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Home My WebLink About03-20-15 J 1505614134 exma�al(ri� REV-1500 OFFICIAL USE ONLY BureauoflntlivitlualTaxes CounryCaJe Year FileNumber ao eox 2eo6oi INHERITANCE TAX RE7URN 2 1 1 y 0 7 2 9 r+a«�snuw.an mze-o5oi RESIDENT DECEDENT ENTER�ECEDENT INFORMATION BELOW SocialSewrityNumber Dateo/DeatM1 MMDOYYYY DateofBin� MM�DYYYY 0 6 2 9 2 0 1 4 0 7 1 9 1 9 5 8 �ecetlenCs Last Name SURx DecetlenCs Firs[Name MI S U D 0 L S T A N I S L A W Z pf Applicable�Enler Surviving Spouse's Infortnation Balow Spouse's Last Name Suffix Spause's First Name MI S ll D 0 L M A L G 0 R Z A T A THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW O 1.Original Retum � 2. SuOPlemental Retum � 3. Remainder Retum(Eate of dea�h Priar ta 12�13-82) � 4.AgriculNre Exemption � & Fulure Interest Compmmise(dale of � 6. FeOeral Esla�e Tax ReWrn Requiretl (tlateoltleallonoraflerl4�2011) dealhafler1242-82) � ].Oecedenl Oietl Testate � 9.Decetlent Maintainetl a Living Tmst � &Total Num�er of Sa�e Deposit Boxes �Al18ch0opy01wll) (AIGCM1Wpy01W51) � ID.Litigalion P�oceeds Received � 11. Noo-Probate Transferee Relurn � 12. DeferrallElection ot Spousal Trusts (Schetlule F anE G Assets only) ❑ 13.Business Asse�s ❑ iC. Spouse Is Sole Benefciary (No tmst involved) CORRESPONDENi-THIS SECiION MUSi BE COMPLETE�.ALL CORRESPONOENCE ANO CONFIOENTIAL iA%INFORMAiION SHOUL�BE OIRECTEO T0: Name Daylime Telephone Number D A V I D H S T 0 N E , E S Q IJ I R E 7 1 7 7 7 4 7 4 3 5 Firs[Line o(Adtlress 4 1 4 B R I D G E S T R E E T Second Line otAdtlress Clty or Pos�Office State ZIP CoOe N E W C U M B E R L A N D P A 1 7 � 7 0 . Correspontlent§e-mailaEtlresa: DSTONEaSTONELAW . NET � , � � ___..__�.Q- _ _ __��-_i—__ . . Rt�iSCEaoFwiu$useoHiro � REGiSTEftOFWILL8U6E0N�V ' �� DATEFILEDMMODYYW__ _ . '' � L� I � i OpTE FILE�STAMP � �� . __.. ._ .—_---_ .r__�.Ty—_-.__ v� �:l PLEASE USE ORIGINAL FORM ONLY Side 1 I IIIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII II'I L 15�5614134 15�5614134 J J 1505614234 Rev-isoo ex tF0 DecetlenCs Social Securily Number oe�eoem':Hame�. STANISLAW Z• SUDOL ftECAPITULATION 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . 1. ' 2. Slocks antl 8onds�Scnedule B) . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . Z. ' 3. Closety Heltl Corporation.PaMership or Sole-Proprietorship(Schetlule C) . . . . . 3. • 4. MORgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . A. • 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schetlule E). . . . . . . 5. 1 4 5 7 2 . 0 6 6. Jointly Ownetl Property(Schetlule F) ❑ Separa�e 0111ing RequesteE . . . . . . . 6. • ]. Inler-Vivos Transfe�s 8 Miscellaneous N -0wba�e Pmpetly (Schetlule G) � Separate Billing Requestetl . . . . . . . ]. . 8. Total Gross Assets(total Lines 1 �hrough�) . . . 8. 1 4 $ 7 2 , � 6 9. Funeral Expenses antl Atlminis�rative Cos[5(Schedule H) . . . . . . . . . . . . . . . . . 9_ 1 3 9 4 9 . 5 8 10. �ebis of Oecetlent,Mortgage Liabilities,antl Liens(Sc�etlule I) . . . . . . . . . . . . . 10. 2 3 1 5 . 2 2 ��. Towi �etluctions Ito�ai�ines 9 antl �O) .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 1 5 7 6 4 . 9 0 12. Net Value ot Eatate(Line e minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . �Z_ - 1 1 9 2 . 7 9 13. Charitable antl Govemmental BequesfslSec 9113 Tms�s tor w�ich an election lo tax has nol�een matle(Schetlule J) . .. . . . . . . . . . . . . . . . . . . . 13. • td. Net Valua Subjacl to Taz(Line 12 minus Line 13) . . . 16. - 1 1 9 2 . � 4 TAX CALGULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amounl ofLine ibtaxable att�e spousallaxrate,or [ransfers untler Sec 9t�6 (a)(i21X.o0_ 0 , 0 0 �5. 0 . 0 0 16. Amount oi Line 161axable atlinealra[e X .0 � . � 0 16. � . � � 1 Z Amount ot Line 14 taxable a�sionoyra�e x.iz 0 . 0 0 n. 0 . ❑ ❑ 18. Amount of Line 141arable atcoua�erairate x.i5 0 . 0 0 te. 0 . � 0 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. � . 0 � 20. FILL IN THE OVAL IF VOU ARE REpUESTING A REFUND OF AN OVERPAYMENT ❑ llnder Oenalues oi perlury,I tledare I�ave e�ammea��ie reWrn,incWaing accompany�ng u�e�ules and s�atamen�s.antl to Ne bes�ol my knowlMge an0�ellel p Is�me,wrrecl an0 complete.DeGaration o�preparer otM1er iM1an��e pPSon RsOonsible tor flling t�e reWm Is Oased on all mformaLon ol w�¢�preparer M1as any knowletlge. IGNAT EO GEft50NRE50N51BLE FlLIN RETURN �ATE � 3-/ 7-/S nooREss 93 IP DR VE MECHANICSBURG PA 1705� SIG UREOF EP H TMANPERSONRESPONSIBLEFORFlLINGTHERETURN OFTE � ADDR 414 BRIDGE S,TRE� T NEW NMBERLAND PA 17070 IIIII'llllll�llllll�lllllll III�IIIIIIIIIIIIIIII I�IIIIIIII�II Side 2 L 15�5614234 1505614234 � ftEV�t 500 E% (Fp Page] File NumOei Decedent's Complete Address: ZL 14 0729 �ECE�ENT'SNAME STANISLAW Z . SUDOL srReernooaess 931 WILLCLIFF DRIVE CRY STATE ��21P MECHANICSBURG PA �, 17050- Tax Payments and Credits: �. Tax Due(Page 2,Line t9) (1) 0 • 0 0 2 Credi(5/Payments A.Prior Paymenls . B. Discount (See insWc�ionsJ Tolal Credts(A.6� (2J �• 00 3. Interes� (31 0 . 0� 4. I(Line 2 is grealerihan Line 7 �Gne 3,enler Ihe diHerence.This is Ihe OVERPAYMENT. Fill In oval on Page 7,Line 20[o requesl a refund. (4) 0 •0 0 5. If Line 1 +Line 3 is grealer�han Llne 2,enler Ihe diHerence.This is�he TAX OUE. (5� 0 . pQ Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. �id0eceden�makeaUans�eranB. Ves No a. re�ain�heuseorincomeofihepmpetlY�ransferred ..___.._.._..............._..................................... ❑ Q b. re�ainiherigMtodesignatewhoshalluselheprope�ytranstertedorilsincome ......_......._..........._. ❑ QX c. retainareversiona7interest ._....... . . ................ ._._... _........ ._........... ❑ ❑X tl. receivethepromiseforlifeofei�herpayments,benefitsorcare� ,.._._. _...._................... ❑ ❑X 2. II deelh ocarred after�ec.12, 19B2,ditl decedan�transfer pmperty wlihin one year of dea�h wilhoNrxeivingadequaleconsideration? ....._.._... .. ................ ....._.... ...._.... ❑ ❑X 3. �iddecedentownan'inlmstfor'orpayable-upon-0ealhbankaccounlorsecuriryalhisorherdeath? ____. ❑ Q 4. �id deceden�own an intlividual relirement accowt,annuiry or o�her non-pmbale pmpetly,which conlainsabeneficiarydesignation7........... ........._ _...._. ..._ ... ❑ Q IF THE ANSWER TO ANV OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART Of THE RETURN. For tlates of tleath on or after July 1, 1994,and 6efore Jan. 1, 1995,��e ta�rate imposetl on[he net value of Iransiers to or�or ihe use of ihe surviving spouse is 3 percent�72 P.S.§9116(a)(1.1)(i)�. For tlates of dealh on or aker Jan. 1, 1995,the tax rate imposed on the net value of irans/ers to or for ihe use of the surviving spouse is 0 percent [72 P.S.§9118(a)(1.1)(ii)J.The staWte does no�exempt a Vansfer ro a surviving spouse imm tme,antl tne staNtory requiremenb for aisclosure o�assets ane ftling a�ax reWrn are still applicable even if Ihe surviving spouse is the only beneficiary. For tlales of death on or aAer July 1, 2000: • The tax rate imposetl on Ihe net value af Iransfers from a tleceased child 21 years of age or younger al 0eath�o or for the use of a naNral parent an atloptive parent or a step-parenl of Ihe chlld is 0 percent�l2 P.S §9116(aJ(12)�. • The tav rate imposetl on the ne�value of[ransfers to ar�or the use oi the tlece4enYs lineal 6eneficiaries is 4.5 percent,except as notetl in�72 P.S. §911fi(a)(1)�. • The tax rate impased on ihe net value ot Iransfers to or for Ihe use of ihe tlecedenPs siblings is 12 percent�72 P.S.§9116(a)(1.3)].A sibling is defined, untler Section 9102,as an indivitlual wha has at least one pareN in common with ihe tlecedenL whether by blood or adoption. REV-1508 E%+(0&�Y) pennsylvania SCHEDULE E 9E�ppTMENiOF0.E�E"�E CASH, BANK DEPOSITS & MISC. �aF�ioEnroECEOEvr��p� PERSONAL PROPERTY ESTATE OF: FILE NUMBER: STANISLAW Z . Sl1DOL 21 14 0729 Include the proceetls of litigalion and I�e date the pmceetls were recerved by the eslate. All property Jolntly ownetl with right o(survivorship must be tlisclosed on Schetlula F. ITEM VA W E AT OATE NUMBER OESCRIPTION OF�EATH � First National Bank-Checking Acct �95021961 14 ,572 • 06 TOTAL(Also en�eron Line 5,Recapitulation) E 14�572 • 06 If more space is neetled use atltlilional sheels of paper of Ihe same size. REV-t5tt E%+(0&13) pennsylvania SCHEDULE H oePnA.MeHroFAeveHue FUNERALEXPENSESAND iuHcairnNcernxaeruev ADMINISTRATIVE COSTS aesioeuroeceoer�r ESTATE OF FILE NUMBER STANISLAW Z • SUDOL 21 14 0729 DecetlenCs EeMs must be repotletl an ScheEule I. ITEM NUMBER �ESCRIPTION AMOUNT A. FUNERALEXPENSES. i. W Orville Kimmel Funeral Home-funeral expenses 6,291. 05 2 • St • John Cemetery-services rendered 1,800 • 00 B. ADMINISTRATIVE WSTS: 1. PersonalRepresenlative Commissions' Name�s)ot Personal Representa�ive�s� Streetatltlress Ciry Stale ZIP Vear�S�Commission Paid: z. nnor�eyFees�. Stone LaFaver B Shekletski 1,500 • 00 3. FamoyE.amn�io��.!itdewdem'sedaressisnouhesameasciaimenrs,anache*nia�auo�) 3�500 • 00 aa�mant Malqorzata Sudol sireeinaere:s 931 Wi1lQiff Drive c;y Mechanics6urq S�a�e PA zia 17050 aeiaaonsn�poiCiaimanuooeaeaem Survivinq spouse a. a�ooa�eFees�. Cum6erland County 128 • 5� 5 AccaumamFees' 6. TaxRelumPreparerFees'. z Federal express debit pd directly from chking acct 73•03 2 Automatic payment to Com Pur from chkinq acct 27. 00 3 Register of Wills-filing ITR and Inventory 30 � 00 4 Reserve for closing expenses 100 • 00 TOTAL(AlsoenlaronLine9,Recapitula6on) S L3,449 • 58 Ii more spam le naedetl,use eatlltlonal sheets o!peper oi Ne seme 6izB. RPV.1512 EX�(�2-121 pennsylvania SCHEDULE I oePAr+*mEnroF aEve��e DEBTS OF DECEDENT� w�+eair,�Hcer,+xREruav MORTGAGE LIABILITIES& LIENS aEsioErvroECEOErvr ESTATE OF FILE NUMBER STANISLAW Z • SUDOL 21 14 0729 Report de6ta Incurred bylhe decedent prior lo death that remained unpaid at the date af death,including unreimhursed mMical expenses. ITEM VA W E AT DATE NUMBER DESCRIPTION OF�EpTH i. Capital One-VISA Card #48�2139779215571 796 • 18 2 . Capital One-MasterCard a5178059823441648 978 •90 3 • Capital One-MasterCard #5155970039662420 270 •14 4 . West Shore EMS-ALS - de6t of decedent 270 . 00 TOTAL(Also en�er on Line 10,Recapi�ulafionl E 2.315 • 22 If more space is needetl,insert atldi�ional sM1ee[s of[he same size. REV-15t3 E%�(C�-10) pennsylvania SCHEDULE J oeanarmEHr oF aeveN�e BENEFICIARIES INHERIiqNW iq%REipRN aEsi;ErvroECEOENr ESTATE OF: FILE NUMBER: STANISLAW Z • SUDOL 21 14 0729 RELATIONSHIPTODECEDENT AMOUNTORSHARE NUMBER NAMEANDA�DRESSOFPERSON�S�RECEIVIN6PROPERTY OONotLislTmslee�s) OFESTATE � TAXABLEDISTRIBUTIONS pnclu0eoutrigh�spousaltlistn�u�ionsantllransfersuntler Sec 9118(e�(12�.1 i. MALGORZATA SIJDOL Spousal 0 . 00 931 WILLCLIFF DRIVE MECHANICSBURG, PA 1705� EMER DOLLAR AMOUMS FOR DISTRIBUTIONS SHOWN ABOVE ON LMES 15 THROUGH 18 OF REV�1500 COVER SHEET,AS APPROPRIATE. ��. NON-TAXABLE DISTRIBUTIONS' A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN'. 1. B.CHARITABLE ANO GOVERNMEMAL DISTRIBUTIONS'. 1 TOTAL OF PART II- EMER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 130F REV�1500 COVER SHEET. S I(more space is neetled,use addilional sheets ol paper of the same size. �� Frst National Banl< 4140 East State Sireet, Hermitage, PA 161483487 724-981-6000 August 26, 2014 Smne LaFaver& Shekletski Attornevs a[ Law 41� Bridge Street Pn Bor E New Cumberland, PA 17070 RE: STANISLAW Z SUDOL SSN: 396-84-0767 Dear Sir or Madain, As per your request, the following information is provided as of 6/29/2014: Checkine H 95021961 Opened 6/23/OS Titled CADM Stanislaw Z Sudol Balance $14,572.06 Accrued Inrerest $0.00 Sole Pmprieturship If you should have any further questions, please do no[ hesitate to con[act me at 724-983-2427. Very tmly yours FIRST NATIONAL BANK Ka�e� Tl�w-w�.ay Kate Thomas Jexioa,<iivi, 1505614134 REV-1500 OFFILIAL OSE ONLY Bureau ot Intlividual Taxes Counry Go4e Year File Number Po Box zeosoi �NHERITANCE TAX RETURN 2 1 1 y p 7 2 9 Harrisbur PA nt28-osoi RESIDENT DECEDENT ENtER DECEOENTINFORMATION BELOW $Ocial Sew�ity Numb¢� Date of�e2th MMO�VYYV Dd�¢Of Birth MMDOVYYY 3 9 6 8 4 0 7 6 7 0 6 2 9 2 0 1 4 0 7 1 9 1 9 5 8 Oecetlenfs Last Name Sufflx DewtlenCs Firsl Name MI S U D 0 L S T A N I S L A W Z (I�Applicable)Enler Surviving Spouse's Information Below Spouse'sLastName Suffix Spouse'sFirsWame MI S U D 0 L M A L G 0 R Z A T A THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BEIOW O 1.Original ReWm � 2. Supplemenlal Retum � 3. Remaintler ReWm(tla�e of dealh Prior to 12-13A2) � 4 AgriwlNre ExemO�ion � 5. FuWre Interes[Compromise(tlale of � 6. Federal Es[ate Tax ReWm Requiretl (ddIC01QEB[h0l101eflB1�-0-2�12) dCdlhdM¢f1242-82) � t. Decetlent Dietl Testa[e � 8. Decetleni MaiMained a Living Tms� � 9.Total Number of Safe Deposil Boxes �Atlachwpyo(wi0.) (AtlacM1copyolimst) � 10. Lltigation Pmceetls Received � 11. Non-Probate Transferee Re[um � 12. DeferrallEleciion ot Spousal Tmsts (Schetlule F and G Assets only) ❑ 13. Business Assets ❑ i<. Spouse is Sole Beneficiary (No trust imolved) CORRESPONOENT-THIS SELTION MUST BE COMPLETED.ALL CORRESPONDENCE ANO CONFIDENTIAL TA%INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number D A V I D H S T 0 N E , E S Q U I R E 7 1 7 7 7 4 7 4 3 5 First Line of Atltlress 4 1 4 8 R I D G E S T R E E T Sewntl Line of Adtlress Cl�y or Pos�Offme State ZIP Code N E W C U M B E R L A N D P A 1 7 0 7 0 Correspondent'se-ma�laddress: DSTONEaSTONELAW • NET REGIST[ROFWILLSU$E�ONLY- '� �� _ .____ C � 'J RF615IEROFW L6V9EONLV ! � � DAiE FREO MMODYYYY_ _ � ' � ' �T__J � � , C; OATEFILEDSiAMP�� _—. _. - .. .� . � ,, .1 � l Cl ' I OJ PLEASE USE ORIGINAL FORM ONLY Side 1 L IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 1505614134 15�5614134 J J 1505614234 REV4500 E%(Fp DecetlenCs Sacial Sewrity Number oe�eaemsName�. STANISLAW Z . SUDOL 3 9 6 8 4 0 7 6 7 RECAPITUTATION 1. Real Eslate(5chetlule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. ' 2. S�ocks antl Bontls(Schetlule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Z. ' 3. Closely Heltl Corporetion, Patlnership or Sole-0mprietorshlp(Schedule C) . . . . . 3 ' 4. Mortgages and Notes Receivable(Schedule 0) . . . . . . . . . . . . . . . . . . . . . . . . . . 4. ' 5. Cash,eank Depasits and Miscellaneous Personal PropeRy(Schetlule E). . . . . . . 5. 1 4 5 7 2 . � 6 6. Jointly Ownetl PropeRy(Schetlule F) ❑ Separa[e Billing RequesteE . . . . . . . 6. ' �. Inter-Vivos Transfers&Miscellaneous Ng�Probate Pmpetly (ScheCule G) U Separate Billing ReQuested . . . . . . . 1. • e. roiai c�oss n:se�Ro�ai u�es i m�o�yn�� . _ . . . _ _ . . . e. 1 4 5 7 2 , 0 6 9. Funeral Expenses antl Adminis[ra�ive Cosls(Scheaule H) . . . . . . . . . . . . . . . . . . 9. 1 3 4 4 9 . 5 8 10. Debts ot Decetlent,Mongage�iaeibties,antl�iens(Schetlule p . . . . . . . . .. . . . to. 2 3 1 5 . 2 2 >>. rowi oea�cno�s(m�ai u�es s a�a iol _ _ _ . . _ . . . _ . . . . . . _ _ _ _ _ i i. 1 5 7 6 4 . B 0 12. NetvalueotESWle(LineBminusLinell) . . . . . . . . . . . . . . . . .. . . . . .. . . . . �2_ - 1 1 9 2 . 7 4 13. Charilable antl Govemmental BequeslslSec 9113 Trus�s for wM1ich an elec[ion to�ax has no�been matle(Schetlule J) . . . . . . . . . . . . . . . . . . . . . . �3� • 14. Ne[Value Sublect ro Taz(Line 12 minus Line 13) . . . . . . . . . . . . . . . . 14. - 1 1 9 2 . 7 4 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount ot Line 14 taxable at�he spousal tax�ate.or Uansfers untler Sec. 9116 p , � Q 15. � . � � (a)(L2)X.00_ 16. Fmoun�of�ine 141axable O . O O al Ilneal ra�e X A_ 0 . 0 � i6. n. Amount ot Line ta taxabie 0 � � �� p . 0 0 at sibling rate X.12 iB. Amount of line 14 taxable at collaleral rate %.15 � • 0 � �g. � • � � 19. TAX Dl1E . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. � . � � 20. FILL IN THE OVAL IF YOU ARE REOl1ESTING A REFUNO OF AN OVERVAVMENT ❑ UnOer penalties of Oerlury.I declare 1 have examinetl�his reWm.lncluding acwmpanying scM1etlules and s�a�ements,an010�ne bes�of my knowletlge and Uelie[ I�is tme.correct ane mmplete.�xleraLon ol preparer ol�er Nan�M1e Derson responsiEla for flling Ne reWrn is Oasetl on all Inlormation of wM1ic�preperer M1as any knowletlge. 51 NN E F PERSON R PON51 �OR FI G TURN �AT �/ �DaESS 931 WILL F RIVE MECHANICSBURG PA 17050 SIGNNT A E ER THAN PERSON RESPONSIBLE FOR FlLING THE RETURN DNTE _ � ' ADDRES ' 414 GE S EET NEW CUMBERLAND PA 17070 I I�IIII IIIIIIIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIIIIII Sitle 2 L 15�5614234 15�5614234 � REV4500EX �FI� pa9P3 FileNumOer DecedenYs Complete Address: 21 14 0729 DECEDENT'SNAME STANISLAW Z � SUDOL _ _ .. . _ _. _ .._ _ . ____. _ . .. __. _._.__ __ _ . srREEraooaess 931 WILLCLIFF DRIVE _ _ . . . _____. .. _ . . _ .. ___.- ._ CITY� STATE ZIP MECHANICSBURG . PA � 17�5�- Tax Payments and Credits: �- Tax Oue�Page 2,Line 19) (1) 0 � 0 0 2. Credits/Payments A.PriorPayments ._ .. . .._ B.Discaunt _ _. .___- (See'msVuctlons.) TolalCre�ils(A+B) (2) 0 • 0� 3. mterest �3� 0 . 00 4. I�Line 2 is qreater ihan Line 1 a Line 3,enter the OiHerence.This is�he OVERPAYMENT. Fill in oval on Page Y,Line EOIo requesla refund. (4) 0 • 0� 5. H line 1 .Llne 3 is grea�er than Llne 2,en�er�he tlitterence.Thls Is the TA%DUE. (5) 0 •00 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS 8Y PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Diddeceden�makeaVans�erand: �es No a. re�ain�heuseorincomeoflhepropeM1ylransferred ..... .__.._ _.. ..._ ❑ � b. re�ain�herighltodesigna�ewhoshallusethepropenytransferredon�sincome _.. ..... ❑ � c. retain a reversionary mterest ............ ......... ..... _... ....... ❑ ❑ tl. receive�hepromisefor6feofeitherpayments,benefilsorrare� ..... .__ .._... x 2. N dealh accurred afler�ec. 12,1982,did Decedent transfer propetly wdhm one year of dea�h withaWreceivingadequa�econsideration? ._._..... ......... ........_._... ....... ❑ � 3. �iddecedenlownan'in�mslfor'orpayableupon-0ealhbankaccounlor6ecutl�yelhlsorhe�death� ......_ ❑ ❑X 4. Oitl Oeceden�own an indivitlual retiremem account,annuity or o�her non-probate pmpetly,which mntainsabene9ciarytlesignation?......... ......... ._._... ._..__................. ❑ 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Po�dates of deat�on or after July 1, 1994, and before Jan. 1, 1995,the tax ra�e imposed an�he ne�value oi transfers ro or for ihe use o�the surviving spouse is 3 percent[72 P.S.§9116(a) (1.1)(i�]. For dates of tlea�h on or afler Jan. 1, 1995, the tax rate imposed on Ihe ne�value of iransfers lo or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a) (1.1)(ii)].The statute does not exempt a transter�o a surviving spouse from tae,and the sUNtory repuirements tor tlisclosure of asse�s and fling a lax reWm are still applicable even if the surviving spouse is the only benefciary. For tlates o(death on or after July 1,2000: • The tax rete imposed on the net value of transfers from a deceased child 21 years of age or younger at death ro or for ihe use of a natural parent,an adoptive parent or a step-parent of�he child is 0 percent[72 P.S.§9116(a)�12�]. • The tae ate imposetl on tha net value of transfers�o or for the use o�the tleceaenYs Ilneal beneilciades ls 4.5 pement,except as notetl in �72 P.S. 4911fi�a)(1)]. • The tax rate imposed on ihe nel value of transfers to or for ihe use of the decedenCs siblings is 12 percent�72 P.S.§9116(a)(1.3)�.A si6ling is defned, under Section 9102,as an intlividual who has at least one parent in wmmon with the decedent whether 6y blootl or adoption. REV-1508 E%+(0&12) pennsylvania SCHEDULE E oEaaa.Me�+roFREvervue CASH, BANK DEPOSITS & MISC. iuHEaanHcerazaEruae pERSONAL PROPERTY aesioer�roEceo�rvr ESTATE OF: FILE NIIMBER: STANISLAW Z � SUDOL 21 14 0729 Inclutle Ihe proceetls of litigation antl Ihe date the pmceeds were received by Ne esla�e. All proparty joinlly ownetl with rigM ot survivorship mus[be tlisclosetl on Schedule F. ITEM VALUE AT DATE Nl1MBER DESCRIPTION OFDEATH i First National Bank—Checking Acct �95021961 14,572 . 06 TOTAL(Also enter on Line 6,Recapitulalion) E 14.572 • 06 If more space is needeq use adtlitional sheets o(paper of the same size. FEV-1511 EX��08�13) pennsylvania SCHEDULE H °E'"aT""`"'o`RE�E""` FUNERAIEXPENSESAND irvHEairaNCErsxaEruau ADMINISTRATIVECOSTS aEsioEn*oECEOEvr ESTATE OF FILE NIIMBER STANISLAW Z • SIJDOL 21 14 0729 �ecetlenPs OeMs must be reportetl an Schedule�. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERALERPENSES' i. W Orville Kimmel Funeral Home—funeral expenses 6,291 • OS 2 • St � John Cemetery—services rendered 1,800 • 00 B. ADMINISTRATIVECOSTS'. 1. Personai Represenlative Cammissions�. Name(s)ot Personal Represan�eiive�s� S�ree�Aatlress C�iry S1ate ZIP Year�s)Commission Paa. z, nnomeyFees: Stone LaFaver 8 Shekletski 1,500 . 00 3. FamilyExemptiom(IltleceUenYsadaressisnol�tesameasclaimanfs,aAachexplanation.) 3i500 • 0� aa�mam Malqorzata Sudol s�ree�nderess 931 Wi1lQiff Drive c;ryMechanicsburq sta�e PA na17050 Rela�ions�ipo�Qaiman�loDeceaen� S�rVlVlflq Sp0U5e a. proba�eFees. Cumberland County 128 • 50 5 A�unlanlFees: 6. TaxReWmPreparerFees�. z Federal express debit pd directly from chking acct 73 • �3 2 Automatic payment to Com Pur from chkinq acct 27 • 00 3 Regis[er of Wills—filing ITR and Inventory 3� � �� 4 Reserve far clasing expenses Loo . 00 TOTAL(Alsoen�eronCine9,RecapiWla�lon) S y3�449 •58 Ifmore spaceis neeaetl,use atltlitionals�eets o�paperol�M1e same size. REV-rv512 EX�(12-02) pennsylvania SCHEDULE I oEvnRrmEn�oFaEVErvue DEBTSOFDECEDENT� wnEai,Ar�cE-.+xR_.�aN MORTGAGE LIABILITIES & LIENS a�sioErvroECEOENr ESTATE OF FILE NUMBER STANISLAW Z • SUDOL 21 14 0729 Report debk inwrretl by Ihe tlecetlent prior to death that remained unpaid at the tlate of dealh,including unreimbursetl medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH i. Capital One-VISA Card �48�2139779215571 796•18 2 • Capital One-MasterCard a5178059823441648 978 • 90 3 • Capital One-MasterCard #5155970039662420 270 • 14 4 . West Shore EMS-A�S - deht of decedent 270 •00 TOTAL(Alsoen�eronLinel�,RecapiWla�ion) E 2,315• 22 I�more space is needetl,insert addilional sheels o��he same size. aev-�s�a ex.ioi-ioi pennsylvania SCHEDULE J oePar+*me�+roFaevEuuE BENEFICIARIES IVHERIiANGETAXREIUHN RESiDENiDECECEN` ESTATE Of: FILE NUMBER: STANISLAW Z . SIJDOL 21 14 �729 RELATIONSHIPTO�ECEDENT AMOUNTORSHARE NUMBER NAME AND AO�RESS OF PERSON�S)RECEIVING PROPERTV �o Not ListTmslee�s) OF ESTATE � TAXABLEDISTRIBUTIONS pncWaeoutnghispousaltlisVibmionsantllrans�ersuntler Sac91161e1(��I�I i. MALGORZATA Sl1DOL Spousal a •00 931 WILLCLIFF DRIVE MECHANICSBURG , PA 17050 ENTER�OLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LWES 15 THROUGH 180F REV-0500 COVER SHEET,AS APPROPRIATE. ��, NON-TAXABLE�ISTRIBUTIONS: A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B.CHARITABLE AN�GOVERNMENTAL DISTRIBl1T10N5'. 1. TOTAL OF PART I I - EMER TOTAL NON-TAXABLE DISTRIBUTIONS ON LWE 13 OF REV-1500 COVER SHEET. $ If more space is needed,use aaditianal sheets of paper of the same size. �� Frst National Banl< 4140 East State Sireet, Hermitage, PA 16148-3487 724-981-6000 August 26, 2014 Stone LaFaver& Shekletski Attorneys a[Law 41J �ridge Street PO Hox E New Cumbedand, PA 17070 RE: STANISLAW Z SUDOL SSN: 396-84-0767 Dear Sir or Madam, As per vour request, the following infortnation is provided as of 6/29/2014: Checkine k 95021961 Opened 6/23/08 Titled CADM S[anislaw Z Sudol Balance $14,572.06 Accrued Incerest $0.00 Sole Proprietorship If you should have any furthec questions, please do not hesitate to contact me at 724-983-2427. Very tmly yours FiRST NATIONAL BANK Ka�}2 TNa-w�ay Kate Thomas INVENTORY REGISTBR OF WILLS OF CUMBERLAND COLJNTY, PBNNSYLVANIA COMMONWGALTHOPP�NTSYI VANIA COIJNTVOP CUMBERLAND 5S FileNumber �1 14 0729 Versonal Reprerentativc(s)ofthe Estare af STANISLAW ZBIGMEW SUDOL deccased, depose(s)and say(s)that[he itcros appearing in the following imenrory include all oClhc personal assets wherever siNate and aIl oC the real eslale in Ihe Cortunomveal[h of Pennsylvnnia of said Decedent,[ha[[he valuation placed opposite eech item of said inventory represents its fuir value as ofthe dete of[he decedenCs death,and that Dcceden[owned no real esta[e outside ofthe Cmnmonweal[h of Pennsylvania except that which appears in a menmeand�m at Ihe end of this invemory. I venl'y tha[the slarements madc in this Inven- ��A��Q_ �,�_� tory are tme and correcL I understand that false sta�e- � MALGOR TA SUDOL, ADMINISTRATRIX ments herein are made suhjcct m[he penalties of 18 Pa.C.S. §4904 relating to unswom Celsifica[ion ro authorities. A[rorney -- (Nnme/ DAVID H STONE ESQUIRE (SupremeCourtLD. No.) 39785 lAddress) 414 BRIDGE STREET P.O. BOX E NEW CUMBERLAND PA 17070- (Telephone� (717)7747435 onreaFOEa.n usraesioervcE oECEOEHrssocsec �+o 931 WILLCLIFF DRIVE 6/29/2014 MECHANICSBURG PA 17050- 396-84-0767 FIGURES MUST BE TOTALF.D First National Bank-Checking Acct#95021961 14,572.06 c� -, , : o �i � � � r � i c;, � i (Attnch aAditlonal sHeefs as needeA) TOTAL: 14,572.06 VOTE' The Memornndum of rcal¢lev wtsiae th.Communwcnl@ ofPennsylvnnia may,et tl�e eleminn nfdm personal rcpecscnta�ive includeihe vuluc ol cudi nem,bm.mch fguresshonld noi hc�mndctl Inm tha mml of iM1e Invcn�op�.ISee 10 Po.CC§130i(A)/ Form RIV'-09 rev. 10.13.116 STONE LAFAVEA & SHEKLETSKI FTTORNEYS AT LAW 414 BPIDGE STREET OAVIO H.STONE POST OFFICE 90%E OF COIlNSEL GERhtDJ.SMEftLETSKI New Ccnace�wNo.PA 1"]O"JO CHFRLES H.STONE wwwstonelaw.rtet JON F LwFAVER TELEPHONE P I])�9G-]<35 MaTC11 17� ZQZrJ FACSIMILE p19j]J4-98fi9 Register of Wills Office Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3887 RE: Estate of Stanislaw Zbigniew Sudol No. 21-14-0729 Greetings : Enclosed please find an original and one copy of the Inheritance Tax Return and Inventory for the above mentioned estate. Please clock in the copy of the Inventory and send it back to my office along with any receipts in the enclosed stamp addressed envelope. Should you have any questions, please do not hesitate to contact my office . Very truly yours, STONE La ER & SHEKLETSKI avid Stone DHS/tmb Enclosures c� <:_ � �� - � � n> u i �-' i � � � N -� � z E M n v > r c o 3 y A D D ,��i:�:fl ._ . -.. .. _ moa < f - - -. � ... aromo . . .. . � ^_ mAr zm �, R> m (�; � O m y y N l I :i1.� =� I-� � . �_� D K m � � m � r, r �n - - " 0�?.:'� . . . � � � �„�, .. -; .� r. z > ,� c . _ Q j �' _ [T ,'^, � '� � n T ' � o 0 _ i 'J � ^ � _, n c - � � � � �� y a m < =� n � x o � V G .� S O N � 3 0 o UNII� ao S m � � 9� ava {"n A o+ \ O 3o� I�� Y � m � 3 I �pO o � mw� ` O� � To � � T o�, o �