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Home My WebLink About01-0205 REV_I,I)OEX ,.5":c'\ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT 280601 HARRISBURG, PA 17128-0601 lC-~-~i~ -1 REV-1500 I- Z W C W U W C w ..., ~$lJ) ,,0::< w"" ",00 ,,0:-' ..", .. " INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENTS NAME (LAST. FIRST. AND MIDDLE INITIAL) LUCIA LUCILE A DATE OF DEATH (MM-DD.YEAR) 12/03/2000 DATE OF BIRTH (MM.DD.YEAR) 11/24/1915 ilF APPLICABLE) SURVIVING SPOUSEB NAME (LAST. FIRST, AND MIDDLE INITIAL) [:J 1. Original Return o 4. Limited Estate ~ 6. Decedent Died Testate iAttach copy cfWIII) o 9. Litigation Proceeds Received D 2. Supplemental Return o 4a. Future Interest Compromise (date afdeath after 12-12-B2) o 7. Decedent Maintained a living Trust (Attach copy afTrust) o 10. Spousal Poverty Credit (date ofdeatll blltween 12-31-91 and 1-1-95) OFFICIAL USE ONLY C FILE NUMBER .1.... ...L - Q... L .Q...Q...2.....Q..2 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 186 4 THIS RETURN MUST BE FilED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Return (date af death prior 10 12_13-821 o 5. Federal Estate Tax Return Required Jl 8. Tolal Number of Safe Deposll Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0\ z o !;;: ..J ::::l l- ii: c( u w 0:: ..., z w C Z o .. '" W 0: 0: o " LUANNE JOY HUNTER FIRM NAME (If Applicablel 10 HILLSIDE LANE ETTERS PA 17319 TELEPHONE NUMBER 717/938-6816 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (1) (2) (3) (4) (5) O. 105,413. O. O. 63,483. 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes ReceIvable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. JOIntly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or l) 8. Total Gross Assets (tota/lines 1-7) (6) (7) (B) 7,033. 675. 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent Mortgage Liabilities, & liens (Schedule I) 1'l. Total Deductions (total lines 9 & 10) (9) (10) 12. Net Value of Estate (line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an ejection to tax has not been made {Schedule J) 14. Net Value Subject to Tax (line 12 minus line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o !;t I-' ::::l II.. ~ o u ~ 15. Amount of line 14 taxable at the spousal tax O. rate, or transfers under Sec. 9116 (a)(1.2) x.O_ (15) 16. Amount of line 14 taxable at lineal rate 161,188. ,0 45 (16) 17. Amount of Line 14 taxable at sibling rate O. x .12 (17) 18. Amount of line 14 taxable at collateral rate O. x .15 (18) 19. Tax Due (19) 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE Sll~E TO ANS'M:R J>,Lla .S " OFFICIAL USE ONLY O. O. 168,896. (11) (12) (13) 7,708. 161,188. O. (14) 161,188. O. 7,253. O. O. 7,253. becedent's Complete Address: STREET ADDRESS 1100 GRANDON WAY CITY I STATE PA 17055 HECHANICSBURG Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 7.353. (3) O. (4) O. (5) 113. (5A) O. (58) 111 O. 6.800. 340. Total Credits ( A + 8 + C ) (2) 3. InteresUPenaity if applicable D. Interest E. Penalty o. O. TotallnteresUPenalty ( D + E ) 4. If Line 2 is grealer than Line 1 + Line 3. enter the difference. This is the OVERPAYMENT. Check box on Page 1 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. A. Enter the interest on the tax due. I ZIP 7.140. 8. Enter the totai of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT _"'~'.'~_o '<;;'?'__"':~l~~Tj~~'::....:h"u":.,,..!,~?" ~'>~ " . c., PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred;.......................................................................................... D b. retain the nght to designate who shall use the property transferred or its income; ............................................ D c. retain a reversionary interest; or........ ...................... ........ ....................... ........... ....... ........................ ................... 0 d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 2. If death occurred after December 12. 1982. did decedent transfer property within one year of death without receiving adequate consideration? .. ......... ... ........ ..... ......... ......... ...... .............................. ...... ....................... 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................... ...... ..... ... ........... ......................................................... ................... 0 No o [Xl [i] [i] [Xl [i] GJ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of pe~ury, I declare that I have examined lt1is retum, including accompanying schedules and statements, and to the best 01 my knowledge and belief, it is true, correct and complete. Declaration of pre parer other than the pe~onal representative is based on all information of which pre parer has any knowledge. SIGNATURE OF PERSON RESPONSI8L,.E ,OR FILING RETURN \...... ~ '" ...\ 0\.1 .l:i Uvv.. t.u\ ADDRESS I \0 \-\.; \\SIJ.e Lv...,,-(. E-\-"\-ev.s:, Po.. SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE '2-'1-3-0\ I-'~i "I DATE ADDRESS J...( For dates of death on or after Jury 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 39116 (a) (1.1) (i)]. For dales of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 39116 (a) (1.1) (ii)J The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are slill applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1. 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death 10 or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 39116(a)(I.2)]. The tax rale imposed on Ihe net value at transfers to or forthe use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 39116(1.2) [72 P.S. 39116(a)(I)J. The tax rate imposed on the net value of lransfers 10 or for the use of the decedent's siblings is 12% [72 P.S. !l9116(a)(1.3)J. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1SOJEX.p.9n *' SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER LUCILE A LUCIA 21 01 00205 All property jointfy-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. VANGUARD GNMA FUND 10,400.94 shares NAV 12/1/00 10.13 NAV 12/4/00 10.14 105,413. TOTAL (Also enteron line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 105,413. THMmguard::Rour. PAUL LAUTENSCHLAGER ATfY-IN-fACT LUCILE A LUCIA Trade date 1/21 1/31 2/23 2/29 3/01 3/23 3/31 4/20 4/30 5/01 5/23 5/31 6/30 7/31 8/31 9/29 10/31 11/30 12/29 Transaction Balance on 12/31/1999 Systematic withdrawal Income dividend Systematic withdrawal Income dividend Checkwriting 1001 Systematic withdrawal Income dividend Systematic withdrawal Income dividend Check purchase Systematic withdrawal Income dividend cash Income dividend ACH ")COI'I~ dividend ACH Income dividend ACH Income dividend ACH Income dividend ACH Income dividend ACH Income dividend ACH Balance on 12/31/2000 Income dividends Purchases year-fo-date Redemptions year-to-date December 31,2000, year-to-date Vanguard GNMA Fund (800) 662-2739 Fund number: Account number: Starement number: 005749 - Client Services 36 9937331267 012757034 2 4 Page 4 of 6 111111/ 111111111111111111111111111111111111111111111 11111111111111111111111 4- 6 B71 107C M3 1 X REV.I508EX. (1.s7) . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DEe DENT ESTATE OF FILE NUMBER LUCILE A LUCIA 21 01 00205 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH CHECKING ACCOUNT # 360227200 STANDARD BANK 2400 W 95TH STREET EVERGREEN PARK IL 60805 1,958. 2. VANGUARD MONEY MARKET FUND # 9937331267 61,425. 3. MISCELLANEOUS PERSONAL PROPERTY 100. TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 63,483. THEVanguardJROUP. PAUL LAUTENSCHLAGER AnY-IN-FACT LUCILE A LUCIA Trade date 5/17 5/31 6/30 7/31 8/31 9/18 9/29 10/11 10/31 11/09 11/30 12/29 Transaction Balance on 12/31/1999 Exchange from Wellington Income dividend cash Income dividend ACH Income dividend ACH Income dividend ACH Checkwriting 1003 Income dividend ACH Checkwriting 1004 Income dividend ACH Checkwriting 1005 Income dividend ACH Income dividend ACH Balance on 12/31/2000 December 31, 2000, year-to-date Page 3 of 6 Vanguard Prime Money Market Fund - Client Services 30 9937331267 012757034 (800) 662-2739 Fund number: Account number: Statement number: ACCOUNT VAL.UE On 12131/1999 On 12131/2000 $0.00 $ 61,424.81 Dollar amount Share Q.fjce Shares transacted Total shares owned $1.00 .000 $ 67,047.81 1.00 67,047.810 67,047.810 159.45 67,047.810 348.65 67,047.810 363.00 67,047.810 362.06 67,047.810 -3,229.00 1.00 -3,229.000 63,818.810 342.17 63,818.810 -1,894.00 1.00 -1,894.000 61,924.810 336.89 61,924.810 -500.00 1.00 -500.000 61,424.810 320.80 61,424.810 330.33 61,424.810 $ 1.00 61,424,810 $ 2,563.35 Annualized Compound Distribution yield annual yield payable date $ 67,047.81 October 6.34% 6.53% 11/01/2000 5,623.00 November 6.34 6.53 12/01/2000 December 6.33 6.52 1/02/2001 Income dividends Purchases year-la-date Redemptions year-to-dale 2 4 3- 6 871 t07C M3 1 X 005748 11111111111/111111111'11111 "'" 111111111111I111111111111 111111111111111111 REV-1511 EX... \12.99) 9"~'" ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER LUCILE A LUCIA 21 01 00205 ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES: 1. SCHEDULE ATTACHED 7,033. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City Slale _ lip O. Year(s) Commission Paid: 2. Attorney Fees O. 3. Family Exemption: (II decedent's address is not the same as claimant's, attach explanation) O. Claimant Street Address City State _ Zip Relationship of Claimant to Decedent 4. Probate Fees O. 5. Accountant's Fees O. 6. Tax Return Preparer's Fees O. 7. TOTAL (Also enter on line g, Recapitulation) $ 7,033. Debts of decedent must be reported on Scl1edule I. (If more space is needed, insert additional sheets of the same size) PA REV-1500 ESTATE OF LUCILE A LUCIA SCHEDULE H ITEM A PAYEE Dulles Airport Staples Northside Mobile Blooms by Vickrey Publix Race Trac Evans Sunoco Walmart MBE Eckerd Drugs Eckerd Drugs Family Dollar Store Family Dollar Store Family Dollar Store MBE MBE MBE Port Charlotte Motel Port Charlotte Motel Publix Joy Hunter MBE USAir Budget Rent A Car Flower Gallery David Hunter Cremation Society of PA Publix Publix MBE Blooms by Vickrey Kostas Eckerd Drugs Paul Lautenschlager Harrisburg Wholesale EXPLANATION Parking for travel for funeral Supplies for graveside service Travel for memorial service Flowers Flowers Travel for memorial service Travel for memorial service Carryon bag for ashes Copy will Pictures for memorial service Pictures for memorial service Binder for estate file Estate supplies Estate supplies Copies for accountant Fax Copies Lodging for memorial service Lodging for memorial service Memorial service food Reimburse for funeral expenses Fax Travel for memorial service Travel in Florida for memorial service Funeral flowers Reimburse for travel to funeral Cremation Food for memorial service Food for memorial service Copies Flowers Memorial dinner Copies Photos Reimburse for travel and honorarium Flowers AMOUNT 44.00 5.28 20.00 10.60 119.22 18.75 13.22 16.98 1.19 1.27 12.38 1.59 3.18 1.06 0.85 5.00 0.51 154.00 616.00 48.03 142.79 3.21 399.00 199.00 200.00 2,401.87 435.00 27.12 20.04 2.01 145.72 421 62,48 1,425.00 55,45 7,032.80 'EV.'~"".".n". COMMONwEALTH OF PENNSYLVANIA INHERITANCE TAX RETtJRN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF LUCILE A LUCIA FILE NUMBER 21-01-0205 Include unreimbursed medical expens... ITEM NUMBER DESCRIPTION AMOUNT 174 107 59 8 49 5 159 100 14 1. 2. 3. 4. 5. 6. 7. 8. 9. Brockie Pharmacy Beacon Medical Group Outlook Pointe Verizon Universal Card Verizon United States Treasury Balance on 2000 taxes R.H. Daemicke & Asso 2000 income tax preparation Beacon Medical Group TOTAL (Also enteron line 10. Recapitulation) $ (If more space IS needed, Insert additional sheels of the same size) 675 REV.1513EX.ll.gn . SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF LUCILE A LUCIA FILE NUMBER NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 21 01 00205 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE 1. LUANNE JOY HUNTER 10 HILLSIDE LANE ETTERS PA 17319 DAUGHTER 50% 2. PAUL LAUTENSCHLAGER 7400 TUDOR ROAD COLORADO SPRINGS CO 80919 SON 50% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) "---." ~ LAST WILL AND TESTAMENT OF LUCILE ADLINE LUCIA I, LUCILE ADLINE LUCIA, permanently residing at 179 Palm Harbor Drive, Venice, Sarasota County, Florida, being of sound and disposing mind, memory and understanding and not under the restraint or undue influence of any person, do hereby make, publish and declare this my Last Will and Testament, hereby expressly revoking all other Wills and Codicils by me heretofore made. 1. I hereby direct that all my debts incurred during my lifetime, as well as all expenses incident to my death and to the administration of my estate, be paid by my per- sonal representative herein named as soon as practicable after my death, out of the first monies available therefor. 2. I hereby give, devise and bequeath all property which I own or have the right to dispose of at my decease, of whatever kind, character and description, real, personal, intangible and mixed, and wherever situated to my husband, C:c>q~~oETTRO AUGUSTINE LUCIA. In the event my said husband should predecease me, or should he fail to ~urvive me by at least thirty (30) days, I direct that ~y entire said estate be , ,~ .,t divided equally between my children, LUANNE J. HUNTER of Etters, Pennsylvania and PAUL J. LAUTENSCHLAGER of St. , i I I I I ~ I i i , I \ \ I LAST WILL AND TESTAMENT OF LUCILE ADLINE LUCIA Pa ge 2 Louis, Missouri, or among their respective lineal descen- dants living at the time of my death, per stirpes. In the event my son, the said PAUL J. LAUTENSCHLAGER should pre- decease me, or should he fail to survive me by at least thirty (30) days, I direct that the share of my estate which would be distributible to his lineal descendants be distri- buted in trust to my daughter, the above named LUANNE J. HUNTER, as Trustee for the lineal descendants of my said son. The Trustee shall have sole discretion as to the management and administration of the trust assets, and shall be empower- ed to pay such of the principal and/or income from the same to or on behalf of the trust beneficiaries as she shall in her sole discretion deem advisable. My Trustee shall not be required to furnish bond in any jurisdiction, and shall not be held to account for her administration of the trust assets beyond the minimum required by law. I have not chosen my Trustee because of any special skill or expertise which she may have in administering trust assets, but be- cause of her close family relationship with the trust bene- ficiary. I therefore direct that she be held to no higher standard of duty or care than any other prudent person in similar circumstances. 3. I hereby appoint my husband, ETTRO AUGUSTINE LUCIA as personal representattye of my estate and as executor of this my Last Will and Testament. I direct that my said t. ~ . LAST WILL AND TESTAMENT OF LUCILE ADLINE LUCIA Page 3 personal representative not be required to post bond for the faithful performance of his duties in any jurisdiction, any law to the contrary notwithstanding. Should my said husband be unable or unwilling to so serve, I appoint my daughter, LUANNE J. HUNTER as alternate personal representative, and as a second alternate personal representative, my son, PAUL J. LAUTENSCHLAGER, to act in his stead, also without bond. 4. In the administration of my estate, I do hereby authorize my personal representative appointed herein and any substitute or successor personal representative to sell, lease, pledge, mortgage, transfer, exchange, convert or otherwise dispose of, or grant options with respect to, any real or personal property at any time forming a part of my estate, in such manner, at such times, for such purposes, for such prices, and upon such terms, conditions or credits as he may deem advisable. I also authorize my personal representative or his substitutes and successors to com- promise or otherwise adjust any claims or demands in favor of or against my estate. I further authorize my personal representative or his substitutes and successors to execute and deliver such instruments as may be necessary to carry out any of these powers; and, in addition to that specified herein, to do without order or permission of any court, any other acts which he may deem necessary or desirable for the proper execution or discharge of any powers or duties held LAST WILL AND TESTAMENT OF LUCILE ADLINE LUCIA Pa ge 4 by or imposed upon him, whether by the terms of this Wi 11, or by applicable law. IN WITNESS I C141-.. WHEREOF, I have hereunto set my hand this day 0 f 1'1 /h" A.D. , 1983, at North Port, Florida, in the presence of each and all of the subscribing witnesses, each of whom I have re- quested in the presence of each of the others to subscribe his or her name, with his or her address written opposite thereto, as an attesting witness, in my presence and in the presence of each of the others. 4' <. ":. /~/ .. '. ,0' ! : ,...".. t" ~aU~, "- A~<~.<.'",,-- LUCILE AOLINE LUCIA , , ,", WE DO HEREBY CERTIFY that the foregoing instrument, composed of this and three other typewritten pages fastened hereto, being signed by the testatrix, was this I q .Jt.. day 0 f 1'/1 A V , A.D., 1 g 8 3 , signed, sealed, delivered and published by LUCILE ADLINE LUCIA as her Last Will and Testament in the joint presence of the undersigned, the said LUCILE ADLINE LUCIA then being of sound and vigorous mind and free from any constraint or compulsion, whereupon we, being well acquainted with LUCILE AOLINE LUCIA, immediately subscribed our names hereto in the presence of each other and of the said LUCILE AOLINE LUCIA for the purpose of attesting the said Will as she requested us to do. --) ~ /C /' . C_::::::-;:'.~ - .j ~&/L res i din gat ~~~A//C€rr , FL....... :o-p L~:rur {} .t'l<':-<4./ residing at L"-Ij - . it; /Ie (:- P/-. A. LAST WILL AND TESTAMENT OF LUCILE ADLINE LUCIA ) \ I f OATH AND PROOF OF WILL , , f',' STATE OF FLORIDA COUNTY OF SARASOTA WE, LUCILE ADLINE LUCIA, CORD C. MELLOR, and ETTRO AUGUSTINE LUCIA, the testatrix and the witnesses respec- tively, whose names are signed to the attached or foregoing instrument, having been sworn, declared to the undersigned officer that the testatrix, in the presence of witnesses, signed the instrument as her Last Will and Testament, that she signed, and that each of the witnesses, in the presence of the testatrix and in the presence of each other, signed i f the Will as a witness. ) .,./ r- ~.,<.-<''-....-< ./ l ~.-/~. '7 ~ ..-:: "....r ,_._ _~ ,> ,./ .C/, ~~ ~ &.. --. t ., ' / ( l / 'tC.-. Cl ii:-.C/(C'...c;'./ SWORN TO AND SUBSCRIBED before me by LUCILE ADLINE LUCIA, the testatrix, and by CORD C. the witnesses, on j'vIAI-Y MELLOR and ETTRO AUGUSTINE LUCIA, ) '1 , A. D., 1983. i1M1i' /; t:clJzt. _. / fA---t.J I NOTARY PUBLIC Notary Public, State 01 Florid" at l.or90 My Commission Expires September 4, 1983 Bonded By A.'na life '" CJsudlY This Instrument Prepared By CORD C. MELLOR, ATTORNEY AT LAW Post Office Box 7126 North Port, Florida 33596 Estate oiL L.L C- \ \ e also known as PETITION FOR PROBATE and GRANT OF LETTERS Ac\I\'ne Lu..c-\ ~ No. J... 1- (j /- ~S- To: Register of Wills for the 1 , Deceased. County of (.Wl'Y\ bu) , bV\ C~/~ in the Social Security No. \ <;1 I" -"3. i - "2- ~ iP () Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age o!;.plder an the executy' " y.. in the last will of the above decedent, dated LJ 0....'1 I 9. Lb and codicil(s) dated ( lJ /1) named , 19~ EttV"o (+ v-. ~ l.\.Ad~ ~ n ~ \.-~ L \ 0.. (.Ro..,e (state relevant circumstances, e.g. renunciation, death of executor, etc.) ~-\~-qg 13.0(0 years of age, died [).p C ,3... , ~ QO P 0 at 0 S So ' Except as ollows, decedent did not arry, 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: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ ISo,()OO... 00 $ $ $ WHEREFORE, petitioner(s) respectfully request(s) the probte of the last will and codicil(s) presented herewith and the grant of letters t- () c.. t 0.. h'\ € V'\ 0.. V 'f (testamentary; administration c.La.; administration d.b.n.c.t.a.) theron. ~ V> <1 h ~~~ J~~~n~d ~.~ ff~ (L s ~ P . '" ~ I 9 ('ljO';:: ~<!) ~t:l.. <!) '- ;0 ~ t:: OJ) iZi h~ YU--~' ->t lJ./v\ tul OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OFGu.. ~ \--,.u \~JVH:t J The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Swom to ~' affirmed d'nd snbscdbed J \-.-u..ll."""", ~.}i II ~.~ 11 ~ befo~~ ~ day Of L~~ I:. ~ i{ ~ '7na~e.~.-,a,4~ ~ 1.. - LI RegIster ~ . / - a I ~I I n No. 21-01-205 Estate of LUCILE ADLINE LUCIA , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW FEBRUARY 22, 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 ..5 -I q - I '1 3 ""3 described therein be admitted to probate and filed of record as the last will of L l.L c- \ \~ ~~~~ L ~c... \ 0- and Letters ,,- VY\ e... Y"I -b 0.. V' 1 are hereby granted to L ~ N-. V\SL .j, )f LlN'\ 1) fl 7/7l~ e. ~ 'fUA. t!O.~~,~ Register of Wills FEES Probate, Letters, Etc. ......... $ 235.00 Short Certificates( 4) . . . . . . . . .. $ 12.00 ~ ~JC:r:IY\.. ?AG~~..4 $ 12.00 JCP $ 5.00 TOTAL _ $ 264.00 Filed . f;E.:aE.VMX . f;2.,. . ZOP.~ . . . . . . . . . . . . . ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE CALLED EXECUTRIX FEBRUARY 22, 2001, ORDERS ENCLUDED 05.805 REV ~/86 This is to certify that the information here given is correctly copied from an original certificate of death du~~ filed with me as Local Registtar.' The otiginal cettificate will be forwarded to the State Vital Records Office for permanent hlmg. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 p 7021054 No. /J ..py, ?f-' ~ //( "l~"1J!-?-L_" Local Registrar 1-' DEe 0 4 2000 Date COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH t3Rsy 2187 NAME Of DECEDENT (flrSl. Middle. las) 1. Luc.~.e.e A. Luc.ia AGE (last 8irtt>day) UNOEA 1 YEAR Months Days SEX 2. F e.ma.-te. ST~E ~I\.E NUM8ER SOCIAL seCURITY NUMBER 3.186 34 - 2360 UNOER 1 DI<If Houts Minut.. 8IRTHP'-'CE (C.... """ Stale Ol' FCfe.goCOUnuYI PlACE OF QEAtH ICt>eck (lI"lly (If'o8 u -;ee msffUCloOm on alN!1 SlOe) tfOSPITAl~ Inpah.n~ ERIOutpattent 0 ClOA 0 ~=oIyIO PA I);d - Ifve... _1 l1d.o :"'''''::'':::'.. MOTHER'S NAME ,F..st. Middle. Malden SUfOatnel It. 8aJr. baJr. a AM Uytd e.yt Me.R.d INf'OR"ANT'S~Jl\Nj;\flODljE~ISb,...CotylTown.:lle~.lop~1 PA 17319 2~. 10 H~~~~~ae Layte, t~~~~, PLACE OF DlsPOS/T1ON. ""'l'" 01 ~Oty. c;.....toIY lOCRION . CotylT_. Stat.. Z'op ~ ..Ollled"_ Cltema.t~oyt Soc.~e.:t1j o PA Clte.matolt NAME AND AOORESSOF FACIUTY 22c. 41 00 J 0 yte.~towyt 5. 85 COUNTY Of DeAJ'H v,.. Cu.mb~R.aytd .... DECEDENT'S USUAl OCCUp,q1ON (at..,. ktnd 01 WOfk done dorlllQ mosI ~ WOIttinQ h; do MI use ,_ed l IlL 11~ ---------------- DECEDENT'S MAILING AIlOllt:SS (51..... C..,f1'own. s.... Z'op Code) DECEDENT'S ACTUAL RESIDENCE (See mslruclJOl\S on OCher Stde. 1100 Gltaytdoyt Way Mec.hayt~c.~bU1tg,PA 17055 ,.. 17.. Slate Cu.mb~R.aytd 1111. c...nty FRHER'SNAME (Filst. MI()dSe, LaS!) II. C ltu.6 Sc.hOc./2 INFORMANT'S '"-'ME (TVP8IP,inll ~~. Luanyte. J. Huytte.lt METHOO OF DISPOSITION Bunot 0 C........... 1M (Spoc<ly 21c. 24. 27. PlUJT I: EnI.' lhe diMa..... injuries Of compliCahons which caused the dealh 00 l6il only ooe cause on each hIM L.O,:)~ ta'Of'1 ane!ol.. shoCk Of heart h.~. SequenIlolIy ..-. if anv. lNding to lfftIMdiate ~. Ent... UNDERLytNQ CAUSa (o.s.a.. Of tOfUl'y . . 1'\al1OlliaIed8't'efllS ,-...ng en death. LAST I : DUE ClUE 10 lOR AS A CONSEQUENCE Qf) WERE AUlOPSY FINDINGS MANNER OF DEATH -.l.A8LE PRIOR 10 COMPLETION OF CAUSE ~ D OF llEJU'H1 Nau,.,.' Homic:.ide Accldenl D Pending InvestigAtion D Y.. 0 No]:8" Swcido 0 Could not be delermlned D OATE Of INJURY (Month. Day. 'teal) RACE - Am.ncan k\dian. 8lack. Whit.. Me. I_I Wh~:te. 10. MARITAl STATUS - M_ N.IN Manied. Widowed. 0N00<:ed (Spec"') 14.W~dowe.d SURVIVING SPOUSE I" wA.. grte m8lden name) 110.0.....__.. ...". Mec.ha.rt~c..6bU1tg coty-.. PA LICENSE NUMBER NoD PART H: Othet si9nillcant condiIions conuibuting 10 death. but not resuning in the undefIytng cause giwn in PAAT I. d TIME OF INJURY " ~.~~: [~'~~_~o LOCATION (Street. CavtTov.n. SlaIe) H. 30.. 3Gb. PLACE OF INJURY - AI home. farm, 51,eet. 'actory. office budding. elc. ISpecllv) _. 2aL 21b. CERTIFiER ,et-tICk oniy one} .CEATIFYING PHySICIAN IPhysx::..an CI'!fWYlng cause d dealh whet' ano!llef phvSIC.an has p10n0unced death anCl ccmpleled Item 23\ To ttM beatO' my knowlMlge. death occun'H due to &he cause(s) and manne' .. stated. .,......,.. ~PAONOUNCING AND CERTIFYING PHYSICIAN (PhySICian bol~ ~onOU(lCing oealh and cert"yiOCJ 10 cause of dealhl To ItM beat of my knowledge. death occurred at the Ume. date. and pl.c.. and due to the C.UH(.) and manne, as stilted loVP?/1 I 31. N (IIem 271 Type Of p,int f2-I1 tr-IA ~ rt14 Vs;. ~ )oW) D cJ ,.. 21-01-205 LAST WILL AND TESTAMENT OF LUCILE ADLINE LUCIA I, LUCILE ADLINE LUCIA, permanently residing at 179 Palm Harbor Drive, Venice, Sarasota County, Florida, being of sound and disposing mind, memory and understanding and not under the restraint or undue influence of any person, do hereby make, publish and declare this my Last Will and Testament, hereby expressly revoking all other Wills and Codicils by me heretofore made. 1. I hereby direct that all my debts incurred during my lifetime, as well as all expenses incident to my death and to the administration of my estate, be paid by my per- sonal representative herein named as soon as practicable after my death, out of the first monies available therefor. 2. I hereby give, devise and bequeath all property which I own or have the right to dispose of at my decease, of whatever kind, character and description, real, personal, intangible and mixed, and wherever situated to my husband, ETTRO AUGUSTINE LUCIA. In the event my said husband should predecease me, or should he fail to survive me by at least thirty (30) days, I direct that ~y entire said estate be LAST WILL AND TESTAMENT OF LUCILE ADLINE LUCIA Page 2 divided equally between my chi1drens LUANNE J. HUNTER of Etters, Pennsylvania and PAUL J. LAUTENSCHLAGER of St. Louiss Missouris or among their respective lineal descen- dants living at the time of my deaths per stirpes. In the event my son, the said PAUL J. LAUTENSCHLAGER should pre- decease me, or should he fail to survive me by at least thirty (30) dayss I direct that the share of my estate which would be distributible to his lineal descendants be distri- buted in trust to my daughter, the above named LUANNE J. HUNTERs as Trustee for the lineal descendants of my said son. The Trustee shall have sole discretion asto the management and administration of the trust assets, and shall be empower- ed to pay such of the principal and/or income from the same to or on behalf of the trust beneficiaries as she shall in her sole discretion deem advisable. My Trustee shall not be required to furnish bond in any jurisdictions and shall not be held to account for her administration of the trust assets beyond the minimum required by law. I have not chosen my Trustee because of any special skill or expertise which she may have in administering trust assetss but be- cause of her close family relationship with the trust bene- ficiary. I therefore direct that she be held to no higher standard of duty or care than any other prudent person in similar circumstances. 3. r hereby aPPQtnt my husbands ETTRO AUGUSTINE LUCIA as personal representattve of my estate and as executor of this my Last Will and Testament. I direct that my said LAST WILL AND TESTAMENT OF LUCILE ADLINE LUCIA Page 3 personal representative not be required to post bond for the faithful performance of his duties in any jurisdiction, any law to the contrary notwithstanding. Should my said husband be unable or unwilling to so serve, I appoint my daughter, LUANNE J. HUNTER as alternate personal representative, and as a second alternate personal representative, my son, PAUL J. LAUTENSCHLAGER, to act in his stead, also without bond. 4. In the administration of my estate, I do hereby authorize my personal representative appointed herein and any substitute or successor personal representative to sell, lease, pledge, mortgage, transfer, exchange, convert or otherwise dispose of, or grant options with respect to, any real or personal property at any time forming a part of my estate, in such manner, at such times, for such purposes, for such prices, and upon such terms, conditions or credits as he may deem advisable. I also authorize my personal representative or his substitutes and successors to com- promise or otherwise adjust any claims or demands in favor of or against my estate. I further authorize my personal representative or his substitutes and successors to execute and deliver such instruments as may be necessary to carry out any of these powers; and, in addition to that specified herein, to do without order or permission of any court, any other acts which he may deem necessary or desirable for the proper execution or discharge of any powers or duties held LAST WILL AND TESTAMENT OF LUCILE ADLINE LUCIA Pa ge 4 by or imposed upon him, whether by the terms of this Will, or by applicable law. IN WITNESS WHEREOP, I have hereunto set my hand this I q ~k day of l'\-1 /+y A. D. , 1983, at North Port, Florida, in the presence of each and all of the subscribing witnesses, each of whom I have re- quested in the presence of each of the others to subscribe his or her name, with his or her address written opposite thereto, as an attesting witness, in my presence and in the presence of each of the others. ~- ~o 4 L' ..- ., ~ .-..... ..- ,- 7'" - - - , ,/ _ ...., / -; ',', './q"., ~ . .<-<--"--- LUCILE ADLINE LUCIA WE DO HEREBY CERTIFY that the foregoing instrument, composed of this and three other typewritten pages fastened hereto, being signed by the testatrix, was this I q -/t.. day 0 f 1~ A V , A.D., 1 98 3 , signed, sealed, delivered and published by LUCILE ADLINE LUCIA as her Last Will and Testament in the joint presence of the undersigned, the said LUCILE ADLINE LUCIA then being of sound and vigorous mind and free from any constraint or compulsion, whereupon we, being well acquainted with LUCILE ADLINE LUCIA, immediately subscribed our names hereto in the presence of each other and of the said LUCILE ADLINE LUCIA for the purpose of attesting the said Will as she requested us to do. ~) ,,/ c/ ..' / ~_C~. residing at ~A/ / Ct::r F'L.A . , ~cl~~ re sid i n gat tI t71V Ie E' P,L A, LAST WILL AND TESTAMENT OF LUCILE ADLINE LUCIA OATH AND PROOF OF WILL STATE OF FLORIDA COUNTY OF SARASOTA WEt LUCILE ADLINE LUCIAt CORD C. MELLORt and ETTRO AUGUSTINE LUCIAt the testatrix and the witnesses respec- tivelYt whose names are signed to the attached or foregoing instrumentt having been swornt declared to the undersigned officer that the testatrixt in the presence of witnessest signed the instrument as her Last Will and Testamentt that she signedt and that each of the witnessest in the presence of the testatrix and in the presence of each othert signed the Will as a witness. ,.. Ur- t? ~ SWORN TO AND SUBSCRIBED before me by LUCILE ADLINE LUCIAt the testatrixt and by CORD C. MELLOR and ETTRO AUGUSTINE LUCIAt the wit n e sse s ton ,IV? /+y I 't t A. D. t 1 983 . k~ j~ I NOTARY PUBLIC Notary Public, State of Fiorid;~ at Large My Commission Expires Sep~embcr 4, 1933 Bonded By Aetna Life & Casuidly This Instrument Prepared By CORD C. MELLORt ATTORNEY AT LAW Post Office Box 7126 North portt F10rtda 33596 E .- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: LU-Cl\e A~I~n~ L k (_ , (\ Date of Death: \ ":L - '3 ~ 0 0 t::; \R*" ~\- '2...00\- 0'2.0 5. Will No. Admin. No. Ft=- "'.l.. 0 0 \- 0 0 ':2.. 0 S To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on '3 - 3 - (~ I ----- Name Address L u.. 0'-'\ '" ~ 'C.-\' ).-l LL V\ t lL'; -, '1 0 8\ \Ad III Rcl C_ 0 \ 0 veX ct 0 s. f'" \ Yl 10 c () \ . ~o919 \ 0 )-L..il..s..ld e L a.. h .JL t::.t:te.V'S, Po. \ \1sl'1 R .it\) , \J Q u. \ J. L L\'~.J XJV'\.~ c " \ t ~ e( Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: -b- 3 0- 0 I h ~r-.L ~."}f ~--h4 Signature Name l LJJ)JV\ ~ ~j . )-{ 1...L 'Y\ tIll Address \ 0 )-1:. \ \ \ $ ,~ L ~ ~ E t t -Q,L1 i Po-. \ 1 ~ I cr Telephone n I 'fl ~ ::, <it - G ~ \ 10 Capacity: j Personal Representative _Counsel for personal representative 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 LUANNE J HUNTER 10 HILLSIDE LANE ETTERS, PA 17319 -------- fold ESTATE INFORMATION: SSN: 186-34-2360 FILE NUMBER: 21-2001- 0205 DECEDENT NAME: LUCIA LUCILE ADLlNE DATE OF PAYMENT: 08/27/2001 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 12/03/2000 NO. CD 000200 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $11 3.00 I I I I I I I I TOTAL AMOUNT PAID: $ 1 1 3.00 REMARKS: LUANNE J HUNTER CHECK# 543 SEAL INITIALS: PB RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS /0-d2I~-'1 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX LUANNE JOY HUNTER 10 HILLSIDE LN ETTERS PA 17319 DATE ESTATE OF DATE OF DEATH FILE NUMBER 'COUNTY ACN 10-22-2001 LUCIA 12-03-2000 21 01-0205 CUMBERLAND 101 5t* REY-15~7 EX AFP 112-001 LUCILE A Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .. REv=is'47-Ex--AFP--fi'2---ooY-NoTIcE--oF-YtiHEifITAi.fcE-TAirAPPRjriSEiiiNT~--ALLOWANCE-oi-------------- --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF LUCIA LUCILE A FILE NO. 21 01-0205 ACN 101 DATE 10-22-2001 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 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 U) (2) (3) (4) (5) (6) (7) .00 105,413.00 .00 .00 63,483.00 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (SChedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) UO) 7,033.00 675.00 Ul) (2) (13) (4) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 168,896.00 7.708 00 161,188.00 .00 161,188.00 NOTE: If an assessment was issued previously. lines 14. 15 and/or 16. 17. 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate 16. Allount of Line 14 taxable at Lineal/Class A rate 17. Allount of Line 14 at Sibling rate 18. Allount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due US) .00 X 00 = .00 (6) 161,188.00 X 045 = 7,253.00 (7) .00 X 12 = .00 (8) .00 X 15 = .00 (19)= 7,253.00 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02-21-2001 AA478047 357.89 6,800.00 08-27-2001 CDOO0200 .00 113.00 TOTAL TAX CREDIT 7,270.89 BALANCE OF TAX DUE 17.89CR INTEREST AND PEN. .00 TOTAL DUE 17.89CR . IF PAID AFTER DATE INDICATED, SEE REVERSE 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 MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) C-- STATUS REPORT UNDER RULE 6.12 \ \ R L \.A- c... \ C\.. Name of Decedent: ',-- \.A. <- \ ~ Date of Death: \ 'J.. - 3- "). c (; 0 ~ 0) \~* 2\ o l- 0 '2., () S Will No. Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State w~her administration of the estate is complete: YesY- -No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. 0- o CV'\ ::> ~ ,:J \i~~tdl ~ ~ 0 '\ t1lMr1tuJ L u. Q VI n z -J () 'I H u Y) t t ( Name (Please type ~r print) \ D rt' \ \ l S', ct.it L h E t -\ e vS' I Address p 0.. . ( 11'1) cr~ g - La .8 \ to \ f '3 I 9 Tel. 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