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HomeMy WebLinkAbout01-0081 REV-1500 EX + (6-00) OFFICIAL USE ONLY I COMMONWEALTH OF PENNSYLVANIA REV-1500 I~ ,;tD,3 ID , "' - - DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER HARRISBURG, PA 17128.0601 RESIDENT DECEDENT 21 2001 0081 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Rabena , Julius M. 195-07-5998 DECE- DATE OF DEATH (MM.DD.YEAR) I DATE OF BIRTH (MM.DD.YEAR) THIS RETURN MUST BE FILED IN DUPLICATE DENT 12/19/00 01/31/1915 WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 3. Remainder Return CHECK ~',..,- ~' Supplemental Return B (date of death prior to 12.13.82) APPRO- 4. Limited Estate 4a. Future Interest Compromise 5. Federal Estate Tax Return Required (date of death after 12-12-82) PRIATE 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach copy of Will) (Attach a copy 01 Trust) BLOCKS 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date 01 death between 0 11. Election to tax under Sec. 9113(A) 12-31-91 and H-95) (AlIachSchQ) tjji$-$~~(\\)jstllgqQI\WIii;!i;q;iM;4CQjjli~IWj;;~ji!;\Q~fltij;);j!t!AliTA*ji'if~jijMA"(jQl'-I$HQ!J4j}!mtjjR~$ti!PTo; NAME COMPLETE MAILING ADDRESS COR- David H. Stone, Esquire 414 Bridge Street RE- FIRM NAME -w 4"....f;"",hl",\ Ne\\,.Curri:Jerland. PI\ 17070 SPON DENT Stone LaFaver & :onekletski TELEPHONE NUMBER (717) 774-7435 OFFICIAL USE ONLY 1. Real Estate (Sc~ed:.J!3 A) (1) 72,885.00 2. Stocks and Bonns (S.,;hedule B) (2) 123,913.96 3. Closely Held Corporation. Partnership or Sole-Proprietorship (3) None 4. Mortgages & Notes FleceivabJe (Schedule 0) (4) NOne 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 47,542.75 6. Jointly Owned Property (Schedule F) D Separate Bijhng Requested (6) None RECA- PITULA- 7. Inter-Vivos Transfers & Miscellaneous I TION Non-Probate Property (Schedule G or L) (7) None 8. Total Gross Assets (total Lines 1-7) (8) 244,341.71 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 23,945.01 10. Debts of Decedent, Mortgage Liabilities, & Uens (Schedule I) (10) 3,135.26 11. Total Oeductlons (total Lines 9 & 10) (11) 27,080.27 12. Net Value of Estate (Line 8 minus Line 11) (12) 217,261. 44 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax (13) 30,000.00 has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 187,261. 44 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amount of Line 14 taxable attha spousal tax rata. or transfers undar Sac. 9116 (a}(1.2) X .0 (15) 16. Amount of Una 14 taxable atlinaal rate 0.00 X.O 45 (16) 0.00 TAX - COMPU- 17. Amount of Line 14taxabla at sibling rata 187,261. 44 x .12 (17) 22,471.37 TATION 18. Amount of Una 14 taxable at collateral rata 0.00 X .15 (18) 0.00 19. Tax Due (19) 22,471.37 20. 0 Iqll~pKij~I'Il$!FYQliAll~!l~Qij~$TIf<<jA!leftlNPQ#MQ\Ii!!j"Amf)!ft..j . . .~"SESLlI'l:l!'rOANSWEl'\ALl,;OUesrIONsONPAal!;2ANDRECHl!:CKMATH"" . o PA15001 NTF 29755 Copyright 2000 GreatlandlNalco LP - Fonns Software Only PA REV.1500 EX (6-00) DjiCedep,t's ComDlete Address: Js~;:ET . JDRESS 405 15th Street Page 2 CITY New Cumberland Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A Spousal Poverty Credit B. Prior Payments C. Discount I STATE PA I ZIP 17070 (1) 22,471-37 21,084.54 1,052.63 Total Credits (A + B + C) (2) 22,137.17 3. Interest/Penalty if applicable D. Interest E. Penalty Total interesVPenalty (0 + E) (3) 4. If Une 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Une 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 interestonthe tBV ri'IO (SA) B. Enter the total of Line 5 + SA. This is the IlALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT _ 0.00 334.20 0.00 334.20 ~[~,~~rX~~!~~+~~~~~i.~~i~~~G~~+l6~~~~~~6i~~x~r;;i;;l~~~~~~~~~~r.;:~~:~:~66~~ 1. Did decedent make a transfer and: \"11':; No a. retain the use or income of th~ ?roperty transferred; . . . . . . . . . . . . . . . . . . . . . .. . . . . . . I, ! I b. retain the right to designai:a W'10 shall use the property transferred or its income; ! c. retain a reversionary intere.:.'; Dr.............. ...................... . ....... I I d, receive the promise for life of either payments, benefits or care? ...,.,.................., . . i .1 2. If death occurred after December 12. 1982, did decedent transfer property within one year of death without receiving adequate consideration? ......................,...,.......,................ I ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?" !. j ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non.probate property which_ contains a beneficiary designa~ion? .................................... . . . . . . . . . . . IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETUFiN. Under penalties of perjury, I declare that I have examined this return including accompanying schedules and statements, and to the best of my knowleCIge and belief, it is true, correct and complete. Declaration 0/ preparer other than the personal representative is based on information of which re arer has an knowled e. SIGN RSON RE ONSIBLE FOJ~ ~I . RN DATE ADORES ..}4~ j/~I ft- t-J\ See Schedule SIGNAT I' LJ ~ ched OTHER THAN REPRESENTATIVE DATE 1\- 1\ 17070 00 00 [72 P.S. Ii 9116 (a)(1.1) (i)]. For dates 0' death on or after January 1. 1995, the tax rate is imposed on the net value of transfers to or for the use of the I>urviving spouse is 0% (72 P_S. fj 9116 (a) (1.1) (ii)j. The statute dOA!,; not AlIAmnt a transfer to a surviving spouse from tax. and the statutory requirements for disclosure of assets and fiiing a tax return are stili applicable e' '" 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. 19116(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. Ii 9116(1.2) [72 P,S. i9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use 0' the decedent's siblings is 12% [72 P.S. 19116(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. o PA15002 NTF 29756 Copyright 2000 GreatlandlNelco LP - Forms Software Only ~statE: of: Julius M. Rabena 21-2001-0081 The following person(s) are signing the return as representative(s) of the estate: Thecx:1ore A. Rabena 405 15th Street New Cumberland, PA 17070 REV-1502 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA I"HERITANCE TAX RETURN .~ESIDENT DECEDENT ESTATE OF Julius M. Rabena SCHEDULE A REAL ESTATE FILE NUMBER 21-2001-0081 All real property owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a wllJing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which Is jointly-owned with right of survivorship must be dIsclosed on Schedule F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 1/2 interest in property located at 405 15th St., New Cumberland, Cumberland County, PA by deed dated September 11, 1997 and recorded in Cumberland County Deed Book 166, Page 422, granted and conveyed unto Theodore A. Rabena and Julius Rabena, as tenants in carmon. Value at assessed value $145,770 divided by2 72,885.00 7 CPA21 NTF 10904 Copyright Forms Software Only. 1997 Nelco. )nc TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 72,885.00 REV.1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA ItJHERITANCE TAX RETURN . RESIDENT DECEDENT ESTATE OF Julius M. Rabena SCHEDULE B STOCKS & BONDS FILE NUMBER 21-2001-0081 All property Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 Hilliard Lyons-11,972.363 shs. Black Rock Gov't Inc Fund B @ $10.35 per share 123,913 . 96 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same Size) 123,913.96 7 CPA31 NTF 10905 Copyright Forms Software Only, 1997 Nelco, Inc REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Julius M. Rabena 21-2001-0081 Include proceeds of litigation & dale proceeds were received by the estate. All Drop. faintly-owned with rlaht of survivorship must be disclosed on Sch. F. ITEM VALUE AT NO. DESCRIPTION DATE OF DEATH 1 PNC Bank-Checking Acct. #5140051179 14,767.59 Interest on above item accrued as of decedent's death 4.33 2 PNC Bank-Savings Acct. #5001029932 5,797.51 Interest on above item accrued as of decedent's death 13 .84 3 PNC Bank-Savings Acct. #5130060055 12,804.04 Interest on above item accrued as of decedent's death 10.92 4 PNC Bank-Cert. of Deposit #21001017326 11,323.14 Interest on above item accrued as of decedent's death 36.38 5 1988 Chrysler New Yorker Sedan 4D 2,785.00 7 CPA81 NTF 1090S Copyright Forms Software Only, 1997 Nelco, Inc. TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 47,542.75 REV.151 1 EX.. (1-97) , COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Julius M. Rabena SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-2001-0081 Debts of decedent must be reDorted on Schedule I. ITEM NO. A. FUNERAL EXPENSES: DESCRIPTION AMOUNT 1 partherrore Funeral Horre-fllileral expenses 7,441.20 B. . ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representat\ve(s) Social Security Number(s}/EIN No. of Personal Aepresentative{s) Street Address 0.00 City State Zip Year{s) Commission Paid: 2. Attorney Fees Narre: David H. Stone, Esquire 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Theodore A. Rabena Street Address 405 15th Street City New Cumberland State PA Zip 17070 Relationship of Claimant to Decedent brother 12,077.00 3,500.00 4. Probate Fees 258.00 5. Accountant's Fees 0.00 6. Tax Return Preparer's Fees 0.00 7 Cumberland Law Journal-advertising grant of letters 75.00 8 The Patriot News Co. -advertising grant of letters 93.81 9 Reserve for filing Inheritance Tax RetUlll, Inventory, First and Final AcCOllilt and closing expenses 500.00 TOTAL (Also enter on line 9, Recapitulation) $ <If more space is needed, insert additional sheets of the same size) 23,945.01 7 CPA11 NTF10911 Copynght Forms Software Only. 1997 Nelco. Inc REV-1512 EX + (1-97) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Julius M. Rabena Include unreimbursed medical expenses. ITEM NO. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21-2001-0081 DESCRIPTION AMOUNT 1 West Shore EMS-arclJulance service 42.00 2 Pharmerica-debt of last illness 266.00 3 Brockie Pharmatech-debt of last illness 618.04 4 Rayrrond C. Grandon, M.D. -services rendered 12.45 5 East Pennsl::oro Ambulance-service to hospital 7.05 6 Aka VI, lLC (Creekview) -nursing hare services 648.82 7 East Pennsboro Ambulance-service from hospital 100.00 8 Camp Hill Care Center-services at hare 1,233.03 9 Quantum Iffi3.g. & Ther. -services rendered 4.66 10 Quantum Iffi3.g. & Ther. -services rendered 36.81 11 Susquehanna Surgeons, LID-services rendered 2.91 12 Pinnacle Health Hospital-services rendered 163.49 7 CPA12 NTF 10912 TOTAL (Arso enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 3,135.26 Copyright FOJTIls Software Only, 1997 Nelco. Inc. REV-1513 EX + (1-97) . COM~)NWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER No. NAME ANO ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 21-2001-0081 RELATiONSHIP TO DECEDENT AMOUNT OR Do Not Ust Trustee(s) SHARE OF ESTATE Julius M. Rabena 1 Theodore A. Rabena 405 15th Street New Cumberland, PA 17070 brother 187,261. 44 ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 17 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 None B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 New Cumberland Fire Departrrent 319 Fourth Street New Cumberland, PA 17070 15,000.00 2 Trinity United Methodist Church Fourth and Bridge Streets New Cumberland, PA 17070 15,000.00 TOTAL OF PART II n ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 30,000.00 7 CPA13 NTF 10913 (If more space is needed, insert additional sheets 01 the same size) COpyright Forms Sottware Only, ,997 Nelco. Inc. ,W',,'_; "", ,"".-' ~'~~''.:,'' . ~ -'~'~. t,.: ~-:'~;',,~!:-:'.:.~. ..;....,..~ .~. :"';~'''-''~'''J'''~'~~..~~'' ~,_t " ;ft;" ... " . I _" . .". "",.1" ,.,..,. ,.' , . .,'. ....,,,i,;'%'.,. ... "., '. Mt~t#,.~_I~,1t'm:'" '''''-- +-n..l-s:...-,f'.l! '_7'>~:' "... .::. I ......~~..~, '''"'{. >,"I>~ "~~;''"'?P''~~'4 '1^~'i~~~."'~"<~1';!r~;;:.4,.~,~~" T,~ :.: ~I . ~. \:,~~'r:-:-~~~..,';,,-.- d' ,..fr't'< ',' ,~k':'(O;.{ 'd' ~ ......1 """. . ',-,. , ~I__ ,~-:If(ff.(....~ ~ . ";' ' . ~ ' ...;:' . /' ~. '. . f .. . r " . - :. , f~,J.:,,...,:J;.;<~,,. .(;~r..:;:"'i'...~t,~.t."J.,:~)'..:'~..,,~~Y'~~. -;'" ,~~~~,'J,,'i-,,<,, ':. <}'i(;._...~~._..+.".,-,~:!.;a}&.~"iJ.:.1t:i~(r,~.,{,'~il."'2(~'\.~\I..~'~~;~'';'~ ~.;-:If ~!"i.l';~T>' lP',"'~,+ ~ ... LAST WILL AND TESTAMENT OF JULIUS M. RABENA I, JULIUS M. RABENA, of 405 15th Street, New Cumberland, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I give and bequeath $15,000 to the New Cumberland Fire Department. ITEM II: I give and bequeath $15,000 to TrlniEy united Methodist Church of New Cumberland, Pennsylvania. ITEM III: I give, devise and bequeath all the rest, residue and remainder of my estate to my brother, Theodore A. Rabena. ITEM IV: I name my brother, Theodore A. Rabena, executor of this my last will. IN WITNESS WHEREOF, I, Julius M. Rabena, /J;:- f<.. day of i}' J -- have hereunto set my hand and seal this , 1997. Page 1 of 3 ~' . COMMONWEALTH OF PENNSYLVANIA : : ss: COUNTY OF CUMBERLAND . . We, ~,;.\A~ and ~~(J ,~ , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw Testator sign and execute the instrument as his last will; that Testator signed willingly and that he executed it as his free ,.arrd .....1.,1:ltary act for the purposes 'thereill "'A~ressed; that each of us in the hearing and sight of the Testator signed the will as witnesses; that to the best of our knowledge, the Testator was at that time eighteen or more years of age, of sound mind and under no con- straint or undue influence. Witness Sworn to or affirmed to and acknowledged before me by a ~ tj so&;..... , ~~.~ witnesses, this If? day of , 1997. Notary Publ~c NOTARIAL SEAL CON~-II.""f'-' V~'I"I "'r'- ph" I..... '~:.....: L. ('J",lll:, L.:;~JY uu:g~ New CumO:Ji!:md, FA Cumi:'2rl2.~d Ce. My Commission Expires April 13. 1999 Page 3 of 3 7172494878 HOv-et-B1 10:33 AM ccpe ..\d....\.I~,....,-M,..II. ;)~ (J~ ;::1 TAX pARCEL NO. 26-23-0543-523 l!W 1'HIS lNDEN'rURE made the I~ day at 5:t;-nJ~'" in. t.he year 199;, butween PNC BANK, N.A., EX~cutcr of th. Last Will and Te8tarnent ot HAAtA R. ZUMMO, late of the Borough af New Cumberland, County of C\lmberlana, and. Commonwealth of i1etlnaylvania, of the fir8t part, hereinafter called the Grantor, .. AUD .. THEon,,,:,!!' - ., ~~, JULIUS RABENA, a8 tenants in common, of the second part, hereinafter e.lled the Grantee., WHEREAS, the Baid HARIA R. ZU~10 became in her lifetime aeiBed, as of he I of a.nd in to a certain tJ..act of land, to';lether with the irnI1rovements thereon erected, dtual',e in tne Borough of New cumberland, County of cumberland., alld Commonwealth of P'enneylvaniA, anci more particularly delcribad her(<inafter; and beinq 110 th&reof sei..d, died on May 23. 1995, havih9 firet mA4e her Last Will and Testament in writinq dated May 29, 1974, duly probated and ~.9i8tered in the office of the 1\eghtsr of wllh ot CumbGrla.nd CQunt.y on Junl!J; 2'1, 199$, wherein and. whereby sl\e &ppointed a. Executo.t', Cumberland county National Sank <ll.nd 'Cru.t Co, now, by merger, PNC DANK, N.A., to ",hOrn letter. tB$tamen\;ary were duly i"8ued by .aid. llegiater of Wille on June 27, 199!:l, and wherein and whereby said promises hereina.t:ter descrikled ...,ere I<ot IIpecifically d.evieed, all as - I .. IOU! lGG rm 4Z! p.03 _..J ) , I / NQ'V-01-01 10:34 AM CCAC 7172494878 P.04 , .~ in and by said Will and the records of said Regi.t8r of Wills more fully appears; NOW THIS INDENTURE ~ITNESSETH, that the said Grantor, for and in consideration of the sum of ONE HUNDRED TWENTY TWO THOUSAND SEVEN HUNDRED FIFTY AND NO/100-----------($122,750.001------------ Dollars, which has been paid tQ-it b} -~_;,71tees at or before the sealing anct delivery hereof, receipt whereof is hereby acknowledged, has granted, bargained, .old, aliened, released and confirmed, and by the.e presents does grant, bar9ain, eell, alien, release and confirm unto the said Grantees, as tenant5 in common, ALL THAT CERTAIN lot or land situate in the Dorough of New Cumberland, formerly Lower Allen Township, Cumberland County, Pennsylvania, bounded and described as follows: !sOUNDED on tha Welilt by Lot No. 25, Sac::. ~E" in a plan hereinafter rnentionadl on tho North by Lot No. 12, Sec. "B" in II plan of Lots tlerll'inafter mentioned: on the E&5t .by Lot NO. 27, Sec. "'2" in plan of Lots hereinafter mentioned I and on the South by Pifteenth Street, beinq Lot No. 26, Sec. "E" Plall of Hilhide. u.id Plan record.ed in the ~ecordors Office in and for Cumberland County in Plan Book NO.1, Page 75, said tot No. 26, Sec. liE" fronting one hundred (100) feet on the north aide of Fifteenth Street, and extending back an ever. width three hundred eixty-eix (3661 feet, more Qr less. HAVING ~HEREON ERECTED a dwelling house known and numbered 48 405 15th Street, New Cumberland, pennsylvania. rOR title into the decedent, Bee Decree Awarding Real !atate recorded in Cumberland County O.ed Book 31-Y, Page 537. fOGE~HER with all and singular the buildings, improvements, ways, .treeta, alleye, paesag.e, water., water-couree., rights, liberties, privileges, hereditamenta and appurtenances whatliloa~8r, thereunto belonginq or in any wise appertaining and the reversions and - 2 - 800' 1GG 1m 423 re\dea\ZUHMO-HA.RIA il{5,1-:to..oo TAX PARCEL NO. 26-23-0543-523 THIS INDENTURE made the DEED day of , in the year 1996, between PNC BANK, N.A., Executor of the Last will and Testament of MARIA R. ZUMMO, late of the Borough of New Cumberland, County of cumberland, and Commonwealth of Pennsylvania, of the first part, hereinafter called the Grantor, -AND- THEODORE A. RABENA and JULIUS RABENA, as tenants in common, of the S"'-".Ida part, hereinafter called. theGri:21~.'.,::; WHEREAS, the said MARIA R. ZUMMO became in her lifetime seised, as of fee, of and in to a certain tract of land, together with the improvements thereon erected, situate in the Borough of New Cumberland, County of Cumberland, and Commonwealth of Pennsylvania, and more particularly described hereinafter; and being so thereof seised, died on May 23, 1995, having first made her Last will and Testament in writing dated May 29, 1974, duly probated and registered . in the Office of the Register of wills of Cumberland County on June 27, 1995, wherein and whereby she appointed as Executor, Cumberland County National Bank and Trust Co, now, by merger, PNC BANK, N.A., to whom letters testamentary were duly issued by said Register of Wills on June 27, 1995, and wherein and whereby said premises hereinafter described were not specifically devised, all as - 1 - in and by said will and the records of said Register of Wills more fully appears; NOW THIS INDENTURE WITNESSETH, that the said Grantor, for and in consideration of the sum of ONE HUNDRED TWENTY TWO THOUSAND SEVEN HUNDRED FIFTY AND NO/I00-----------($122,750.00)------------ Dollars, which has been paid to it by the said Grantees at or before the sealing and delivery hereof, receipt whereof is hereby acknowledged, has granted, bargained, sold, aliened, released and confirmed, and by these presents does grant, bargain, sell, alien, release and confirm unto the said Grantees, as tenants in common, ALL THAT CERTAIN lot or land situate in the Borough of New Cumberland, formerly Lower Allen Township, Cumberland County, Pennsylvania, bounded and described as follows: BOUNDED on the West by Lot No. 25, Sec. "E" in a plan hereinafter mentioned; on the North by Lot No. 12, Sec. "E" in a plan of Lots hereinafter mentioned; on the East by Lot No. 27, Sec. "E" in Plan of Lots hereinafter mentioned; and on the South by Fifteenth Street, being Lot No. 26, Sec. "E" Plan of Hillside, said Plan recorded in the Recorders Office in and for Cumberland County in Plan Book No.1, Page 75, said Lot No. 26, Sec. "E" fronting one hundred (100) feet on the north side of Fifteenth Street, and extending back an even width three hundred sixty-six (366) feet, more or less. HAVING THEREON ERECTED a dwelling house known and numbered as 405 15th Street, New Cumberland, Pennsylvania. FOR title into the decedent, see Decree Awarding Real Estate recorded in Cumberland County Deed Book 31-Y, Page 537. TOGETHER with all and singular the buildings, improvements, ways, streets, alleys, passages, waters, water-courses, rights, liberties, privileges, hereditaments and appurtenances whatsoever, thereunto belonging or in any wise appertaining and the reversions and - 2 - ~ remainders, rents, issues and profits thereof, and all the estate, right, title, interest, property, claim and demand whatsoever of her, the said MARIA R. ZUMMO, at and immediately before the time of her decease, in law, equity, or otherwise howsoever, of, in, to or out of the same. TO HAVE AND TO HOLD the said lot or piece of ground above described, with the buildings and improvements thereon erected, hereditaments and premises hereby granted or mentioned, and intewded so to be, with the appurtenances unto the said Grantees, to and for the only proper use and benoot of the said Grantees, forever. And the said Grantor, for itself and its respective successors and assigns, does covenant, promise and agree to and with the za:i.r.l Grantees, their heirs and assigns, that it, the said Grantor, has Lot heretofore done or committed any act, matter or thing whatsoever whereby the premises hereby granted, or any part thereof, is, are, shall or may be impeached, charged, or encumbered in title, charge, estate or otherwise howsoever. IN WITNESS WHEREOF, said Grantor has caused this Indenture to be executed by its who has hereunto set his hand and seal the day and year first above written. ATTEST: PNC BANK, N.A., Executor of the Last will and Testament of MARIA R. ZUMMO By - 3 - - COMMONWEALTH OF PENNSYLVANIA: COUNTY OF SS: On this, the day of , 1997, before me the undersigned officer, a Notary Public, personally appeared , who acknowledged himself to be the of PNC Bank, N.A., and that he as such officer being authorized to do so, executed the foregoing instru- ment for the purposes therein contained by signing the name of the Corp0rpr;n~ by himself as Notary Public I hereby certify that the precise address of the Grantee is 405 15th Street, New Cumberland, PA 17070. Attorney for COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND 55: RECORDED on this day of , A.D. 1997, in the Recorder's Office of the said county, in Deed Book , Page Given under my hand and the seal of the said office, the date above written. Recorder. - 4 - ". 1,1 , ~t."'" ... '''':;\"''1tJ . j h.~~. \, "'fJI ~' 1'~dI~ ~ '~., . j~ \ \ \ "~"-. ;I ~ HILLIARD LYONS 4242 Carlisle Pike Suite 237 Camp Hill. PA 17011 717-730-2331 . 877-409-3579 FAX 717-730-2416 January 25,2001 Attn: David H. Stone Stone, LaFaver & Shekletski 414 Bridge Street New Cumberland, PA 17070 Re: Estate of Julius M. Rabena Brokerage account #77817627 Date of Death value :-Dear I;_.' J, Julius Rabena had one brokerage account (#77817627) with Hilliard Lyons. As of the date of his death on December 19, 2000, the account held one position which was the Black Rock Government Income Fund B shares (Symbol PNGBX). There were 11,972.363 shares and the price per share was $10.35 on the date of death. The total value of the account on that date was $123,913.95. Please contact us ifthere is any additional information you need. Looking forward to the eventual liquidation of the account, we will need a death certificate, a short certificate, and the federal tax identification number for the estate. We will need to open an estate account with the executor signing the new account form and we will need a letter from the executor authorizing us to transfer the assets from the individual account into the trust account. From that point, we would then liquidate the account at the direction of the executor. Enclosed is a new account form for your use to initiate the process of opening the estate account. Please contact us at 717-730-2331 if you have any questions. We look forward to working with you toward the completion of this matter. Sincerely, <~.//./~ /:Uw~ . Bill Barton , J.J.B. Hilliard, w.L. Lyons, Inc. . Member New York Slack Exchange and SIre FEB-21-2001 11:10 P.01/02 . . o PNCB~N< Decedent Reporting Firstside Center P7-PFSC-4-F 500 First A venue Pittsburgh, PA 15219-3128 /SCP February 21, 2001 David H. Stone 414 Bridge Street P.O. Box E New Cumberland, P A 17070 RE: Estate of Julius M. Rabena, Deceased SSN: 195-07-5998 000: 12/19/2000 Dear Mr. Stone: Please find the date of death balances you have requested listed below. CERTIFICATE OF DEPOSIT #21001017326 Established 08/2511990 JULIUS M RABENA DOD Balance: $11,323.14 + $36.38 accrued interest CHECI<ING ACCOUNT #5140051179 Established 06/06/1990 JULIUS M RABENA DOD Balance: $14,767.59 + $4.33 accrued interest Page 1 of2 A member of The PNC Financial Services Group PN( R;-lnk N.A. Pi! l,ourgh Pt-nn<;ylvanlil 15265 FEB-21-2001 11:10 P.02/02 . . , ~PNCBAN< SAVINGS ACCOUNTS #5001029932 Established 05/12/1997 JULIUS M RABENA DOD Balance: $5,797.51 + $13.84 accrued interest #5130060055 Established 02/24/1986 JULIUS M RABENA DOD Balance: $12,804.04 + $10.92 accrued interest For Brokerage information, please call1-800-7e1:L-oJ l i. !NV #77817627 Our office only provides date of death balances for IRA's, CD's, Checking and Savings accounts. We do NO Financial Transactions or Statement Orders. For Further information please call1-800-4-BANKER or your local PNC Branch and ask to speak with a Financial Services Representative. Sincerely, . G1M/lJJk ~ Rachelle Sciullo 1-800- 762-1775 Page 2 of2 A member of The PNC financi2J Services Group PNC 'Bank N.A. Pittsburgh Pc:nnsylvania 15'65 TOTAL P.02 Kelley Blue Book Used Car Values Page I of I Kdey Blue Book kbb.com - guiding the car buyer New Car Prici og Bui Id a Car Incentives My Car's Value Used Car Retail Buy a New Car Buy a Used Car Sell Your Car Motorcydes Financing Insurance Lemon OIeck Warranties Accessories Car Revi ews Car Previews Ded si on Guides Advice About kbb Home INNOVATIVE DESIGN EXQUISITE FEATURES . . . . . . . . . . . . . SPIRITED PERFORMANCE Click on the image above to visit this advertiser Blue Book Retail Report Pennsylvania. October 24, 2001 1988 Chrysler New Yorker Sedan 40 Engine: V6 3.0 Liter Trans: A",:v,nc.tic Drive: Front Wheel Drive Mileage: 98,000 Buy a Used Car Financino Quot IllSUrilJlceQuOte \/"arrantv Quote Pre-Pl.lrcb'lse LnsPectioll Payment Calculator Equipment Air Conditioning Power Steering Power Windows AM/FM Stereo Retail Value $2,785 Suggested retail represents the price a dealership might ask for this make and model vehicle. This represents a fully reconditioned vehicle in excellent condition with a clean title history. This retail price is not a trade-in or private- party value, but rather assumes that a dealer has absorbed the cost of making the vehicle ready for sale, reconditioning, advertising, sales commissions, arranging for financing and insurance and standing behind the vehicle for any mechanical or safety problems. Many late model vehicles at this price have passed an inspection program or carry a warranty. Actual dealer selling price may vary from this price. Ge.t ..?l._~rj~Qte_.P?lrty,\"-~lYe G.e:t InvQi.c::e: St, M.SRPonNew Cars Copyright @ 2001 by Kelley Blue Book Co., All Rights Reserved. Sep-Oct 2001 Edition. The information in this report was printed from the Kelley Blue Book Web site (www.kbb.com) and is intended for the personal use of the customer only and may not be sold or transmitted to another party. We assume no responsibility for errors or omissions.(v.01090) INNOVATIVE DESIGN EXQUISITE fEATURES SPIRITED PERfORMANCE http://www.kbb.com/kb/ki.dll/kw.kc.ur?kbb.P A;828036& 1 7070;r&40;Chrysler; I 988%20Ne. . 10/24/01 Estate of Julius M. Rabena also known as PETITION FOR PROBATE and GRANt OF LEi.l.t:RS rLl... () I" ? I No. To: Register of Wills for the Deceased. County of Cumber land in the SocIai Security No. 1 Y!:>-O 7-5998 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 executor in the last will of the above decedent, dated Jul v 18 and cOdicil(s) dated named , 1997 (state relevant circumstances, e.g. renuncialion, clealh of executor, etc.) Decendent was domiciled at death in Cumber 1 ~nn County t Pennsylvania, with h is last family or principal residence at 405 1 Sth street, New Cumberland Borouqh, Cumber land County, Pennsv 1 vania (list street, number and muncipafity) Decendent, then 85 years of age, died TP~pmhPr 19, 2000 ,~ at Hol v Spirit Hospital, E. Pennsboro ~ f l'11TTlhl::.r 1 ~nn County, 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: Decendent at death owned property with estimated values as follows: {I f domiciled in Pa..> AIl personal propeny (If not domiciled in Pa.) Personal propeny in Pennsylvania (If not domiciled in Pa.) Personal propeny in County Value of real estate in Pennsylvani.a situated as. follows: one half lnterest in 405 15th st., Cumber.lana county, pennsYJ.vanla 5133,000.00 S 5 S 50,000.00 New Cumberland Borouqh, WHEREFORE, petitioner(s) respectfully requcst(S) the probate of the last will and codiciI(s) presented herewith and the grant of letters testamentaI:Y (testamentary; administration C.l.a.: administration d.b.n.e.t.a.) theron. lit ";j' u C u :;:-::;- \1\ _ c.J -- :x~ -=,0 -.- ;-= E~ ;0' :; C QO en I~~~ ~ 4iA!4~ Tlieodore . Rabena 405 15th street New CllmhPrland. PA 17070 OATH OF PERSONAL REPRESENTATIVE COMMON\VEl1.LTH OF PENNSYLVANIA } ss COUNTY OF eillffi~LMID The p.ctitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of theknowiedge and belief of petitioner(S} and that as personal represen- rative(s) of (he above decedent peritioner(s) will well y administer the estate according to law. CI) 00' .... ~ "..; "'" :,..., - Sworn ... t...o o. r affirmed and SUbSCri. bed~ 'fr ~ef~~e this ~:~ , day of 1P~ 9:~.. .:1I?>t/0 ~~ ''-'/ / G- ;)(; ~s- Iv RegISTer I \.. No. 21-01-81 Estate of JULIUS M. RABENA , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW JANUARY 18 , ~ 2001, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated July 18, 1997 described therein be admitted to probate and filed of record as the last will of Julius M. Rabena and Letters Testamentarv are hereby granted to Theodore A. Rabena FEES Probate, Letters, Etc. ......... $ 235.00 Shorr Certificates( 4) . . . . . . . . .. $ 12.00 ~ ~JC:r:IM-.r9.S..~... $ 6.00 JCP $ 5.00 TOTAL _ $ 258.00 Filed ...I~PA.~~ .~?!. .~qq~................ ~~ ~4!~~ ~~. f#Al , ~~~"11 I~~ Register of Wills . David H. stone #39785 A TIORNEY (Sup. Ct. 1.0. No.) 414 Bridge St., New Cumberland, FA 17070 ADDRESS (717) 774-7435 PHONE MAILED TO ATTORNEY JANUARY 19, 2001 f . J. ~ , f ' ~ j + /~# It , I COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND l j 55: Theodore A. Rabena being duly ~wnrn according to law, deposes and says that he is the Exec'ltor of the Estate of Julius M. Rabena late of ___-.N~w_C1J.lnbJ~J::._l_C!nd_:aoro].:L'1_h------ , Cumberland County, Pa., deceased and that the within is an inventory made by rph~nnorp A "RAhena_ _, the said RXPC!l1t-nr of the entire estate of said decedent, consisting of all the personal prop~rty and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. 19 I / /~~{} l~i4l,/;(j , Theodore A. Executor - ~i.AW~ 'tV Rabena J 405 15th Street New Cumberland, PA 17070 Address and subscribed before me, Date of Death 19 12 2000 Day Month Year INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV. Fiduciaries Act of 1949. ~ ::s 0 ~ 0 ~ -c >- co ro Q) t-- W .,. >- e::: t-- s:: s:: ItI W -< Q) ct1 Q) ~ 0.. t-- .a r-I u CD 0 Q) 0 en co ~ c C' >0- W w J: e::: p::: Q) tg CD t- o.. 0.. C t-- ....J U. .a ItI ... Z -< 0 . S 0.. 0 U. ....J = I w 0 -< w ~ ::s >. > Z e::: U -< II .... Z 0 (J) c: Ii c ::s ~ ~ 0 en Z 0 0::: .r-! Q) U z I w < r-I Z "" 0.. " ::s c: t-) 10 I ~ ~ I 0 Q) ..0 " ~ Q) E 0 .... ...! ItI ~ 0 I ....J U u: CD ~ nventory of the real and personal estate of Julius M. Rabena deceased Inventory Estate of Julius M. Rabena From 12/19/00 To 10/25/01 Description Accrued Interest Checking Accounts PNC Bank-Checking Acct. 4.33 Savings Accounts PNC Bank-Savings Acct. 13.84 PNC Bank-Savings Acct. 10.92 Ccmron Stocks Hilliard Lyons-Black Rock Gov't Inc Certificates of Deposit PNC Bank-Cert. of Deposit 36.38 Residences 1/2 interest in 405 15th St. prop. Misc. Personal Property 1988 Chrysler New Yorker Sedan 4D 9: Value 5,811.35 12,814.96 Total 14,771.92 18,62631 123,913.96 11,35 .52 72,88 .00 2,78 .00 244,34 .71 ------- ------- Hl0'i.XO'i R!\ <11.% 21-01-81 This is to certify that the information here given is correctly copied fron: an original certificate of denh du!)~ filed with Local Registrar. The original certificate will be forwarded to the State Vaal Records Office for pernl~; nent hltng. WARNING: It is illegal to duplicate this copy by photostat or photograph" me as No. ", I I ",""""',,,,,,,, "t'~ t..~\lUJF pr;;'"" ,II''''-'':/- ~l:lf4t-~ \,\~" . ~~ l~~. ...... ~\ !:E( . ':. \~~ ~ S\ .('f~' . !~~ ~*~".. ,*~ ~ a' vo~.. /~\~ ~ ~~.. A/~l\ -:.;..~~Aflll~6 -_/~ ~~ ,,\\1 ~--~......,'" EN1 ~ """ .......'//'",,1111111 ~~~/- Local Registrar cI' Fee for this certiflcate, $2.00 P 7022289 DEe 2 1 2000 Date ~3 Rey 2187 COMMONWEALTH OF PENNSYLVANIA e OEPARTMENT OF HEALTH e VITAL RECORDS CERTIFICATE OF DEATH 85 UNDeR 1 VEAR MonIhs Days STATE FILE ~UM8ER SOCIAL SECURITY NU~8ER NAME OF DECEDENT Ifl;~.dClIe. LasI) J ul i~'-M:--R~b-;~~------------ SEXma Ie 1. 2, 3. AGE (LaSl Btnh<lay) UNDER 1 DAY Hauls MinUl" BIRTHPlACE ,Coly aI'''' PlACE OF DEATH /Ct>eck Oflly Ol'tl -- .;ee ,nSUUCI,()(l,) on 0Ihet SIOeI Slale Of f cle.gn COUfIUYI HOSPITAl' - Harrisburg, PA Inpalienl f.ll ERIOuIpallenl 0 ~ 0 7. ... FACIUT'I' NAME (II not ,nSIolIJII()(I. gIve sCree! ano nombefl g'::tIy) 0 y,.. 5. COUNT'I' OF OERH .. Cumberland RACE - Amencan Indian. 8I&c:k. While. etc:. ($peclly) whi te 10. DeCEDENT'S USUAL OCCUPATION (~=:Ii~:OC:::::z&:i' ...~hoe Repairman ..1I.Shoe Repair DECEDENT'S MAILING ADDRESS (SII"" C'lyflOwn. SIaIa. Zip Code) DECEDENT'S 405 15th St. ~i~~E New Cumberland, PA 17070 ~~~::~ MARITAL STATUS. Mamed Ne_ Ma"ied, Widowed. wi~;':d~ SURviVING SPOUse In ....... gIve maaOen namel 17.. SIal. PA 14. 17c:.0 _, ~nt liYed in r.p Cumberland Did dececIant live IfU IOWnlhip? No, dacedenllNad 17d.(j wilt\in Ktuallimlls 01 MOTHER'S NAME ,Fils!. Middle. MiUden Sutnamel New Cumberland ,.. FATHER'S NAME (FilS!. MtOdle. LaSl) 17b. County cotylbooo E. Tony Rabena Bella Valenza ". INFORMANT'S NAME (TypelPrllll) 22a. JL Complete "ems 2~W~l'lCertliYlng ,- ~.. ~. notaya' I lIme of dealh 10 ~ '*"'Y c:a~ 01 death. METHOD OF DISPOSITION Butial fi ClarNllOR 0 Removal "om Sial. 0 Olhar (Spectlyl DATE OF DISPOSITION (Month. 0.'1'. '$at) 12/22/2000 o 2111. 1.. INFORMANT'S MAllINO ADDRESS (SIt_. CtlyfTown, Slate. Zip Code) .405 15th St. New Cumberland, PA 17070 PlACE OF DISPOSITION. Neme 01 Cemelety. Crematoty LOCATION. CityfTown. Slate, XIp Code Of Othe. PIKe Rolling Green Mem. Park 21c:. Lower Allen Twp., PA 21d. Theodore A. Rabena ~.-;. __ 24-2e _ be compIeled by .- ~ whO pronounces death. ~ LICENSE NUMBER rl.~ 2211.FS 012849 L - bliiibNt- OtmYknowledge. death OCCUlled al ''''' lime. dale and place Slaled (SignalUfeanclTd~ _ / ~ 238. ~ ~L-/YL-~ IME OF DEATH DATE PRONOUNCED DEAD (Month. Day. Veat) 24. '0'.55 M. 25. De('(n~){r (91i^.OOO . ~ 27. MAT I: Em81 lhe di541ases, ,nJulies Of romphcallORS which caused I"" death 00 nol enlel I"" mode of dying, such as caldiac 01 respllaloty all8sI. shock 01 heartladure LISt 0"'" one cause on eaell hoe NAME AND ADDRESS OF FAClllT'l' ufarthemoreF.H.&Cremation LICENSE NUMBER tJ2.IZ2.1, L 17070 No~ IllllEDtATl CAlIS!! (fllloll ~OI condtllOf'l ~,.-..oo III dlIaIhl- :: ~ at condibons ~ iI My.1Nding 10 immediate ....C8lM8. Enler UNDERLYING ,~~o.s:::ltl~y -. l-..IIng III o.anl LAST ~ DuE 10 (OR AS A CONSEQUENCE Of): -(J-?U.........~--- H. I Apc)foxlI1lale : inlf1f\181 between I onset and death , lS PART": Other signillcanl condiliona comnbuting 10 dealh. but not resulting in ltle underlying ca... Qiven in PART I. DUE 10 (OR AS A CONSEOUENCE Of): ().. DUE 10 (OR AS A CONSEQUENCE Of): . w..s AN AUlOPSY -:;PEAFOAMED? ~ d. WERE AUTOPSY FINDINGS A""'lA8t.E PRIOR 10 COMPLETION 0#' CAUSE OF DEnH? MANNER OF DEATH DATE OF INJURY (Month. Day. Yeatl TIME OF INJURY C Ant1 ("" 6J...; ~. 1=..; b y ~~ INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED. Swcide ~ o o HomICide o o o PLACE OF INJURY. AI home. lalm~;"I. 'aclory. office M. building, elC. ISpec,'y) 308. 'f880 NoD Natural '" ,~ Accident Pending In_igalion .PRONOUNCING AND CERTIFYING PHYSICIAN IPhysoclan booh ;llonOUfoC,ng oealh ancI ce<htYlng 10 cause 01 oeath\ To lhe beet ot my knoWledQfl, d.ath occurred ilt ltIe Ume. dille, and plilc.. ilnd due 10 lhe caUse(iI) ilnd mannel ilS illilled o r.tJ> Pv / /'/v/ _0 NoQg v.. 0 NoD JOe. Could not be delenn,ned 218. 21b. CERTIFIER (Check oniy one) "CERTIFYING PHYSICIAN /'phYSlClan Ce<h'y,og cause oJ Clealh when anolhe, phYSIC,an has ptonounceO oealh ana cOtnpleleO Item 23) To 1he best ot my knowledve, deilth occu".ed d\M 10 the cauH(s) and milnne' iliI s1etecl. . . . . . . . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29. iI aI it ~ "MEDICAL EXAMINER/CORONER On the b11lls 0' e.aminatlon and/or Invealigalion. in my opinion. death occurred It lhe time. date. and place, and due to the cauae(a) and manner .. .tated.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31a. REGISTRAR'S SIGNATURE AND NUMBER o 33. ~~~ I~/I~J/I STONE LAFAVER & SHEKLETSKI ATTORNEYS AT LAW DAVID H. STONE GERALD J. SHEKLETSKI ELIZABETH B. STONE 414 BRIDGE STREET POST OFFICE BOX E NEW CUMBERLAND. PA 17070 www.stonelaw.net OF COUNSEL CHARLES H. STONE JON F. LAFAVER September 19, 2001 TELEPHONE (717) 774.7435 FACSIMILE (717) 774-3869 Register of Wills Office Cumberland County Court House Carlisle, PA 17013 RE: Estate of Julius M. Rabena File No. 21-2001-0081 Greetings: Enclosed is an estate check in the amount of $1,084.54 representing payment for inheritance tax due for the above captioned estate. please send the receipt of payment to our office in the enclosed stamped addressed envelope. Thank you for your attention to this matter. Very truly yours, ~ LaFAVER ~S:~~~ETSKI ,..-- ", d~'!) '";) ~ .J ',^ Dan n. st.Jne ~I""C. DHS/tmb Enclosures: COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX( 11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT STONE LAFA VER & SHEKLETSKI 414 BRIDGE STREET POBOX E NEW CUMBERLAND, PA 17070 -------- fold ESTATE INFORMATION: SSN: 195-07-5998 FILE NUMBER: 21-2001- 0081 DECEDENT NAME: RABENA JULIUS M DATE OF PAYMENT: 09/20/2001 POSTMARK DATE: 09/1 9/2001 COUNTY: CUMBERLAND DATE OF DEATH: 12/19/2000 NO. CD 000283 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1,084.54 I I I I I I I I TOTAL AMOUNT PAID: $1,084.54 REMARKS: THEODORE A RABENA C/O STONE LAFA VER & SHEKLETSKI CHECK#18 SEAL INITIALS: SK RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS ep\wil.ls\RABENA.JUL 21-01-81 LAST WILL AND TESTAMENT OF JULIUS M. RABENA I, JULIUS M. RABENA, of 405 15th Street, New Cumberland, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I give and bequeath $15,000 to the New Cumberland Fire Department. ITEM II: I give and bequeath $15,000 to Trinity United Methodist Church of New Cumberland, Pennsylvania. ITEM III: I give, devise and bequeath all the rest, residue and remainder of my estate to my brother, Theodore A. Rabena. ITEM IV: I name my brother, Theodore A. Rabena, executor of this my last will. IN WITNESS WHEREOF, I, Julius M. Rabena, I,f-f'-dayof }?~ -J) ~~t~ /?2~ l/IUS M. RABENA have hereunto set my hand and seal this , 1997. I< aI~~ Page 1 of 3 SIGNED, SEALED, PUBLISHED and DECLARED by JULIUS M. RABENA, the Testator above named, as and for his Last will and Testament, and in the presence of us, who at his request, in his presence and in the have subscribed witnesses. Address Cc...-C Kf~ Witness ~" ~~-eJ-~( ~-. Address COMMONWEALTH OF PENNSYLVANIA: SS: COUNTY OF CUMBERLAND . . I, JULIUS M. RABENA, the Testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law do hereby acknowledge that I signed and executed this instru- ment as my last will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein contained. ~~~{~~2f1 R ~~ Sworn to or affirmed to and acknowledged before me by JULIUS M. '#1 C\~rJd RABENA, the Testator, this IR day of U~~ ' 1997. /} 0- lV~~1-/Y<d ~ Notary Public Page 2 of 3 ---, NOTARIAL SEAL ~ CONSTtr'C' L Puc!Jc N!>w ~ ,41 (\ My CormnissionExpiies Aprii 13, 1991 COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND ~,.. Ij.~ We, and ~~(j ~ , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw Testator sign and execute the instrument as his last will; that Testator signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the will as witnesses; that to the best of our knowledge, the Testator was at that time eighteen or more years of age, of sound mind and under no con- straint or undue influence. Witness Sworn to or affirmed to ~tJ.~ witnesses, this If day of and acknowledged before me by and O~tJ ~ ~ ,1997. ~' . --' -X;<'cW( Notary PubllC , Page 3 of 3 NomRfAL SEAL CONSTNSC:: l.. N tJVI C u: r:',: b,: ;. :.: ~I. i'j ci t My Cmni"ilissioll Expires April 13, 1999 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX( 11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT STONE DAVID HEAN 414 BRIDGE STREET NEW CUMBERLAND, PA 17070 -------- fold ESTATE INFORMATION: SSN: 195-07-5998 FILE NUMBER: 21-2001- 0081 DECEDENT NAME: RABENA JULIUS M DATE OF PAYMENT: 11/07/2001 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 12/19/2000 NO. CD 000499 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $334.20 I I I I I I I I TOTAL AMOUNT PAID: $334.20 REMARKS: THEODORE A RABENA CHECK# 20 SEAL INITIALS: VZ RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT STONE DAVID HEAN 414 BRIDGE STREET NEW CUMBERLAND, PA 17070 -------- fold ESTATE INFORMATION: SSN: 195-07-5998 FILE NUMBER: 21-2001- 0081 DECEDENT NAME: RABENA JULIUS M DATE OF PAYMENT: 01/04/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 12/19/2000 NO. CD 000720 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $435.77 I I I I I I I I TOTAL AMOUNT PAID: $435.77 REMARKS: THEODORE RABENA C/O DAVID H STONE ESQUIRE CHECK# 21 SEAL INITIALS: VZ RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS STONE LAFAVER & SHEKLETSKI ATTORNEYS AT LAW DAVID H. STONE GERALD J. SHEKLETSKI ELIZABETH B. STONE 414 BRIDGE STREET POST OFFICE BOX E NEW CUMBERLAND. PA 17070 www.stonelaw.net OF COUNSEL CHARLES H. STONE JON F. LAFAVER TELEPHONE (717) 774-7435 FACSIMILE (717) 774-3869 March 19, 2001 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 RE: Estate of Julius M. Rabena No. 21-01-0081 Greetings: Enclosed please find estate check No. 7 in the amount of $20,000.00 on account of inheritance taxes in the above captioned estate. Please note the timely postmark of this correspondence. Very truly yours, YER & SHEKLETSKI DHS/krl Enclosure 'v /6--c2L:l0 -/G') COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT 1 ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX Recoroeci Reqi Sr?;~ BUREAU OF INDIVIDUAL TAXES INH~RITANCE TAX DIVISION DEPT. 280601 HARRISBURG I PA 17128-0601 " of DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN -02 JAN 11 P 3 :20 DAVID H STONE ESQ STONE ETAL 414 BRIDGE ST NEW CUMBERLAND C"'" .'. . i't;lfh. . Ctllnb .-' ,,' . 'l..:.'! ii:", " PA 17070-0'56'2 12-31-2001 RABENA 12-19-2000 21 01-0081 CUMBERLAND 101 '* REV-151i7 EX AFP (12-00> JULIUS M Allount Rellitted (1) (2) (3) (4) (5) (6) (7) 72,885.00 123,913.96 .00 .00 47,542.75 .00 .00 NOTE: To insure proper credit to your accountl subllit the upper portion of this forll with your tax paYllent. (8) 2441341.71 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE1 PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-V :is4-j-ix--AFP--fi"2-:ooi--NO,.-ici--oF-.rNHiifiTAifcE-"-AX-A-PPRA-isEi"-ENT~--Ai:.i-oWAifcE-O-R----------- - - - --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF RABENA JULIUS M FILE NO. 21 01-0081 ACN 101 DATE 12-31-2001 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE 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) s. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Govern.ental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 201445.01 23.1;80 27 2201761.44 301000.00 1901761.44 NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: .00 X 00 = .00 .00 X 045 = .00 1901761.44 X 12 = 221891.37 .00 X 15 = .00 (19)= 221891.37 3.135.26 (11) (12) (13) (14) PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-19-2001 AA478180 11052.63 201000.00 09-19-2001 CDOO0283 .00 11084.54 11-07-2001 CDOO0499 .00 334.20 INTEREST IS CHARGED THROUGH 01-15-2002 TOTAL TAX CREDIT 221471.37 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 420.00 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 15.77 TOTAL DUE 435.77 . IF PAID AFTER DATE INDICATED 1 SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $11 NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)I YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) P' ~v (6-88) ~OMMONW~NNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENTS NAME INHERITANCE TAX EXPLANA TION OF CHANGES RABENA, JULIUS FILE NUMBER LARRY SZOLLOSY ACN 2101-0081 101 REVIEWED BY ITEM SCHEDULE NO. H B-3 EXPLANATION OF CHANGES The claim for the family exemption has been disallowed. The claimant must be a spouse or if no spouse, a parent or child living in the same household as the decedent as of the date of death. ROW Page 1 I ~-dtJJ -10 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT C/* REV-IU7 EX AFP CUI-Ol) DAVID H STONE ESQ STONE ETAL 414 BRIDGE ST NEW CUMBERLAND .02 f1AR-1 !\11 :2 1 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-25-2002 RABENA 12-19-2000 21 01-0081 CUMBERLAND 101 JULIUS M Allount Rellitted ,-,\ \,.,.;;"1 P'~l'TllllO MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REv=ic,o"7-ix-AFP-foi-:o2i-------...--iNHERITANCE--Y;.X-STAfEMENY-OF-;.C-coutif--...--------------------- ESTATE OF RABENA JULIUS M FILE NO.21 01-0081 ACN 101 DATE 02-25-2002 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUHMARY 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: 12-31-2001 P R I NC I PAL TAX DUE: ........................................................................................................................................................................................................................... 22,891.37 PAVMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-19-2001 AA478180 1,052.63 20,000.00 09-19-2001 CDOO0283 .00 1,084.54 11-07-2001 CDOO0499 .00 334.20 01-04-2002 CDOO0720 15.01- 435.77 TOTAL TAX CREDIT 22,892.13 BALANCE OF TAX DUE .76CR INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .76CR . SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) '""'I I .~ V ,/ ........./ STATUS REPORT UNDER RULE 6.12 Name of Decedent: Julius M. Rabena Date of Death: December 19, 2000 Will No. 21-01-0081 II I To the Register: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes ~ No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: (a) Did the personal representative file a final account with the Court? Yes No X (b) The separate Orphans' Court No. the personal representative's account is: (if any) for N/A (c) Did the personal representative state an account informally to the parties in interest? Yes~ No Date: (d) Copies of receipts, releases, joinders and approvals of formal or informal accounts be filed with the Clerk of the Orphans' Court and ,e attached to this report. j~r 3-0)~ e, 1"Esquire 414 Bridge S reet New Cumberland, PA 17070 717-774-7435 Capacity: Personal Representative X Counsel for Personal Representative ~ Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 11/05/2002 THEODORE A RABENA 405 15TH STREET NEW CUMBERLAND, PA 17070 RE: Estate of RABENA JULIUS M File Number: 2001-00081 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 12/19/2002 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, MARY C. LEWIS REGISTER OF WILLS cc: rj File Counsel Judge est\rel\rabenated ('-- IN RE: ESTATE OF JULIUS M. RABENA, LATE OF THE BOROUGH OF NEW CUMBERLAND, CUMBERLAND COUNTY, PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21- 01- 0 0 81 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, THEODORE A. RABENA, being one of the beneficiaries under the will of Julius M. Rabena, do hereby acknowledge that I have received all sums of money and property due me by virtue of the death of Julius M. Rabena, in full satisfaction and settlement of all of my rights and claims under his estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribu- tion had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, THEODORE A. RABENA, do by these presents, remise, release, quitclaim and forever discharge the Executor, his heirs, successors and assigns, from the acts of the Executor as 'I . aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Executor. IN WITNESS WHEREOF, I have hereunto set my hand and seal the s.+- f .9--- ! 6- , 2002. (}t~ {l J~~ THEODORE A. RABENA COMMONWEALTH OF PENNSYLVANIA: ss: COUNTY OF CUMBERLAND On this, the ;if day of ~!- , 2002, before me a Notary Public, the undersigned officer, personally appeared THEODORE A. RABENA, 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 have hereunto set my hand a~d seal the day and year first above written. -2- ~~A~ v Notary Public - . --'-'--""'NOTARIAL Sl::AL TINA M. BURKEY~ Notary r-:ubUc ~ :\!I-~\'i Cumberland Bow, Cumbeli~nd Co~ : '.:!'., Cormnlss\Gfl Explres AprU 1~)1 20051 __.~_._._..__~____._...:t'oO:l"'~~4.~Il:.._...t;r,...,.~A""""""'M:II:.~~'>r:'4~ ~ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Julius M. Rabena Date of Death: December 19, 2000 Will No. 2001-00081 To the Register: I certify that notice of beneficial interest 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 23, 2001. New Cumberland Fire Department 319 Fourth Street New Cumberland, PA 17070 Trinity United Methodist Church Fourth and Bridge Streets New Cumberland, PA 17070 Theodore A. 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'" Z C x ... .. en ." ... ... ... N 0 I co co :3': en ~ z 0 m Z ~ m (') "'tI ~ t""l c 0 ~): s: en :. OJ -f OJ m 0 :tJ <:~ :tJ ." 0 mo r- ." G') ~~ )> n m Ro~ z m en !:J OJ -f enC/) "'tI 0 :tJ ::I: 0 ~ X m m"T1 m ...a m -f ~ -..J 0 m -...I ~ 0 en ~ ~ ,..1. ....I \;;;, t-J. (..1 (..1 (..1 - () () :::0 ,J) : PJ ~ (I) I'.) I"""i 3 LQ f-J IT' ~. '.":;, - f-J- (I) (f) I',:' (f) ~ rt - f-J f-J (I) (I) PJ I-i - ~ - ~ 0 I-d H1 ~ () - 0 =8 .~ - f---l ~ ~- .~ ...J ~ f-J 0 rt f-J .~ f---l ~ (f) .- w () 0 0 H1 'K C H1 .~ I-i ~- .- rt 0 - ... (I) ~ ... 0 .~ ~ -.. (f) ,~ -. (I) .- ... .. 'K - .- '- -- '. '- ,- ... .- 'K .- -- ... - ~ '-. 1 \ ~ ~,/ r~ -- C'\ ,: ~ --......,"'- ~r;~~J; ~:./~ ~'.~ ::~-,/ \ 0 I ::::\ .. '\ t, . 'oO:: (t.' \., '~'.t .\ t't.' . '\ i.i..- \. ..' ............ ..' .... t \:. b:. .., ..' :::::.. ::...... ~;.... ... :::..... 't... ;;:~ ~ ~ ~ ~ ~ ~ z to ~ r o~~~'i C(J)OJ~~ ~ ~ ':D <... 0 9?oo~~ ,.. "1'\ G') ",., _ ~f,tT\~~ ~tT\~tJ)o OOJ':D~"1'\ '"'O~%~ ~tT\"""t'" ~ ~ e. ~ o p :13 " <'\ jd ~ 0 ro -- 0 ~ill. ': s:u () tJ ~. :::. K 0 It\ m -- ~ ~ \V (1' ': ~. ~ K ro -:-mK~K :=~~s:u ': ro oRa L-- C rtI -:::-rdm()~ ::: ~ ro 0 ~. -:- U1S~ - (\ y ~ -:- ~(1'm -:- ~ 'p) N(. -J o K () ~ ro 0 vJ ~ ~ o C m ro ~ \ \ ~ PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF Cumberland Estate of Julius M. Rabena also lrnown as . Deceased Rebecca R. Wagner Social Security Number 195-07-5998 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COAfPLETE'A' or'B' BELON :) A. Ptrobate and Grant of Letters Testamentary and aver that Petitioner(s) is /arc the last Wi[1 ofthe Decedent dated and codtcit{s} dated named in the {State relernnt circrmrstances e.g., renrarclatlon, death oferecmor, era) Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrument(s) offered for probate, was not the victim of a I:illing and was never adjudicated an incapacitated person: B. Grant of Letters of Administration d.b.n.c.t.a. -- see attached explanation (lfappllcable, enter e.t.a.; db.tt.at.a.; pendentelfte; druanteabsenNa; durmrtendnariraM) Petitioner(s) aAer a proper search has /have ascertained that Decedent left no Will and was stnvived by the following spouse (if any) and heirs: (If AdnrlnlslraNotr, e.t.a. or• d.b.n.c.t.a., etrter dote of il'lll itr Seclion A aboti~e and complete List of heirs.) ev c°~ "J Name Relatianshi Reside n t !-~ ; , •i ~-~ (C011lPLETEINALL CASES.•) Attach addtlionalslreets jf trecrssar3~. ;-~ ~ -'-~ Z _- ~' ~ Decedent was domiciled at death in Cumberland County, Pennsylvania ti~th his Qfrtfr last principal resi~ned at € '.~ .- 40515th Street New Cumberland Cumberland Countv Pennsvh/anla ~ ~ ~"'~ `-=~ (List street address, torvniciry; tmrnship, corarp; state, zip code) V1 Decedent, then 85 years of age, died on 12 / 19 / 0 0 at Holy Spirit Hospital Decedent at death owned property with estimated values as follov<5: (Ifdomiciled in PA) All personal property $ {if not domiciled in PA) Personal property in Pennsylvania $ {if noE domiciled in PA) Personal property in County $ Value ofreal estate in Pennsyltntnia $ situated as follo~tis: wherefore, Petitioner(s) respectfirlly request{s) the probate of the last will and Codicil(s) presented with this Petition and the grant of Lcaers in the appropriate form to the undersigned: Si azure 1' or rioted name and residence ~{ 409 S. 13th Street, Harrisburg, PA 17104 COUNTY, PENNSYLVANIA File Number 21- D 1- 0 0 81 Fonrr Rlt'-02 rev. 10.13,06 Page I of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF SS 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 representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirme~d+-and subscribed before me the I " 1 ~ day of For the Registe File Number: Estate of Julius M. Rabena Signature of Personal Represe ive Signature of Personal Representative Signature of Personal Representative ~-j t~ c~ ~ ° ~a J r,-`~ . .~ ~ ~ -'1 ' ~ ~. * J ~ ~-~ l.s'~ ' 1"'i 21 0 -'' ~ "~ ~` - 1-0081 Social Security Number: 195-07-5998 '--~ Cam, ~~-, ~ -, ,- -~ "` C7 i ~ -i-i Dec~e~ Ca f'--- ' ~r-~i --1 rZ Date ofDeath:12/19/00 D -` `''`'- ' AND NOW, IVIJV . (1 , ~_, in consideration of the foregoing Petition, satisfactory proof having been presented ore me, IT IS DECREED that Letters {~m~,r:, sT rZiaz ~ uN `DE~,TiA are hereby granted to WLCCC~ ~ L~3 ~YW..t"' in the above estate and that the instrument(s) dated -1- 1$ -G~l described in the Petition be admitted to probate and filed of record as the lash Wlyll (and Codicil(s)) of Decedent FEES Letters ............... $ 20.00 Short Certificate(s) ........ $ (Renunciation(s) .......... $ i'~lA~rc~~ - tM ... $ ~ . C~C~ ... $ ... $ ... $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. $ ~ S. UU Q9-@8' Form RW-01 rev. 10.13.06 Re ist • of Wills (i '' < (/ 11\~I Attorney Signature: Attomey Name: Marvin Beshore, Esquire Supreme Court I.D. No.: 31979 Address: 130 State Street, P.O. Box 946 Harrisburg, PA 17108-0946 Telephone: (717) 236-0781 Page 2 of 2 REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA In Re: Estate of Julius M. Rabena No. 21-O1-0081 ATTACHMENT TO PETITION FOR LETTERS OF ADMINISTRATION. DBNCTA 1. Theodore A. Rabena was the Executor of the Estate of Julius M. Rabena. Theodore A. Rabena died November 18, 2002. The proceedings for his Estate are at 2002- 01075. Rebecca R. Wagner, Petitioner herein, is the Executrix of the Estate of Theodore A. Rabena. 2. Theodore A. Rabena was the sole heir to the Estate of Julius M. Rabena. Rebecca R. Wagner was the sole heir to the residue of the Estate of Theodore A. Rabena. 3. This Petition is brought for the sole purpose of claiming the proceeds of a life insurance policy on the life of Julius M. Rabena. Pursuant to the Will of Julius M. Rabena and the Will of Theodore A. Rabena the proceeds of this insurance policy belong to Rebecca R. Wagner, your Petitioner. C7 0 co _ `:~~ ~ ~ V~ , .. - r •~ _: '' _ C+'J ~_ ~ C~ i_ _ s~] ._ ~ / ~ ~ x 1 1 ~,..~ _. ( ~~ ~ ~ , ~-,i ~~ ~ C ~~'T ~ .l4 ly -a i r>',, ,_"i ~ '7