The URL can be used to link to this page

Home My WebLink About05-26-15 . ��- ��- �h�► FAMILY SETTLEMENT AND FINAL RELEA� ;; _ � ESTATE OF JOSEPH J. PATSY � o � � �; {-.,:� 'r� .:...� r:> �,, �-. --c , ,�.� .. N � ; KNOW ALL MEN BY THESE PRESENTS, that Joseph ;1. Patsy,`��ate o`f' Middlesex Township, Cumberland County, Pennsylvania, deceased, died te�ate b�; September 13, 2014, having first made his/her Last Will and Testament,_which bvas duli�=; �,> c.� executed on August 6, 2014 and probated in the Office of the Register o�Vills ofr Cumberland County, on October 3, 2014. WHEREAS, the said Joseph J. Patsy, by the aforesaid Last Will and Testament, named John T. Kranchick, Jr. as Executor of said Last Will and Testament; WHEREAS, Letters Testamentary on the Estate of the said decedent were duly issued by the Register of Wills of Cumberland County, Pennsylvania, to the said Executor, hereinafter called personal representative, and indexed to No. 2114-0950; WHEREAS, the personal representative has gathered the assets of the Estate of the said decedent and the assets consist of personal and real property with the total value of $56,499.19 as set forth in Exhibit "A", which is a copy of the Pennsylvania Inheritance Tax Return filed and approved by said personal representative, and which is attached hereto and made a part hereof, and marked Exhibit "A"; WHEREAS, the debts and deductions, including the payment of inheritance tax in the said Estate, which have now been paid, leave a balance for distribution of $36,370.73, also as set forth in the statement of said personal representative, which is attached hereto and marked Exhibit "B"; WHEREAS, the balance for distribution as shown in the said statement marked Exhibit "B" has been reduced to cash and has been distributed as herein indicated in accordance with the terms of the Last Will and Testament of the said Decedent; NOW, THEREFORE, Francis A. Patsy and Glorio J. Patsy, Jr., being all of the heirs under the Last Will and Testament of the said decedent, and being those persons entitled to inherit under said Last Will and Testament, do hereby each of us acknowledge that we have this day had and received from the aforesaid personal representative, in full satisfaction and payment of all sums of money, legacies, bequests, and devises as are given, devised and bequeathed to each of us respectively � � � ■�a . � ��" Turo Robinson l � � � ` �L Attot'�2eys at Law = - ;� ;��;_� �,�;� � ` www.turorobinson.com .,, �tv'.�: � RON TURO, Esquire-Of Counsel - � ,' q„�,_,_: �, �'.'� �!� 129 South Pitt Sfreet �M� - .� -�-,�.�z-� �x u�`, JAMES M. ROBINSON, Esquire � �� "'"�'��-i �;�� ';`��'�� r��,�,�� Carlisle, Pennsylvania 17013 ,s � if ' ,,, �'� -�, � � �� (717) 245-9688 JESSICA E. BREWBAKER, Esquire -�� -; ��. ��I ,,�`"; JUSTIN S ABEL, Esquire � _ - ''�s';� u �-�La -- 800 562-9778 �.. �, �� . :}., ( ) �� Fax(717) 245-2165 �. � _ ,.. , ,. JRobinson@TuroLaw.com May 5, 2015 Glorio J. Patsy, Jr. Francis A. Patsy 7735 Llangollen Way 715 Avondale Drive Cumming, GA 30041 Sterling, VA 20164 Re: Estate of Joseph J. Patsy Dear gentlemen: Administration of Joe's estate is wrapping up. Enclosed is a Family Settlement and Final Release document that you must sign at the bottom of page 2 and return to me. Upon receipt of the fully executed document, I will file it with the Cumberland County Register of Wills and then close my file. All of the requisite taxes, fees and expenses have been paid. I am sending this to Glorio first in hopes that he will sign it and forward it to Frank in the enclosed envelope addressed to him. Frank can then sign and return just the three-page document to me in the envelope addressed to me. Because of the manner in which this document works, it gets confusing when you see,it for the first time. The Amount Remaining to Be Distributed on Exhibit "B" is actually the value of the real estate that has already been conveyed to you. There will be no further distributions. Please do not hesitate to contact me by phone or email if you have any questions. Sincerely yours, ` .,�il � . / � ,--� / J /�""i,f��•�.�.�-�� James M. obinson, Esquire JrobinsonCa�TuroL,.�;�wv.�_cJm Enclosure Cc: John T, Kranchick, Jr. by the said Last Will and Testament, the amounts due us under said Last Will and Testament, which amounts we have received this day or prior to this day; and, each of us do hereby stipulate that in order to avoid the expense and time involved in the filing of a formal account and schedule of distribution, we each agree that no account is necessary and we do hereby agree that we do consent to distribution being made without the filing of an account and schedule of distribution, the same to be with the same force and effect as if they had been filed and confirmed by the Orphan's Court Division of the Court of Common Pleas of Cumberland County, Pennsylvania. THEREFORE, we and each of us, do hereby remise, release, quitclaim and forever discharge the said personal representative, John T. Kranchick, Jr., his heirs, executors, administrators and assigned, of and from the said estate and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever for or by reason thereof, or for any other use, matter, cause or thing whatsoever, touching upon the Estate of the said decedent, and each of us do further hereby covenant and agree that should any liability come due to the estate of the said decedent after the signing of this Agreement, we and each of us do hereby covenant and agree with each other and the aforesaid personal representative, that we will contribute pro-rata our share of the Estate to satisfy any and all claims, demands, suits or causes of action which may be successfully prosecuted against the said Estate or the aforesaid personal representative after the signing, sealing and delivery of this Family Settlement Agreement and Final Release. IN WITNESS WHEREOF, we have hereunto set our hands and seals the day and year noted below. � �� ; - � �� .� v�, � Date Witnes Francis A. atsy n � ;� - � �� a �e� --.� - � �/(l�" . o%�. Dat Witness lorio J. Pats , r. Ciry/Counry of �'<-L �-t�l-�'► ...�.. ._...........�.w � � � SEEMA J.SIN6HAl 1 ccrtify this to bc a complctc,full,dvc and cxact � ` N01ARY PUBUC reproduction of thc original documcn� �" �� ' RE(i1STRATION N 760(!595 CcrtifiedthisZ?-da of 20�j ��,�(j II �- �' �: COMMONWEALTNOrV�aGINIA Y 3d.n�1_� �� ' �^� : MY COMMISSIOri xPiRES •-`� � �---'"'"—�� ' SEfTEMBER'2�• 018 NOTICE OF INHERITANCE TAX : �,�,� pennsylvania APPRAISEMENT, ALLOWANCE OR DISALLOWANCE `' DEPARTMENTOFREVENUE BUREAU oF INDIVIDUAL TAXES OF DEDUCTIONS AND ASSESSMENT OF TAX ! _.__._._. DIVISION REV-1547 EX AFP (11-14) PO BOX 280601 HARRISBURG PA 17128-0601 DATE 04-20-2015 ESTATE OF PATSY JOSEPH J DATE OF DEATH 09-13-2014 FILE NUMBER 21 14-0950 COUNTY CUMBERLAND ROBINSON JAMES M ACN 101 129 S PITT ST APPEAL DATE: 06-19-2015 CARL I SL E PA 17 013-3425 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE � RETAIN LOWER PORTION FOR YOUR RECORDS � ------------------------------------------------------------------------------------------- REV-1543 -E� Ar�' C11�1G� MOTICE �F INHERI�A9JCE TAX APPRAISEi�ENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: PATSY JOSEPH JFILE N0. :21 14-0950 ACN: 101 DATE: 04-20-2015 TAX RETURN WAS: C X) ACCEPTED AS FILED O CHANGED APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate CSchedule A) �1� 4 2,4 71.00 NOTE: To ensure proper 2. Stocks and Bonds (Schedule B) �Z� .00 credit to your account, .00 submit the upper portion 3. Closely Held Stock/Partnership Interest CSchedule C) (3) of this form with your 4. Mortgages/Notes Receivable CSchedule D) C4) •00 tax payment. 5. Cash/Bank Deposits/Misc. Personal Property CSchedule E) (5) 14�028.19 6. Jointly Owned Property CSchedule F) C6� .00 7. Transfers (Schedule 6) �� .0 0 8. Total Assets (8) 56.499. 19 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9� 10,010.95 10. Debts/Mortgage Liabilities/Liens CSchedule I) C10] 5.157.98 11. Total Deductions C11) 15,168.93 12. Net Value of Tax Return �12� 41,330.26 13. Charitable/6overnmental Bequests; Non-elected 9113 Trusts CSchedule J) �13� .00 14. Net Value of Estate Subject to Tax �14� 41,330.26 NOTE: If an assessment was issued previously, Lines 14, 15, 16, 17, 18 and/or 19 will reflect figures that include the total of all returns assessed to date. ASSESSM[yT OF TAX: - 15. Amount of Line 14 at spousal rate C15) •00 X 00 = .00 16. Amount of Line 14 taxable at lineal rate C16) -�� x 04 5 = .00 17. Amount of Line 14 at sibling rate C17) 41 .3�0.26 X 12 = 4,959.63 18. Amount of Line 14 taxable at collateral rate C18) .00 X 15 = .00 19. Principal Tax Due �19�= 4,959.63 TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) pMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 12-12-2014 CD020019 247.98 4,7i1.65 � EXHIBIT TOTAL TAX PAYMENT 4,959.63 � `� � BALANCE OF TAX DUE .00 a � INTEREST AND PEN. .00 � TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A CREDIT CCR), YOU MAY BE DUE FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FDR INSTRUCTIONS. �/ 1505610143 � R�V'��OO��Z�� ;�",�. OFFICIAL USE ONLY PA Department of Revenue pennsylvania counry coae Year File Number Bureau of Individual Taxes OEPARiMENTOFREVENUE PO BOX.280601 INHERITANCE TAX RETURN �1 14 0 0 9 5 0 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 09 13 2014 07 01 1948 DecedenYs Last Name Suffix Decedent's First Name MI PATSY JOSEPH J (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M� Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1. Original Retum ❑ 2. Suppiemental Retum ❑ 3�Pnor to 12 3e-82j�Date of Death � 4. Limited Estate [] 4a.Future Interest Comprom�se � 5. Federal Estate Tax Retum Required (date of death after�2-12-82) � 6. �ecedent Died Testate ❑ �� Attach co a�of Tius j uving Tn,st � 8. Totai Number Of Safe Deposit Boxes (Attach Copy of Nfill) � py � 9. Litigation Proceeds Received ❑ 10.beiween 12-31�91 and�tl�Dat�e5�f Death � 11.�Att ch 8chedule 0)Sec.9113(A) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATIO I�HOULD BE DIRECTED T0: Name Day�igie Telephor�lumt� � JAMES M ROBINSON 71� cQ45 �968� � r� � � � c� r ..,.,, R�61�ER�-OF VyJL+LS U��LY � � ,_�,'� N ;� c7 First Line ofi Address �" � r` `-� � �� .�7 � V.! 12 9 SOUTH PITT STREET `� � � � �` � ;, c� ,.� c� � c� r- tri Second Line of Address •:,� `� � �j O . �' OD �1 DATE FILED City or Post O�ce State ZIP Code CARI�ISLE PA � �-17013 Correspondent'se-mailaddress: j�ObirlsOn@tu1'OIaW.COm Under penalties of perjury,I declare that 1 have examined this retum,inciuding accompanying schetlules and statements,and to the best of my knowledge and belief, it is true,correct and comptete.Declarafion of preparer- ther than the personal representative is based on all information of which preparer has any knowledge. SIGNi��TURE OF PERSON RESP�NSIBLE F6R FILI R •U DATE � "� John T. Kranchick,Jr. pz�►� � o � A5 ' Crossroads Schooi Road,Car��sie, PA 17015 �, SIGNA'� RE OF PREPARER THEt2 EPRESENTATIVE DATE �.�,,,,�,,�� ,��, James M Robinson 6 z-�s�� s� AD�DR SS Tu,�o Robinso �Z9 South Pitt�Street, Carlisle, PA 17013 Side 1 � 1505610143 1505610143 � � 1505610243 REV-1500 EX DecedenYs Social Security Number DecedenYs Name: P A T S Y, J O S E P H J. RECAPITULATION 1. Real Estate(Schedule A)................................ 4 2 , 4 7 1 . 0 0 .......................................................... 1. 2. Stocks and Bonds(Scheduie B)............................................................................... 2. 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C).......... 3. 4. Mortgages&Notes Receivable(Schedule D).......................................................... 4. 5• Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)................ 5. 14 , 0 2 8 . 1 9 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............. 6. 7. inter-Vivos Transfers&Miscelianeous Non-Probate Properly (Schedule G) ❑ �Separate Billing Requested............. 7. g. Total Gross Assets(total Lines 1 through 7).......................................................... 8. 5 6 , 4 9 9 . 1 9 9. Funeral Expenses and Administrative Costs(Schedule H)..................................... 9. 1 0 , 0 10 . 9 5 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................. 10. 5 , 1 �J 7 . 9 8 11. Total Deductions(total Lines 9 and 10).................................................................. 11. 1 5 , 16 8 . 9 3 �2• Net Value of Estate(Line 8 minus Line 11)............................................................. 12. 4 1 , 3 3 0 . 2 6 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J)................................................. 13. 14. Net Value Subject to Tax(Line 12 minus Line 13)................................................. 14. 4 1 , 3 3 0 . 2 6 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X.00 15. 16. Amount of Line 14 taxable at lineal rate X .045 16. 17. Amount of Line 14 taxable at sibling rate x .�2 41 , 3 3 0 . 2 6 17� 4 , 9 5 9 . 6 3 18. Amount of Line 14 taxable at collateral rate X .15 �$' 19. TAXDUE................................................................................................................... 19. 4 , 959 . 63 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. � Side 2 � 1505610243 1505610243 ,J REV-1500 EX Page 3 File Number 21 - 14 - 00950 Decedent's Complete Address: DECEDENT'S NAME Patsy, Joseph J. STREET ADDf2ESS 1206 Harrisburg Pike ___ C�-�y STATE ZIP Carlisie PA 17015 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 4,9 5 9.6 3 2. Credits/Payments A. Prior Payments B. Discount 247.98 Total Credits(A +B) (2) 247.98 3. Interest (3) 0.0 0 4. If Line 2 is greater than Line 1+Line 3,enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2,Line 20 to request a refund 5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 4,711.6 5 `� Make Check Payable to: REGISTER OF WILLS, AGENT. .y ,a s .r �r '�'�-�,�`„� r3 y... _�� . .,,..�+�`�. �'�f h � vS�a aj'�r'��_-��'��r^ ��."€5�'�-^�a�.��....'�j°'� ��.��,+/��::��.,�'`.��'3, ��-w�-�'-' Y^^ �. �S'�` %fi�-�,-i�` -xr`-^-� 7 �,��-�.�s.,,.=��..._,. e� � �� 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 b. retain the right to designate who shall use the property transferred or its income:.................................... ❑ ❑X c. retain a reversionary interest;or.................................................................................................................. x d. receive the promise for life of either payments,benefits or care?.............................................................. ❑ � 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receivingadequate consideration?....................................................................................................................... ❑ 0 3. Did decedent own an"in trust fo�' or payabie upon death bank account or security at his or her death?......... � 0 4. Did decedent own an individual retirement account,annuity,or other non-probate property which ❑ ❑ containsa beneficiary designation?...................................................................................................................... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMP�ETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. f� �,=s" r � �r' t -.s�a' .+i»�. �.� "`�hr- " ,zrr`v�-e"�' �.��°w�'p' � �� 3'�� '�g�"`r;�u _�..;,�.v�m,��cr��.:�"';s"'�.. � .'��M.�s�,�rt5 a-e�, .. .,?'a�,'"'i' �:<�"`��""��;.::�'`-��.`��N'�:s�-�`'��s�.�_�.t��'m��3�.9s�'�'��..��-.�.;_��tv�'�m� .�b�"'��,��m _ , � For dates of death on or after JulY 1,1994 and before Jan.1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after January 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(n)]. The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disciosure of assets and filing a tax refurn are still appiicabie even if the surviving spouse is the only beneficiary. For dates of death on or after Jufy 1,2000: •The ta�c rate imposed on the net value of transfers from a deceased chiid 21 years of age or younger a#death to or for the Use of a natural parent,an adoptive parent,or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)]. •The tax rate imposed on the net value of transfers to or for the use of the decedenYs lineal beneficiaries is 4.5 percent,except as noted in [72 P.S.§9116(a)(1)]. •The tax rate imposed on the net value of transfers to or for the use of the decedenYs Siblings is 12 percent[72 P.S.&9116(a)(1.3)1. A sibling is defined under Section 9102,as an individual who has at least one parent in common wi#h the decedent,wfiether by blooa or adoption. � w { pennsylvania SCHEDULE A �ir DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT FILE NUMBER ESTATE OF Patsy, Joseph J. 21 - �4-oos5o Ali 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 willing buyer and a wiifing seller, neither being compelled to buy or sell,both hav'ing reasonable knowledge of the relevant facts.Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. Attach a copy of the settlement sheet if the property has been sold. include a copy of the deed showing decedenYs interest if owned as tenant in common. ITEM VALUE AT DATE OF DESCRIPTION DEATH NUMBER 1 1206 Harrisburg Pike, Middlesex Township, Cumberland County-a One-Third interest as 42,471.00 tenant in common with Glorio J. Patsy, Jr. and Francis A. Patsy. Value calculated as assessed value times common level ratio($128,700 x.99)/3 TOTAL(Also enter on Line 1,Recapitulation) 42,471.00 �►.� ,; pennsylvania SCHEDULE E , ` DEPARTMENT OF REVENUE �' CASH, BANK DEPOSITS AND MISC. INHERITANCE TAX RETURN • RESIDENT DECEDENT PERSONAL PROPERTY FILE NUMBER ESTATE OF Patsy, Joseph J. 21 - 14-00950 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. i ITEM VALUE AT DATE OF NUMBER DESCRIPTION DEATH 1 Orrstown Bank-Acct. No. 108-003808 14,028.19 TOTAL(Also enter on Line 5,Recapitulation) 14,028.19 REV'1511 EX+(10-09) SCHEDULE H o : pennsylvania �NERALF�S�� DEPARTMENT OF REVENUE INHERITANCETAXRETURN _ �'Nh7`TIV'1�E�1�7� RESIDENT DECEDENT FILE NUMBER ESTATE OF Patsy, Joseph J. 21 - 14-00950 Decedent's debts must be reported on Schedule I. _ — ITEM DESCRIPTION AMOUNT NUMBER FUNERAL EXPENSES: A. 1 Hoffman-Roth Funeral Home&Crematory, Inc. 4,141.31 2 VFW Post 477-Hall Rental&Food at Post-Ceremony Reception 640.00 3 Hoffman-Roth Funeral Home-Additional Charges for Graveside Service, including 620.00 Clergy B, ADMINISTRATIVE COSTS: �, Personal Representative's Commissions Name of Personal Representative(s) Street Address �� State Zip Year(s)Commission Paid 2. Attorney's Fees Turo Robinson Attorneys at Law 2,824.96 3, Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation) Claimant Street Address Ci� State Z�P Relationship of Claimant to Decedent 210.50 4. Probate Fees Register of Wills 222.40 The Sentinel Cumberland Law Journal 75.00 5. AccountanYs Fees 6. Tax Return Preparer's Fees 7_ Other Administrative Costs � Cumberland County Recorder of Deeds-Filing Fee to convey interest in 1206 80.00 Harrisburg Pike, Middlesex Township, Cumberland County See attached 1,196.78 TOTAL(Also enter on line 9,Recapitulation) 10,010.95 z, pennsylvania SCHEDULE I e ^� DEPARTMENT OF REVENUE MORTGAGE ,'�� INHERITANCETAXRETURN DEBTS OF DECEDENTy RESIDENTDECEDENT LIABILITIES & LIENS FILE NUMBER ESTATE OF Patsy, Joseph J. 2� - �4-oo9so Report debts incurred by the decedent prior to death that remained unpaid at the date of death, inciuding unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 1,848.00 1 Carlisle Regional Medical Center 2,421.00 2 Manor Care Health Services 81.23 3 Cumberland Goodwili Fire Rescue EMS, inc. 158.66 4 Century Link 98.19 5 Dish Network 59.73 6 Mid-State Mobile Health Partners, Inc. 182.37 7 Middlesex Township Municipal Authority , 40.00 8 Cigna Healthspring 50.00 9 Carlisle Digestive Disease Assoc. 77.34 10 PPL Electric Utilities 15.06 11 Heartland Care Partners PA 126.40 12 Darryl Guistwite, D.O. TOTAL(Also enter on Line 10,Recapitulation) 5,157.98 REV-'1513 EX+(01-10) �� 4 pennsylvania SCHEDULE J /�!�` DEPARTMENTOFREVENUE BENEFICIARIES Lii INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF I FILE NUMBER Patsy, Joseph J. 21 - 14-00950 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) �$$�) RECEIVING PROPERTY Do Not List Tnistee(s) I� 7AXABLE DISTRIBUTIONS d�str but onsr�and transfers under Sec.9116(a)(1.2)] 1 Francis A. Patsy Brother One-Haif Property 21,235.50 715 Avondale Drive Interest Sterling,VA 20164 2 Glorio J. Patsy, Jr. Brother One-Half Properly 21,235.50 7735 Llangollen Way Interest Cumming, GA 30041 I I I Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate. II� NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.�� i .... �.a�■ . � EXHIBIT "B" GROSS ESTATE NET OF TAX $ 51,539.56 LIABILITIES A. Hoffman-Roth Funeral Home & Crematory, Inc. $ 4,761.31 B. VFW Post 477 - Rental Hall & Food 640.00 C. Turo Robinson Attorneys at Law 2,824.96 � D. Register of Wills 210.50 E. Cumberland Law Journal 75.00 F. The Sentinel 222.40 G. Cumberland County Recorder of Deeds 80.00 H. Frank J. Roberto, Tax Collector 1,196.78 I. Carlisle Regional Medical Center 1,848.00 J. Manor Care Health Services 2,421.00 K. Cumberland Goodwill Fire Rescue EMS 81.23 L. Century Link 158.66 M. Dish Network 98.�9 N. Mid-State Mobile Health Partners, Inc. 59.73 O. Middlesex Township Municipal Authority 182.37 P. Cigna Healthspring 40.00 Q. Carlisle Digestive Disease Assoc. 50.00 R. PPL Electric Utilities 77.34 S. Heartland Care Partners PA 15.06 T. Darryl Guisfinrite, D.O. 126.40 TOTAL LIABILITIES $ 15,168.93 AMOUNT REMAINING TO BE DISTRIBUTED $ 36,370.63 DISTRIBUTIONS: Francis A. Patsy $ 18,185.32 Glorio J. Patsy, Jr. 18,185.31 TOTAL $ 36,370.63