RESIDENTS, PLEASE PROVIDE PROOF OF 2003 INCOME AND INSURANCE PREMIUMS ASAP. . REV"1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER FIIKO A ~NA MAE 21 02 ""0 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distMbutions, and transfers under Sec9116(a){l.2)1 1. Penelope F. Munsch Daughter An equal 1/4 share of 1700 Pinetown Road Residuary Estate Wellsville, PA 17365 2. Luana G. Rabbett Daughter An equal 1/4 share of 125 East Sl. Residuary Estate Windsor, CT 06095 3. Elayna M. Richards Daughter An equal 1/4 share of 212 Clover Lane Residuary Estate Palmyra, PA 17078 4. Priscilla L. Straka Daughter An equal 1/4 share of 1619 Teel Rd. Residuary Estate Pen Argyl, PA 18072 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) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SMALL MICHAEL H ESQ P O BOX 1 13 201 /203 SOUTH RAILROAD STREET PALMYRA, PA 17078 ACN ASSESSMENT CONTROL NUMBER fold ESTATE INFORMATION: SSN: 3~ ~-0~-6702 FILE NUMBER: 2102-1 169 DECEDENT NAME: FUKO ANNA MAE DATE OF PAYMENT: 04/21 /2003 POSTMARK DATE: 04/18/2003 COUNTY: CUMBERLAND DATE OF DEATH: 10/24/2002 AMOUNT 101 ~ 5175.68 TOTAL AMOUNT PAID: REMARKS: ELAYNA M RICHARDS C/O MICHAEL H SMALL ESQUIRE SEAL CHECK# 10 INITIALS: CW RECEIVED BY: DONNA M. OTTO 5175.68 DEPUTY REGISTER OF WILLS REV-1162 E?;(11-96) NO. CD 002471 REGISTER OF WILLS V~ uK STATUS REPORT UNDER RULE 6.12 Name of Decedent: Anna Mae Fuko, a/k/a Anna M. Fuko Date of Death: October 24, 2002 Wi 11 No . 2002-01169 Admi n . No . Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of tl~e 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: N/A 3. If the answer to No. 1 is Yes, state the followings 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 t:he personal representative state an account informally to tt-e parties in interest? Yes X No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orpl~aris' Court and may be attached o this repor . Date: 04/25/03 ~2 Signature Michael H. Small, Esquire Name (Please ty e or print 201 South Railroad ~treet, P.O. ~ox 113 Palmyra,PA 17078-0113 Address ( 717) 838-1385 Tel. No. Capacity: Fersonal Representative X __ Counsel for personal representative (MAH:rmt!AM3) i, \ ~~ ) ~ b• ~ ~/ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 260601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX f) l^ .. ~ ., ,- ~.._. MICHAEL H SMALL ESQ FARRELL B SMALL PO BOX 113 PALMYRA PA 1.7078 REV-3547 IX AFP CO1 -03) DATE 06-16-2003 ESTATE OF FUKO ANNA M DATE OF DEATH 10-24-2002 FILE NUMBER 21 02-1169 COUNTY CUMBERLAND ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS -~ ---------------------------------------------------------------------------------------------------------------- REV-1547 EX AFP CO1-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX csrerF nF FUKO ANNA M FILE N0. 21 02-1169 ACN 101 DATE 06-16-2003 TAX RETURN WAS: C X) ACCEPTED AS FILED C ) 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. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) .00 NOTE: To insure proper (2) .00 credit to your account, (3) ,QQ submit the upper portion C4) ,00 of this form with your C5) 48,878.46 tax payment. (6) .00 (7) .00 ($) 48,878.46 APPROVED DEDUCTIONS AND EXEMPTIONS: 4,952.88 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 3.17 9.59 (11) 8.132.47 11. Total Deductions 40,745.99 12. Net Value of Tax Return (12) .00 13 Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedu le J) C13) . 40,745.99 14. Net Value of Estate Subject to Tax (14) NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due (15) .00 X 00 = .00 (16) 40 , 745.99 X 045 . 1 , 833.57 (ln • 00 X 12 .00 c18) .00 X 15 .00 (ly)= 1,833.57 IAA I.RCLl IJ' PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID 01-21-2003 CD002073 82.89 1,575.00 04-18-2003 CD002471 .00 175.68 TOTAL TAX CREDIT 1,833.57 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED. SEE REVERSE ( IF TDTAL DUE IS LESS THAN 81, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before December 12, 1962 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. C72 P.S. Section 9140). PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side. --Make check or money order payable to: REGISTER OF HILLS, AGENT REFUND (CR): A refund of a taz credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (TT only). OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. 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. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. 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 (6Y.) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 20% .000548 1987 9Y. .000247 1999 7Y. .000192 1983 16% .000436 1988-1991 11% .000301 2000 8Y. .000219 1984 11% .000301 1992 9% .000247 2001 9Y. .000247 1985 13% .000356 1993-1994 7% .000192 2002 6% .000164 1986 10% .000274 1995-1998 9% .000247 2003 5% .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NU?[BER 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 date shown on the Notice, additional interest must be calculated.